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The Truth About Creatine

First in a Two-Part Series
by: Rod Smith
AFM Staff Writer
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Athletes in all sports, especially football, are always looking for ways to become bigger, stronger and faster. To attain the quintessential trifecta of size, strength and speed, athletes have been known to use any and all means necessary.

Unfortunately, even alternatives with documented harmful side effects such as steroids have been seen as viable options. The current "magic potion" for many athletes is creatine monohydrate. But what is it? What will it do? And, does it actually do what it claims? Is creatine the safe, legal answer athletes have been searching for?

Many athletes think so. Yet, despite mounds of scientific research in its favor-more than 100 studies have been done on subjects of all ages-creatine usage continues to draw concern and criticism. The deaths of three collegiate wrestlers last year, and the subsequent rumors of their creatine usage, simply added fuel to the criticisms. Perhaps now the most popular sports supplement, creatine has quickly become the key player in what can best be labeled a supplemental conundrum.

What Is It?

A combination of three amino acids, creatine is a nutrient found naturally in the body as well as in a variety of meats including beef, pork, cod and herring. Even smaller traces of the nutrient can be found in cranberries and milk. While most people get all the creatine their bodies need from daily dietary regimens, those whose diets are lacking need not panic. Our bodies normally produce up to two grams of creatine per day, mostly in the liver. This naturally synthesized total equals what a sedentary individual will expend in one day. While athletes and other active individuals will typically burn much more, the actual amount depends on the type of sport, relative intensity level and an individual's own muscle mass.

Natural stores of creatine in the body vary according to diet and body composition. An average sized male (155 pounds or 70 kilograms) will store just over four ounces (120 grams) in his muscles. In fact, 95 to 98 percent of all stored creatine can be found in skeletal muscles. The rest is found in the brain, heart and testes. Two-thirds of this nutrient is stored as what is called creatine phosphate or phosphocreatine.

When You Ingest

Whether you rely upon natural creatine stores or choose to supplement, ingested creatine gets absorbed into the blood stream in the intestinal tract. From here, creatine travels to the muscles. Once locked inside individual muscle cells, creatine cannot escape-until energy is expended. When this happens creatine becomes an essential player in the energy system referred to as the "phosphagen system." Also called the ATP-CP system because of its two key components (adenosine triphosphate and creatine phosphate), this energy system serves as the body's initial source of muscle contraction. The bursts of energy common to this oxygen independent system last for short periods of time (possibly up to 30 seconds), and act as a sort of jump start for the body's two other energy delivery systems.

The entire process begins when muscles contract. ATP acts as the initial fuel, giving up one of its phosphate molecules to become ADP (adenosine diphosphate). Once ATP stores are depleted-which could be in as little as 10 seconds-the body must move on to other anaerobic sources of energy such as carbohydrates, unless there is an overabundance of creatine stores. Recent studies have shown pre-workout levels of creatine phosphate may reach up to four times greater than the available supply of ATP. The bottom line? The more creatine stored in the muscles, the larger the amount of ATP that can be regenerated-and the longer an athlete can perform at or near his or her potential.

This regeneration process not only allows you to train harder and longer, but keeps you from relying on another carbohydrate-based energy system called glycolysis. Lactic acid, the toxin that makes your legs burn at the end of a heavy set of squats, is a direct result of this system. Increasing the amount of ATP produced can actually delay the onset of lactate build-up, which in turn allows you to workout longer.


Link to a larger pic.

Creatine Time Line

The time line on creatine dates back to 1832 when French scientist Chevreul first identified the amino acid as a meat extract. Scientific research continued into the 20th century when scientists learned creatine was, in fact, stored in the body. Soon after, two more discoveries served to push the extent of creatine knowledge. First in 1912, discoveries revealed ingesting creatine could boost natural levels of stored creatine. Then in 1927, scientists discovered creatine phosphate, revealing the nutrient's important metabolic role.

The first significant studies of creatine's beneficial effects on sports participation were conducted more than 35 years ago in the former Soviet Union. In 1961, Dr. Nikolai Volkov, a biochemist and sports nutritionist for the Soviet Olympic program, was able to accurately predict creatine supplementation could be of value to Soviet Olympic athletes. The discovery was thought so valuable it quickly became a closely-guarded state secret.

