Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance

Creatine monohydrate has become the supplement of choice for many athletes striving to improve sports performance. Recent data indicate that athletes may not be using creatine as a sports performance booster per se but instead use creatine chronically as a training aid to augment intense resistance training workouts. Although several studies have evaluated the combined effects of creatine supplementation and resistance training on muscle strength and weightlifting performance, these data have not been analyzed collectively. The purpose of this review is to evaluate the effects of creatine supplementation on muscle strength and weightlifting performance when ingested concomitant with resistance training. The effects of gender, interindividual variability, training status, and possible mechanisms of action are discussed. Of the 22 studies reviewed, the average increase in muscle strength (1, 3, or 10 repetition maximum [RM]) following creatine supplementation plus resistance training was 8% greater than the average increase in muscle strength following placebo ingestion during resistance training (20 vs. 12%). Similarly, the average increase in weightlifting performance (maximal repetitions at a given percent of maximal strength) following creatine supplementation plus resistance training was 14% greater than the average increase in weightlifting performance following placebo ingestion during resistance training (26 vs. 12%). The increase in bench press 1RM ranged from 3 to 45%, and the improvement in weightlifting performance in the bench press ranged from 16 to 43%. Thus there is substantial evidence to indicate that creatine supplementation during resistance training is more effective at increasing muscle strength and weightlifting performance than resistance training alone, although the response is highly variable.     

Comparison of creatine monohydrate and carbohydrate supplementation on repeated jump height performance

Creatine monohydrate (CrMH) supplementation aids the ability to maintain performance during repeated bouts of high-intensity exercise, including jump performance. However, carbohydrate supplementation may also provide similar benefits and is less expensive. This study compared the effects of an energy-free placebo, 2 different caloric concentrations of carbohydrate drinks, and a CrMH supplement on repeated jump heights. Sixty active males (mean age, 22 +/- 3.2 years) performed 2 sets of countermovement static jump height tests (10 jumps over 60 seconds) separated by 5 days to determine the differential effects of the placebo, carbohydrate, and CrMH on jump height sustainability over 10 jumps. Subjects were randomly assigned to groups (15 subjects per group) to receive daily doses (x5 days) of carbohydrate drinks containing 100 or 250 kilocalories (kcal), a 25-g CrMH supplement, or an energy-free placebo. After 5 days, the CrMH group experienced a significant weight gain (+1.52; +/-0.89 kg, p < 0.01), while the other groups did not. The 2 levels of carbohydrate and CrMH supplements were all significantly better at sustaining jump height than the energy-free placebo over the final 3-4 jumps. The 250-kcal carbohydrate-supplemented group experienced a level of benefit (p < 0.01) that was at least equal to that of the CrMH group (p < 0.05), suggesting that the higher dose of carbohydrate was as effective as CrMH in maintaining repeated bouts of high-intensity activity as measured by repeated static jumps. Given the equivalent performance improvement and the absence of weight gain, the carbohydrate supplementation could be considered the preferred option for weight-conscious power athletes involved in activities that require repeated- motion high-intensity activities.     

Effects of creatine supplementation on muscle wasting and glucose homeostasis in rats treated with dexamethasone

We aimed to investigate the possible role of creatine (CR) supplementation in counteracting dexamethasone-induced muscle wasting and insulin resistance in rats. Also, we examined whether CR intake would modulate molecular pathways involved in muscle remodeling and insulin signaling. Animals were randomly divided into four groups: (1) dexamethasone (DEX); (2) control pair-fed (CON-PF); (3) dexamethasone plus CR (DEX-CR); and (4) CR pair-fed (CR-PF). Dexamethasone (5 mg/kg/day) and CR (5 g/kg/day) were given via drinking water for 7 days. Plantaris and extensor digitorum longus (EDL) muscles were removed for analysis. Plantaris and EDL muscle mass were significantly reduced in the DEX-CR and DEX groups when compared with the CON-PF and CR-PF groups (P < 0.05). Dexamethasone significantly decreased phospho-Ser⁴⁷³-Akt protein levels compared to the CON-PF group (P < 0.05) and CR supplementation aggravated this response (P < 0.001). Serum glucose was significantly increased in the DEX group when compared with the CON-PF group (DEX 7.8 ± 0.6 vs. CON-PF 5.2 ± 0.5 mmol/l; P < 0.05). CR supplementation significantly exacerbated hyperglycemia in the dexamethasone-treated animals (DEX-CR 15.1 ± 2.4 mmol/l; P < 0.05 vs. others). Dexamethasone reduced GLUT-4 translocation when compared with the CON-PF and CR-PF (P < 0.05) groups and this response was aggravated by CR supplementation (P < 0.05 vs. others). In conclusion, supplementation with CR resulted in increased insulin resistance and did not attenuate muscle wasting in rats treated with dexamethasone. Given the contrast with the results of human studies that have shown benefits of CR supplementation on muscle atrophy and insulin sensitivity, we suggest caution when extrapolating this animal data to human subjects.     

