Efficacy Of Creatine Supplementation Research Articles

The Efficacy of Creatine Supplementation in Improving Cognitive Performance in Adolescents: A Phase-II, Triple-Blind, Randomized Study Protocol

Background/Aims: Creatine supplementation has demonstrated cognitive benefits in neurodegenerative conditions, having a protective effect in the brain's function in stressful situations, with excellent safety (Watanabe et al., 2002). However, any beneficial effects on the cognitive performance of healthy adolescents underperforming in school is unknown. Our objective is to assess whether creatine supplementation improves cognitive performance in 15- to 17-year-old students with an average school grade below the 50th percentile. Methods: This will be a phase-II, triple-blinded, randomized, parallel-group, superiority, single-center trial. Students with grades below the 50th percentile in the prior semester will be enrolled and randomized to receive juice packages containing either creatine monohydrate supplementation (0.1 mg/kg/day), or placebo, for 12 weeks. The primary outcome will be the mean difference in change of Raven’s Standard Progressive Matrices (RSPM) scores from baseline to week 12 between groups. To achieve a 90% power for detecting a 3-point difference in change in the RSPM score, and accounting for drop-out, 116 participants will be included. Secondary outcomes will include the difference in processing speed (SpaceCode), working memory (SpaceMatrix), non-visual memory (backward digit span), percentage change in lean mass, and any safety events. Conclusion: To our knowledge, this will be the most comprehensive study assessing creatine supple-mentation in adolescents. This is a low-risk intervention that has been shown to improve cognitive function in other populations. This study will potentially support the widespread use of creatine supplementation in adolescents with low school performance, while having a positive impact on this population.

Creatine supplementation in the pediatric and adolescent athlete-- A literature review

BackgroundAn increase in intra-muscular creatine through supplementation has been proposed as a strategy for improving muscle performance and recovery, with studies showing some benefit for adult athletes who rely on short, explosive movements. We reviewed and summarized the current literature on creatine supplementation in a pediatric and adolescent population. MethodsThe databases PubMed and EMBASE were queried to identity articles related to the use of creatine supplementation in a healthy pediatric and adolescent population according to the guidelines established by PRISMA. The abstracts of all articles were reviewed to determine relevancy, with those meeting the pre-defined criteria included in the final review. ResultsA combined total of 9393 articles were identified. Following application of filters and review of abstracts, 13 articles were found to meet criteria and were included in the final review. There was a total of 268 subjects across all studies, with mean age ranging from 11.5 to 18.2 years. More than 75% of the studies were randomized-controlled trials, and 85% involved either soccer players or swimmers. The overall quality of the studies was poor, and there were no consistent findings regarding creatine supplementation and improvements in athletic performance. No studies were designed to address the topic of safety. ConclusionsThere is a gap in the study of the safety and efficacy of creatine supplementation in adolescents. Additional studies are needed to evaluate the effects of alterations in muscle composition on the growth, development, and performance of the developing athlete. Orthopedic providers should counsel their pediatric and adolescent patients on the current limitations in trying to assess the true risk and benefit of creatine supplementation for the aspiring athlete. Level of evidenceReview, III.

Efficacy of Creatine Supplementation and Resistance Training on Area and Density of Bone and Muscle in Older Adults.

To examine the efficacy of creatine (Cr) supplementation and any sex differences during supervised whole-body resistance training (RT) on properties of bone and muscle in older adults. Seventy participants (39 men, 31 women; mean age ± standard deviation: 58 ± 6 yr) were randomized to supplement with Cr (0.1 g·kg-1·d-1) or placebo (Pl) during RT (3 d·wk-1 for 1 yr). Bone geometry (radius and tibia) and muscle area and density (forearm and lower leg) were assessed using peripheral quantitative computed tomography. Compared with Pl, Cr increased or maintained total bone area in the distal tibia (Cr, Δ +17 ± 27 mm2; Pl, Δ -1 ± 22 mm2; P = 0.031) and tibial shaft (Cr, Δ 0 ± 9 mm2; Pl, Δ -5 ± 7 mm2; P = 0.032). Men on Cr increased trabecular (Δ +28 ± 31 mm2; P < 0.001) and cortical bone areas in the tibia (Δ +4 ± 4 mm2; P < 0.05), whereas men on Pl increased trabecular bone density (Δ +2 ± 2 mg·cm-3; P < 0.01). There were no bone changes in the radius (P > 0.05). Cr increased lower leg muscle density (Δ +0.83 ± 1.15 mg·cm-3; P = 0.016) compared with Pl (Δ -0.16 ± 1.56 mg·cm-3), with no changes in the forearm muscle. One year of Cr supplementation and RT had some favorable effects on measures of bone area and muscle density in older adults.

