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Hua Y, Huang W, Wang F, Jing Z, Li J, Wang Q, Zhao Y. Metabolites, gene expression, and gut microbiota profiles suggest the putative mechanisms via which dietary creatine increases the serum taurine and g-ABA contents in Megalobrama amblycephala. FISH PHYSIOLOGY AND BIOCHEMISTRY 2023; 49:253-274. [PMID: 36897433 DOI: 10.1007/s10695-023-01177-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/01/2023] [Indexed: 05/04/2023]
Abstract
A 90-day experiment was conducted to explore the effects of creatine on growth performance, liver health status, metabolites, and gut microbiota in Megalobrama amblycephala. There were 6 treatments as follows: control (CD, 29.41% carbohydrates), high carbohydrate (HCD, 38.14% carbohydrates), betaine (BET, 1.2% betaine + 39.76% carbohydrates), creatine 1 (CRE1, 0.5% creatine + 1.2% betaine + 39.29% carbohydrates), creatine 2 (CRE2, 1% creatine + 1.2% betaine + 39.50% carbohydrates), and creatine 3 (CRE3, 2% creatine + 1.2% betaine + 39.44% carbohydrates). The results showed that supplementing creatine and betaine together reduced the feed conversion ratio significantly (P < 0.05, compared to CD and HCD) and improved liver health (compared to HCD). Compared with the BET group, dietary creatine significantly increased the abundances of Firmicutes, Bacteroidota, ZOR0006, and Bacteroides and decreased the abundances of Proteobacteria, Fusobacteriota, Vibrio, Crenobacter, and Shewanella in the CRE1 group. Dietary creatine increased the content of taurine, arginine, ornithine, γ-aminobutyric acid (g-ABA), and creatine (CRE1 vs. BET group) and the expression of creatine kinase (ck), sulfinoalanine decarboxylase (csad), guanidinoacetate N-methyltransferase (gamt), glycine amidinotransferase (gatm), agmatinase (agmat), diamine oxidase1 (aoc1), and glutamate decarboxylase (gad) in the CRE1 group. Overall, these results suggested that dietary supplementation of creatine (0.5-2%) did not affect the growth performance, but it altered the gut microbial composition at the phylum and genus levels, which might be beneficial to the gut health of M. amblycephala; dietary creatine also increased the serum content of taurine by enhancing the expressions of ck and csad and increased the serum content of g-ABA by enhancing the arginine content and the expressions of gatm, agmat, gad, and aoc1.
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Affiliation(s)
- Yizhuo Hua
- College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
- Key Lab of Freshwater Animal Breeding, Ministry of Agriculture, Wuhan, 430070, China
- Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Wuhan, 430070, China
| | - Wangwang Huang
- College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
- Key Lab of Freshwater Animal Breeding, Ministry of Agriculture, Wuhan, 430070, China
- Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Wuhan, 430070, China
| | - Fan Wang
- College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
- Key Lab of Freshwater Animal Breeding, Ministry of Agriculture, Wuhan, 430070, China
- Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Wuhan, 430070, China
| | - Zhao Jing
- College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
- Key Lab of Freshwater Animal Breeding, Ministry of Agriculture, Wuhan, 430070, China
- Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Wuhan, 430070, China
| | - Juntao Li
- Institute of Tropical Bioscience and Biotechnology, Haikou, 570102, China
| | - Qingchao Wang
- College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
- Key Lab of Freshwater Animal Breeding, Ministry of Agriculture, Wuhan, 430070, China
- Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Wuhan, 430070, China
| | - Yuhua Zhao
- College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China.
- Key Lab of Freshwater Animal Breeding, Ministry of Agriculture, Wuhan, 430070, China.
- Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China.
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Wuhan, 430070, China.
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Rosan Fortunato Seixas F, Kempfer Bassoli B, Borghi Virgolin L, Chancare Garcia L, Soares Janzantti N. Physicochemical Properties and Effects of Fruit Pulps from the Amazon Biome on Physiological Parameters in Rats. Nutrients 2021; 13:nu13051484. [PMID: 33924791 PMCID: PMC8146226 DOI: 10.3390/nu13051484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 01/04/2023] Open
Abstract
This study aimed to analyze the physicochemical characteristics and the effects of Amazonian pulp fruits consumption, such as araçá-boi (Eugenia stipitata), abiu grande (Pouteria caimito), araticum (Annona crassiflora), biri-biri (Averrhoa bilimbi L.), and yellow mangosteen (Garcinia xanthochymus), on hematologic, metabolic, renal, and hepatic function parameters in Wistar rats (n = 10 rats/group). The pulp of abiu had the highest levels of soluble solids, sugars, and pH. Biri-biri pulp had the highest levels of ascorbic acid and total titratable acidity, and a low pH. The araticum pulp had higher (p ≤ 0.05) ash content, total phenolic compounds, and antioxidant activity than the pulp of other analyzed fruits. No significant increase in hematocrit, nor reduction of blood glucose, plasma cholesterol, and serum levels of glutamic-pyruvic transaminase (TGP), creatinine, and urea was observed in experimental groups relative to the control group of rats after the consumption of fruits pulp. The intake of abiu and araticum pulps promoted a significant reduction (p ≤ 0.05) in total leukocytes of the experimental groups as compared to the control group and only the intake of araticum significantly increased (p ≤ 0.05) triglyceride blood levels in rats (99.50 mg/dL). The regular consumption of biri-biri pulp for 30 days significantly (p ≤ 0.05) increased serum glutamic-oxaloacetic transaminase (TGO) levels in rats (116.83 U/L) compared to the control group (98.00 U/L). More researches are needed to generate knowledge about these promising Amazonian fruits, supporting the native fruit production, in addition to promoting health in the population and sustainability in the Amazon region.
