creatine supplementation & roles beyond athletic performance€¦ · not recommended to take if...

Creatine Supplementation & Roles

Beyond Athletic PerformanceMekayla MacPherson

UWGB Spring Research Conference 2020

Outline

What is creatine?

Sources of creatine

Safety

Possible benefits

Research articles

RD’s role

What is Creatine?

Chemical found in the body stored in muscles

Source of energy for muscles and brain

Made into a supplement

Helps with enhancing athletic performance

Natural Food Sources

Beef, pork, veal, lamb, organ meats, poultry

0.11 grams/oz

Tuna, cod, salmon

0.16 grams/oz

Bratwurst, lunch meats, sausage

0.06 grams/oz

Average daily adult creatine consumption

Men: 1.0 grams/day

Women: 0.70 grams/day

Most studied supplement in the world

According to International Society of Sports Nutrition:

Safe both short and long term

Bloating from water retention

No evidence that it can cause:

GI upset

Dehydration

Musculoskeletal injuries

Renal dysfunction

Not recommended to take if have kidney disease

Is Creatine Safe?

Possible Benefits Of Creatine

Supplementation

Improving athletic performance

Increasing muscle strength in

people with heart failure,

muscular dystrophy, McArdle’s

disease

Treating Parkinson’s disease and

Gyrate Atrophy

Rheumatoid arthritis

Lou Gehrig’s Disease (ALS)

Cognitive development

Depression and bipolar disorder

Creatine & The

Brain

Brain creatine is responsive to

supplementation

Neuron activity puts high energy

demand on brain

Creatine needed for ATP

enhancement

More creatine in the brain means

better cognitive performance

Creatine & Cognitive Performance

Reduction in mental fatigue

Demanding mental activity

Sleep deprivation

Traumatic Brain Injury

Mental fatigue from exercise

Improve working memory

Those with lower animal protein

intake

Vegan/vegetarians

Elderly individuals

Depression

Adjunctive treatment

Study 1:

Oral Creatine Monohydrate

Supplementation Improves Brain

Performance: A Double-Blind, Placebo-

Controlled, Cross-Over Trail

Authors: Caroline Rae, Alison L. Digney, Sally R. McEwan, Timothy C. Bates

Journal: The Royal Society

Location: The University of Sydney, Sydney Australia

Citation: Rae, C., Digney, A. L., McEwan, S. R., & Bates, T. C. (2003). Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial. Proceedings. Biological sciences, 270(1529), 2147–2150. https://doi.org/10.1098/rspb.2003.2492

Study 1: Research Purpose

To determine whether creatine

supplementation can have a beneficial effect

on mental performance if the creatine

reservoir in the brain were increased in those

with the lowest creatine levels, such as

vegetarians.

Study 1: Participants

45 Participants

20-40 years old, male median 27 years, female 25 years

Inclusion:

Vegan/vegetarians

Student at the university

Exclusion

Medical history of drug/alcohol abuse

Diagnosed psychiatric disorders

Diabetes

Renal insufficiency

Study 1: Design

Randomly assigned to intervention or control group for 18

weeks

Must take the full dose of supplement at the same time

daily

Intervention Group:

n = 23

5 grams creatine monohydrate

Control Group:

n = 22

5 grams maltodextrin

Study 1: Measurements

Primary Outcomes

Working memory

RAPMs & Wechsler Auditory BDS cognitive tests

Secondary Outcomes

Creatine levels of RBCs

Study 1: Results

No subjects violated fasting

Compliance for taking supplement

Creatine: 91% compliant

Placebo: 97% compliant

RBC creatine levels p < 0.001

Creatine supplementation increased intelligence

p < 0.001

Placebo

p = .21 (RAPMs)

p = 0.40 (BDS)

Study 1: Results

Study 1: Conclusions

Increasing creatine intake by oral

supplementation resulted in improved brain

function, reduced mental fatigue, and

correlates positively with recognition

memory

Study 1: Analysis

Positive score based on EAL worksheet!