Effects of creatine supplementation and three days of resistance training on muscle strength, power output, and neuromuscular function

Previous studies have demonstrated increases in peak torque (PT) and decreases in acceleration time (ACC) after only 2 days of resistance training, and other studies have reported improvements in isokinetic performance after 5 days of creatine supplementation. Consequently, there may be a combined benefit of creatine supplementation and short-term resistance training for eliciting rapid increases in muscle strength, which may be important for short-term rehabilitation and return-to-play for previously injured athletes. The purpose of this study, therefore, was to examine the effects of 3 days of isokinetic resistance training combined with 8 days of creatine monohydrate supplementation on PT, mean power output (MP), ACC, surface electromyography (EMG), and mechanomyography (MMG) of the vastus lateralis muscle during maximal concentric isokinetic leg extension muscle actions. Twenty-five men (mean age +/- SD = 21 +/- 3 years, stature = 177 +/- 6 cm, and body mass = 80 +/- 12 kg) volunteered to participate in this 9-day, double-blind, placebo-controlled study and were randomly assigned to either the creatine (CRE; n = 13) or placebo (PLA; n = 12) group. The CRE group ingested the treatment drink (280 kcal; 68 g carbohydrate; 10.5 g creatine), whereas the PLA group received an isocaloric placebo (70 g carbohydrate). Two servings per day (morning and afternoon) were administered in the laboratory on days 1-6, with only 1 serving on days 7-8. Before (pre; day 1) and after (post; day 9) the resistance training, maximal voluntary concentric isokinetic leg extensions at 30, 150, and 270 degrees x s(-1) were performed on a calibrated Biodex System 3 dynamometer. Three sets of 10 repetitions at 150 degrees x s(-1) were performed on days 3, 5, and 7. Peak torque increased (p = 0.005; eta(2) = 0.296), whereas ACC decreased (p < 0.001; eta(2) = 0.620), from pretraining to posttraining for both the CRE and PLA groups at each velocity (30, 150, and 270 degrees x s(-1)). Peak torque increased by 13% and 6%, whereas ACC decreased by 42% and 34% for the CRE and PLA groups, respectively, but these differences were not statistically significant (p > 0.05). There were no changes in MP, EMG, or MMG amplitude; however, EMG median frequency (MDF) increased, and MMG MDF increased at 30 degrees x s(-1), from pretraining to posttraining for both the CRE and PLA groups. These results indicated that 3 days of isokinetic resistance training was sufficient to elicit small, but significant, improvements in peak strength (PT) and ACC for both the CRE and PLA groups. Although the greater relative improvements in PT and ACC for the CRE group were not statistically significant, these findings may be useful for rehabilitation or strength and conditioning professionals who may need to rapidly increase the strength of a patient or athlete within 9 days.     

Effects of creatine supplementation on performance and training adaptations

Creatine has become a popular nutritional supplement among athletes. Recent research has also suggested that there may be a number of potential therapeutic uses of creatine. This paper reviews the available research that has examined the potential ergogenic value of creatine supplementation on exercise performance and training adaptations. Review of the literature indicates that over 500 research studies have evaluated the effects of creatine supplementation on muscle physiology and/or exercise capacity in healthy, trained, and various diseased populations. Short-term creatine supplementation (e.g. 20 g/day for 5–7 days) has typically been reported to increase total creatine content by 10–30% and phosphocreatine stores by 10–40%. Of the approximately 300 studies that have evaluated the potential ergogenic value of creatine supplementation, about 70% of these studies report statistically significant results while remaining studies generally report non-significant gains in performance. No study reports a statistically significant ergolytic effect. For example, short-term creatine supplementation has been reported to improve maximal power/strength (5–15%), work performed during sets of maximal effort muscle contractions (5–15%), single-effort sprint performance (1–5%), and work performed during repetitive sprint performance (5–15%). Moreover, creatine supplementation during training has been reported to promote significantly greater gains in strength, fat free mass, and performance primarily of high intensity exercise tasks. Although not all studies report significant results, the preponderance of scientific evidence indicates that creatine supplementation appears to be a generally effective nutritional ergogenic aid for a variety of exercise tasks in a number of athletic and clinical populations.     