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Affiliation(s)
- Fernanda Rosan Fortunato Seixas
- Department of Health Science, Federal University of Grande Dourados, Highway Dourados/Itahum, Km 12—Unit II, 79804-970 Dourados, Brazil;
- Department of Engineering and Food Technology, São Paulo State University, R. Cristóvão Colombo, 2265—Jardim Nazareth, 15054-000 São José do Rio Preto, Brazil; (L.B.V.); (N.S.J.)
- Correspondence: ; Tel.: +55-(69)-981351440
| | - Bruna Kempfer Bassoli
- Medical School, Federal University of Roraima, Avenida Capitão Ene Garcês, n° 2413—Aeroporto, 69310-000 Boa Vista, Brazil;
| | - Lara Borghi Virgolin
- Department of Engineering and Food Technology, São Paulo State University, R. Cristóvão Colombo, 2265—Jardim Nazareth, 15054-000 São José do Rio Preto, Brazil; (L.B.V.); (N.S.J.)
| | - Laís Chancare Garcia
- Department of Health Science, Federal University of Grande Dourados, Highway Dourados/Itahum, Km 12—Unit II, 79804-970 Dourados, Brazil;
| | - Natália Soares Janzantti
- Department of Engineering and Food Technology, São Paulo State University, R. Cristóvão Colombo, 2265—Jardim Nazareth, 15054-000 São José do Rio Preto, Brazil; (L.B.V.); (N.S.J.)
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Forbes SC, Candow DG, Ferreira LHB, Souza-Junior TP. Effects of Creatine Supplementation on Properties of Muscle, Bone, and Brain Function in Older Adults: A Narrative Review. J Diet Suppl 2021; 19:318-335. [PMID: 33502271 DOI: 10.1080/19390211.2021.1877232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Aging is associated with reductions in muscle and bone mass and brain function, which may be counteracted by several lifestyle factors, of which exercise appears to be most beneficial. However, less than 20% of older adults (> 55 years of age) adhere to performing the recommended amount of resistance training (≥ 2 days/week) and less than 12% regularly meet the aerobic exercise guidelines (≥ 150 min/week of moderate to vigorous intensity aerobic exercise) required to achieve significant health benefits. Therefore, from a healthy aging and clinical perspective, it is important to determine whether other lifestyle interventions (independent of exercise) can have beneficial effects on aging muscle quality and quantity, bone strength, and brain function. Creatine, a nitrogen containing organic compound found in all cells of the body, has the potential to have favorable effects on muscle, bone, and brain health (independent of exercise) in older adults. The purpose of this narrative review is to examine and summarize the small body of research investigating the effects of creatine supplementation alone on measures of muscle mass and performance, bone mineral and strength, and indices of brain health in older adults.
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Affiliation(s)
- Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Luis H B Ferreira
- Research Group on Metabolism, Nutrition and Strength Training, Federal University of Paraná, Curitiba, PR, Brazil
| | - Tacito P Souza-Junior
- Research Group on Metabolism, Nutrition and Strength Training, Federal University of Paraná, Curitiba, PR, Brazil
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Omeragic E, Marjanovic A, Djedjibegovic J, Turalic A, Dedic M, Niksic H, Lugusic A, Sober M. Prevalence of use of permitted pharmacological substances for recovery among athletes. PHARMACIA 2021. [DOI: 10.3897/pharmacia.68.e54581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives: Food supplements and medicines which are not on the list of prohibited substances of the World Anti-Doping Agency are included in the group of permitted pharmacological agents for athlete’s recovery.
The aim of this study was to describe qualitatively and quantitatively food supplements (FS) and over-the-counter drugs use among athletes in the last six month.
Methods: This was a cross sectional study. Data on food supplements and the over-the-counter drugs, usage were collected during 2018 by self-administered, anonymous questionnaire.
Results: A total of 112 athletes completed the survey. A total of 51.8% (n = 58) athletes reported the use of food supplements. The use of medical supplements was reported by 50.0% (n = 56) of athletes, 26.8% (n = 30) reported using ergogenic supplements, 1.8% (n = 2) using of sports food and 4.5% (n = 5) using other supplements. The use of over-the-counter drugs was reported by 35.7% (n = 40) of athletes. The over-the-counter analgesic drugs were used by 95% (n = 38) of over-the-counter drug users. Concomitant administration two or more over-the-counter drugs was reported by 40% (n = 16) athletes. Doctors and coaches had no advisory role in the use of food supplements or over-the-counter drugs.
