Creatine… A supplement to enhance sport performance

Creatine as a dietary supplement (which is also used for treating patients with disturbances of the metabolism of creatine), has had a huge boom in recent years among athletes and among scientists, thus becoming the most studied supplement in recent years. Many scientific studies have investigated the effect of supplementation with creatine monohydrate in a variety of exercises and sports, although not all with good results which may be due to different initial levels of creatine, dose and duration of supplementation (3, 5 or more days), exercise evaluation, gender, duration of exercise, different statistical treatment, etc.

Introduction 

In 1832, creatine, a molecule of nitrogen, was identified in meat by the French scientist Chevreul. Later, in 1847, Lieberg concluded that the accumulation of creatine in the body is directly involved in the production of muscular work. The investigation of creatine supplementation started using creatine about 1900 extracted from the meat. The production of synthetic creatine starts in the mid-60s and was initially used in the countries that formed the Soviet Union. Some British Olympic athletes were supplemented with creatine in the Barcelona Olympics in 1992. Moreover the Olympic Games in Atlanta were referred to as "The Creatine Games”, since a significant number of athletes supplemented with creatine achieved gold medals.

Creatine is a compound that is found in our bodies (95% of Creatine is found in the muscles and the rest in the heart and brain), and is formed from three precursor amino acids: glycine, Arginine and Methionine. The normal concentration of creatine in plasma is 50-100 mmol/L and the turnover of the same man in an average of 70 kg is estimated at 2 grams.

Information on nutritional supplements can be quite confusing in many cases. Today we find enough literature on the information that appears to supplements such as the Internet, in magazines, advertisements, etc. Still says that many people receive mixed messages. This is especially true in the case of a product has become the "boom" of supplements to boost athletic performance, we're talking, of course, of the creatine.

Every day we receive more queries from interested parties seeking information, questions and questioning the credibility of the press who have published so many conflicting reports.
In the past year, more than 175 television news and more than 900 newspaper articles have included stories about creatine. Although often successfully posted functions creatine, never missing the misleading advertising such as a recent article in Decatur, Illinois, the Herald and Review exaggerating the effects of the supplement to the point of titles such as "magic bullet".

Furthermore, we find the erroneous information that appeared in St. collude Times, in which the doctor stated that "if not used properly, creatine may even delay the healing of wounds.”

Fortunately, in the midst of this chaos caused by the boom of creatine are voices of reason, scientific experts, like Richard Kreider, PhD, who offers an oasis of information on what really creatine " does or does not do" information based on scientific literature, not rumors or hearsay.

People who attended a recent symposium at the National Strength and Conditioning Association's annual meeting at 21 the June 24 in Nashville, Tennessee, could witness a quite understandable overview, summarized by Dr. Kreider, who 4 clearly presented the latest scientific facts about creatine supplementation and its effects on athletic performance. Dr. Kreider has authorized us to publish this presentation, which will undoubtedly help to those who are not familiar with the benefits of creatine, to acquire knowledge of what the supplement can and can not accomplish and who should use it or not use. They also provided extensive knowledge about the effects of this supplement in sports and muscle growth.

Theoretical understanding about Creatine supplementation 

• During the course of type short and explosive, the biochemical reaction catalyzed by the enzyme refosforilasa from ADP (adenosine diphosphate) is phosphorylated to form ATP (adenosine triphosphate, the basic form of energy used by cells) is determined largely by the amount of phosphocreatine stored in the muscle.
• When stocks begin to run out of phosphocreatine, athletic performance deteriorates rapidly due to the inability of ATP to maintain the pace required.
• Creatine supplementation increases total muscle creatine content and phosphocreatine between 10 and 40%. Increasing the bioavailability of phosphocreatine increasing levels of ATP during intense exercise and the pace at which the ATP.

Report on the Effects of load creatine on muscle power

It increases in total muscle creatine by 10 to 25% and phosphocreatine by 20 to 40% (with some variability between different people).

