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Research into CREATINE
Research into the effectiveness of CREATINE -
CREATINE is one of the most widely researched supplements with numerous studies
into its effectiveness including:
Thorax. 2005 Jul;60(7):531-7.
Skeletal muscle wasting and dysfunction are strong independent predictors of
mortality in patients with chronic obstructive pulmonary disease (COPD).
CREATINE nutritional supplementation produces increased muscle mass and exercise
performance in health. A controlled study was performed to look for similar
effects in 38 patients with COPD. METHODS: Thirty eight patients with COPD (mean
(SD) forced expiratory volume in 1 second (FEV(1)) 46 (15)% predicted) were
randomised to receive placebo (glucose polymer 40.7 g) or CREATINE (CREATINE
monohydrate 5.7 g, glucose 35 g) supplements in a double blind trial. After 2
weeks loading (one dose three times daily), patients participated in an
outpatient pulmonary rehabilitation programme combined with maintenance (once
daily) supplementation. Pulmonary function, body composition, and exercise
performance (peripheral muscle strength and endurance, shuttle walking, cycle
ergometry) took place at baseline (n = 38), post loading (n = 36), and post
rehabilitation (n = 25). RESULTS: No difference was found in whole body exercise
performance between the groups: for example, incremental shuttle walk distance
mean -23.1 m (95% CI -71.7 to 25.5) post loading and -21.5 m (95% CI -90.6 to
47.7) post rehabilitation. CREATINE increased fat-free mass by 1.09 kg (95% CI
0.43 to 1.74) post loading and 1.62 kg (95% CI 0.47 to 2.77) post
rehabilitation. Peripheral muscle performance improved: knee extensor strength
4.2 N.m (95% CI 1.4 to 7.1) and endurance 411.1 J (95% CI 129.9 to 692.4) post
loading, knee extensor strength 7.3 N.m (95% CI 0.69 to 13.92) and endurance
854.3 J (95% CI 131.3 to 1577.4) post rehabilitation. CREATINE improved health
status between baseline and post rehabilitation (St George's Respiratory
Questionnaire total score -7.7 (95% CI -14.9 to -0.5)). CONCLUSIONS: CREATINE
supplementation led to increases in fat-free mass, peripheral muscle strength
and endurance, health status, but not exercise capacity.
CREATINE may constitute a new ergogenic treatment in COPD.
Rev Neurol (Paris). 2005 Mar;161(3):284-9.
CREATINE deficiency syndromes are a newly described group of inborn errors of
metabolism affecting CREATINE metabolism. Three diseases have been described:
deficiency of arginine: glycine amidinotransferase (AGAT), deficiency of
guanidinoacetate methyltransferase (GAMT) and CREATINE transporter defect (CRTR).
STATE OF ART: These syndromes are characterized by a depletion of CREATINE/phosphoCREATINE
in the brain. Clinically, most of the patients develop a variable mental
retardation and a severe speech delay associated with epilepsy, extra-pyramidal
syndrome and behavior disturbances. These diseases are often diagnosed during
infancy but a few adult cases have been reported recently. Diagnosis is
established by measurement of guanidinoacetate and CREATINE in biologic fluids
and in vivo proton magnetic resonance spectroscopy by the total lack of
intra-cerebral CREATINE/phosphoCREATINE demonstrating. GAMT and AGAT
deficiencies are treatable by oral CREATINE supplementation whereas patients
with CRTR do not respond to the treatment.
J Sports Med Phys Fitness. 2004 Dec;44(4):411-6.
School of Sports Medicine, University of Trieste, Trieste, Italy.
This review focuses on the potential side effects caused by oral CREATINE
supplementation on gastrointestinal, cardiovascular, musculoskeletal, renal and
liver functions. No strong evidence linking CREATINE supplementation to
deterioration of these functions has been found. In fact, most reports on side
effects, such as muscle cramping, gastrointestinal symptoms, changes in renal
and hepatic laboratory values, remain anecdotal because the case studies do not
represent well-controlled trials, so no causal relationship between CREATINE
supplementation and these side-effects has yet been established. The only
documented side effect is an increase in body mass. Furthermore, a possibly
unexpected outcome related to CREATINE monohydrate ingestion is the amount of
contaminants present that may be generated during the industrial production.
Recently, controlled studies made to integrate the existing knowledge based on
anecdotal reports on the side effects of CREATINE have indicated that, in
healthy subjects, oral supplementation with CREATINE, even with long-term
dosage, may be considered an effective and safe ergogenic
aid. However, athletes should be educated as to proper dosing or to take
CREATINE under medical supervision.