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Barcelos I, Shadiack E, Ganetzky RD, Falk MJ. Mitochondrial medicine therapies: rationale, evidence, and dosing guidelines. Curr Opin Pediatr 2020; 32:707-718. [PMID: 33105273 PMCID: PMC7774245 DOI: 10.1097/mop.0000000000000954] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Primary mitochondrial disease is a highly heterogeneous but collectively common inherited metabolic disorder, affecting at least one in 4300 individuals. Therapeutic management of mitochondrial disease typically involves empiric prescription of enzymatic cofactors, antioxidants, and amino acid and other nutrient supplements, based on biochemical reasoning, historical experience, and consensus expert opinion. As the field continues to rapidly advance, we review here the preclinical and clinical evidence, and specific dosing guidelines, for common mitochondrial medicine therapies to guide practitioners in their prescribing practices. RECENT FINDINGS Since publication of Mitochondrial Medicine Society guidelines for mitochondrial medicine therapies management in 2009, data has emerged to support consideration for using additional therapeutic agents and discontinuation of several previously used agents. Preclinical animal modeling data have indicated a lack of efficacy for vitamin C as an antioxidant for primary mitochondrial disease, but provided strong evidence for vitamin E and N-acetylcysteine. Clinical data have suggested L-carnitine may accelerate atherosclerotic disease. Long-term follow up on L-arginine use as prophylaxis against or acute treatment for metabolic strokes has provided more data supporting its clinical use in individuals with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome and Leigh syndrome. Further, several precision therapies have been developed for specific molecular causes and/or shared clinical phenotypes of primary mitochondrial disease. SUMMARY We provide a comprehensive update on mitochondrial medicine therapies based on current evidence and our single-center clinical experience to support or refute their use, and provide detailed dosing guidelines, for the clinical management of mitochondrial disease. The overarching goal of empiric mitochondrial medicines is to utilize therapies with favorable benefit-to-risk profiles that may stabilize and enhance residual metabolic function to improve cellular resiliency and slow clinical disease progression and/or prevent acute decompensation.
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Affiliation(s)
- Isabella Barcelos
- Center for Applied Genomics, Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Edward Shadiack
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Rebecca D. Ganetzky
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Marni J. Falk
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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de Guingand DL, Palmer KR, Snow RJ, Davies-Tuck ML, Ellery SJ. Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E1780. [PMID: 32549301 PMCID: PMC7353222 DOI: 10.3390/nu12061780] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022] Open
Abstract
Creatine Monohydrate (CrM) is a dietary supplement routinely used as an ergogenic aid for sport and training, and as a potential therapeutic aid to augment different disease processes. Despite its increased use in recent years, studies reporting potential adverse outcomes of CrM have been mostly derived from male or mixed sex populations. A systematic search was conducted, which included female participants on CrM, where adverse outcomes were reported, with meta-analysis performed where appropriate. Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%). Twenty-nine studies monitored for adverse outcomes, with 951 participants. There were no deaths or serious adverse outcomes reported. There were no significant differences in total adverse events, (risk ratio (RR) 1.24 (95% CI 0.51, 2.98)), gastrointestinal events, (RR 1.09 (95% CI 0.53, 2.24)), or weight gain, (mean difference (MD) 1.24 kg pre-intervention, (95% CI -0.34, 2.82)) to 1.37 kg post-intervention (95% CI -0.50, 3.23)), in CrM supplemented females, when stratified by dosing regimen and subject to meta-analysis. No statistically significant difference was reported in measures of renal or hepatic function. In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females. Nor does the use of creatine supplementation increase the risk of total adverse outcomes, weight gain or renal and hepatic complications in females. However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.
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Affiliation(s)
- Deborah L. de Guingand
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (M.L.D.-T.); (S.J.E.)
| | - Kirsten R. Palmer
- Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia;
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | - Rodney J. Snow
- Institute of Physical Activity and Nutrition, Deakin University, Melbourne 3125, Australia;
| | - Miranda L. Davies-Tuck
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (M.L.D.-T.); (S.J.E.)
| | - Stacey J. Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (M.L.D.-T.); (S.J.E.)
- Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia;
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Effect of creatine ethyl ester supplementation and resistance training on hormonal changes, body composition and muscle strength in underweight non-athlete men. BIOMEDICAL HUMAN KINETICS 2019. [DOI: 10.2478/bhk-2019-0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Study aim: The aim of this study to determine whether creatine ethyl ester (CEE) supplementation combined with resistance training (RT) is effective for improving hormonal changes, body composition and muscle strength in underweight non-athlete men.
Materials and methods: Sixteen underweight non-athlete men participated in this double-blind study and were randomly assigned to one of two groups: RT with placebo (RT + PL, n = 8) and RT with CEE supplementation (RT + CEE, n = 8). The participants performed 6 weeks of RT (60–80% 1RM) combined with CEE or PL. 48 hours before and after the training period, muscle strength (1RM for leg press and bench press), body composition (percentage of body fat, circumference measurements of the arm and thigh), serum levels of testosterone, cortisol, and growth hormone (GH) of the participant were measurements.
Results: Significant increases were observed for weight, muscle strength and muscle mass, serum levels of testosterone and GH between pre and post-test in the RT + CEE group (p < 0.05). In addition, cortisol level was significantly decreased in the post-test in the RT+CEE group. The decrease in fat percent was greater in the RT + PL group than in the RT + CEE group (%change = –6.78 vs. –0.76, respectively). Weight and leg strength changes in the RT + CEE group were significant compared to the RT + PL group (p < 0.001, p = 0.05, p = 0.001; respectively). However, in other variables, despite the increase of GH and testosterone levels and lower levels of cortisol in the RT + CEE group, no significant differences were observed between the two groups (p < 0.05).