Effects of zinc deficiency and supplementation on plasma leptin levels in rats

The effects of zinc deficiency and supplementation on plasma leptin levels were studied in Sprague-Dawley rats. After 6 wk on a zinc-deficient diet containing 0.65 ppm Zn/g, the mean body weight was significantly lower than that of normal or zinc-supplemented rats, which showed no difference among them. The plasma leptin and zinc levels were lowest in zinc-deficient animals and highest in those that received a normal diet and daily intraperitioneal injections of 3 mg Zn/kg. These results indicate that zinc deficiency leads to a significant inhibition in plasma leptin levels, whereas zinc supplementation significantly increases plasma leptin.     

Effect of a defined lacto-ovo-vegetarian diet and oral creatine monohydrate supplementation on plasma creatine concentration

This study examined the effects that preceding creatine supplementation with a lacto-ovo-vegetarian diet would have on plasma creatine concentration. Twenty-six healthy moderately fit omnivorous men were assigned to either a 26-day lacto-ovo-vegetarian (LOV; n = 12) or omnivorous (Omni; n = 14) diet. On day 22, subjects were also assigned in a double-blind manner either creatine monohydrate (CM; 0.3 g.kg(-1).day(-1) + 20 g Polycose) or an equivalent dose of placebo (PL) for 5 days. Blood samples were taken on days 1, 22 and 27. Consuming a LOV diet for 21 days was effective in reducing plasma creatine concentration (p < 0.01) in the LOV group. Regardless of diet, the CM group showed an increase in plasma creatine concentrations from day 22 to 27, whereas the PL group's levels remained the same (p < 0.05). Although the LOV diet caused a deprivation effect in plasma creatine concentration relative to the Omni diet, concurrent supplementation with creatine resulted in no difference in plasma creatine concentrations between the LOV and Omni diet groups. Dietary advice should be provided to LOV athletes that supplementation with creatine may help to increase their muscle stores of creatine, and thus their ATP resynthesis capabilities, to levels similar to those of omnivores.     

The effect of creatine supplementation on mass and performance of rat skeletal muscle

This study investigated the effect of dietary creatine supplementation on hypertrophy and performance of rat skeletal muscle. Male Sprague-Dawley rats underwent either tibialis anterior ablation or partial ablation of the plantaris/gastrocnemius to induce compensatory hypertrophy of the extensor digitorum longus (EDL) or soleus respectively, or sham surgery. Creatine (300 mg/kg) was administered to one half of each group for 5 weeks, after which force production was measured. With the leg fixed at the knee and ankle, the distal tendon of the EDL or soleus was attached to a force transducer and the muscle was electrically stimulated via the sciatic nerve. Synergist ablation resulted in a significant increase in EDL mass and in soleus mass relative to control muscles. However, no effect of creatine supplementation on muscle mass or performance was found between control and either group of creatine-treated rats. Despite an apparent increase in muscle creatine content, creatine supplementation did not augment muscle hypertrophy or force production in rat EDL or soleus muscle, providing evidence that the potential benefits of creatine supplementation are not due to a direct effect on muscle but rather to an enhanced ability to train.     

The effect of creatine supplementation on glucose uptake in rat skeletal muscle

Glucose transport in muscle is a function of the muscle metabolic state, as evidenced by the increase in glucose transport which occurs with conditions of altered aerobic metabolism such as hypoxia or contractile activity. The energy state of the muscle can be determined by the muscle phosphocreatine concentration. Dietary supplementation of creatine has been shown to increase both phosphocreatine (PCr) and creatine (TCr) levels in muscle, although not in the same proportion, so that the PCr/TCr ratio falls suggesting an altered energy state in the cell. The purpose of this study was to determine the effect of increased creatine content on glucose uptake in muscle. PCr and TCr were determined in plantaris muscles from rats following five weeks of dietary supplementation of creatine monohydrate (300 mg/kg/day). (3)H-2-deoxyglucose uptake was measured in epitrochlearis muscles incubated in the presence or absence of a maximally stimulating dose of insulin. Despite a significant increase in creatine content in muscle, neither basal nor insulin-stimulated glucose uptake was altered in creatine supplemented rats. Since PCr levels were not increased with creatine supplementation, these results suggest that the actual concentration of PCr is a more important determinant of glucose uptake than the PCr/TCr ratio.     

