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Creatine: More than a Sports Nutrition Supplement
By Will Brink

Author of :

Brink's BodyBuilding Revealed

"Bodybuilding Revealed is a complete blue print to muscle building success.
Everything you need to know about diet & muscle building nutrition, over 50
bodybuilding supplements reviewed, weight training routines, high intensity cardio,
the mental edge, pre made muscle building diets and an online private members
forum, diet planner, meal planner and much more. It's all in Will Brink's ultimate
guide to gaining muscle mass."

Fat Loss Revealed

"Fat Loss Revealed is the ultimate fat loss manual. A complete online and offline
system used by anybody looking to attain a fantastic lean physique. A complete fat
loss diet plan, with pre made diets, over 40+ fat loss supplement reviews, resistance
workouts, and cardio , along with motivation and goal setting and a huge online
private members area and forum form Will Brink's Ultimate Fat loss Program.

"Creatine: More than a sports nutrition supplement"

Although creatine offers an array of benefits, most people think of it simply as a
supplement that bodybuilders and other athletes use to gain strength and muscle
mass. Nothing could be further from the truth.

A substantial body of research has found that creatine may have a wide variety of
uses. In fact, creatine is being studied as a supplement that may help with diseases
affecting the neuromuscular system, such as muscular dystrophy (MD). Recent
studies suggest creatine may have therapeutic applications in aging populations for
wasting syndromes, muscle atrophy, fatigue, gyrate atrophy, Parkinson's disease,
Huntington's disease and other brain pathologies. Several studies have shown
creatine can reduce cholesterol by up to 15% and it has been used to correct
certain inborn errors of metabolism, such as in people born without the enzyme(s)
responsible for making creatine. Some studies have found that creatine may
increase growth hormone production.

What is creatine?

Creatine is formed in the human body from the amino acids methionine, glycine and
arginine. The average person's body contains approximately 120 grams of creatine
stored as creatine phosphate. Certain foods such as beef, herring and salmon, are
fairly high in creatine. However, a person would have to eat pounds of these foods
daily to equal what can be obtained in one teaspoon of powdered creatine.

Creatine is directly related to adenosine triphosphate (ATP). ATP is formed in the
powerhouses of the cell, the mitochondria. ATP is often referred to as the "universal
energy molecule" used by every cell in our bodies. An increase in oxidative stress
coupled with a cell's inability to produce essential energy molecules such as ATP, is
a hallmark of the aging cell and is found in many disease states. Key factors in
maintaining health are the ability to: (a) prevent mitochondrial damage to DNA
caused by reactive oxygen species (ROS) and (b) prevent the decline in ATP
synthesis, which reduces whole body ATP levels. It would appear that maintaining
antioxidant status (in particular intra-cellular glutathione) and ATP levels are
essential in fighting the aging process.

It is interesting to note that many of the most promising anti-aging nutrients such as
CoQ10, NAD, acetyl-l-carnitine and lipoic acid are all taken to maintain the ability of
the mitochondria to produce high energy compounds such as ATP and reduce
oxidative stress. The ability of a cell to do work is directly related to its ATP status
and the health of the mitochondria. Heart tissue, neurons in the brain and other
highly active tissues are very sensitive to this system. Even small changes in ATP
can have profound effects on the tissues' ability to function properly. Of all the
nutritional supplements available to us currently, creatine appears to be the most
effective for maintaining or raising ATP levels.

How does creatine work?

In a nutshell, creatine works to help generate energy. When ATP loses a phosphate
molecule and becomes adenosine diphosphate (ADP), it must be converted back to
ATP to produce energy. Creatine is stored in the human body as creatine
phosphate (CP) also called phosphocreatine. When ATP is depleted, it can be
recharged by CP. That is, CP donates a phosphate molecule to the ADP, making it
ATP again. An increased pool of CP means faster and greater recharging of ATP,
which means more work can be performed. This is why creatine has been so
successful for athletes. For short-duration explosive sports, such as sprinting,
weight lifting and other anaerobic endeavors, ATP is the energy system used.

To date, research has shown that ingesting creatine can increase the total body
pool of CP which leads to greater generation of energy for anaerobic forms of
exercise, such as weight training and sprinting. Other effects of creatine may be
increases in protein synthesis and increased cell hydration.

Creatine has had spotty results in affecting performance in endurance sports such
as swimming, rowing and long distance running, with some studies showing no
positive effects on performance in endurance athletes. Whether or not the failure of
creatine to improve performance in endurance athletes was due to the nature of the
sport or the design of the studies is still being debated.

>Creatine can be found in the form of creatine monohydrate, creatine citrate,
creatine phosphate, creatine-magnesium chelate and even liquid versions.
However, the vast majority of research to date showing creatine to have positive
effects on pathologies, muscle mass and performance used the monohydrate form.
Creatine monohydrate is over 90% absorbable. What follows is a review of some of
the more interesting and promising research studies with creatine.