Conclusion: It seems that the consumption of CEE combined with RT can have significant effects on body weight and leg strength in underweight non-athlete men. This supplement may provide a potential nutritional intervention to promote body weight in underweight men.
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Dolan E, Swinton PA, Painelli VDS, Stephens Hemingway B, Mazzolani B, Infante Smaira F, Saunders B, Artioli GG, Gualano B. A Systematic Risk Assessment and Meta-Analysis on the Use of Oral β-Alanine Supplementation. Adv Nutr 2019; 10:452-463. [PMID: 30980076 PMCID: PMC6520041 DOI: 10.1093/advances/nmy115] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/02/2018] [Accepted: 11/16/2018] [Indexed: 01/04/2023] Open
Abstract
β-Alanine supplementation is one of the world's most commonly used sports supplements, and its use as a nutritional strategy in other populations is ever-increasing, due to evidence of pleiotropic ergogenic and therapeutic benefits. Despite its widespread use, there is only limited understanding of potential adverse effects. To address this, a systematic risk assessment and meta-analysis was undertaken. Four databases were searched using keywords and Medical Subject Headings. All human and animal studies that investigated an isolated, oral, β-alanine supplementation strategy were included. Data were extracted according to 5 main outcomes, including 1) side effects reported during longitudinal trials, 2) side effects reported during acute trials, 3) effect of supplementation on circulating health-related biomarkers, 4) effect of supplementation on skeletal muscle taurine and histidine concentration, and 5) outcomes from animal trials. Quality of evidence for outcomes was ascertained using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework, and all quantitative data were meta-analyzed using multilevel models grounded in Bayesian principles. In total, 101 human and 50 animal studies were included. Paraesthesia was the only reported side effect and had an estimated OR of 8.9 [95% credible interval (CrI): 2.2, 32.6] with supplementation relative to placebo. Participants in active treatment groups experienced similar dropout rates to those receiving the placebo treatment. β-Alanine supplementation caused a small increase in circulating alanine aminotransferase concentration (effect size, ES: 0.274, CrI: 0.04, 0.527), although mean data remained well within clinical reference ranges. Meta-analysis of human data showed no main effect of β-alanine supplementation on skeletal muscle taurine (ES: 0.156; 95% CrI: -0.38, 0.72) or histidine (ES: -0.15; 95% CrI: -0.64, 0.33) concentration. A main effect of β-alanine supplementation on taurine concentration was reported for murine models, but only when the daily dose was ≥3% β-alanine in drinking water. The results of this review indicate that β-alanine supplementation within the doses used in the available research designs, does not adversely affect those consuming it.
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Affiliation(s)
- Eimear Dolan
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Paul A Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Vitor de Salles Painelli
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Bruna Mazzolani
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Bryan Saunders
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Guilherme G Artioli
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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An Open-Label Pilot Study of Combined Augmentation With Creatine Monohydrate and 5-Hydroxytryptophan for Selective Serotonin Reuptake Inhibitor- or Serotonin-Norepinephrine Reuptake Inhibitor-Resistant Depression in Adult Women. J Clin Psychopharmacol 2017; 37:578-583. [PMID: 28787372 PMCID: PMC5578880 DOI: 10.1097/jcp.0000000000000754] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Many women with major depressive disorder (MDD) respond inadequately to standard treatments. Augmentation of conventional antidepressants with creatine monohydrate and 5-hydroxytryptophan (5-HTP) could correct deficits in serotonin production and brain bioenergetics associated with depression in women, yielding synergistic benefit. We describe an open-label study of 5-HTP and creatine augmentation in women with MDD who had failed selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) monotherapy. METHODS Fifteen women who were adequately adherent to an SSRI or SNRI and currently experiencing MDD, with a 17-item Hamilton Depression Rating Scale (HAM-D) score of 16 or higher, were treated with 5 g of creatine monohydrate daily and 100 mg of 5-HTP twice daily for 8 weeks, with 4 weeks of posttreatment follow-up. The primary outcome was change in mean HAM-D scores. RESULTS Mean HAM-D scores declined from 18.9 (SD, 2.5) at pretreatment visits to 7.5 (SD, 4.4) (P < 0.00001), a decrease of 60%. Participants did not experience any serious treatment-related adverse events. CONCLUSIONS Combination treatment with creatine and 5-HTP may represent an effective augmentation strategy for women with SSRI- or SNRI-resistant depression. Given the limitations of this small, open-label trial, future study in randomized, placebo-controlled trials is warranted.
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Abstract
The approach to rehabilitation of upper extremity injuries in athletes differs from traditional rehabilitation protocols. In general, athletes have higher functional demands and wish to return to competitive sport in a timely manner. Comprehensive rehabilitation must therefore be balanced with a timely and safe return to sport. Several rehabilitation programs and adjunctive therapies are available to hasten convalescence while minimizing the athlete's risks of reinjury. Here, we review techniques for soft tissue mobilization and strength training in athletic populations. We also discuss orthotics, taping, and alternative therapies used in rehabilitation and evaluate the evidence in support of these modalities.