Effects of ribose supplementation on repeated sprint performance in men

This study used a randomized, placebo-controlled, crossover design to evaluate the effects of oral ribose supplementation on short-term anaerobic performance. After familiarization, subjects performed 2 bouts of repeated cycle sprint exercise (six 10-second sprints with 60-second rest periods between sprints) in a single day. After the second exercise, bout subjects ingested 32 g of ribose or cellulose (4 x 8-g doses) during the next 36 hours. After supplementation, subjects returned to the laboratory to perform a single bout of cycle sprinting (as described above). After a 5-day washout period, subjects repeated the protocol, receiving the opposite supplement treatment. Ribose supplementation lead to statistically significant increases in mean power and peak power in sprint 2 (10.9 and 6.6%, respectively) and higher (although not significant) absolute values in sprints 1, 3, and 4. In conclusion, ribose supplementation did not show reproducible increases in performance across all 6 sprints. Therefore, within the framework of this investigation, it appears that ribose supplementation does not have a consistent or substantial effect on anaerobic cycle sprinting.     

Effects of resistance exercise on plasma, erythrocyte, and urine Zn

Twelve healthy male volunteers performed two resistance exercise sessions: a moderate resistance (MR) exercise session and a heavy resistance (HR) exercise session. Blood was collected before exercise and 5 min, 30 min, and 24 h after exercise. Urine was collected for 24 h before and 24 h after exercise. Plasma zinc (Zn) was markedly increased both 5 min and 30 min after MR and HR exercise and was returned to control values the next day. Total blood cell (TBC) Zn was decreased 5 min after MR and HR exercise but was not significantly different than control values at 30 min or 24 h. The changes in plasma and TBC Zn after HR exercise were significantly greater than changes after MR exercise. The results of this study are the first to report changes in Zn after resistance exercise. These data agree with previous studies reporting increases in plasma Zn and decreases in erythrocyte Zn after strenuous running, treadmill, or cycle ergometry exercise; however, the magnitude of the changes reported in this study are considerable greater that changes reported these previous studies. These data support suggestions that increases in plasma Zn levels are the result of leakage from the muscles resulting from muscle damage. The opinions or assertions contained herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense.     

Effects of creatine supplementation on the performance and body composition of competitive swimmers

The objective of this study was to determine the effect of creatine supplementation on performance and body composition of swimmers. Eighteen swimmers were evaluated in terms of post-performance lactate accumulation, body composition, creatine and creatinine excretion, and serum creatinine concentrations before and after creatine or placebo supplementation. No significant differences were observed in the marks obtained in swimming tests after supplementation, although lactate concentrations were higher in placebo group during this period. In the creatine-supplemented group, urinary creatine, creatinine, and body mass, lean mass and body water were significantly increased, but no significant difference in muscle or bone mass was observed. These results suggest that creatine supplementation cannot be considered to be an ergogenic supplement ensuring improved performance and muscle mass gain in swimmers.     

Effect of different frequencies of creatine supplementation on muscle size and strength in young adults

The purpose was to determine if creatine supplementation, consumed immediately before and immediately after exercise, with different dosing frequency (i.e., 2 or 3 d wk) could enhance the gains in muscle size and strength from resistance training (RT) in young adults. A group of 38 physically active, nonresistance trained university students (21-28 years) was randomly allocated to 1 of 4 groups: CR2 (0.15 g·kg creatine during 2 d wk of RT; 3 sets of 10 repetitions; n = 11, 6 men, 5 women), CR3 (0.10 g·kg creatine during 3 d wk of RT; 2 sets of 10 repetitions; n = 11, 6 men, 5 women;), PLA2 (placebo during 2 d wk of RT; n = 8, 5 men, 3 women), and PLA3 (placebo during 3 d wk of RT; n = 8, 4 men, 4 women) for 6 weeks. Before and after training, measurements were taken for muscle thickness of the elbow and knee flexor and extensor muscle groups (ultrasound), 1-repetition maximumleg press and chest press strength, and kidney function (urinary microalbumin). Repeated-measures analysis of variance showed that strength and muscle thickness increased in all groups with training (p < 0.05). The CR2 (0.6 ± 0.9 cm or 20%; p < 0.05) and CR3 groups (0.4 ± 0.6 cm or 16.4%; p < 0.05) experienced greater change in muscle thickness of the elbow flexors compared to the PLA2 (0.05 ± 0.5 cm or 2.3%) and PLA3 groups (0.13 ± 0.7 cm or 6.3%). Men supplementing with creatine experienced a greater increase in leg press strength (77.3 ± 51.2 kg or 62%) compared to women on creatine (21.3 ± 10 kg or 34%, p < 0.05). We conclude that creatine supplementation during RT has a small beneficial effect on regional muscle thickness in young adults but that giving the creatine over 3 d wk did not differ from giving the same dose over 2 d wk.     