It has been shown that ingestion of glucose (100 grams), creatine (5 grams) increases the concentration of insulin and promotes the increased use of creatine by the muscle as well as the synthesis of glycogen.

ATP increases the bioavailability of explosive and effort during the exercise of high repetitive intensity.

It accelerates the pace at which the ATP is done after high intensity exercise.

Benefits of creatine supplementation in the short and long term

• Increases 1 Repetition Maximum (1RM) and / or maximum stress.
• Improves performance in vertical jump and jumps repetitive.
• Increases during sets of maximum effort for repetitive muscular contraction.
• Increases single effort sprint duration of 6 to 30 seconds.
• Increases the explosive repetitive effort (6 C 6 seconds with 30 seconds rest)
• Better performance in high intensity events lasting between 90 to 600 seconds.
• Increases AT (Anaerobic Threshold) and VO2 max (the body's ability to carry oxygen to muscles).

Observed changes in body composition 

Changes in body composition:

• Increases total muscle mass.
• Increases lean muscle tissue.
• Decreased percentage of adipose tissue.

Theories on the increase in lean muscle tissue:

• Fluid retention
• Protein synthesis
• Improved quality of training
• Theories of yield improvement
• Increase of total creatine and intramuscular phosphocreatine.
• Better resynthesis of ATP and / or metabolic efficiency during high intensity exercise.
• Increases in promoting better quality of the training adaptations to training over time.
• Increases lean muscle tissue, promoting more force.

Possible side effects

Report side effects: Weight gain.

Side Effects anecdotal published by the press:

Cramps / dehydration. Muscle Pulls
Kidney disorders. Concerns

Long-term side effects?

Ethics

Motion Study 

Retrospectively we evaluate the side effects observed when using a questionnaire survey in two post-test and controlled double-blind randomized study in which the effects of supplementation of creatine in sport performance and body composition during training.

Methods 

164 questionnaires were evaluated post-test study of two were double-blind and random.
84 people taking placebo, 80 took supplements containing creatine during training.

After the supplementation period, people of study describe the positive and negative aspects of taking the supplements that were administered.

The post-study questionnaires were filled in anonymously.

Content questionnaire survey 

What impact did the supplements ingested during your workout in the study, compared with a recent training and / or during a competition?
In percentage terms, how would that affect the protocol to supplement your training and / or explosive effort in your performance?
How did you feel was the most positive aspects of taking supplements?.
What was the most negative aspect of taking supplements?.
Describe any comments you may have about the supplements you took. (Taste, quality, effectiveness, likelihood of purchase and consumption of the product, etc.)
Compliance? What group was most affected? What they believed they were taking a supplement? Ratio of confidence in the choice of it.

Critical analysis of studies that showed no ergogenic benefit

Creatine supplementation in various clinical studies produced no improvement in athletic performance. This happens:

• When ingested less than 20 grams a day for 5 days or when ingested 2 to 3 grams per day during training (with or without a high dose or period of initial load.)
• In people who experience less than 20% increase in the content of creatine in the muscle.  In experimental studies crossed with periods of less than 5 weeks of use.
• In efforts of explosive repetitive length between 6 and 60 seconds, when there are prolonged periods of rest between the series of efforts explosives.
• In high-intensity aerobic exercise after short periods of loading.
• When recovery time is too short to replenish phosphocreatine.

Concerns about creatine supplementation 

Removal of the natural synthesis of creatine?
Kidney disorders?
Muscle cramps?
Pulling muscle?
Long-term effects?
Ethics in improving sports performance?
Effects of supplementation?
Expenditure? Administrative Control

Could removing the natural synthesis of creatine happen?

It has been reported that the natural synthesis of creatine decreases during periods in which increases the content creatine in the diet.

However, the synthesis of creatine seems back to normal upon cessation of supplementation.

There is evidence in animal or human evidence to indicate a long-term suppression of the natural synthesis of creatine.

