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Creatine Supplementation
- 2. “Something from the supplement Cart?”
- 3. Objectives Introduction Rationale for Use Legal issues Mechanism of Action What does the research show
- 4. Introduction Greek Olympians ate mushrooms Romans ate Testicles Aztec ate human hearts
- 5. Introduction 1904 Olympic marathon runner used strychnine, brandy, and raw eggs during the race 1920 Olympic 100m runner drank sherry with raw egg pre-race 1956 synthetic steroid Dianabol 1960 Olympic Danish cyclist died from amphetamine abuse
- 6. Introduction 1987-90, 18 European cyclist die after rhepo is introduced 1992, female Chinese swimmers convicted of steroid use 2003 Steeplechaser champ + for epo 2008 US cyclist + for strychnine 2013 Lance Armstrong
- 7. Introduction $28 billion industry 50% US population takes a supplement 45-90% athletes take a supplement 70% of supplements violate rules
- 8. duction billion industry US population 0% athletes companies violate rules
- 9. Rationale Increases body weight, total body H2O May increase lean mass May increase strength and power Improve repeat high intensity exercise Improve ability to regenerate CP stores
- 10. Rationale How much control does the US Food and Drug Administration have? 1994 Dietary Supplement Health and Education Act shifted responsibility away from manufacturers Eliminated FDA regulation of herbal “food products”
- 11. 1994 Dietary Supplement Health and Education Act (DSHEA) Allow access to nutrition-based supplements FDA not responsible for purity or safety Responsible for taking action against UNSAFE dietary supplements after market Manufacturers responsible for safety and efficacy but do not have to provide evidence No approval or product registration required
- 12. 1994 Dietary Supplement Health and Education Act (DSHEA) FTC responsible for regulating advertising claims and labeling Can make health, nutrient, or structure/function claim but CANNOT make disease claim “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease”
- 13. 2006 Dietary Supplement & Non- Rx Drug Consumer Protection Act All nutritional supplements now subject to GMP Effective August 2007 (phased in through 2010) Controls for manufacturing, packaging, labeling, distribution and holding of nutritional supplements Maintain reviewable manufacturing record Test ingredients purchased from supplier Production & process controls Test finished product Report complaints & adverse events
- 14. 2006 Dietary Supplement & Non- Rx Drug Consumer Protection Act Informed Choice® National Sports Federation International® Ensure that specific supplements are free of any banned substances Do NOT determine efficacy
- 15. Rationale for Creatine Creatine reduces fatigue by creating more available ATP ATP is needed for muscles to function ATP is converted to ADP after muscle contraction More creatine means more frequent and longer workouts more lean muscle mass Lean muscle means increased performance
- 16. Mechanism Glycine, arginine, methionine 98% in muscle; combine with Pi = CP Muscle [creat] = 90-160 mmol/kg CP + ADP = creatine + ATP Removes cytosolic ATP which stimulates metabolism
- 17. Mechanism High intensity exercise uses ATP + CP ATP exhausted in 5 s CP exhausted in 5-15 s Muscle CP depletion limits maximal sprint effort performance Creatine monohydrate High intensity exercise uses ATP + CP ATP exhausted in 5 s CP exhausted in 5-15 s Muscle CP depletion limits maximal sprint effort performance
- 19. The proof Meta- analysis showing 16 controlled trials Increased weight lifted in men No change in women or persons >60 y/o Meta-analysis of 100 studies Increased in activity in repetitive 30 second bursts No improvement in running or swimming
- 21. The proof 5 gm/day of creatine for 4-7 days increases total muscle creatine 15-20% Creatine supplements can improve performance in short term repetitive sports No benefit on endurance capacity
- 22. The proof J Pediatr (Rio J). 2009 Jul-Aug;85(4):287- 94.doi:10.2223/JPED.1907. Epub 2009 Jul 7. Dietary supplement use by adolescents “unrestrained consumption of dietary supplements should be avoided”
- 23. The Proof J Int Soc Sports Nutr. 2013 Oct 9;10(1):44. doi: 10.1186/1550-2783-10-44. Effects of 8 weeks of Xpand® 2X pre workout supplementation on skeletal muscle hypertrophy, lean body mass, and strength in resistance trained males 20 resistance trained males randomly assigned Muscle thickness measured by ultrasound
- 24. Xpand Results
- 25. Xpand Results
- 26. The Bottom Line Adverse effects Short term (3-5 days) Weight gain from total body water Long term (310 days) limb edema a month 2 46% of oral creatine is removed in urine same day GNC $32 1kg = 161 servings Needs further research in renal failure
- 27. The Bottom Line Creatine studies fall short Do not quantify amount of gains with practical methods No cost analysis Is it clinically significant??
- 28. Sources Allen PJ. Creatine Metabolism and Psychiatric disorders: Does creatine supplementation have therapeutic value, Neurosci Biobehav Rev. 2012 May;36(5):1442-62. doi: 10.1016/j.neubiorev.2012.03.005. Epub 2012 Mar 24 Alves C, Lima RV. Dietary Supplement use by Adolescents. J Pediatr (Rio J). 2009 Jul-Aug;85(4):287-94. doi: doi:10.2223/JPED.1907. Epub 2009 Jul 7. Branch JD. Effect of creatine supplementation on body composition and performance: a meta-analysis. Int J Sport Nutr Exerc Metab. 2003;13(2):198- 226. Dempsey RL, Mazzone MF, Meurer LN. Does oral creatine supplementation improve strength? A meta- analysis. J Fam Pract. 2002;51(11):945-951. Jenkinson D., Harbert A. Supplements and Sports. American Family Physician 2008;78(9): 1039-1046 Lowery RP. Et. Al, Effects of 8 weeks of Xpand® 2X pre workout supplementation on skeletal muscle hypertrophy, lean body mass, and strength in resistance trained males. J Int Soc Sports Nutr. 2013 Oct 9;10(1):44. doi: 10.1186/1550-2783-10-44 Ziegenfuss TN, Lowery LM, Lemon PW. Acute fluid volume changes in men during three days of creatine supplementation. J Exerc Phys. 1998;1(3)