Effects of acrylamide on creatine kinase from rabbit muscle

The mechanism of inhibition of creatine kinase (CK) by acrylamide (Acr) has been examined (in vitro). Within the concentration range of 0 to 1 M, Acr markedly inhibited CK and depleted the protein thiols. Both inactivation and thiol depletion were time- and Acr concentration-dependent. Addition of dithiothreitol (DTT) did not reactivate CK inactivated by Acr. However, CK with 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB) pre-blocked thiols can be reactivated by DTT after incubation with Acr. The transition-state analogue also had a significant protective effect on CK against Acr inhibition. We conclude that thiol alkylation is a critical event in inactivation of CK by Acr. Furthermore, Acr binding to CK changed its surface charge, which may be the same effect for the toxicity of Acr towards other proteins.     

Effects of effervescent creatine, ribose, and glutamine supplementation on muscular strength, muscular endurance, and body composition

The purpose of this study was to examine the effects of a combination of effervescent creatine, ribose, and glutamine on muscular strength (MS), muscular endurance (ME) and body composition (BC) in resistance-trained men. Subjects were 28 men (age: 22.3 +/- 1.7 years; weight: 85.8 +/- 12.1 kg; height: 1.8 +/- 0.1 m) who had 2 or more years of resistance-training experience. A double blind, randomized trial was completed involving supplementation or placebo control and a progressive resistance-training program for 8 weeks. Dependent measures were assessed at baseline and after 8 weeks of resistance training. Both groups significantly improved MS and ME while the supplement group significantly increased body weight and fat-free mass. Control decreased body fat and increased fat-free mass. This study demonstrated that the supplement group did not enhance MS, ME, or BC significantly more than control after an 8-week resistance-training program.     

Effect of creatine supplementation during high resistance training on mass,strength, and fatigue resistance in rat skeletal muscle

The aim of this study was to utilize a rodent model of resistance exercise to compare training with creatine supplementation with training alone. We tested the hypothesis that creatine supplementation during high resistance training would result in greater increases in muscle mass, contractile force, and superior resistance to fatigue compared with training alone. Two groups of rats underwent training of the tibialis anterior muscle (TA) for 4 weeks without creatine (NCr group) or with creatine (0.5 g.kg(-1).d(-1)) (CrT group). The relative loads in each animal were held constant during the training protocol. Training resulted in comparable significant increases in muscle contractile force in both the NCr and CrT groups. Creatine supplementation did not result in a significant increase in fatigue resistance and resulted in a significant decrease in postfatigue recovery compared with training alone. Training resulted in a significant increase in muscle dry weight in both groups, whereas muscle wet weight gains in the CrT group were double the gains in the NCr group. The data from this study suggest that for creatine to have a beneficial effect on muscle strength and mass beyond training alone, the workloads need to be adjusted. That is, any potential benefit of creatine to enable a greater lifting volume during resistance training needs to be incorporated into the training regime for creatine to be effective.     

Studies on the safety of creatine supplementation

Doubtful allegations of adverse effects of creatine supplementation have been released through the press media and through scientific publications. In the present review we have tried to separate the wheat from the chaff by looking for the experimental evidence of any such claims. Anecdotal reports from athletes have appeared on muscle cramp and gastrointestinal complaints during creatine supplementation, but the incidence of these is limited and not necessarily linked to creatine itself. Despite several unproved allegations, liver (enzymes, urea) and kidneys (glomerular filtration urea and albumin excretion rates) show no change in functionality in healthy subjects supplemented with creatine, even during several months, in both young and older populations. The potential effects (production of heterocyclic amines) of mutagenicity and carcinogenicity induced by creatine supplementation have been claimed by a French Sanitary Agency (AFSSA), which might put consumers at risk. Even if there is a slight increase (within the normal range) of urinary methylamine and formaldehyde excretion after a heavy load of creatine (20 g/day) this is without effect on kidney function. The search for the excretion of heterocyclic amines remains a future task to definitively exclude the unproved allegation made by some national agencies. We advise that high-dose (>3–5 g/day) creatine supplementation should not be used by individuals with pre-existing renal disease or those with a potential risk for renal dysfunction (diabetes, hypertension, reduced glomerular filtration rate). A pre-supplementation investigation of kidney function might be considered for reasons of safety, but in normal healthy subjects appears unnecessary.