Renal problems

Diets high in protein (> 3g/kg/d) increase renal overload in patients with renal failure. Some concerns are based on the possibility that creatine can cause kidney overload. Ingesting
15 to 25 grams per day of creatine increases the protein intake at 0.1 to 0.2 g / kg / d (ie, 8 to 16 grams of protein per day for a 83 kg athlete)

There is evidence that adding less than the equivalent of 30 grams of protein per day (0.1 to 0.2 g / kg / d.) to the diet is an overload or renal failure in healthy people.

Although it has been reported that levels creatine rise moderately after creatine supplementation (ie 1.2 to 1.4 umol / L), these are among the normal parameters for high performance athletes. Increased creatinine may be due to excess creatine eliminated.

There are no studies reporting elevations in liver enzymes in response to creatine supplementation.

Recent studies indicate that creatine supplementation (20 grams daily for 63 days) does not increase the possibility of renal failure.

Can it cause muscle cramps?

Some advertisements or articles have suggested the possibility that athletes taking creatine can experience a higher incidence in muscle when train at high temperatures.

The proponents of this theory believe that creatine causes water retention, dehydration and / or electrolyte imbalance leading to cramps when you are training at high temperatures. The cause of cramps is unknown.

There are no studies that have reported a disproportionate increase in the % of total water in the body, excessive retention of intracellular fluid, changes in plasma volume, and / or electrolyte imbalances in response to creatine supplementation.

There are no studies that have reported the occurrence of cramps in relation to creatine supplementation, although many of these studies have evaluated highly trained athletes during periods of high intensity.

Preliminary reports indicate that there is no relationship between creatine supplementation and dehydration and / or cramps in athletes training for 1 hour at 37 º C (98.6 º F).

Can it cause muscle jerks?

It has also been suggested that creatine causes a higher incidence of muscle jerks due to the rapid increase in weight and strength however the increase in yield strength and explosive efforts usually from 5 to 8% are accompanied by increases in lean body mass. No study has documented the increase in the number of injuries after creatine supplementation.
There is clinical evidence that supplementation with creatine accelerates recovery after orthopedic surgery.

Concern for cramping and muscle pulls 

We are preparing studies to investigate these alleged negative effects.
Logically, if creatine supplementation promotes cramping and / or a higher incidence of muscle pulls, it would not be a very popular supplement among athletes because all teams would be injured or cramping, and therefore would not be able to participate in their sporting events. Most scientists believe that this information is exaggerated.

Concern over the long term effects 

Athletes take creatine as a nutritional supplement, using the last 10 years.
Creatine has been used to treat errors of creatine synthesis in children, patients with heart failure, and prevent arrhythmias in patients of heart.

There has not been reported any significant side effects in medical studies for up to 2 years.
Although studies are still needed long-term, there is no evidence to date that creatine supplementation may lead to adverse medical situations when taken in recommended doses.

Ethical considerations

Concerns about ethics have emerged because the athletes are taking a nutritional supplement that clearly improves athletic performance. While creatine supplementation is similar to the loads of carbohydrates, which is fully accepted.

Should all supplements and / or strategies believed to improve performance sports be banned?

Ultimately, medical technology, physical, nutritional and psychological applied to sport improved as a result of the investigation (today's cars are the same as in 1920?). Nobody disputes that progress in other areas is ethical, all non-aggressive techniques on health in the short or long term to improve physical performance are not considered unethical

Concern about abuse 

The concern started by the possibility that athletes can take high doses of creatine (ie 50 to 100 grams per day) or even that they can take other supplements ineffective or potentially dangerous.

Some people believe that proper education is needed among athletes and coaches to inform them of the effects of nutritional supplementation in the training and the recommended dose for each athlete as a better means of reducing risks.

Need for Administrative Control 

Legal concerns have emerged regarding the administrative control of supplementation in the equipment and the responsibility of teams, universities and government bodies that provide creatine the athletes.

Most authorities believe that if creatine teams provide their athletes should ingest these supplements on a voluntary basis after having adequate knowledge about the effects they produce.

Concern in spending 

Some argue that creatine supplementation is expensive and a waste of limited budget resources of the sport. Although initially creatine was expensive, now is sold in the market cheaply. Accordingly, the cost of the creatine is actually cheaper than most sports drinks.

