Renewed interest in the effects of creatine use by a large number of American athletes from the professional level on down has led to a number of studies, many of them producing conflicting findings.

Adding to this research-and producing more definitive information-will be proceedings from the American College of Sports Medicine’s scientific roundtable entitled “The Physiological and Health Effects of Oral Creatine Supplementation.

The complete manuscript includes references to reviews from hundreds of scientific studies. Twelve world-renowned specialists contributed, including experts from Belgium, Canada, Great Britain, the Netherlands and the United States.

Ronald Terjung, Ph.D., FACSM, roundtable chair, who is Professor of Biomedical Science in the College of Veterinary Science at the University of Missouri, authored the journal’s introductory comments, which include statements on such questions as: What is creatine, how is it metabolized in the body, and what is the impact of creatine supplementation? Does creatine supplementation improve energy during exercise? Does it increase skeletal muscle creatine concentrations?

Does it enhance exercise performance? Are all forms of creatine alike? Does the inclusion of other nutrients enhance the effects of creatine supplementation? Are there documented or potential side effects? Are there potential clinical uses for creatine supplementation?

Findings reveal that creatine ingestion enhances exercise performance involving short periods of extremely powerful activity (anaerobic) as well as strength gains during strength training programs. Creatine supplementation does not increase maximal isometric strength, the rate of maximal force production, nor aerobic exercise performance. A high dose of 20 grams per day, common to many research studies, is not necessary; three grams/day will achieve the same increase in phosphocreatine given time. Also noteworthy, creatine supplementation leads to weight gain within the first few days, likely due to water retention related to creatine uptake in the muscle. An important part of the statement noted that changes in muscle do not mimic adaptive changes, and cannot replace the necessity and value of training.

Much of the widespread use of creatine by professional athletes, elite sports competitors, collegiate athletes, amateur and recreational athletes, and hopeful teenage athletes has taken place without the benefit of understanding applicable research. Creatine supplementation is perceived as relatively safe, but there has been little real critical evaluation of its health implications.

The panel concurred that there is no definitive evidence that creatine supplementation causes gastrointestinal, renal, and/or muscle cramping complications. Creatine supplementation is not advised for use immediately prior to exercise, nor is it for the pediatric population or pregnant/lactating women. There is evidence to warrant clinical use of creatine supplementation in certain patients.

Further, the panel noted that questions remain about creatine supplementation in adolescent athletes, asking why it should be used when athletic skill, training and effort remain the most important qualities of true athletic competition.

Creatine, the Next Ergogenic Supplement?

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