Eur J Nutr. 2004 Aug 11
Use of CREATINE has become widespread among sportsmen and women, although there
are no conclusive evidences concerning possible health risks of long-term
CREATINE supplementation. To investigate long-term effects of CREATINE
monohydrate supplementation on clinical parameters related to health. Eighteen
professional basketball players of the first Spanish Basketball League
participated in the present longitudinal study. The subjects were ingesting 5 g
CREATINE monohydrate daily during three competition seasons. Blood was collected
in the morning after an overnight fast, five times during each of the three
official competition seasons. Standard clinical examination was performed for 16
blood chemistries. RESULTS. The plasma concentrations of all clinical parameters
did not alter significantly during the analyzed time frames of CREATINE
supplementation. All of these parameters were, with the exception of creatinine
and CREATINE kinase, within their respective clinical ranges at all time points.
CONCLUSION. Our data shows that low-dose supplementation with CREATINE
monohydrate did not produce laboratory abnormalities for the majority of the
parameters tested.
Neurology. 2004 May 25;62(10):1771-7.
To determine whether CREATINE monohydrate supplementation increases strength and
fat-free mass (FFM) in boys with Duchenne muscular dystrophy (DD). Thirty boys
with DD (50% were taking corticosteroids) completed a double-blind, randomized,
cross-over trial with 4 months of CREATINE (about 0.10 g/kg/day), 6-week
wash-out, and 4 months of placebo. Measurements were completed of pulmonary
function, compound manual muscle and handgrip strength, functional tasks,
activity of daily living, body composition, serum CREATINE kinase and creatinine,
urinary markers of myofibrillar protein breakdown (3-methylhistidine), DNA
oxidative stress , and bone degradation. RESULTS: During the CREATINE treatment
phase, there was an increase in handgrip strength in the dominant hand and FFM,
with a trend toward a loss of global muscle strength only for the placebo phase,
with no improvements in functional tasks or activities of daily living.
Corticosteroid use, but not CREATINE treatment, was associated with a lower
8-OH-2-dG/creatinine, and CREATINE monohydrate treatment was associated with a
reduction in N-telopeptides. Four months of CREATINE
supplementation led to increases in FFM and handgrip strength in the dominant
hand and a reduction in a marker of bone breakdown and was well tolerated in
children with DD.
Ostojic SM. Sports Medicine Institute, Yugoslavia. Int J Sport Nutr Exerc Metab.
2004 Feb;14(1):95-103.
The purpose of this study was to examine the effects of acute
CREATINE-monohydrate supplementation on soccer-specific performance in young
soccer players. Twenty young male soccer players participated in the study and
were matched and allocated to 2 randomly assigned trials: ingesting
CREATINE-monohydrate supplement (3 x 10-g doses) or placebo for 7 days. Before
and after the supplementation protocol, each subject underwent a series of
soccer-specific skill tests: dribble test, sprint-power test, endurance test,
and vertical jump test. Specific dribble test times improved significantly in
the CREATINE group after supplementation protocol. Sprint-power test times were
significantly improved after CREATINE-monohydrate supplementation as well as
vertical jump height in CREATINE trial. Furthermore, dribble and power test
times, along with vertical jump height, were superior in CREATINE versus placebo
trial at post-supplementation performance. There were no changes in specific
endurance test results within or between trials (p > .05). There were no
between-trial differences in the placebo trial (p > .05). The main finding of
the present study indicates that supplementation with
CREATINE in young soccer players improved soccer-specific skill performance compared with ingestion of placebo.
Kutz MR, Gunter MJ. Palm Beach Atlantic University, West Palm Beach, Florida
33416, USA.
J Strength Cond Res. 2003 Nov;17(4):817-21
Seventeen active males (age 22.9 +/- 4.9 year) participated in a study to
examine the effects of CREATINE monohydrate supplementation on total body weight
(TBW), percent body fat, body water content, and caloric intake. The TBW was
measured in kilograms, percent body fat by hydrostatic weighing, body water
content via bioelectrical impedance, and caloric intake by daily food log.
Subjects were paired and assigned to a CREATINE or placebo group with a
double-blind research design. Supplementation was given for 4 weeks (30 g a day
for the initial 2 weeks and 15 g a day for the final 2 weeks). Subjects reported
2 days a week for supervised strength training of the lower extremity.
