Creatine Presentation Final

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Creatine Presentation Final

  1. 1. Does Consumption of Phosphate Creatine supplements lead to Chronic Heart Failure? By, Katie Miller, William Fox, Richard Whytock, Kathryn Banfeild, Rebecca Wykes, Henry Klosok and Jade Barraclough
  2. 2. What is Creatine Phosphate?, and why do people take the supplements? <ul><li>Creatine phosphate is a compound found in the body which enables </li></ul><ul><li>a chemical reaction to take place, thus turning ADP to ATP. This </li></ul><ul><li>process provides all muscles with huge amounts of energy, especially that </li></ul><ul><li>of explosive short lived energy. Which is especially important to provide </li></ul><ul><li>tissues such as the brain with a constant supply of energy. </li></ul><ul><li>What the supplements do! </li></ul><ul><li>The supplement as stated on a leading manufacturers packaging , </li></ul><ul><li>Increases energy levels, maintains and increases lean muscle mass, </li></ul><ul><li>increases endurance and stamina, speeds up muscle recovery, </li></ul><ul><li>Combats lactic acid build up, aids joint repair. The recommended </li></ul><ul><li>dosage is 5g before any workout, and should be taken with a litre of </li></ul><ul><li>water. The maximum amount to be taken in a day is 15g. </li></ul>
  3. 3. Introduction <ul><li>Aim: To investigate whether Creatine Phosphate supplements can induce heart failure. </li></ul><ul><li>The long term effects are unknown, however there are some studies that have found evidence that the use of creatine phosphate supplements have actually improved cardiac function in patients with heart failure. </li></ul><ul><li>Heart Failure: problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs. </li></ul><ul><li>The major signs and symptoms of heart failure are; </li></ul><ul><li>Coughing </li></ul><ul><li>Swelling in the ankles and legs </li></ul><ul><li>Tiredness and lethargy </li></ul><ul><li>Pulmonary edema </li></ul><ul><li>Hypothesis </li></ul><ul><li>As there is more evidence to support the fact that creatine phosphate supplements actually improve cardiac function, the expected outcome is that supplementation will not lead to chronic heart failure. </li></ul>
  4. 4. Positive and Negative Effects of Creatine Phosphate supplements Most research is out of date, findings are not accurate and therefore not reliable . Many studies show no increase or decrease in fatigue. “ fatigue is banished” Can cause a large , sudden increase in body weight, causing heart attacks Muscles maximal force and power significantly increase Many side effects, i.e. vomiting, headaches, cramps, muscle damage Increases energy, and stamina (Important for all athletes) Negative Positive
  5. 5. Cohort study <ul><li>Advertise at Rugby Clubs and gyms for volunteers. </li></ul><ul><li>Ideal number of subjects would be 2,000 people for each group. </li></ul><ul><li>Subjects will be divided into two groups: People who take Creatine and people who do not </li></ul><ul><li>The only restrictions on subjects are the players can not smoke. </li></ul><ul><li>Duration 1 year </li></ul><ul><li>Advantages </li></ul><ul><li>The players have contracts and are likely to stay at the club so it is easy to find them in the future. </li></ul><ul><li>They are all health conscious therefore less likely to smoke. </li></ul><ul><li>The players are all going to be roughly the same fitness, so the testing will be fair. </li></ul><ul><li>Disadvantages </li></ul><ul><li>Investigators have no control over the way subjects are exposed. </li></ul><ul><li>These subjects are all physically active so do not represent the normal population. </li></ul><ul><li>Therefore the likely hood of heart problems are unlikely. Very little relevant data is available for this argument, thus relationship between creatine phosphate supplements and heart failure has not been significantly proven. </li></ul>
  6. 6. Testing-Measures of Exposure <ul><li>There is a need to measure the level of creatine phosphate that each </li></ul><ul><li>subject has been exposed to. </li></ul><ul><li>Continues measures (of the dose of creatine phosphate ) </li></ul><ul><li>A total cumulative dose-when did they start taking creatine supplements, there lifetime intake? </li></ul><ul><li>The average dose – how much do they take per day </li></ul><ul><li>What percentage of the standard dose do they take? </li></ul><ul><li>This information can be obtained by two main ways </li></ul><ul><li>Questionnaires , open and closed questions </li></ul><ul><li>Interviews, on a group and individual basis. </li></ul>