Creatine and neuromuscular diseases

One of the most promising areas of research with creatine is its effect on
neuromuscular diseases such as MD. One study looked at the safety and efficacy
of creatine monohydrate in various types of muscular dystrophies using a double
blind, crossover trial. Thirty-six patients (12 patients with facioscapulohumeral
dystrophy, 10 patients with Becker dystrophy, eight patients with Duchenne
dystrophy and six patients with sarcoglycan-deficient limb girdle muscular
dystrophy) were randomized to receive creatine or placebo for eight weeks. The
researchers found there was a "mild but significant improvement" in muscle strength
in all groups. The study also found a general improvement in the patients' daily-life
activities as demonstrated by improved scores in the Medical Research Council
scales and the Neuromuscular Symptom scale. Creatine was well tolerated
throughout the study period, according to the researchers.1

Another group of researchers fed creatine monohydrate to people with
neuromuscular disease at 10 grams per day for five days, then reduced the dose to
5 grams per day for five days. The first study used 81 people and was followed by a
single-blinded study of 21 people. In both studies, body weight, handgrip,
dorsiflexion and knee extensor strength were measured before and after treatment.
The researchers found "Creatine administration increased all measured indices in
both studies." Short-term creatine monohydrate increased high-intensity strength
significantly in patients with neuromuscular disease.2 There have also been many
clinical observations by physicians that creatine improves the strength, functionality
and symptomology of people with various diseases of the neuromuscular system.

Creatine and neurological protection/brain injury

If there is one place creatine really shines, it's in protecting the brain from various
forms of neurological injury and stress. A growing number of studies have found
that creatine can protect the brain from neurotoxic agents, certain forms of injury
and other insults. Several in vitro studies found that neurons exposed to either
glutamate or beta-amyloid (both highly toxic to neurons and involved in various
neurological diseases) were protected when exposed to creatine.3 The researchers
hypothesized that "… cells supplemented with the precursor creatine make more
phosphocreatine (PCr) and create larger energy reserves with consequent
neuroprotection against stressors."

More recent studies, in vitro and in vivo in animals, have found creatine to be highly
neuroprotective against other neurotoxic agents such as N-methyl-D-aspartate
(NMDA) and malonate.4 Another study found that feeding rats creatine helped
protect them against tetrahydropyridine (MPTP), which produces parkinsonism in
animals through impaired energy production. The results were impressive enough
for these researchers to conclude, "These results further implicate metabolic
dysfunction in MPTP neurotoxicity and suggest a novel therapeutic approach, which
may have applicability in Parkinson's disease."5 Other studies have found creatine
protected neurons from ischemic (low oxygen) damage as is often seen after
strokes or injuries.6

Yet more studies have found creatine may play a therapeutic and or protective role
in Huntington's disease7, 8 as well as ALS (amyotrophic lateral sclerosis).9 This
study found that "… oral administration of creatine produced a dose-dependent
improvement in motor performance and extended survival in G93A transgenic mice,
and it protected mice from loss of both motor neurons and substantia nigra neurons
at 120 days of age. Creatine administration protected G93A transgenic mice from
increases in biochemical indices of oxidative damage. Therefore, creatine
administration may be a new therapeutic strategy for ALS." Amazingly, this is only
the tip of the iceberg showing creatine may have therapeutic uses for a wide range
of neurological disease as well as injuries to the brain. One researcher who has
looked at the effects of creatine commented, "This food supplement may provide
clues to the mechanisms responsible for neuronal loss after traumatic brain injury
and may find use as a neuroprotective agent against acute and delayed
neurodegenerative processes."

Creatine and heart function

Because it is known that heart cells are dependent on adequate levels of ATP to
function properly, and that cardiac creatine levels are depressed in chronic heart
failure, researchers have looked at supplemental creatine to improve heart function
and overall symptomology in certain forms of heart disease. It is well known that
people suffering from chronic heart failure have limited endurance, strength and tire
easily, which greatly limits their ability to function in everyday life. Using a double
blind, placebo-controlled design, 17 patients aged 43 to 70 years with an ejection
fraction <40 were supplemented with 20 grams of creatine daily for 10 days. Before
and after creatine supplementation, the researchers looked at:

1) Ejection fraction of the heart (blood present in the ventricle at the end
of diastole and expelled during the contraction of the heart)
2) 1-legged knee extensor (which tests strength)
3) Exercise performance on the cycle ergometer (which tests endurance)

Biopsies were also taken from muscle to determine if there was an increase in
energy-producing compounds (i.e., creatine and creatine phosphate). Interestingly,
but not surprisingly, the ejection fraction at rest and during the exercise phase did
not increase. However, the biopsies revealed a considerable increase in tissue
levels of creatine and creatine phosphate in the patients getting the supplemental
creatine. More importantly, patients getting the creatine had increases in strength
and peak torque (21%, P < 0.05) and endurance (10%, P < 0.05). Both peak torque
and 1-legged performance increased linearly with increased skeletal muscle
phosphocreatine (P < 0.05). After just one week of creatine supplementation, the
researchers concluded: "Supplementation to patients with chronic heart failure did
not increase ejection fraction but increased skeletal muscle energy-rich
phosphagens and performance as regards both strength and endurance. This new
therapeutic approach merits further attention."10