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Affiliation(s)
- Michael S Gart
- Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, 675 North St Clair Street, Suite 19-250, Galter Pavilion, Chicago, IL 60611, USA.
| | - Thomas A Wiedrich
- Department of Orthopedic Surgery, Chicago Center for Surgery of the Hand, Northwestern University Feinberg School of Medicine, 737 North Michigan Avenue, Suite 700, Chicago, IL 60611, USA
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Andres RH, Wallimann T, Widmer HR. Creatine supplementation improves neural progenitor cell survival in Huntington's disease. Brain Circ 2016; 2:133-137. [PMID: 30276289 PMCID: PMC6126277 DOI: 10.4103/2394-8108.192519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 01/30/2023] Open
Abstract
Preclinical and clinical studies suggest that striatal transplantation of neural stem cells (NSCs) and neural progenitor cells (NPCs) may be an appealing and valuable system for treating Huntington's disease. Nevertheless, for a neural replacement to become an effective translational treatment for Huntington's disease, a certain number of difficulties must be addressed, including how to improve the integration of transplanted cell grafts with the host tissue, to elevate the survival rates of transplanted cells, and to ensure their directed differentiation into specific neuronal phenotypes. Research focusing on the translational applications of creatine (Cr) supplementation in NSC and NPC cell replacement therapies continues to offer promising results, pointing to Cr as a factor with the potential to improve cell graft survivability and encourage differentiation toward GABAergic phenotypes in models of striatal transplantation. Here, we evaluate research examining the outcomes of Cr supplementation and how the timing of supplementation regimes may affect their efficacy. The recent studies indicate that Cr's effects vary according to the developmental stage of the cells being treated, noting the dynamic differences in creatine kinase expression over the developmental stages of differentiating NPCs. This research continues to move Cr supplementation closer to the widespread clinical application and suggests such techniques warrant further examination.
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Affiliation(s)
- Robert H Andres
- Department of Neurosurgery, University of Berne, Inselspital, CH-3010 Berne, Switzerland
| | - Theo Wallimann
- Department of Biology, Institute of Cell Biology, Swiss Federal Institute of Technology (ETH), CH-8093 Zurich, Switzerland
| | - Hans R Widmer
- Department of Neurosurgery, University of Berne, Inselspital, CH-3010 Berne, Switzerland
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Andres RH, Ducray AD, Andereggen L, Hohl T, Schlattner U, Wallimann T, Widmer HR. The effects of creatine supplementation on striatal neural progenitor cells depend on developmental stage. Amino Acids 2016; 48:1913-27. [PMID: 27129463 DOI: 10.1007/s00726-016-2238-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/12/2016] [Indexed: 01/14/2023]
Abstract
Transplantation of neural progenitor cells (NPCs) is a promising experimental therapy for Huntington's disease (HD). The variables responsible for the success of this approach, including selection of the optimal developmental stage of the grafted cells, are however largely unknown. Supporting cellular energy metabolism by creatine (Cr) supplementation is a clinically translatable method for improving cell transplantation strategies. The present study aims at investigating differences between early (E14) and late (E18) developmental stages of rat striatal NPCs in vitro. NPCs were isolated from E14 and E18 embryos and cultured for 7 days with or without Cr [5 mM]. Chronic treatment significantly increased the percentage of GABA-immunoreactive neurons as compared to untreated controls, both in the E14 (170.4 ± 4.7 %) and the E18 groups (129.3 ± 9.3 %). This effect was greater in E14 cultures (p < 0.05). Similarly, short-term treatment for 24 h resulted in increased induction (p < 0.05) of the GABA-ergic phenotype in E14 (163.0 ± 10.4 %), compared to E18 cultures (133.3 ± 9.5 %). Total neuronal cell numbers and general viability were not affected by Cr (p > 0.05). Protective effects of Cr against a metabolic insult were equal in E14 and E18 NPCs (p > 0.05). Cr exposure promoted morphological differentiation of GABA-ergic neurons, including neurite length in both groups (p < 0.05), but the number of branching points was increased only in the E18 group (p < 0.05). Our results demonstrate that the role of Cr as a GABA-ergic differentiation factor depends on the developmental stage of striatal NPCs, while Cr-mediated neuroprotection is not significantly influenced. These findings have potential implications for optimizing future cell replacement strategies in HD.
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Affiliation(s)
- Robert H Andres
- Department of Neurosurgery, University of Berne, Inselspital, Freiburgstrasse 10, 3010, Berne, Switzerland
| | - Angelique D Ducray
- Department of Neurosurgery, University of Berne, Inselspital, Freiburgstrasse 10, 3010, Berne, Switzerland
| | - Lukas Andereggen
- Department of Neurosurgery, University of Berne, Inselspital, Freiburgstrasse 10, 3010, Berne, Switzerland.,Department of Neurosurgery and F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Tabea Hohl
- Department of Neurosurgery, University of Berne, Inselspital, Freiburgstrasse 10, 3010, Berne, Switzerland
| | - Uwe Schlattner
- Laboratory of Fundamental and Applied Bioenergetics, Université Grenoble Alpes, BP53, 38041, Grenoble Cedex, France.,Inserm, U1055, BP53, 38041, Grenoble Cedex, France
| | - Theo Wallimann
- Professor emeritus, formerly at Institute of Cell Biology, Swiss Federal Institute of Technology (ETH), Schafmattstrasse 18, 8093, Zurich, Switzerland
| | - Hans R Widmer
- Department of Neurosurgery, University of Berne, Inselspital, Freiburgstrasse 10, 3010, Berne, Switzerland.
