Creatine as a supplement has many benefits to the body not only to the muscular system, but also to the well-being.
The following benefits of creatine supplementation to power output are all evidence based:
- Decreases exercise-induced muscle damage leading to increased performance and power output.
- Increases muscle creatine content and muscle strength improving power output.
- Increases muscle thickness improving power output.
- Helps patients of certain diseases to maintain the best well-being and to lead a productive life. Patients of neurological diseases such as Parkinson disease can benefit from creatine in improving their muscular complains. Patients of osteoarthritis can have benefits in improving their movement and decreasing joint stiffness. Patients of respiratory diseases can benefit from creatine in improving their well-being and quality of life, but not in improving their respiratory complains which are pathophysiologically unrelated to creatine deficiency.
- Some people with special needs, such as vegetarians who have limited dietary creatine intake and friable postmenopausal women who are at a great risk to develop osteoporosis and life-threatening fractures, can also benefit from creatine supplementation.
Studies confirming benefits of creatine for power output
- A study was done in 2011 to investigate the effects of an acute bout of resistance exercise on oxidative stress response and oxidative DNA damage in male athletes. Resistance-trained males were divided into two groups: the first were supplemented with creatine, and the second took placebo for 7 days. They performed resistance exercises before and after the 7 days which consisted of 7 sets of 4 exercises. Blood and urine samples were taken before, immediately, and 24-hour after exercise for plasma malondialdehyde (MDA) and urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) excretion. Creatine supplementation induces a significant increase in athletics performance and attenuates the changes observed in the urinary 8-OHdG excretion and plasma MDA. This study indicates that creatine supplementation reduced oxidative DNA damage and lipid peroxidation induced by a single bout of resistance exercise.1
- A Study was performed in 2011 on elite male volleyball players with proficient jumping skills. The supplemented group took creatine monohydrate for 4 weeks. Subjects performed 1 RM spike jump test followed by the repeated block jump test pre- and postsupplementation. Creatine supplementation improved repeated block jump performance.2
- A study designed in 2012 to discover the ergogenic and physiological effects of 10 days of creatine supplementation. Muscle strength, muscle power and muscle creatine content were all assessed after the 10 days. The study found that the supplemented group had more muscle creatine than the placebo group. Similarly, bench press average power was significantly greater for the supplemented group. Also, the supplemented group showed significant pre- to post-test increase in 1-RM squat and bench press.3
- To determine if creatine supplementation has any benefits for muscle size and strength from resistance training, a study was made in 2011 for six weeks on physically active non-resistance trained young men and women (21-28 years). Before and after training, muscle thickness of the elbow and knee flexor and extensor muscle groups was measured with ultrasound. Strength and muscle thickness increased in all groups with training; however, the supplemented group showed more significant increase. In addition, men supplemented with creatine experienced a greater increase in leg press strength compared to women on creatine.4
- The role of creatine in improving physical function in osteoarthritis (OA) patients is supported by a 2011 study performed on postmenopausal women with knee OA for 12 weeks. They were divided into a creatine supplemented group and a placebo group. They were assessed by their physical functions (measured by the timed-stands test), lean mass, quality of life, pain, stiffness, and muscle strength before and after the 12 weeks. physical function significantly improved only in the supplemented group. Furthermore, the supplemented group showed improvements in physical function and stiffness. They also showed a significant improvement in lower limb lean mass as well as in the quality of life.5
- Acute caffeine ingestion after creatine supplementation augments intermittent high-intensity sprint performance as determined by a 2011 study. Physically active men were divided into two groups, the first group administered creatine for 5 days then placebo and the second group administered creatine for five days + caffeine. After 5 days, they performed a repeated sprint test. Mean power, peak power, rating of perceived exertion, and heart rates were all measured during the test. Blood samples for lactate, glucose, and catecholamine concentrations were drawn at specified intervals. The mean and peak power observed in the (creatine + caffeine) group were significantly higher than those found in the (creatine + placebo) group. Heart rates, plasma lactate, and glucose increased significantly in the first group during most sprints. acute ingestion of caffeine further improves power output.6
