Creatine supplementation: scientific evidence for nutrition professionals

How often, as a nutrition professional, have you been asked about creatine supplementation? And how long does it take you to find a reliable source of information that is easy and quick to understand?

We already know that creatine is one of the most popular and studied dietary supplements in the field of sports nutrition, widely known for its positive effects on physical performance and body composition. As such, creatine has sparked great interest among nutrition professionals seeking to provide effective and scientifically validated guidance to their clients.

Read this article to find out what the most current evidence tells us about the basics of creatine, including its endogenous synthesis, distribution in the body, and biological function.

We explore creatine in detail, addressing its benefits, mechanisms of action, and practical applications. Through an up-to-date review of the available scientific evidence, we aim to provide essential information to clarify recommendations for safe and effective creatine supplementation.

Mechanisms of creatine action: The role in muscle energy production

Creatine is a molecule produced in the liver and, to a lesser extent, in the kidneys and pancreas. Creatine stores phosphate groups in the form of phosphocreatine.

These groups are donated to adenosine diphosphate (ADP) to regenerate adenosine triphosphate (ATP); this is the main energy carrier into cells and is the main source of fuel for high-intensity exercise.

Creatine supplementation increases the amount of cellular phosphocreatine, which causes more phosphate groups to be donated to ADP and thus accelerates the recycling of ADP into ATP, making more energy available for high-intensity exercise. This increased energy availability can promote improvements in strength and power.

Creatine is naturally present in some foods of animal origin, most prevalent in meat and fish. In supplement form, it is usually available in powder or capsule form.

Creatine supplementation: how to recommend it to clients?

There is no rule that requires all athletes to supplement creatine. It can, however, be interesting to see if the athlete "responds" to creatine or to get slightly faster benefits.

Creatine cycles are widely used strategies in sports nutrition to optimize the benefits of creatine supplementation. Understanding the concept and proper application of creatine cycles is essential for nutrition professionals who want to help their clients achieve significant results in physical performance and body composition. But, how to do it?

Creatine supplementation is typically divided into 3 parts: a "loading" period followed by a "maintenance" period and finally a "washout" period.

• Loading period: take 20-25 g (or 0,3 g/kg) over 5-7 days.
• Maintenance period: take 5 g per day during 3-4 weeks.
• Washout period: stop taking creatine one to two weeks and then repeat the cycle.

It's possible to do loading cycles as either just "taking creatine" by using 5-10g per day, or smaller amounts of 2-3 g.

Cycling creatine causes faster saturation of the muscles, which can create a sharp increase in strength and body weight, largely through water retention.

Taking creatine through this strategy, can also confer the psychological/placebo effect, as the clients sees themselves increasing the volume of fitness.

By taking a smaller dose over a longer period of time, the same saturation point will eventually be reached but it takes longer.

Either way, the differences at the end of a cycle, should one choose to end the cycle, will be minimal.

There are many different forms of creatine available on the market, with creatine monohydrate being the most economical and most effective. Another option is micronized creatine monohydrate, which dissolves more easily in water and, as such, may be more practical.

What are the benefits of creatine?

The main benefit of creatine is its effect on strength and power exerted during endurance exercise, and slightly increasing lean body mass.

It has also been studied for its effects on anaerobic running capacity. Although the results are quite mixed, they suggest a slight improvement in running performance.

When it comes to cognitive development, current research is still limited to be able to say that creatine is effective, but its use may have benefits in some contexts. It appears to reduce mental fatigue in situations of demanding mental activities and sleep deprivation. It may also improve memory, although this is probably only in people with below average creatinine levels, such as vegetarians and older adults.

What are the main drawbacks of creatine?

When consuming a larger than expected amount of creatine in a single dose, episodes of diarrhea and nausea may occur. In this case, the dosages should be spread out over the day and taken with meals.

When creatine supplementation is taken without drinking enough water, stomach cramps may occur.

Creatine supplementation usually results in weight gain, partly due to an increase in total body water, which can be of particular concern for individuals competing in weight-sensitive sports.

Creatine in elite athletes vs amateurs: what the evidence shows

Creatine is beneficial for all strength-based exercises in all individuals. However, this benefit seems to be less noticeable in elite athletes than in novice athletes.

When it comes to studies conducted on whether or not a supplement can provide a benefit for sport and exercise, the first batch of studies are usually conducted on untrained or poorly trained people. There is a reason for this, and it is because this group of people are going to get benefits anyway when they start exercising and any interaction of the supplement is going to be more prominent to the researchers. It wasn't until later that researchers looked at elite athletes, as not only are they more unusual, but they tend to be more resistant to dietary supplements that benefit performance.

It is not uncommon for a supplement to benefit the beginner but fail the elite; does creatine, the king of ergogens, fall into this category?

Creatine supplementation has indeed shown benefits in athletes considered elite and has been shown to do so in: soccer (or football), volleyball, wrestling, swimming, and others. However, there are some occasions when creatine supplementation does not benefit elites, usually in situations that are not related to power explosions.

Ultimately, it appears that the magnitude of benefit is somewhat smaller, with studies in elite athletes recording smaller anti-fatigue effects and strength increases, which contrasts with supplementation promoting large strength gains in the novice athlete.

Summary

Creatine is a widely studied and used dietary supplement in the field of sports nutrition. It is known for its positive effects on physical performance, muscle strength and body composition.

Creatine supplementation plays an important role in muscle energy production by increasing the availability of ATP. This supplementation can be done through loading cycles or just taking it, always with doses appropriate for each individual.

It is important to point out that creatine can have side effects, such as diarrhea, nausea, and increased body weight due to water retention. Therefore, adequate water intake is essential when supplementing creatine.

Nutrition professionals should consider all the individual factors of each client, such as goals, type of sports, and overall health, when recommending creatine supplementation. It is critical to closely monitor the effects and adjust as necessary to ensure maximum safety and effectiveness of creatine use.

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