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Effects of Creatine Supplementation on Exercise Performance

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Abstract

While creatine has been known to man since 1835, when a French scientist reported finding this constituent ofmeat, its presence in athletics as a performance enhancer is relatively new. Amid claims of increased power and strength, decreased performance time and increased muscle mass, creatine is being hailed as a true ergogenic aid. Creatinine is synthesised from the amino acids glycine, arginine and methionine in the kidneys, liver and pancreas, and is predominantly found in skeletal muscle, where it exists in 2 forms. Approximately 40% is in the free creatine form (Crfree),while the remaining 60%is in the phosphorylated form, creatine phosphate (CP). The daily turnover rate of approximately 2g per day is equally met via exogenous intake and endogenous synthesis. Although creatine concentration (Cr) is greater in fast twitch muscle fibres, slow twitch fibres have a greater resynthesis capability due to their increased aerobic capacity. There appears to be no significant difference between males and females in Cr, and training does not appear to effect Cr. The 4 roles in which creatine is involved during performance are temporal energy buffering, spatial energy buffering, proton buffering and glycolysis regulation. Creatine supplementation of 20g per day for at least 3 days has resulted in significant increases in total Cr for some individuals but not others, suggesting that there are ‘responders’ and ‘nonresponders’. These increases in total concentration among responders is greatest in individuals who have the lowest initial total Cr, such as vegetarians. Increased concentrations of both Crfree and CP are believed to aid performance by providing more short term energy, as well as increase the rate of resynthesis during rest intervals. Creatine supplementation does not appear to aid endurance and incremental type exercises, and may even be detrimental. Studies investigating the effects of creatine supplementation on short term, high intensity exercises have reported equivocal results, with approximately equal numbers reporting significant and nonsignificant results. The only side effect associated with creatine supplementation appears to be a small increase in body mass, which is due to either water retention or increased protein synthesis.

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References

  1. Needham DM. Machina carnis: the biochemistry of muscular contraction in its historical development. Cambridge: Cambridge University Press, 1971

    Book  Google Scholar 

  2. Hunter A. Monographs of biochemistry: creatine and creatinine. London: Longmans, Green and Co., 1928

    Google Scholar 

  3. Balsom PD, Soderlund K, Sjordin B, et al. Skeletal muscle metabolism during short duration high-intensity exercise: influence of creatine supplementation. Acta Physiol Scand 1995; 154: 303–10

    Article  PubMed  CAS  Google Scholar 

  4. Hultman E, Bergstrom T, Anderson NM. Breakdown and resynthesis of phosphorylcreatine and adenosine triphosphate in connection with muscular work in man. Scand J Clin Lab Invest 1967; 19: 56–66

    Article  PubMed  CAS  Google Scholar 

  5. Devlin TM. Textbook of biochemistry: with clinical correlations. New York: Wiley-Liss, 1992

    Google Scholar 

  6. Harris RC, Soderlund K, Hultman E. Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin Sci 1992; 83: 367–74

    PubMed  CAS  Google Scholar 

  7. Guimbal C, Kilimann MW. A Na+-dependent creatine transporter in rabbit brain, muscle, heart and kidney. J Biol Chem 1993; 268: 8418–21

    PubMed  CAS  Google Scholar 

  8. Haugland RB, Chang DT. Insulin effect on creatine transport in skeletal muscle. Proc Soc Exp Biol Med 1975; 148: 1–4

    PubMed  CAS  Google Scholar 

  9. Odoom JE, Kemp GJ, Radda GK. Control of intracellular creatine concentration in a mouse myoblast cell line [abstract]. Biochem Soc Trans 1993; 21: 441S

    PubMed  CAS  Google Scholar 

  10. Gerber GB, Gerber G, Koszalka TR, et al. Creatine metabolism in vitamin E deficiency in rats. Am J Physiol 1962; 202: 453–60

    PubMed  CAS  Google Scholar 

  11. Heymsfield SB, Arteaga C, McManus C, et al. Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J Clin Nutr 1983; 37: 478–94

    PubMed  CAS  Google Scholar 

  12. Harris RC, Viru M, Greenhaff PL, et al. The effects of oral creatine supplementation on running performance during maximal short term exercise in man [abstract]. J Physiol 1993; 467: 74P

    Google Scholar 

  13. Crim MC, Calloway DH, Margen S. Creatine metabolism in men: creatine pool size and turnover in relation to creatine intake. J Nutr 1976; 106: 371–81

    CAS  Google Scholar 

  14. Bjornsson TD. Use of serum creatinine concentration to determine renal function. Clin Pharmacokinet 1979; 4: 200–22

    Article  PubMed  CAS  Google Scholar 

  15. Walker JB. Metabolic control of creatine biosynthesis: effect of dietary creatine. J Biol Chem 1960; 235: 2357–61

    PubMed  CAS  Google Scholar 

  16. Delanghe J, DeSlypere JP, Debuyzere M, et al. Normal reference values for creatine, creatinine and carnitine are lower in vegetarians. Clin Chem 1989; 35: 1802–3