Often referred to as anecdotal in creatine literature, Volkov's three-decade old studies have been verified by Robert Hackman, the Executive Director for the Center of Complementary and Alternative Medicine Research at the University of California-Davis. "I know this to be true because I've seen Dr. Volkov's research complete the red hammer and sickle stamp," said Hackman, who himself promotes a "balanced formula" approach to creatine supplementation. "It's crazy to think all muscles need is creatine. High schoolers need to understand that there is no one simple chemical that is a magic bullet."

Usage Today

While little is known as to the potential long-term side effects, if any, creatine's popularity as the athlete's supplement of choice continues to soar, as does its consumption. According to a report in USA Today, domestic sales of the supplement were in the $100 million range for 1997 and expected to continue to grow at a 20-25 percent annual clip. While powder varieties are the most common, manufacturers produce creatine products in pill, gel, liquid, serum, tablet and gum forms. But just as creatine comes in many forms, so too does it come in different levels of purity. Producing 100 percent pure creatine involves a chemical synthesis in which an acidic compound called cyanamide (NCNH2) is reacted with sodium (or another compound called potassium sarcosinate in water or a water mixture). The process must be performed at a specific temperature and corresponding pH value. (The second installment of this article will cover the topic of purity and what is currently being done by those who produce creatine in more detail, but for now a superficial mention of the subject is necessary.)

Regardless of purity, athletes often tend to think that if a little is good, then more must be better. While there are no cut-and-dried specifications on what constitutes "proper creatine dosage," manufacturers recommend athletes ingest up to 20 grams per day as part of the "loading phase," which can last from five to seven days. Most then recommend a maintenance dosage of up to 5 grams per day for the length of the supplementation period. To acquire a similar 5-gram dose through natural means would require a person to eat nearly 2.5 pounds of fresh, uncooked steak.

Richard B. Kreider, the assistant department chair in the Department of Human Movement Sciences and Education at the University of Memphis, says general guidelines for dosage include loading 0.3 grams per kilogram of body weight per day for 5-7 days. "You can then maintain loaded levels by ingesting 3-5 grams per day up to 20 weeks," said Kreider, who has overseen five creatine studies since 1994.

Enhancing Supplementation

It should be noted, however, that "proper dosage" varies based on three ingredients-an individual's body weight, exercise intensity and his or her relative natural levels of creatine production and storage. Athletes who weigh more or have more muscle mass require more creatine, as do those who exercise at high intensity levels for extended periods of time. Vegetarians, or others who may not ingest as much creatine in their diets, may also have a greater need for the supplement. Because of lower initial creatine levels, these individuals may also have a greater reaction to creatine supplementation.

According to Kreider, taking creatine with simple sugars, such as those found in fruit juices, can increase the body's uptake of creatine. Thus, the supplementation becomes even more effective. "Creatine uptake appears to be insulin mediated and glucose and sodium dependent," Kreider said. A number of studies have shown creatine uptake can be enhanced by 10 percent or more by pairing it with simple sugars.

Studies have also shown the popular stimulate caffeine to curb creatine's potential benefits. A 1996 study published in the Journal of Applied Physiology revealed a link between caffeine and decreased ergogenic benefits. The amount of caffeine used in the study (400 mg) was the equivalent of about three and one-half cups of drip or brewed coffee or six cups of instant coffee. More moderate caffeine consumption-generally associated with drinking tea or cola-apparently creates little reason for concern.

Whether loading or maintaining, individual doses, say experts, should not exceed 5 grams. Staying within this benchmark virtually eliminates the possibility of over-saturation. Like a fuel tank, the body can only store a certain amount of creatine. Once the muscles have been loaded to capacity, simply maintaining elevated levels of creatine becomes the goal.

Ultimately, the body's creatine storage capacity is linked directly to an individual's amount of muscle mass-because that is where creatine stores. After the ultimate storage capacity is reached, excess creatine is simply excreted from the body.