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Effects of amino acid derivatives on physical, mental, and physiological activities. Crit Rev Food Sci Nutr 2016; 55:1793-807. [PMID: 24279396 DOI: 10.1080/10408398.2012.708368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Nutritional ergogenic aids have been in use for a long time to enhance exercise and sports performance. Dietary components that exhibit ergogenic activity are numerous and their consumption is common and popular among athletes. They often come under scrutiny by legal authorities for their claimed benefits and safety concerns. Amino acid derivatives are propagated as being effective aids to enhance physical and mental performance in many ways, even though studies have pointed out that individuals who are deficient are more likely to benefit from dietary supplementation of amino acid derivatives than normal humans. In this review, some of the most common and widely used amino acids derivatives in sports and athletics namely creatine, tyrosine, carnitine, HMB, and taurine have been discussed for their effects on exercise performance, mental activity as well as body strength and composition. Creatine, carnitine, HMB, and taurine are reported to delay the onset of fatigue, improve exercise performance, and body strength. HMB helps in increasing fat-free mass and reduce exercise induced muscle injury. Taurine has been found to reduce oxidative stress during exercise and also act as an antihypertensive agent. Although, studies have not been able to find any favorable effect of tyrosine administration on exercise performance, it has been proved to be very effective in fighting stress, improving mood and cognitive performance particularly in sleep-deprived subjects. While available data from published studies and findings are equivocal about the efficacy of creatine, tyrosine, and HMB, more comprehensive researches on carnitine and taurine are necessary to provide evidence for the theoretical basis of their ergogenic role in nutritional modification and supplementation.
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Havenetidis K. The use of creatine supplements in the military. J ROY ARMY MED CORPS 2015; 162:242-8. [DOI: 10.1136/jramc-2014-000400] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/08/2015] [Indexed: 01/06/2023]
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15
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Souza WM, Heck TG, Wronski EC, Ulbrich AZ, Boff E. Effects of creatine supplementation on biomarkers of hepatic and renal function in young trained rats. Toxicol Mech Methods 2013; 23:697-701. [DOI: 10.3109/15376516.2013.843108] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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16
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Abstract
BACKGROUND Progressive muscle weakness is a main symptom of most hereditary and acquired muscle diseases. Creatine improves muscle performance in healthy individuals. This is an update of our 2007 Cochrane review that evaluated creatine treatment in muscle disorders. Previous updates were in 2009 and 2011. OBJECTIVES To evaluate the efficacy of creatine compared to placebo for the treatment of muscle weakness in muscle diseases. SEARCH METHODS On 11 September 2012, we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL (2012, Issue 9 in The Cochrane Library), MEDLINE (January 1966 to September 2012) and EMBASE (January 1980 to September 2012) for randomised controlled trials (RCTs) of creatine used to treat muscle diseases. SELECTION CRITERIA RCTs or quasi-RCTs of creatine treatment compared to placebo in hereditary muscle diseases or idiopathic inflammatory myopathies. DATA COLLECTION AND ANALYSIS Two authors independently applied the selection criteria, assessed trial quality and extracted data. We obtained missing data from investigators. MAIN RESULTS A total of 14 trials, including 364 randomised participants, met the selection criteria. The risk of bias was low in most studies. Only one trial had a high risk of selection, performance and detection bias. No new studies were identified at this update.Meta-analysis of six trials in muscular dystrophies including 192 participants revealed a significant increase in muscle strength in the creatine group compared to placebo, with a mean difference of 8.47%; (95% confidence intervals (CI) 3.55 to 13.38). Pooled data of four trials including 115 participants showed that a significantly higher number of participants felt better during creatine treatment compared to placebo with a risk ratio of 4.51 (95% CI 2.33 to 8.74). One trial in 37 participants with idiopathic inflammatory myopathies also showed a significant improvement in functional performance. No trial reported any clinically relevant adverse event.In metabolic myopathies, meta-analyses of three cross-over trials including 33 participants revealed no significant difference in muscle strength. One trial reported a significant deterioration of activities of daily living (mean difference 0.54 on a 1 to 10 scale; 95% CI 0.14 to 0.93) and an increase in muscle pain during high-dose creatine treatment in McArdle disease. AUTHORS' CONCLUSIONS High quality evidence from RCTs shows that short- and medium-term creatine treatment increases muscle strength in muscular dystrophies. There is also evidence that creatine improves functional performance in muscular dystrophy and idiopathic inflammatory myopathy. Creatine is well tolerated in these people. High quality but limited evidence from RCTs does not show significant improvement in muscle strength in metabolic myopathies. High-dose creatine treatment impaired activities of daily living and increased muscle pain in McArdle disease.