Uso do suplemento de creatina em praticantes de atividades físicas: uma revisão integrativa

Objetivo: Identificar evidências científicas na literatura da eficácia do suplemento de creatina na melhoria da performance dos praticantes de atividades físicas. Métodos: Tratou-se de uma revisão teórica do tipo integrativa, do período de 2015 a 2019, com acesso às bases LILACS, PUBMED e SCIELO. Os critérios para incluir um estudo na revisão foram manuscritos de revistas científicas; qualis B4 e maiores; pesquisas realizadas em humanos; e suplementação exclusivamente oral de creatina. Desse modo, foram selecionados seis artigos para compor o presente trabalho de revisão. Resultados: Quatro dos estudos analisados evidenciaram melhoria no desempenho físico dos praticantes de atividade. Em dois desses quatro, essa melhoria foi estatisticamente significativa. Em outros dois manuscritos, não foi determinado um aumento significativo no desempenho. Considerações finais: A revisão teórica evidenciou que a suplementação de creatina melhora o desempenho dos praticantes de atividades físicas, considerando que em essas estejam envolvidos os esforços de resistência e força muscular.

The effects of phosphocreatine disodium salts plus blueberry extract supplementation on muscular strength, power, and endurance

BackgroundNumerous studies have demonstrated the efficacy of creatine supplementation for improvements in exercise performance. Few studies, however, have examined the effects of phosphocreatine supplementation on exercise performance. Furthermore, while polyphenols have antioxidant and anti-inflammatory properties, little is known regarding the influence of polyphenol supplementation on muscular strength, power, and endurance. Thus, the purpose of the present study was to compare the effects of 28 days of supplementation with phosphocreatine disodium salts plus blueberry extract (PCDSB), creatine monohydrate (CM), and placebo on measures of muscular strength, power, and endurance.MethodsThirty-three men were randomly assigned to consume either PCDSB, CM, or placebo for 28 days. Peak torque (PT), average power (AP), and percent decline for peak torque (PT%) and average power (AP%) were assessed from a fatigue test consisting of 50 maximal, unilateral, isokinetic leg extensions at 180°·s− 1 before and after the 28 days of supplementation. Individual responses were assessed to examine the proportion of subjects that exceeded a minimal important difference (MID).ResultsThe results demonstrated significant (p < 0.05) improvements in PT for the PCDSB and CM groups from pre- (99.90 ± 22.47 N·m and 99.95 ± 22.50 N·m, respectively) to post-supplementation (119.22 ± 29.87 N·m and 111.97 ± 24.50 N·m, respectively), but no significant (p = 0.112) change for the placebo group. The PCDSB and CM groups also exhibited significant improvements in AP from pre- (140.18 ± 32.08 W and 143.42 ± 33.84 W, respectively) to post-supplementation (170.12 ± 42.68 W and 159.78 ± 31.20 W, respectively), but no significant (p = 0.279) change for the placebo group. A significantly (p < 0.05) greater proportion of subjects in the PCDSB group exceeded the MID for PT compared to the placebo group, but there were no significant (p > 0.05) differences in the proportion of subjects exceeding the MID between the CM and placebo groups or between the CM and PCDSB groups.ConclusionsThese findings indicated that for the group mean responses, 28 days of supplementation with both PCDSB and CM resulted in increases in PT and AP. The PCDSB, however, may have an advantage over CM when compared to the placebo group for the proportion of individuals that respond favorably to supplementation with meaningful increases in muscular strength.

Safety of Creatine Supplementation in Active Adolescents and Youth: A Brief Review.

Creatine has been extensively researched and is well-supported as one of the most effective dietary supplements available. There is overwhelming support within the literature regarding the ability of creatine to augment performance following short term (5–7 days) and long-duration supplementation periods. There is also strong support for creatine regarding its safety profile and minimal risk for adverse events or any negative influence on markers of clinical health and safety. Recent research has also highlighted the ability of creatine to confer several health-related benefits in select clinical populations in addition to offering cognitive benefits. Creatine is also a popular supplement of choice for adolescent athletes; however, research in this area is extremely limited, particularly when examining the safety and efficacy of creatine supplementation in this population. Therefore, the purpose of this review was to highlight the limited number of studies available in adolescent populations and systematically discuss the topic of safety of creatine supplementation in a younger population.

