H E A LT H
Understanding Creatine and its Benefits How creatine supplementation can improve exercise performance and recovery BY DARREN CANDOW, PH.D., CSEP-CEP Professor of the Aging Muscle and Bone Health Laboratory, Faculty of Kinesiology & Health Studies, University of Regina; author of numerous health and science publications. DR.DARRENCANDOW
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reatine is produced in the body, in the liver and brain, through reactions involving three amino acids—the building blocks of protein. Alternatively, creatine can be consumed in the diet—primarily from red meat and seafood—or for those on a vegan/ vegetarian diet, through commercially manufactured creatine supplementation. While there are several marketed forms of creatine, creatine monohydrate is the most researched and effective form of creatine for improving exercise and sports performance. The vast majority of creatine research has been conducted on young healthy males, but creatine supplementation can also provide benefits to females across their lifespan, especially vegetarians, and during the aging process. Furthermore, emerging research indicates that creatine supplementation can improve measures of cognition and memory and treat symptoms from traumatic brain injury, including concussion. The vast majority of creatine – 95 per cent – is stored in skeletal muscle with less than five per cent stored in the brain. Creatine supplementation
typically increases muscle creatine levels by 20-40 per cent compared to only 6-10 per cent in the brain. This discrepancy is partially explained by the brain being able to make creatine, thereby blunting uptake from the blood compared to skeletal muscle. Creatine helps to maintain and replenish the energy currency of the cell (ATP or adenosine triphosphate) during and following exercise. Subsequently, this may allow an individual to perform more exercise over time leading to greater improvements in exercise and sports performance. Mechanistically, these benefits may be the result of creatine increasing processes involved in muscle growth and performance and by decreasing inflammation and cellular stress, thus improving recovery.
DOSAGE RECOMMENDATIONS Since creatine needs to accumulate in muscle and/or the brain to be effective, frequent ingestion has to occur. In general, there are a few established creatine ingestion protocols for improving measures of muscle mass and performance.
58 I Fall Fitness & Food Issue 2023 I IMPACT MAGAZINE
The most popular evidence-based strategies are to ingest ~ 20 grams of creatine in the creatine-loading phase: 4 x 5 grams throughout the day for 5-7 days, followed by 2-5 grams/day thereafter (the creatine maintenance phase) or simply ignore the creatine-loading phase and consume 3-5 grams/day. However, this lower daily dosage will take longer (~ 30 days) to top-up muscle creatine levels. Alternatively, 0.10-0.14 g/ kg/day (~ 8-11 grams) has been shown to be effective over time. The requirement to consume creatine at specific times each day to produce muscle benefits is not supported. However, prior muscle contractions from exercise increase creatine uptake into skeletal muscle, so an ideal time to consume creatine is likely before, during and/or after exercise. Thus, creatine can be consumed as a bolus or as smaller, more frequent dosages throughout the day. Further, creatine can be consumed daily, including non-exercise days. Established creatine protocols for increasing brain creatine levels remain to be determined but there is some evidence that 20 grams/day for ≥ one week can be effective in healthy populations.