Creatine

Creatine is a supplement that is often used to help improve muscle strength and athletic performance. There have been numerous studies that have indicated that creatine supplementation can increase body mass and/or muscle mass during training. 

​The International Society of Sports Nutrition (ISSN) also states that in their view it is the most effective nutritional supplement available to athletes to increase high intensity exercise capacity and muscle mass.
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In this article I write about what creatine is and ISSN exercise & sports nutrition review update: research & recommendations 2018.

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What is Creatine?

Creatine is a natural molecule produced in the body that turns into creatine phosphate. Creatine phosphate. Creatine phosphate then helps make a substance called adenosine triphosphate (ATP). ATP provides the energy for muscle contractions. It is involved in making the energy muscles need to work and this can help with exercise performance by rapidly producing energy during activity.  

More creatine means more potential ATP, which translates into improved performance on short-duration, high-intensity tasks. There is also evidence to suggest that supplementing with creatine may also help provide cognitive benefits.
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Creatine can be supplemented but we can also find it naturally in some foods, particularly red meat, eggs and fish. Consuming creatine supplements can help increase skeletal muscle free creatine.

The only clinically significant side effect occasionally reported from creatine monohydrate supplementation has been the potential for weight gain. Many people who use creatine gain weight. This is because creatine causes the muscles to hold water, not because it actually builds muscle.

This can be a consideration for weight making athletes. Because creatine can cause the muscle to hold water,  it may be recommended for weight making athletes to cease creatine supplementation about a week before  weigh-in to help drop in water weight. 

Another thing to potentially watch out for is that stomach cramping can occur when creatine is supplemented without sufficient water. Diarrhea and nausea can occur when too much creatine is supplemented at once, in which case doses should be spread out throughout the day and taken with meals.

​How to Take

The quickest method of increasing muscle creatine stores appears to be to consume ~ 0.3 g/kg/day of creatine monohydrate for 5–7 days followed by 3–5 g/day thereafter to maintain elevated stores. (for example some one who is 70kg= 21g per day for 5-7 days followed by 3-5 g per day thereafter).

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Initially, ingesting smaller amounts of creatine monohydrate (e.g., 3–5 g/day) will increase muscle creatine stores over a three to 4-week period, however, the initial performance effects of this method of supplementation are less supported.

The addition of carbohydrate or carbohydrate and protein to a creatine supplement appears to increase muscular uptake of creatine, although the effect on performance measures may not be greater than using creatine monohydrate alone.​

ISSN Exercise & Sports Nutrition Review Update: Research & Recommendations For Creatine Summery (2018).

1. Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity and lean body mass during training.
2. ​Creatine monohydrate supplementation is not only safe, but has been reported to have a number of therapeutic benefits in healthy and diseased populations ranging from infants to the elderly. There is no compelling scientific evidence that the short- or long-term use of creatine monohydrate (up to 30 g/day for 5 years) has any detrimental effects on otherwise healthy individuals or among clinical populations who may benefit from creatine supple​mentation.
3. ​If proper precautions and supervision are provided, creatine monohydrate supplementation in children and adolescent athletes is acceptable and may provide a nutritional alternative with a favourable safety profile to potentially dangerous anabolic androgenic drugs. However, it is recommended that creatine supplementation only be considered for use by younger athletes who: a) are involved in serious/competitive supervised training; b) are consuming a well-balanced and performance enhancing diet; c) are knowledgeable about the appropriate use of creatine; and d) do not exceed recommended dosages.
4. ​Label advisories on creatine products that caution against usage by those under 18 years old, while perhaps intended to insulate their manufacturers from legal liability, are likely unnecessary given the science supporting creatine’s safety, including in children and adolescents.
5. ​At present, creatine monohydrate is the most extensively studied and clinically effective form of creatine for use in nutritional supplements in terms of muscle uptake and ability to increase high-intensity exercise capacity.
6. ​The quickest method of increasing muscle creatine stores appears to be to consume ~ 0.3 g/kg/day of creatine monohydrate for 5–7 days followed by 3–5 g/day thereafter to maintain elevated stores. Initially, ingesting smaller amounts of creatine monohydrate (e.g., 3–5 g/day) will increase muscle creatine stores over a three to 4 week period, however, the initial performance effects of this method of supplementation are less supported.
7. The addition of carbohydrate or carbohydrate and protein to a creatine supplement appears to increase muscular uptake of creatine, although the effect on performance measures may not be greater than using creatine monohydrate alone.
8. Clinical populations have been supplemented with high levels of creatine monohydrate (0.3–0.8 g/kg/day equivalent to 21–56 g/day for a 70-kg individual) for years with no clinically significant or serious adverse events.​
9. ​Further research is warranted to examine the potential medical benefits of creatine monohydrate and precursors like guanidinoacetic acid on sport, health and medicine.​

References

Kerksick et al (2018). ISSN exercise & sports nutrition review update: research & recommendations. J Int Soc Sports Nutr. 1;15(1):38. doi: 10.1186/s12970-018-0242-y.

Jamie Miller- Personal Trainer
UK Fitness Personal Training
​Aberdeen

Fitness, Nutrition & Personal Training