Significant increases before and after the study were found in TBW and body
water content for the CREATINE group. No significant changes were found in
percent body fat or daily caloric intake in the CREATINE group. No significant
changes were noted for the placebo group. These findings support previous
research that CREATINE supplementation increases TBW. Mean percent body fat and
caloric intake was not affected by CREATINE supplementation. Therefore weight
gain in lieu of CREATINE supplementation may in part be due to water retention.
Gill ND, Hall RD. aikato Institute of Technology, Hamilton, New Zealand.
J Strength Cond Res. 2004 May;18(2):272-5.
This study examined the effects of supplementation with either CREATINE
monohydrate powder in solution or a widely available CREATINE serum on
performance in a repeated maximal sprint cycling test (10 x 6 seconds, 24-second
passive rest between sprints). Using a randomized, double-blind, crossover
design, 11 competitive male athletes supplemented with CREATINE in 2 forms
according to the manufacturer's recommendations on 2 separate occasions. The 2
supplementation protocols were (a) 20 g.day(-1) x 6 days of CREATINE powder in
solution plus a placebo serum (CP) or (b) 5 ml.day(-1) x 6 days of CREATINE
serum plus a placebo powder (CS). Subjects completed 2 familiarization trials
before the 6-day supplementation period. A repeated maximal sprint cycling test
was performed prior to and immediately post supplementation. A 7-week washout
period separated the 2 supplementation protocols. Subjects' total work (9.6%)
and peak power (3.4%) in the cycle sprint improved significantly (p < 0.05)
after loading with CREATINE monohydrate powder, but there was little change
after loading with CREATINE serum. The present data support previous research
findings showing an ergogenic effect of CREATINE monohydrate powder
supplementation but indicate that supplementation with CREATINE serum does not
affect sprint cycling performance. Although the levels of CREATINE in each
formulation were not determined, a substantial conversion of CREATINE into
creatinine has been reported in many formulations and may explain the present
findings.
Int J Sport Nutr Exerc Metab. 2008 Oct ;18
(5):493-508 19033611 (P,S,G,E,B) [Cited?]CREATINE, arginine ?-Ketoglutarate,
amino acids, and medium-chain triglycerides and endurance and performance.
Jonathan P Little, Scott C Forbes, Darren G Candow, Stephen M Cornish,
Philip D Chilibeck
College of Kinesiology University of Saskatchewan, Saskatoon, SK, Canada.
CREATINE (Cr) supplementation increases muscle mass, strength, and power.
Arginine a-ketoglutarate (A-AKG) is a precursor for nitric oxide production and
has the potential to improve blood flow and nutrient delivery (i.e., Cr) to
muscles. This study compared a commercial dietary supplement of Cr, A-AKG,
glutamine, taurine, branched-chain amino acids, and medium-chain triglycerides
with Cr alone or placebo on exercise performance and body composition.
Thirty-five men (~23 yr) were randomized to Cr + A-AKG (0.1 g . kg-1 . d-1 Cr +
0.075 g . kg-1 . d-1 A-AKG, n = 12), Cr (0.1 g . kg-1 . d-1, n = 11), or placebo
(1 g . kg-1 . d-1 sucrose, n = 12) for 10 d. Body composition, muscle endurance
(bench press), and peak and average power (Wingate tests) were measured before
and after supplementation. Bench-press repetitions over 3 sets increased with Cr
+ A-AKG (30.9 +/- 6.6 +/- 34.9 +/- 8.7 reps; p < .01) and Cr (27.6 +/- 5.9 +/-
31.0 +/- 7.6 reps; p < .01), with no change for placebo (26.8 +/- 5.0 +/- 27.1
+/- 6.3 reps). Peak power significantly increased in Cr + A-AKG (741 +/- 112 +/-
794 +/- 92 W; p < .01), with no changes in Cr (722 +/- 138 +/- 730 +/- 144 W)
and placebo (696 +/- 63 +/- 705 +/- 77 W). There were no differences in average
power between groups over time. Only the Cr-only group increased total body mass
(79.9 +/- 13.0 +/- 81.1 +/- 13.8 kg; p < .01), with no significant changes in
lean-tissue or fat mass. These results suggest that Cr
alone and in combination with A-AKG improves upper body muscle endurance, and Cr
+ A-AKG supplementation improves peak power output on repeated Wingate tests.
Int J Sport Nutr Exerc Metab. 2008 Aug ;18
(4):389-98 18708688 (P,S,G,E,B) [Cited?]Effect of CREATINE supplementation and
resistance-exercise training on muscle insulin-like growth factor in young
adults.