Strengths

Randomized, double blind design

Ample time to take supplements

No attrition

Applicable outside research setting

Limitations

No record of current supplements/medications

No biases or study limitations discussed

Study 2:

Can Creatine Combat the Mental

Fatigue – Associated Decrease in

Visuomotor Skills?

Authors: Jeroen Van Cutsem, Bart Roelands, Bert Pluym, Bruno Tassignon, Jo

Verschueren, Kevin De Pauw, Romain Meeusen

Location: Vrije University Brussels, Brussels, Belgium

Citation: Cutsem, J. V., Roelands, B., Pluym, B., Tassignon, B., Verschueren, J., Pauw, K. D., & Meeusen, R. (2020). Can Creatine

Combat the Mental Fatigue–associated Decrease in Visuomotor Skills? Medicine & Science in Sports & Exercise, 52(1), 120–130. doi:

10.1249/mss.0000000000002122


To determine if creatine supplementation can

counteract mental fatigue impartment in

sport-specific visuomotor skills regarding

mental control and movement.


16 initial participants; 14 final participants

10 males, 4 females; 21- 27 years old

Inclusion:

Not Color-blind

No known mental disorder

Low to moderate activity level

Exclusion

High activity

Taking any medications/supplements

Study 2: Design

Randomly assigned to groups for 7 weeks

20 tablets/day (1 g CR/tablet) at hours 8, 12, 16, 20

Not to change eating or sleep patterns

Intervention Group:

n = 7

20 grams creatine monohydrate

Control Group:

n = 7

20 grams calcium lactate (placebo)


Primary Outcomes

Cognition & visuomotor performance

(Visuomotor: The ability to take in visual information

along with physical movement)

Secondary Outcomes

Strength endurance

Study 2: Timeline & Flow Chart

Handgrip Task

Strength endurance

Stroop Task

Cognitive fatigue

Flanker Task

Psychomotor performance

Visuomotor Task

Psychomotor performance

Study 2: Results Flanker Task

Accuracy increased after the mentally fatiguing task in both CR and

PLAC

p > 0.05

Handgrip Task

Dominant hand: strength did not differ in Cr and PLAC

Nondominant hand: higher in CR group

p < 0.05

Visuomotor Task

CR and PLAC was impaired after Stoop task

p > 0.05

Stroop Task


Creatine supplementation improved physical

(endurance) and prolonged cognitive (Stroop)

performance

However, it did not affect short - visuomotor

performance

Study 2: Analysis


Strengths


Analyzed starting cognitive levels

No attrition through the study


Limitations

Short study period

No record of typical diet

Not indicated if subjects were compliant with supplements

No study limitations discussed

Study 3:

Cognitive Effects of Creatine Ethyl

Ester Supplementation

Authors: Jonathan Ling, Minos Kritikos, Braian Tiplady

Location: Sunderland, United Kingdom

Journal: Behavioural Pharmacology

Citation: Ling, J., Kritikos, M., & Tiplady, B. (2009). Cognitive effects of creatine ethyl ester supplementation. Behavioural

Pharmacology, 20(8), 673–679. doi: 10.1097/fbp.0b013e3283323c2a


To assess if creatine ethyl ester improves

performance in five different cognitive tasks

that measure spatial ability, memory recall,

response inhibition, and reaction time.


18-24 years old; 22 males,12 females

34 initial participants; 28 final participants

Exclusion

Vegetarian

Diagnosed psychiatric disorders

Diabetes or renal insufficiency

Recently/currently supplementing creatine

Study 3: Design

Randomly assigned to groups for 15 days

Double-blind, crossover design

Intervention Group:

n = 14

5 grams creatine ethyl ester

Control Group:

n = 14

5 grams maltodextrin (placebo)


Primary Outcomes

Basic cognitive performance

Memory recall

Spatial ability

Secondary Outcomes

Reaction time

Study 3: Timeline & Flow Chart

5 Computer Based Tests:

Memory Scanning Test

Number-Pair Matching

Task

Sustained Attention Task

Arrow Flanker Task

IQ Task

First day

Baseline for all tasks

Given supplements

2-week supplementation

Day 15

Second testing phase

Study 3: Results

Baseline Measure Dependent Variable Significant Value

Memory Scanning Stimulus Number in Set 0.873

Reaction Time 0.320

Number-Pair

Matching

Reaction Time 0.309

Sustained Attention Reaction Time of Correct

Responses

0.030*

Arrow Flankers Overall number of False

Alarms

0.052

Overall Reaction Time 0.678

IQ IQ Score 0.005**

*Performance of CR group better at baselines than PLAC

**Performance of CR group worse at baseline than PLAC

Study 3: ResultsSecond Phase:

Measure

Dependent

Variable

Significant Value

CR

Significant Value

PLAC

Memory Scanning Stimulus Number in Set P < 0.01 P > 0.01

Reaction Time P < 0.01 P > 0.01

Number-Pair

Matching

Reaction Time P < 0.01 P > 0.01

Correct Responses P < 0.01 P > 0.01

Sustained Attention Reaction Time of

Correct Responses

P < 0.01 P > 0.01

Number Correct P > 0.01 P > 0.01

Arrow Flankers Overall number of False

Alarms

P < 0.05 P > 0.05

Overall Reaction Time P < 0.01 P > 0.01

IQ IQ Score P < 0.01 P > 0.01

Significant effects after supplementation P <0.05, P <0.01


Cognitive ability improved by oral creatine

ethyl ester supplementation

Increase in IQ, attention span, and working

memory were the most significant

Study 3: Analysis


Strengths


Crossover Design

Participants compliant

Limitations were addressed


Limitations

Short study period

No record of typical diet/food diary

Attrition rate

RD Role

Give appropriate information to patient on potential benefits

and safety

RD’s scope of practice & importance of supplements

Eat a balanced diet rich in protein sources

Advise against supplementation for patients with kidney disease

Supplement 2 – 5 gm/day

Drink sufficient water

Conclusion

Promising yet very preliminary evidence for

cognitive benefits

Most beneficial for a high demanding cognitive

task

More research is needed

Do your own research!

References

Bakian, A.V., Huber, R.S., Scholl, L. et al. Dietary creatine intake and depression risk among U.S. adults. Transl Psychiatry 10, 52 (2020). https://doi.org/10.1038/s41398-020-0741-x

Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14, 18. https://doi.org/10.1186/s12970-017-0173-z

Busch, S., & Thompson, C. (2019, October 21). The Amount of Creatine in Meat. Retrieved from https://www.livestrong.com/article/524782-the-amount-of-creatine-in-meat/

Creatine. (n.d.). Retrieved from https://www.excelahealth.org/health-library/article?chunkid=21706&db=hlt#ref42

Creatine. (2017, October 12). Retrieved from https://www.mayoclinic.org/drugs-supplements-creatine/art-20347591

Creatine: Uses, Side Effects & Warnings. (n.d.). Retrieved from https://www.drugs.com/creatine.html

Cutsem, J. V., Roelands, B., Pluym, B., Tassignon, B., Verschueren, J., Pauw, K. D., & Meeusen, R. (2020). Can Creatine Combat the Mental Fatigue–associated Decrease in Visuomotor Skills? Medicine & Science in Sports & Exercise, 52(1), 120–130. doi: 10.1249/mss.0000000000002122

Examine.com. (2020, March 2). Creatine - Health Benefits, Dosage, Side Effects. Retrieved from https://examine.com/supplements/creatine/

Kendall.lou.schmidt.fanpage. (2018, November 2). This Is Your Brain On Creatine. Retrieved from https://www.bodybuilding.com/fun/this-is-your-brain-on-creatine.html

Ling, J., Kritikos, M., & Tiplady, B. (2009). Cognitive effects of creatine ethyl ester supplementation. Behavioural Pharmacology, 20(8), 673–679. doi: 10.1097/fbp.0b013e3283323c2a

Rae, C., Digney, A. L., McEwan, S. R., & Bates, T. C. (2003). Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial. Proceedings. Biological sciences, 270(1529), 2147–2150. https://doi.org/10.1098/rspb.2003.2492

https://doi.org/10.1038/s41398-020-0741-x

creatine supplementation & roles beyond athletic performance€¦ · not recommended to take if...

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