- A study done in 2010 investigated the role of creatine supplementation in improving cellular energetics and muscle strength in ambulatory Duchenne muscular dystrophy patients. 18 patients received creatine monohydrate for 8 weeks while 15 patients received placebo. Before and after the trial period, phosphorus metabolite ratios were determined from the right calf muscle of patients by phosphorus magnetic resonance spectroscopy. Analysis showed that mean phosphocreatine /inorganic phosphate ratio in patients treated with creatine was significantly higher compared to the placebo group. The mean percentage increase in phosphocreatine /inorganic phosphate ratio was also more in patients <7 years of age compared to older patients after creatine supplementation indicating variation in therapeutic effect with the age. Besides these improvements, parents reported subjective improvement on the supplemented group versus worsening in the placebo group. These results indicate that creatine supplementation significantly improves the muscle phosphocreatine /inorganic phosphate ratio and preserves the muscle strength in short term.7
- In 2009, a study was done to determine the role of short-term creatine supplementation on muscle contractile properties. The study was done on moderately trained men (25.2 ± 5.1 years) for 5 days. Isometric maximal voluntary contraction, maximal twitch, force-velocity relationship, and dynamic fatiguing contractions were assessed in the elbow flexors. Mechanical and EMG signals were recorded and analyzed. Peak torque of maximal twitch was higher and the time to reach it was less in the supplemented group than the placebo group. Mean fiber conduction velocity was higher in the supplemented group. This study shows that creatine supplementation improves neuromuscular function.8
- Creatine supplementation improves muscular performance in older women (58-71 years old) as shown by a 2008 study. The study investigated the effects of creatine supplementation on body composition, muscular strength and lower-body motor functional performance in older women. They performed three test sessions each separated by one week. Each session consisted of one repetition maximum tests for bench press and leg press, and isometric hand-grip, tandem gait, upper-body ergometer, and lower-body ergometer tests. After the 2nd session, they were divided into a creatine supplemented group and a placebo group. After 7 days, bench press, leg press, body mass and fat free mass all increased and completion time on the functional tandem gait tests decreased in the supplemented group. No significant changes were found for the placebo group on any of the measured variables.9
- Patients of Parkinson disease can benefit from creatine supplementation to improve their muscle strength, increase muscle mass and resist fatigability as demonstrated by a 2007 study. Patients with Parkinson disease were divided into 2 groups: the first administered creatine supplementation, and the second administered placebo for 5 days. Both groups participated in progressive resistance training. Analysis showed that the supplemented group had more muscular strength than the placebo group. Creatine supplementation can enhance the benefits of resistance training in patients with Parkinson disease.10
- Creatine supplementation has no or little effects on females as demonstrated by a 2004 study. Subjects randomly assigned to creatine (six males, five females) and placebo (five males, five females) performed single-limb training with one side of the body two times per week and with the opposite limbs two times per week. Creatine was administered after training of one side of the body and placebo after training the other side. Subjects on placebo always administered placebo after exercise. Elbow flexors and knee extensors muscle thickness, lean tissue mass, fat, and bone mass, and single-limb bench and leg press one-repetition maximum (1-RM) were assessed before and after 6 weeks. elbow flexors muscle thickness increased within the supplemented group, more in the limbs trained on days creatine was administered compared to limbs trained on days placebo was administered. Creatine supplementation after training of the arms resulted in greater increase in muscle thickness of the arms. Males have a greater increase in lean tissue mass than females.11
Creatine supplementation benefits patients with respiratory diseases in improving patient’s well-being and muscle strength; however, their disease does not benefit from supplementation as demonstrated by the results of 2 studies:
- A 2003 study was done on cystic fibrosis patients. 18 patients received creatine supplementation for 12 weeks, and they were monitored during 24-36 weeks. After creatine supplementation, there was no change in lung function and sweat electrolyte concentrations. However, the patients consistently showed significantly increased maximal isometric muscle strength, as well as improved general well-being (assessed by a standardized questionnaire).12
- Another study was done in 2005 on chronic obstructive pulmonary disease patients. They were randomized either to receive creatine supplementation or placebo for 2 weeks. Their pulmonary function and exercise performance were assessed before and after the 2 weeks. Peripheral muscle performance improved. Creatine improved health status between baseline and post rehabilitation. Creatine supplementation leads to increasing peripheral muscle strength and endurance and improving the general well-being status.13
Creatine Monohydrate and Vegetarians
Subjects with initially low levels of muscular creatine such as vegetarians are more responsive to supplementation as concluded by a study done in 2003 on vegetarian subjects (19-55 years) randomized either to placebo or creatine supplementation groups. Before and at the end of the study, muscle biopsies were taken from the vastus lateralis muscle, body composition was assessed by DXA, and strength was assessed using 1-RM bench press and leg press. All these parameters were higher in the supplemented group than the placebo group.14
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