Another study looked at the effects of creatine supplementation on endurance and
muscle metabolism in people with congestive heart failure.11 In particular the
researchers looked at levels of ammonia and lactate, two important indicators of
muscle performance under stress. Lactate and ammonia levels rise as intensity
increases during exercise and higher levels are associated with fatigue. High-level
athletes have lower levels of lactate and ammonia during a given exercise than non-
athletes, as the athletes' metabolism is better at dealing with these metabolites of
exertion, allowing them to perform better. This study found that patients with
congestive heart failure given 20 grams of creatine per day had greater strength
and endurance (measured as handgrip exercise at 25%, 50% and 75% of maximum
voluntary contraction or until exhaustion) and had lower levels of lactate and
ammonia than the placebo group. This shows that creatine supplementation in
chronic heart failure augments skeletal muscle endurance and attenuates the
abnormal skeletal muscle metabolic response to exercise.

It is important to note that the whole-body lack of essential high energy compounds
(e.g. ATP, creatine, creatine phosphate, etc.) in people with chronic congestive
heart failure is not a matter of simple malnutrition, but appears to be a metabolic
derangement in skeletal muscle and other tissues.12 Supplementing with high
energy precursors such as creatine monohydrate appears to be a highly effective,
low cost approach to helping these patients live more functional lives, and perhaps
extend their life spans.

Conclusion

Creatine is quickly becoming one of the most well researched and promising
supplements for a wide range of diseases. It may have additional uses for
pathologies where a lack of high energy compounds and general muscle weakness
exist, such as fibromyalgia. People with fibromyalgia have lower levels of creatine
phosphate and ATP levels compared to controls.13 Some studies also suggest it
helps with the strength and endurance of healthy but aging people as well. Though
additional research is needed, there is a substantial body of research showing
creatine is an effective and safe supplement for a wide range of pathologies and
may be the next big find in anti-aging nutrients. Although the doses used in some
studies were quite high, recent studies suggest lower doses are just as effective for
increasing the overall creatine phosphate pool in the body. Two to three grams per
day appears adequate for healthy people to increase their tissue levels of creatine
phosphate. People with the aforementioned pathologies may benefit from higher
intakes, in the 5-to-10 grams per day range.

About the Author - William D. Brink

Will Brink is a columnist, contributing consultant, and writer for various
health/fitness, medical, and bodybuilding publications.
His articles relating to
nutrition, supplements, weight loss, exercise and medicine can be found in
such publications as Lets Live, Muscle Media 2000, MuscleMag
International, The Life Extension Magazine, Muscle n Fitness, Inside
Karate, Exercise For Men Only, Body International, Power, Oxygen,
Penthouse, Women’s World and The Townsend Letter For Doctors.

He is the author of Priming The Anabolic Environment , Body Building Revealed &
Fat Loss Revealed. He is the Consulting Sports Nutrition Editor and a monthly
columnist for Physical magazine, Musclemag and an Editor at Large for Power
magazine. Will graduated from Harvard University with a concentration in the natural
sciences, and is a consultant to major supplement, dairy, and pharmaceutical
companies.

He has been co author of several studies relating to sports nutrition and health
found in peer reviewed academic journals, as well as having commentary published
in JAMA. He runs the highly popular web site BrinkZone.com which is strategically
positioned to fulfill the needs and interests of people with diverse backgrounds and
knowledge. The BrinkZone site has a following with many sports nutrition
enthusiasts, athletes, fitness professionals, scientists, medical doctors, nutritionists,
and interested lay people. William has been invited to lecture on the benefits of
weight training and nutrition at conventions and symposiums around the U.S. and
Canada, and has appeared on numerous radio and television programs.

William has worked with athletes ranging from professional bodybuilders, golfers,
fitness contestants, to police and military personnel.

See Will's ebooks online here:

Click Here For : Brink's BodyBuilding Revealed

"Bodybuilding Revealed is a complete blue print to muscle building success.
Everything you need to know about diet & muscle building nutrition, over 50
bodybuilding supplements reviewed, weight training routines, high intensity cardio,
the mental edge, pre made muscle building diets and an online private members
forum, diet planner, meal planner and much more. It's all in Will Brink's ultimate
guide to gaining muscle mass."

Click Here For : Fat Loss Revealed

"Fat Loss Revealed is the ultimate fat loss manual. A complete online and offline
system used by anybody looking to attain a fantastic lean physique. A complete fat
loss diet plan, with pre made diets, over 40+ fat loss supplement reviews, resistance
workouts, and cardio , along with motivation and goal setting and a huge online
private members area and forum form Will Brink's Ultimate Fat loss Program.