    PubMed  CAS  Google Scholar 

  17. Tesch PA, Thorsson A, Fujitsuka N. Creatine phosphate in fiber types of skeletal muscle before and after exhaustive exercise. J Appl Physiol 1989; 66 (4): 1756–9

    PubMed  CAS  Google Scholar 

  18. Essen B. Studies on the regulation of metabolism in human skeletal muscle using intermittent exercise as an experimental model. Aust J Sci Med Sport 1978; 454: 1–64

    CAS  Google Scholar 

  19. Edstrom L, Hultman E, Sahlin K, et al. The contents of high-energy phosphates in different fibre types in skeletal muscles from rat, guinea-pig and man. J Physiol 1992; 332: 47–58

    Google Scholar 

  20. McArdle WD, Katch FI, Katch VL. Exercise physiology: energy, nutrition and human performance. Philadelphia: Lea & Febiger, 1991

    Google Scholar 

  21. Moeller P, Bergstrom J, Furst P, et al. Effects of aging on energy rich phosphogens in human skeletal muscle. Clin Sci 1980; 58: 553–5

    CAS  Google Scholar 

  22. Fosberg AM, Nillson E, Werneman JM. Muscle composition in relation to age and sex. Clin Sci 1991; 81: 249–56

    Google Scholar 

  23. Gariod L, Binzoni T, Feretti G. Standardization of 31-phosphorus nuclear magnetic resonance spectroscopy determinations of high-energy phosphates in humans. Eur J Appl Physiol 1994; 68: 107–10

    Article  CAS  Google Scholar 

  24. Bernus G, Gonzalez de Suso JM, Alonso J, et al. 31P-MRS of quadriceps reveals quantitative differences between sprinters and long-distance runners. Med Sci Sports Exerc 1993; 25: 479–84

    PubMed  CAS  Google Scholar 

  25. Bessman SP, Geiger P. Transport on energy inmuscle: the phosphorylcreatine shuttle. Science 1981; 211 (4481): 448–52

    Article  PubMed  CAS  Google Scholar 

  26. Volek JS, Kraemer WJ. Creatine supplementation: its effect on human muscular performance and body composition. J Stren Cond Res 1996; 10 (3): 200–10

    Google Scholar 

  27. Green AL, Hultman E, MacDonald IA, et al. Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans. AmJ Physiol 1996; 271: E821–6

    CAS  Google Scholar 

  28. Soderlund K, Balsom PD, Ekblom B. Creatine supplementation and high intensity exercise: influence on performance and muscle metabolism. Clin Sci 1994; 87 Suppl.: 120

    Google Scholar 

  29. Greenhaff PL, Bodin K, Soderlund K, et al. Effects of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis. Am J Physiol 1994; 266: E725–30

    PubMed  CAS  Google Scholar 

  30. Vandenberghe K, Goris M, VanHecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 1997; 83 (6): 2055–63

    PubMed  CAS  Google Scholar 

  31. Greenhaff PL, Casey A, Short AH, et al. Influence of oral creatine supplementation of muscle torque during repeated bouts of maximal voluntary exercise in man. Clin Sci 1993; 84: 565–71

    PubMed  CAS  Google Scholar 

  32. Dawson B, Cutler M, Moody A, et al. Effects of oral creatine loading on single and repeated maximal short sprints. Aust J Sci Med Sport 1995; 27 (3): 56–61

    PubMed  CAS  Google Scholar 

  33. Earnest CP, Snell PG, Rodriguez R, et al. The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition. Acta Physiol Scand 1995; 153: 207–9

    Article  PubMed  Google Scholar 

  34. Kreider RB, Ferreira M, Wilson M, et al. Effects of creatine supplementation on body composition, strength, and sprint performance. Med Sci Sports Exerc 1998; 30 (1): 73–82

    Article  PubMed  CAS  Google Scholar 

  35. Balsom PD, Soderlund K, Ekblom B. Creatine in humans with special reference to creatine supplementation. Sports Med 1994; 18: 268–80

    Article  PubMed  CAS  Google Scholar 

  36. Birch R, Noble P, Greenhaff PL. The influence of dietary creatine supplementation on performance during repeated bouts of maximal isokinetic cycling in man. Eur J Appl Physiol 1994; 69: 268–70

    Article  CAS  Google Scholar 

  37. Bosco C, Tihanyi J, Pucspk J, et al. Effect of oral creatine supplementation on jumping and running performance. Int J Sports Med 1997; 18: 369–72

    Article  PubMed  CAS  Google Scholar 

  38. Schneider DA, McDonough PJ, Fadel PJ, et al. Creatine supplementation and the total work performed during 15s and 1 min bouts of maximal cycling. Aust J SciMed Sport 1997; 29 (3): 65–8

    CAS  Google Scholar 

  39. Harris RC, Hultman E, Nordesjo LO. Glycogen, glycolytic intermediates and high-energy phosphates determined in biopsy samples of musculus quadriceps femoris of man at rest: methods and variance of values. Scand J Clin Lab Invest 1974; 33: 109–20