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Affiliation(s)
- Rudolf A Kley
- Department of Neurology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
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Eudy AE, Gordon LL, Hockaday BC, Lee DA, Lee V, Luu D, Martinez CA, Ambrose PJ. Efficacy and safety of ingredients found in preworkout supplements. Am J Health Syst Pharm 2013; 70:577-88. [DOI: 10.2146/ajhp120118] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Anne E. Eudy
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
| | | | | | | | | | | | - Carlos A. Martinez
- Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA
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Allen PJ. Creatine metabolism and psychiatric disorders: Does creatine supplementation have therapeutic value? Neurosci Biobehav Rev 2012; 36:1442-62. [PMID: 22465051 PMCID: PMC3340488 DOI: 10.1016/j.neubiorev.2012.03.005] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/07/2012] [Accepted: 03/14/2012] [Indexed: 12/12/2022]
Abstract
Athletes, body builders, and military personnel use dietary creatine as an ergogenic aid to boost physical performance in sports involving short bursts of high-intensity muscle activity. Lesser known is the essential role creatine, a natural regulator of energy homeostasis, plays in brain function and development. Creatine supplementation has shown promise as a safe, effective, and tolerable adjunct to medication for the treatment of brain-related disorders linked with dysfunctional energy metabolism, such as Huntington's Disease and Parkinson's Disease. Impairments in creatine metabolism have also been implicated in the pathogenesis of psychiatric disorders, leaving clinicians, researchers and patients alike wondering if dietary creatine has therapeutic value for treating mental illness. The present review summarizes the neurobiology of the creatine-phosphocreatine circuit and its relation to psychological stress, schizophrenia, mood and anxiety disorders. While present knowledge of the role of creatine in cognitive and emotional processing is in its infancy, further research on this endogenous metabolite has the potential to advance our understanding of the biological bases of psychopathology and improve current therapeutic strategies.
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Affiliation(s)
- Patricia J Allen
- Department of Psychology, Tufts University, Psychology Building, 490 Boston Ave., Medford, MA 02155, USA.
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19
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Effect of short-term creatine monohydrate supplementation on indirect markers of cellular damage in young soccer players. Sci Sports 2012. [DOI: 10.1016/j.scispo.2011.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Perasso L, Spallarossa P, Gandolfo C, Ruggeri P, Balestrino M. Therapeutic Use of Creatine in Brain or Heart Ischemia: Available Data and Future Perspectives. Med Res Rev 2011; 33:336-63. [DOI: 10.1002/med.20255] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Luisa Perasso
- Department of Neuroscience, Opthalmology and Genetics; University of Genova; Genova Italy
- Department of Experimental Medicine, Section of Human Physiology; University of Genova; Genova Italy
| | - Paolo Spallarossa
- Department of Internal Medicine and Cardionephrology; University of Genova; Genova Italy
| | - Carlo Gandolfo
- Department of Neuroscience, Opthalmology and Genetics; University of Genova; Genova Italy
| | - Piero Ruggeri
- Department of Experimental Medicine, Section of Human Physiology; University of Genova; Genova Italy
| | - Maurizio Balestrino
- Department of Neuroscience, Opthalmology and Genetics; University of Genova; Genova Italy
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Carvalho APPF, Molina GE, Fontana KE. Suplementação com creatina associada ao treinamento resistido não altera as funções renal e hepática. REV BRAS MED ESPORTE 2011. [DOI: 10.1590/s1517-86922011000400004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A creatina é o suplemento nutricional mais popular utilizado para melhorar o desempenho em atividades que envolvem exercícios de curta duração e alta intensidade. Porém, as possíveis intercorrências advindas do seu uso não estão totalmente elucidadas. O objetivo do estudo foi avaliar os efeitos de duas dosagens de suplementação com creatina nas funções renal e hepática de adultos saudáveis durante oito semanas de treinamento de musculação. Exames bioquímicos foram realizados em 35 praticantes de musculação distribuídos aleatoriamente em três grupos, placebo (PLA, n = 12), creatina (CRE1, n = 12) e creatina 2 (CRE2, n = 11), antes e após oito semanas de treinamento com exercícios resistidos. Em desenho duplo-cego, os voluntários foram suplementados (20g/dia) com creatina (CRE1 e CRE2) ou placebo (PLA) por sete dias e nos 53 dias subsequentes com 0,03g/kg de massa corporal de creatina (CRE1) e placebo (PLA) e com 5g/dia o grupo CRE2. Não houve intervenção na composição de suas dietas, que foram registradas e analisadas. Os resultados dos exames bioquímicos realizados permaneceram dentro das faixas de normalidade. Os valores de creatinina aumentaram 12,2% no grupo CRE1 e 9,0%, no CRE2, enquanto que no grupo PLA diminuiu 4,7%, entretanto, esses valores não ultrapassaram os índices de normalidade. Os valores dos exames da função hepática diminuíram em quase todas as frações, em todos os tratamentos, contudo, sem significância estatística. Conclui-se que a suplementação com creatina nas dosagens utilizadas (0,03g/kg e 5g/dia) para indivíduos saudáveis por oito semanas não altera a função hepática ou renal, sendo assim, nas condições deste estudo, foi considerada segura.