While loading and cycling are generally felt to provide the most efficient use of the supplement, some research suggests otherwise. A 1992 study conducted at Sweden's Karolinska Institute measured the creatine accumulation rate in muscle and found that after 15 days those who loaded actually had a lower accumulation percentage than those who ingested a smaller, more consistent amount of creatine. Individuals who loaded showed impressive gains at first. But after 28 days, both the individuals who practiced the typical biphasic method (loading followed by maintenance phase) and those who took smaller daily doses received essentially the same benefits from supplementation.

Moreover, subjects who gradually increased their creatine stores did not waste nearly as much creatine as the loading group. Those who loaded 20-30 grams per day excreted nearly half of the creatine loaded. For the first three days of the study, supplement excretion rates were 40 percent, 61 percent and 68 percent, respectively. This study indicates that loading, whatever the initial benefits, may simply take a larger and unnecessary toll on the pocketbook.

Just as the overall benefits of loading remain to be proven, so to do the effects of a popular long-term method of ingesting creatine called cycling. This process involves using the product for a period of time (generally 6-8 weeks), then discontinuing its use for a shorter period of time (usually up to two weeks), before again returning to supplementation.

Cycling was a necessity with steroids because of that drug's adverse side effects. Creatine supplementation has proven to inhibit natural creatine production. Unlike steroid consumption, when an athlete stops using creatine his body will gradually begin to produce creatine again. Although apparently unnecessary, creatine cycling is still believed by many to provide an extra stimulus when supplementing with creatine.

Creatine Conundrum

While creatine's popularity continues to grow, two camps of thought have emerged. Conservatively, one is taking a wait-and-see attitude, while the other points repeatedly to the ever-increasing body of scientific literature.

"Creatine is not just another gimmick supplement," says Kreider, who is currently working on two additional studies. "There is a large body of well-controlled research supporting the ergogenic value of creatine supplementation."

Additional Resources
The following are recommended reading for more information about creatine:

Creatine: Nature's Muscle Builder. Ray Sahelian, Ph.D. This 120-page book explores the subject of creatine in detail and includes pertinent study results, information on dosage, and expert advice on ten things you should know about creatine.

Creatine. Richard A. Passwater, Ph. D. This 48-page booklet is part of the Good Health Guides series printed by Keats Publishing, Inc. (www.keats.com) This book reviews much of the same information presented in Salehian's work, but also includes information about different kinds of creatine supplements, discussion on the legality of supplementation, and practical questions answered by Dr. Paul Greenhaff, a creatine expert. This interview can also be found online at www.solgar.com/nutrition_library/articles/creatine.html.

Sports Supplement Review, third issue. Bill Phillips. While the topic of creatine makes up a small part (15 pages) of this large book (360 pg.), there is no shortage of quality information. Phillips includes history, scientific research, and methods of taking creatine supplementation to an even higher level.

www.nsca-lift.org. National Strength and Conditioning Association homepage. Once here, click on the articles index and search under "nutrition" or "nutrition notes" for recent articles on creatine supplementation. From the menu page, you may also want to click on "NSCA News" to see any recent releases on creatine.

www.sportsci.org. Sportscience: An Interdisciplinary Site for Research on Human Physical Performance. Once in, click on the "Training and Technology" icon. This will take you to a listing of articles by subject. Richard B. Kreider, Ph.D., has written a concise article entitled, Creatine, the next ergogenic supplement?, that not only touches on the ethics and side effects of supplementation, but includes a long list of additional resources.

www.skwchem.com. One of the world's largest manufacturers of creatine monohydrate, SKW Chemicals has patented the process of producing 100 percent pure creatine. In order to find out which companies get their creatine from SKW, visit the company's website, where they encourage consumers to ask any and all questions.

• "Creatine Controversy," Muscle & Fitness, March 1998. This article focuses on the results of a study published in the Journal of Applied Physiology in 1996 and provides pertinent information for those who consume both coffee and creatine.

Is Creatine the One True Ergogenic Aid? Owen Anderson, Ph.D. Although geared towards runners, this article not only explains what creatine is and does, but also touches on the specific benefits for vegetarians as well as provide a list of situations in which creatine supplementation will be most effective for athletes. For a copy, look online at the following address: www.c10world.com/broch4.html.






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