Darren G Burke, Darren G Candow, Philip D Chilibeck, Lauren G Macneil,
Brian D Roy, Mark A Tarnopolsky, Tim Ziegenfuss
Dept. of Human Kinetics, St. Francis Xavier University, Antigonish, NS, Canada.
The purpose of this study was to compare changes in muscle insulin-like growth
factor-I (IGF-I) content resulting from resistance-exercise training (RET) and
CREATINE supplementation (CR). Male (n = 24) and female (n = 18) participants
with minimal resistance-exercise-training experience (=1 year) who were
participating in at least 30 min of structured physical activity (i.e., walking,
jogging, cycling) 3-5 x/wk volunteered for the study. Participants were randomly
assigned in blocks (gender) to supplement with CREATINE (CR: 0.25 g/kg
lean-tissue mass for 7 days; 0.06 g/kg lean-tissue mass for 49 days; n = 22, 12
males, 10 female) or isocaloric placebo (PL: n = 20, 12 male, 8 female) and
engage in a whole-body RET program for 8 wk. Eighteen participants were
classified as vegetarian (lacto-ovo or vegan; CR: 5 male, 5 female; PL: 3 male,
5 female). Muscle biopsies (vastus lateralis) were taken before and after the
intervention and analyzed for IGF-I using standard immunohistochemical
procedures. Stained muscle cross-sections were examined microscopically and IGF-I
content quantified using image-analysis software. Results showed that RET
increased intramuscular IGF-I content by 67%, with greater accumulation from CR
(+78%) than PL (+54%; p = .06). There were no differences in IGF-I between
vegetarians and nonvegetarians. These findings indicate that CREATINE
supplementation during resistance-exercise training increases intramuscular IGF-I
concentration in healthy men and women, independent of habitual dietary routine.
Int J Sport Nutr Exerc Metab. 2003 Sep ;13
(3):294-302 14669930 (P,S,G,E,B) [Cited?]Effect of alpha-lipoic acid combined
with CREATINE monohydrate on human skeletal muscle CREATINE and phosphagen
concentration.
Darren G Burke, Philip D Chilibeck, Gianni Parise, Mark A Tarnopolsky, Darren G
Candow
Department of Human Kinetics, St. Francis Xavier University, Antigonish, Nova
Scotia, Canada B2G 2W5.
Alpha-lipoic acid has been found to enhance glucose uptake into skeletal muscle
in animal models. Studies have also found that the co-ingestion of carbohydrate
along with CREATINE increases muscle CREATINE uptake by a process related to
insulin-stimulated glucose disposal. The purpose of this study was to determine
the effect of alpha-lipoic acid on human skeletal muscle CREATINE uptake by
directly measuring intramuscular concentrations of CREATINE, phosphoCREATINE,
and adenosine triphosphate when CREATINE monohydrate was co-ingested with alpha-lipoic
acid. Muscle biopsies were acquired from the vastus lateralis m. of 16 male
subjects (18-32 y) before and after the experimental intervention. After the
initial biopsy, subjects ingested 20 g x d(-1) of CREATINE monohydrate, 20 g x
d(-1) of CREATINE monohydrate + 100 g x d(-1) of sucrose, or 20 g x d(-1) of
CREATINE monohydrate + 100 g x d(-1) of sucrose + 1000 mg x d(-1) of alpha-lipoic
acid for 5 days. Subjects refrained from exercise and consumed the same balanced
diet for 7 days. Body weight increased by 2.1% following the nutritional
intervention, with no differences between the groups. There was a significant
increase in total CREATINE concentration following CREATINE supplementation,
with the group ingesting alpha-lipoic acid showing a significantly greater
increase (p < .05) in phosphoCREATINE (87.6 --> 106.2 mmol x kg(-1) dry mass
[dm]) and total CREATINE (137.8 --> 156.8 mmol x kg(-1) dm). These findings
indicate that co-ingestion of alpha-lipoic acid with CREATINE and a small amount
of sucrose can enhance muscle total CREATINE content as compared to the
ingestion of CREATINE and sucrose or CREATINE alone.
