Creatine is among the most well-researched and most popular nutritional supplements for exercise and athletic performance, but recent research suggests there’s much more to it for the general population, and could be beneficial as a daily health supplement for everyone.
Its impact on physical performance and muscle strength has been rigorously studied since the early 20th century, but it wasn’t until the 1990s that it became widely available to consumers as a nutritional supplement. Since then it has been marketed to bodybuilders and athletes seeking muscle gains and optimal physical performance.
However, reports Daily Maverick, more and more researchers are exploring its role outside athletic performance and bodybuilding, and recommending that it might be beneficial as a regular daily supplement to support general health, fitness and well-being.
What is creatine?
In a 2017 study, published by the Journal of the International Society of Sports Nutrition, creatine is described as a naturally occurring non-protein amino acid compound found primarily in red meat and seafood, with the majority of the body’s creatine, about 95%, found in skeletal muscle, and small amounts also found in the brain and testes.
“Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations, can improve exercise performance, and/or improve training adaptations. … creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation and concussion and/or spinal cord neuroprotection,” wrote the study’s authors.
While there are six main types of creatine, with slight differences informed by what other elements it is bonded to, the most well-researched and most ubiquitous is creatine monohydrate – made by bonding creatine to a water molecule. It is also the focus of this article.
Benefits of creatine supplementation
A study published in January 2021 sought to review and assess about 1 322 previously published papers on creatine. Quoting some of the peer-reviewed scientific literature, the authors said creatine supplementation has been found to lead to 10% to 20% performance improvement in various high-intensity exercise tasks, including fitness activities like weight training, golf, volleyball, soccer, softball, ice hockey, running and swimming. These benefits also span age groups from children to the elderly.
These findings and others have led researchers, over the past two decades, to study creatine use beyond the field of athletics. The above-mentioned paper’s authors write: “In this regard, creatine supplementation has been reported to help lower cholesterol, triglycerides and/or manage blood lipid levels; reduce the accumulation of fat on the liver; decrease homocysteine thereby reducing risk of heart disease; serve as an antioxidant; enhance glycaemic control; reduce the progress of some forms of cancer; increase strength and muscle mass; minimise bone loss in some studies; improve functional capacity in osteoarthritic and fibromyalgia patients; enhance cognitive function particularly in older populations; and, in some instances, improve the efficacy of some antidepressant medications.”
Based on their assessment of these findings, they concur that not only can creatine supplementation increase cellular energy availability and support general health, fitness and well-being throughout the lifespan, as well as promote gains in strength and help maintain or increase muscle mass in older individuals, but it might also support cognitive function during the ageing process. Additionally, it “may” support mental health, reproductive health and skin health, among other benefits.
To supplement or not to supplement
On average, the human body requires about two grams of creatine a day, half of which is synthesised in the liver and kidneys, and the rest from an omnivorous diet including various animal-based foods – from human breast milk and infant formulas to meat, poultry and fish, according to yet another 2021 study published in August, just seven months after the aforementioned study.
However, looking specifically at surveyed creatine intake among the US population, there was lower-than-expected dietary intake, with some as low as 50% of the recommended amount. As a possible explanation, the authors suggest this reduction in intake might also be related to a reduction in meat consumption, especially red meat.
They write: “Interestingly, preliminary evidence shows a strong relationship between creatine intake and health risks or growth indicators at the populational level. For instance, depression prevalence was 42% higher among US adults in the lowest quartile of dietary creatine consumption (0-0.26 g/day) compared to participants in the highest quartile of creatine intake (0.70-3.16 g/day). After controlling for demographic and lifestyle variables, the risk of screening positive for depression remained 31% lower among adults in the highest, compared to the lowest quartile of creatine consumption.”
After controlling for demographic and nutritional variables, the researchers also found that the shortage of dietary creatine was linked to an increased risk of medical conditions in men and women aged 65 , with elderly people who consume less than a gram of creatine a day having 2.62 times higher risk of angina pectoris, a form of chest pain related to coronary artery disease, and 2.59 times higher risk of liver conditions, compared with older counterparts who consumed more that one gram of creatine daily.
On potential side-effects of consuming or over-consuming creatine, they highlight studies showing that creatine “poses no adverse health risks in healthy people and clinical populations across various life stages and conditions, at dosages ranging from 0.03 to 0.8g per kilogram of body weight per day for up to five years”. While some studies have shown an initial weight gain of 1% to 2% of body mass, this was dependent on dosage.
In conclusion, the researchers write: “After over 100 years of scientific research about creatine, the time has come to perhaps reconsider this simple yet salient dietary compound as more than just another fancy supplement.
“The evidence shows that an inadequate intake of creatine from food could not be fully compensated by internal synthesis, suggesting creatine is an indispensable amino acid derivative for humans… Still, creatine has a long road ahead on the way to general acceptance as a food additive.
“Hopefully, this journey should start beyond sports science and clinical medicine, by encouraging public health authorities to think about creatine as a critical component of the balanced low-meat diet of the 21st century.”
Study 1 details
Creatine in Health and Disease
Richard Kreider and Jeffery Stout
Published in Nutrients on 29 January 2022
Abstract
Although creatine has been mostly studied as an ergogenic aid for exercise, training, and sport, several health and potential therapeutic benefits have been reported. This is because creatine plays a critical role in cellular metabolism, particularly during metabolically stressed states, and limitations in the ability to transport and/or store creatine can impair metabolism. Moreover, increasing availability of creatine in tissue may enhance cellular metabolism and thereby lessen the severity of injury and/or disease conditions, particularly when oxygen availability is compromised. This systematic review assesses the peer-reviewed scientific and medical evidence related to creatine’s role in promoting general health as we age and how creatine supplementation has been used as a nutritional strategy to help individuals recover from injury and/or manage chronic disease. Additionally, it provides reasonable conclusions about the role of creatine on health and disease based on current scientific evidence. Based on this analysis, it can be concluded that creatine supplementation has several health and therapeutic benefits throughout the lifespan.
Study 2 details
Creatine as a food supplement for the general population
Sergej M.Ostojic
Published in Journal of Functional Foods on 21 August 2021
Highlights
• Creatine is non-proteinogenic amino acid available from various animal-based foods.
• Lower-than-expected dietary creatine intake is accompanied by various health risks.
• General public may benefit from creatine to prevent and manage health conditions.
• Supplementation could be sound strategy to supply enough creatine in food systems.
Abstract
Creatine is a non-proteinogenic amino acid available from various animal-based foods or synthesised endogenously in the human body. A number of recent population-based studies demonstrate a lower-than-expected dietary creatine intake across age- and gender-specific cohorts, with low creatine consumption accompanied by various health risks. Those studies suggest that the general public may benefit from creatine to prevent and manage various health conditions or to ensure advanced growth. Favourable safety and promising impact of supplemental creatine on human well-being and functioning emanated from plenty of small-sampled interventional studies perhaps suggest a need for recommending creatine to the general public. In this opinion paper, I have outlined the possible rationales for endorsing supplemental creatine ubiquitously, and discussed opportunities and challenges for population-wide creatine use.
Journal of Functional Foods article – Creatine as a food supplement for the general population (Creative Commons Licence)
Nutrients article – Creatine in Health and Disease (Creative Commons Licence)
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