Contents of ergogenic value of creatine

Total creatine in muscle contributes positively to improving the performance of high intensity training and recovery.

Creatine supplementation (15 to 25 grams per day for 5 to 7 days) may increase the concentrations of total creatine, free creatine in muscle phosphocreatine and about 10 to 40%.

Ingestion of creatine increases the glucose uptake of creatine to a greater degree and improve the synthesis of glycogen.

People with high initial levels do not respond as well to load creatine unless you ingest creatine with glucose, which promotes the absorption of creatine and glycogen.

Creatine supplementation in the short term (15 to 25 grams per daily for 5 to 7 days) can improve aerobic capacity for repetitive series of high-intensity training in a 5 to 10%.

Contents of ergogenic value of creatine 

It has been shown that creatine supplementation during training leads to increases in strength and maximum stress.

Not all studies have shown benefits in athletic performance, possibly due to differences in the time of supplementation, the individual variation in response to creatine supplementation, the evaluation criterion of the training and time recovery observed between the repetitions of the exercise sets.

It has been reported that creatine supplementation in the short run a slightly increased body weight.

Studies of supplementation in long-term (2 to 20 weeks) creatine alone, glucose with creatine or creatine added to proteins / carbohydrates have shown to increase lean muscle mass between 1.5 and 6 kg

Based on current data, creatine supplementation appears to be a safe and effective nutritional strategy to improve athletic performance.

Recommendations in supplementation

Improved athletic performance:

• Recommended 200 mg / kg / day with carbohydrates during the first three days at the load step
• Then Eating 50 mg / kg / day with carbohydrates to maintain the levels of creatine.

Improved athletic performance and increase lean muscle mass:

• Ingesting 200 mg / kg / day with carbs / protein to which the goals of weight / body composition are achieved, then maintain it with a dose (50 mg / kg / day).
• Reducing or eliminating consumption among macrocyclic competitive training.

References

• Sport Nutrition
• Magazine No 1
• DEL CASTILLO, V.C. Creatine Project . Graduate Course "Nutrition for Fitness and Performance." Montana State University. USA. December, 1999.
• Urbanski, R.L. et. andalusia. Creatine Supplementation Affects Differentially Maximal Isometric Strength and Time to Fatigue in Small and Large Muscle Groups. Int Journal of Sport Nut . 9, 136-145, 1999.
• GREENHAFF, P.L. Creatine and Its Application as Ergegenic Aid. Int Jour. of Sport Nut. S. 5, 100-109, 1995.
• Balsom, P.D. et. andalusia. Skeletal muscle metabolism during short duration high-intensity exercise: influence of creatine supplementation, Acta Physiol . Scand. 154, 303-310, 1995.
• Leenders, N. et. andalusia. Creatine Supplementation and Swimming Performance. Int Jouranl of Sport Nut. 9, 251-262, 1999.
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• WYSS, M. et. andalusia. I-4 Creatine metabolism and the consequences of creatine depletion in muscle. Mol. and Cellu. Biochem. 133/134 :51-66, 1994 GUERRERO-
• ONTIVEROS, M.L. et. andalusia. Creatine Suplementation in health and disease. Effects of chronic creatine ingestion in vivo: Down-regulation of the expression of creatine transporter isoforms in skeletal muscle. Mol. and Cell. Biochem. 184: 427-437, 1998.
• POORTMANS, J.R. at. andalusia. Long-term oral creatine supplementation does not impair renal function in healthy athletes. Medicine & Science in Sports & Exercise , 1108-1110, 1999.
• VOLEK, J.S. et. andalusia. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Mid & Scie. in Sport & Exerc. 1147-1156, 1999.
• STONE, M.H. et. andalusia. Effects of in-season (5 weeks) Pyruvate and Creatine Supplementation on Anaerobic Performance and Body Composition in American Football Players. Int Journal of Sport. Nut. 9, 146-165, 1999.

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