    Article  PubMed  CAS  Google Scholar 

  40. Volek JS, Kraemer WJ, Bush JA, et al. Creatine supplementation enhances muscular performance during high intensity resistance exercise. J Am Diet Assoc 1997; 97: 765–70

    Article  PubMed  CAS  Google Scholar 

  41. Earnest CP, Snell PG, Mitchell TL, et al. Effects of creatine monohydrate ingestion on peak anaerobic power, capacity, and fatigue index. Med Sci Sports Exerc 1994; 26: S39

    Google Scholar 

  42. Gordon A, Hultman E, Kaijser L, et al. Creatine supplementation in chronic heart failure increases skeletal creatine phosphate and muscle performance. Cardio Res 1995; 30: 413–8

    CAS  Google Scholar 

  43. Vandenberghe K, Gillis N, Van Leemputte M, et al. Caffeine counteracts the ergogenic action of muscle creatine loading. J Appl Physiol 1996; 80 (2): 452–7

    PubMed  CAS  Google Scholar 

  44. Grindstaff PD, Kreider RB, Bishop R, et al. Effects of creatine supplementation on repetitive sprint performance and body composition in competitive swimmers. Int J Sport Nutr 1997; 7: 330–46

    PubMed  CAS  Google Scholar 

  45. Hultman E, Soderlund K, Timmons JA, et al. Muscle creatine loading in men. J Appl Physiol 1996; 81 (1): 232–7

    PubMed  CAS  Google Scholar 

  46. Balsom PD, Harridge SDR, Soderlund K. Creatine supplementation per se does not enhance endurance exercise performance. Acta Physiol Scand 1993; 149: 521–3

    Article  PubMed  CAS  Google Scholar 

  47. Stoud MA, Holliman D, Bell D, et al. Effects of oral creatine supplementation on respiratory gas exchange and blood lactate accumulation during steady-state incremental exercise and recovery in man. Clin Sci 1994; 87: 707–10

    Google Scholar 

  48. Poortmans JR, Auquier H, Renaut V, et al. Effects of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol 1997; 76 (6): 566–7

    Article  CAS  Google Scholar 

  49. Ingwall JS, Weiner CD, Morales MF, et al. Specificity of creatine in the control of muscle protein synthesis. J Cell Biol 1974; 63: 145–51

    Article  Google Scholar 

  50. Prichard NR, Kalra PA. Renal dysfunction accompanying oral creatine supplements. Lancet 1998; 351: 1252–3

    Article  Google Scholar 

  51. Barnet C, Hinds M, Jenkins DJ. Effects of oral creatine supplementation on multiple sprint cycle performance. Aust J Sci Med Sport 1996; 28 (1): 35–9

    Google Scholar 

  52. Febbraio MA, Flanagan TR, Snow RJ, et al. Effect of creatine supplementation on intramuscular Tcr, metabolism and performance during intermittent, supramaximal exercise in humans. Acta Physiol Scand 1995; 155 (4): 387–95

    Article  PubMed  CAS  Google Scholar 

  53. Mujika I, Chatard J, Lacoste L, et al. Creatine supplementation does not improve sprint performance in competitive swimmers. Med Sci Sports Exerc 1996; 28 (11): 1435–41

    Article  PubMed  CAS  Google Scholar 

  54. Odland LM, MacDougall JD, Tarnopolsky M, et al. The effects of oral Cr supplementation on muscle [Pcr] and power output during a short-term maximal cycling task. Med Sci Sports Exerc 1997; 29 (2): 211–9

    Google Scholar 

  55. Terrillion KA, Kolkhorst FW, Dolgener FA, et al. Effects of creatine supplementation on two 700m maximal running bouts. Int J Sport Nutr 1997; 7: 138–43

    PubMed  CAS  Google Scholar 

  56. Burke LM, Pyne DB, Telford RD. Effect of oral creatine supplementation on single-effort sprint performance in elite swimmers. Int J Sport Nutr 1996; 6: 22–33

    Google Scholar 

  57. Cooke WH, Grandjean PW, Barnes WS. Effects of oral creatine supplementation on power output and fatigue during bicycle ergometry. J Appl Physiol 1995; 78 (2): 670–3

    PubMed  CAS  Google Scholar 

  58. Harridge SDR, Balsom PD, Soderlund K. Creatine supplementation and electrically evoked human muscle fatigue. Clin Sci 1994; 87 Suppl.: 124

    Google Scholar 

  59. Redondo DR, Dowling EA, Graham BL, et al. The effects of oral creatine monohydrate on running velocity. Int J Sport Nutr 1996; 6: 213–21

    PubMed  CAS  Google Scholar 

  60. Thompson CH, Kemp GJ, Sanderson AL, et al. Effects of creatine on aerobic and anaerobic metabolism is skeletal muscle in swimmers. Br J Sports Med 1996; 30: 222–5

    Article  PubMed  CAS  Google Scholar 

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Demant, T.W., Rhodes, E. Effects of Creatine Supplementation on Exercise Performance. Sports Med 28, 49–60 (1999). https://doi.org/10.2165/00007256-199928010-00005

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