A randomized, double-blind, placebo-controlled, proof-of-concept trial of creatine monohydrate as adjunctive treatment for bipolar depression

Depressive episodes are a major cause of morbidity and dysfunction in individuals suffering from bipolar disorder. Currently available treatments for this condition have limited efficacy and new therapeutic options are needed. Extensive research in the pathophysiology of bipolar disorder points to the existence of mitochondrial and bioenergetic dysfunction. We hypothesized that creatine monohydrate, a nutraceutical that works as a mitochondrial modulator, would be effective as an adjunctive therapy for bipolar depression. We conducted a double-blind trial in which 35 patients with bipolar disorder type I or II in a depressive episode by DSM-IV criteria and in use of regular medication for the treatment of this phase of the disease were randomly allocated into two adjunctive treatment groups for 6 weeks: creatine monohydrate 6 g daily (N = 17) or placebo (N = 18). Primary efficacy was assessed by the change in the Montgomery–Åsberg Depression Rating Scale (MADRS). We did not find a statistically significant difference in the comparison between groups for the change in score on the MADRS after 6 weeks in an intention-to-treat (ITT) analysis (p = 0.560; Cohen’s d = 0.231). However, we found significant superiority of creatine add-on vs. placebo when we considered the remission criterion of a MADRS score ≤ 12 at week 6 analyzing the outcome of the 35 randomized patients on ITT (52.9% remission in the creatine group vs. 11.1% remission in the placebo group) and of the 23 completers (66.7% remission in the creatine group vs. 18.2% remission in the placebo group) (p = 0.012; OR = 9.0 and p = 0.036; OR = 9.0, respectively). Two patients who received creatine switched to hypomania/mania early in the trial. No clinically relevant physical side-effects were reported or observed. This proof-of-concept study, aiming to restore brain bioenergetics using an adjunctive mitochondrial modulator, is not conclusive on the efficacy of creatine add-on for bipolar depression, but suggests that this compound may have a role in the adjunctive treatment of this phase of the illness. Further investigation through randomized controlled trials with larger samples should be conducted to verify the efficacy of creatine supplementation for bipolar depression and also for subsyndromal depressive symptoms.

An Update on Effects of Creatine Supplementation on Performance: A Review

Supplementary creatine, available in many different forms but most commonly monohydrate, is a legal and reportedly safe to consume nutritional ergogenic aid. After searching internationally recognised research databases, this review provides and update on the current literature on the physiological effects of creatine supplementation on performance whilst also discussing the underlying physiology regarding the synthesis and dietary provision of creatine as well as addressing issues of safety and the ethical considerations of usage. Research has shown that regular consumption of supplementary creatine can raise associated content within skeletal muscle. Subsequently, there is an extensive, and still growing, body of the literature supporting the efficacy of creatine supplementation on enhancing exercise performance, exercise tolerance, muscle strength and lean body mass. Moreover, little scientific evidence exists showing any unfavourable effects on individuals who are free from illness and disease. This review consolidates the current literature and provides application to the athletic setting which is purposeful for those choosing to either recommend or consume this nutritional ergogenic aid. At this current time, a traditional loading and maintenance supplementation protocol is advised as contemporary research studies are still to unravel the benefits of alternative approaches.

Impact of creatine on muscle performance and phosphagen stores after immobilization.

This study investigated the effect of creatine (CR) supplementation during cast-immobilization to preserve skeletal muscle total work, power and intramuscular phosphocreatine (PCr) kinetics during dynamic exercise. Twenty-five active individuals (24 ± 4 years,) performed wrist flexion exercise within a 1.9 Tesla superconducting magnet before and after 1 week of cast-immobilization. An incremental protocol to fatigue and two constant load (CL1 and CL2) exercise bouts were performed. While casted, participants consumed either 20 g day(-1) of CR or a placebo (PLA). (31)P magnetic resonance spectroscopy was used to quantify in vivo intramuscular PCr levels. No significant group × time interaction effects were found for work or power throughout all exercise bouts. Total work was significantly reduced over time in both groups (p = 0.049) during the incremental exercise bout. Work production in CL1 tended (p = 0.073) to attenuate in the CR group, compared to PLA. No changes were observed in CL2. Baseline PCr significantly decreased with casting in PLA (PRE: 26.6 ± 6.3 vs. POST: 22.5 ± 5.6 mM kg(-1) wet muscle, p = 0.003). No change (p = 0.31) was observed in the CR group. Changes in work production were significantly correlated with changes in resting PCr in CR (r = -0.63, p = 0.021) but not PLA (r = -0.36, p = 0.26) group. Results suggest decreases in short-term endurance may be due to alternations of PCr status and/or metabolism. More research is needed to fully determine the efficacy of CR supplementation during short-term immobilization.

Safety and efficacy of creatine supplementation in juvenile dermatomyositis: a randomized double-blind placebo-controlled cross-over trial

Juvenile dermatomyositis patients may experience persistent weakness, loss of bone mass, and skeletal muscle atrophy as a long-term result of drug treatment and/or disease itself. In this regard, efforts to develop new therapeutic strategies able to attenuate these adverse outcomes have been considered of clinical relevance. It has been suggested that creatine supplementation could be safe, effective and inexpensive for treating idiopathic inflammatory myopathies, but no pediatric study has been conducted so far.