SIDE EFFECTS
In a three-year study designed to find out
whether CREATINE caused stomach cramps, pulled muscles and associated side
effects it was found that CREATINE had no effect on the incidence of injury or
cramping in a group of American footballers [2]. Other research shows
similar results [3]. In a group of 26 athletes using CREATINE for up to four
years, there was no difference in the reported incidence of muscle cramp or
injury compared with athletes not using CREATINE. In September 2004 the
International Journal of Sports Medicine, also showed that CREATINE side effects
are rare [11]. A group of 175 subjects received either 10 grams of CREATINE or
placebo daily for an average period of 310 days. Diarrhea and nausea did cause
three subjects to stop using CREATINE. But there were no other significant
differences between the groups.Truman State University also reported that
long-term CREATINE use appears to be safe [7]. Most people aren't aware
that CREATINE has protective effects in heart, muscle and neurological diseases
- several months of CREATINE supplementation in men and women with borderline
high cholesterol levels reduces very-low-density lipoprotein levels (the
so-called "bad" cholesterol) by almost one-third [1]. In the journal Metabolism.
Twenty-eight days of CREATINE supplementation and resistance exercise lowered
total cholesterol levels to a greater extent than resistance exercise alone
[10]. Studies over the short- (five days), medium- (nine weeks) and long-term
(up to five years) have yet to demonstrate that CREATINE supplementation has any
adverse effects on blood pressure, kidney or liver function in healthy
individuals [3, 5, 6, 7, 8]. There are isolated case reports of
individuals suffering from kidney problems after using CREATINE [4]. Anyone with
existing liver or kidney problems, or those predisposed to such ailments, should
seek medical advice before using CREATINE.
1. Earnest, C., Almada, A., & Mitchell, T.
(1996). High-performance capillary electrophoresis-pure CREATINE monohydrate
reduces blood lipids in men and women. Clinical Science, 91, 113-118
2. Greenwood, M., Kreider, R.B., Melton, C., Rasmussen, C., Lancaster, S.,
Cantler, E., Milnor, P., & Almada, A. (2003). CREATINE supplementation during
college football training does not increase the incidence of cramping or injury.
Molecular and Cellular Biochemistry, 244, 83-88
3. Schilling, B.K., Stone, M.H., Utter, A., Kearney, J.T., Johnson, M.,
Coglianese, R., Smith, L., O'Bryant, H.S., Fry, A.C., Starks, M., Keith, R., &
Stone, M.E. (2001). CREATINE supplementation and health variables: a
retrospective study. Medicine and Science in Sports and Exercise, 33, 183-188
4. Pritchard, N.R., & Kalra, P.A. (1998). Renal dysfunction accompanying oral
CREATINE supplements. Lancet, 351, 1252-1253
5. Poortmans, J.R., & Francaux, M. (2000). Adverse effects of CREATINE
supplementation: fact or fiction? Sports Medicine, 30, 155-170
6. Kreider, R.B., Melton, C., Rasmussen, C.J., Greenwood, M., Lancaster, S.,
Cantler, E.C., Milnor, P., & Almada, A.L. (2003). Long-term CREATINE
supplementation does not significantly affect clinical markers of health in
athletes. Molecular and Cellular Biochemistry, 244, 95-104
7. Mayhew, D.L., Mayhew, J.L., & Ware, J.S. (2002). Effects of long-term
CREATINE supplementation on liver and kidney functions in American college
football players. International Journal of Sport Nutrition and Exercise
Metabolism, 12, 453-460
8. Vannas-Sulonen, K., Sipila, I., Vannas, A., Simell, O., & Rapola, J. (1985).
Gyrate atrophy of the chloroid and retina: a five year follow-up of CREATINE
supplementation. Opthalmology, 91, 1719-1727
9. Volek, J.S., Duncan, N.D., Mazzetti, S.A., Staron, R.S., Putukian, M., Gomez,
A.L, Pearson, D.R, Fink, W.J., & Kraemer WJ. (1999). Performance and muscle
fiber adaptations to CREATINE supplementation and heavy resistance training.
Medicine and Science in Sports and Exercise, 31, 1147-1156
10. Arciero, P.J., Hannibal, N.S. 3rd, Nindl, B.C., Gentile, C.L., Hamed, J., &
Vukovich, M.D. (2001). Comparison of CREATINE ingestion and resistance training
on energy expenditure and limb blood flow. Metabolism, 50, 1429-1434
11. Groeneveld, G.J., Beijer, C., Veldink, J.H., Kalmijn, S., Wokke, J.H.J., &
van den Berg, L.H. (2004). Few adverse effects of long-term CREATINE
supplementation in a placebo-controlled trial. International Journal of Sports
Medicine, 25
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