Creatine Supplementation & Roles Beyond Athletic Performance€¦ · Not recommended to take if...
Transcript of 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
Study 2: Research Purpose
To determine if creatine supplementation can
counteract mental fatigue impartment in
sport-specific visuomotor skills regarding
mental control and movement.
Study 2: Participants
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)
Study 2: Measurements
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
Study 2: Conclusions
Creatine supplementation improved physical
(endurance) and prolonged cognitive (Stroop)
performance
However, it did not affect short - visuomotor
performance
Study 2: Analysis
Positive score based on EAL worksheet!
Strengths
Randomized, double blind design
Analyzed starting cognitive levels
No attrition through the study
Applicable outside research setting
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
Study 3: Research Purpose
To assess if creatine ethyl ester improves
performance in five different cognitive tasks
that measure spatial ability, memory recall,
response inhibition, and reaction time.
Study 3: Participants
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)
Study 3: Measurements
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
Study 3: Conclusions
Cognitive ability improved by oral creatine
ethyl ester supplementation
Increase in IQ, attention span, and working
memory were the most significant
Study 3: Analysis
Positive score based on EAL worksheet!
Strengths
Randomized, double blind design
Crossover Design
Participants compliant
Limitations were addressed
Applicable outside research setting
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