Survey of dietary supplement use in intercollegiate athletes

It is commonly assumed that dietary supplement use is wide spread in intercollegiate athletes. In order to provide relevant nutrition education to student athletes it is necessary to understand both the type of and the degree to which supplements are used. The purpose of this study was to evaluate the results of self‐reported supplement use among intercollegiate athletes in a division I university athletic program. Surveys were administered annually to each student athlete in 11 men's and/or women's sports from 2001–2008. Supplements were grouped into 6 categories: vitamins, minerals, protein, performance enhancers (creatine), weight loss, and joint health. At total of 3303 surveys were analyzed. Results indicate that creatine was the most widely used supplement in men's sports while a multi‐vitamin was the most widely used supplement by female athletes. The overall reported use of dietary supplements was considerably less than expected. However, these results suggest the need for continued discussions on the efficacy of creatine supplementation and the beneficial effects of a daily multi‐vitamin.

The effects of age on skeletal muscle and the phosphocreatine energy system: can creatine supplementation help older adults

Creatine supplementation has been found to significantly increase muscle strength and hypertrophy in young adults (≤ 35 yr) particularly when consumed in conjunction with a resistance training regime. Literature examining the efficacy of creatine supplementation in older adults (55-82 yr) suggests creatine to promote muscle strength and hypertrophy to a greater extent than resistance training alone. The following is a review of literature reporting on the effects of creatine supplementation on intramuscular high energy phosphates, skeletal muscle morphology and quality of life in older adults. Results suggest creatine supplementation to be a safe, inexpensive and effective nutritional intervention, particularly when consumed in conjunction with a resistance training regime, for slowing the rate of muscle wasting that is associated with aging. Physicians should strongly consider advising older adults to supplement with creatine and to begin a resistance training regime in an effort to enhance skeletal muscle strength and hypertrophy, resulting in enhanced quality of life.

Putting to rest the myth of creatine supplementation leading to muscle cramps and dehydration

Creatine is one of the most popular athletic supplements with sales surpassing 400 million dollars in 2004. Due to the popularity and efficacy of creatine supplementation over 200 studies have...

Creatine Controversy?

Department of Athletics, Physical Education and Recreation Yale University Department of Human Movement Sciences and Education University of Memphis Steven Plisk is the Director of Sports Conditioning at Yale University. His previous experiences include the University of Memphis, U.S. Olympic Training Center, James Madison University, Dartmouth College, Austin Peay State University and the University of Colorado. He received his B.S. in Sport & Exercise Science from SUNY-Buffalo in 1987 and his M.S. in Kinesiology from the University of Colorado in 1990, and is a Certified Strength & Conditioning Specialist through the NSCA as well as a Level I coach through USA Weightlifting. His current NSCA activities include the Strength & Conditioning Journal Review Board and Power Systems Scholarship Selection Committee. Richard B. Kreider, PhD, serves as Associate Professor, Assistant Department Chair, and Director of the Exercise & Sport Nutrition Laboratory in the Department of Human Movement Sciences & Education at the University of Memphis. Dr. Kreider has published more than 100 research articles /abstracts and has conducted six studies on the safety and efficacy of creatine supplementation among athletes. Dr. Kreider serves as Research Digest Editor for the International Journal of Sport Nutrition, serves on the editorial board of JSCR, is a Fellow of the American College of Sport Medicine (ACSM), is ACSM certified as an Exercise Specialist and Health/Fitness Director, and is an active member of the NSCA.

Reply Creatine supplementation in chronic heart failure

Dr. M.L. Field has in a Letter to the Editor pointed out several interesting theoretical aspects on creatinine loading of cardiomyoytes concluding the lack of efficacy of creatine supplementation in treating the failing myocardium. The Letter discusses the possibly important role of the free creatine store as ATP acceptor with simultaneous ADP release at the inner mitochondrial membrane. An increased creatine concentration would amplify the local ADP concentration and stimulate respiration [l]. The creatine concentration in the human diseased heart is 1218 mM [2,3], but in the normal contractile cycle 60-70% of the creatine is phosphorylated [4]. The free creatine available for mitochondrial creatine kinase will thus correspond to approximately 5 mM, which is below the K, value given by Saks et al. [5]. This would indicate a positive role for creatine supplementation as stimulator of respiration in heart tissue in cardiac failure. This will of course not necessarily give an increase of the ejection fraction, but the measurement seemed justified since the hypothesis has never been tested. Furthermore, depressed myocardial total creatine levels were reported from explanted hearts [3] that probably had a more deranged myocardial function than present in our patient group. Perhaps a recruitment of a considerably larger and sicker patient population would be necessary to achieve efficacy.