  7. 7. Testing - Measures of Outcome <ul><li>Test design to be used: </li></ul><ul><li>We will use a basic parallel design </li></ul><ul><li>R O X O </li></ul><ul><li>R O O </li></ul>Fluid present on the lungs and an enlarged heart Chest X-Ray – Show size of heart and check for fluid in the lungs Detection of damaged heart valves and heart abnormalities Echocardiogram – Heart movement Abnormal heart activity or arrhythmia ECG – Electrical heart activity SBP >120 mm Hg DBP >80 mm Hg Blood Pressure Cut-off points for Chronic Heart Failure Tests to be carried out:
  8. 8. Statistical Analysis <ul><li>To analyse the results, a Poisson Distribution will be used. </li></ul><ul><li>This is a discrete probability distribution. </li></ul><ul><li>A type of statistical analysis used to find out the probability of a number of events occurring in a fixed period of time. </li></ul><ul><li>In this case; the probability that “x” amount of people, taking creatine phosphate supplements, will develop heart failure. </li></ul><ul><li>Poisson Distribution is useful for experiments that are measuring random events, and have large sample sizes. </li></ul>
  9. 9. Ethical issues <ul><li>Subjects can not be given high doses of creatine phosphate supplements due to the negative effects the supplement in high concentrations can have on health. </li></ul><ul><li>The subjects health must also be taken into consideration when conducting this study, as research suggests that people with kidney disease and dysfunctions, should not take the supplement as it can aggravate past kidneys problems. </li></ul>
  10. 10. <ul><li>Financial profit </li></ul><ul><li>Companies selling creatine phosphate supplements would not appreciate seeing their supplements in a negative light, as this effects the sales of the product. </li></ul><ul><li>Results will usually be collected in such a way than only shows creative supplements in a positive way. Such as the wording of questionnaires, only asking a controlled group that have had positive effects from the supplement. </li></ul><ul><li>There could even be the possibility that research has been collected proving that the product does cause heart disease. This research will never be published due the effects the findings will have on the company financially. </li></ul><ul><li>Sports Clubs or Gyms </li></ul><ul><li>By advertising for individuals in sports clubs/gyms, there is a danger of bias due to self selection. </li></ul><ul><li>Activity clubs are also increasingly biased towards healthy individuals, less healthy people are probably more likely to develop heart failure. </li></ul>Bias Elements of Creatine Phosphate Supplements
  11. 11. Bias continued <ul><li>Activity clubs are also increasingly biased towards healthy individuals, less healthy people are probably more likely to develop heart failure. </li></ul><ul><li>Geographical area </li></ul><ul><li>Bias would occur if subjects were chosen from one particular geographical area. </li></ul><ul><li>Areas with greater incomes often have a better health status and this could therefore prejudice results. Compared to areas with lower income would financially not be able to afford the supplement classed as been a luxury item. </li></ul><ul><li>Supplement consumption </li></ul><ul><li>Bias can be created by the individuals themselves when taking the supplements, studies show that being observed can change habits. Including changing an individuals behaviour, attitude, emotional state, level of stress. Overall resulting in the participant changing the amount of phosphorus creatine supplements that they consume. </li></ul><ul><li>Many participants will wish to say what dosage of phosphate creatine they are consuming as they will not want to be seen in a negative light. </li></ul>
  12. 12. References <ul><li>Books; </li></ul><ul><li>ACSM, (2006), ACSM’s Guidelines For Exercise Testing and Prescription, 7 th edition, Lippincott Williams and Wilkins </li></ul><ul><li>Hall, G.M., Peyrebrune, M.C., Stokes, K. (2005), Effect of Creatine </li></ul><ul><li>Supplementation for Competition in Elite Swimmers, Medicine and Science in Sport and Exercise . 37 no.12, 2140-7. </li></ul><ul><li>Websites; </li></ul><ul><li>Absolute creatine (2007) http://www.absolute-creatine.com </li></ul><ul><li>Graph Pad (2007), Intuitive Biostatistics: Choosing a Statistical Test , http://www.graphpad.com/www/book/Choose.htm </li></ul>

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