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22
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Sobolewski EJ, Thompson BJ, Smith AE, Ryan ED. The Physiological Effects of Creatine Supplementation on Hydration: A Review. Am J Lifestyle Med 2011. [DOI: 10.1177/1559827611406071] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In 1992, Harris and colleagues demonstrated that oral creatine supplementation can enhance muscle creatine stores. Since then, creatine has become an important and popular ergogenic aid for improving athletic performance with reports of up to 74% of athletes supplementing with creatine. Although many recent studies have addressed the safety concerns of creatine supplementation on hydration status in hot and humid environments, anecdotal reports still exist linking creatine usage to heat-related problems. These concerns are based on the premise that creatine is an osmotically active substance resulting in an alteration in fluid balance by increasing intracellular fluid volume and preventing fluid from entering the extracellular environment to aid in thermoregulation. However, a number studies have demonstrated that when recommended amounts of creatine are consumed, creatine does not appear to increase the risk of heat-related problems during exercise and may actually have a positive influence on core temperature and heart rate responses.
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Affiliation(s)
- Eric J. Sobolewski
- Department of Health and Human Performance, Oklahoma State University, Stillwater, Oklahoma
| | - Brennan J. Thompson
- Department of Health and Human Performance, Oklahoma State University, Stillwater, Oklahoma
| | - Abbie E. Smith
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,
| | - Eric D. Ryan
- Department of Health and Human Performance, Oklahoma State University, Stillwater, Oklahoma
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Abstract
BACKGROUND Progressive muscle weakness is a main symptom of most hereditary and acquired muscle diseases. Creatine improves muscle performance in healthy individuals. This is an update of our 2007 Cochrane review that evaluated creatine treatment in muscle disorders. OBJECTIVES To evaluate the efficacy of creatine compared to placebo for the treatment of muscle weakness in muscle diseases. SEARCH STRATEGY We searched the Cochrane Neuromuscular Disease Group Specialized Register (4 October 2010), the Cochrane Central Register of Controlled Trials (11 October 2010, Issue 4, 2010 in The Cochrane Library), MEDLINE (January 1966 to September 2010) and EMBASE (January 1980 to September 2010) for randomised controlled trials (RCT) of creatine used to treat muscle diseases. SELECTION CRITERIA RCTs or quasi-RCTs of creatine treatment compared to placebo in hereditary muscle diseases or idiopathic inflammatory myopathies. DATA COLLECTION AND ANALYSIS Two authors independently applied the selection criteria, assessed trial quality and extracted data. We obtained missing data from investigators. MAIN RESULTS The updated searches identified two new studies. A total of 14 trials, including 364 randomised participants, met the selection criteria. Meta-analysis of six trials in muscular dystrophies including 192 participants revealed a significant increase in muscle strength in the creatine group compared to placebo, with a weighted mean difference of 8.47%; (95% confidence intervals (CI) 3.55 to 13.38). Pooled data of four trials including 115 participants showed that a significantly higher number of patients felt better during creatine treatment compared to placebo with a risk ratio of 4.51 (95% CI 2.33 to 8.74). One trial in 37 participants with idiopathic inflammatory myopathies also showed a significant improvement in functional performance. No trial reported any clinically relevant adverse event. In metabolic myopathies, meta-analyses of three cross-over trials including 33 participants revealed no significant difference in muscle strength. One trial reported a significant deterioration of ADL (mean difference 0.54 on a 1 to 10 scale; 95% CI 0.14 to 0.93) and an increase in muscle pain during high-dose creatine treatment in McArdle disease. AUTHORS' CONCLUSIONS High quality evidence from RCTs shows that short- and medium-term creatine treatment increases muscle strength in muscular dystrophies. There is also evidence that creatine improves functional performance in muscular dystrophy and idiopathic inflammatory myopathy. Creatine is well tolerated in these people. High quality but limited evidence from RCTs does not show significant improvement in muscle strength in metabolic myopathies. High-dose creatine treatment impaired ADL and increased muscle pain in McArdle disease.
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Affiliation(s)
- Rudolf A Kley
- Department of Neurology, University Hospital Bergmannsheil, Ruhr University Bochum, Buerkle-de-la-Camp-Platz 1, Bochum, Germany, 44789
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Gualano B, de Salles Painelli V, Roschel H, Lugaresi R, Dorea E, Artioli GG, Lima FR, da Silva MER, Cunha MR, Seguro AC, Shimizu MH, Otaduy MCG, Sapienza MT, da Costa Leite C, Bonfá E, Lancha Junior AH. Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Eur J Appl Physiol 2010; 111:749-56. [DOI: 10.1007/s00421-010-1676-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2010] [Indexed: 10/18/2022]
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Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clin J Sport Med 2009; 19:399-404. [PMID: 19741313 DOI: 10.1097/jsm.0b013e3181b8b52f] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study investigated resting concentrations of selected androgens after 3 weeks of creatine supplementation in male rugby players. It was hypothesized that the ratio of dihydrotestosterone (DHT, a biologically more active androgen) to testosterone (T) would change with creatine supplementation. DESIGN Double-blind placebo-controlled crossover study with a 6-week washout period. SETTING Rugby Institute in South Africa. PARTICIPANTS College-aged rugby players (n = 20) volunteered for the study, which took place during the competitive season. INTERVENTIONS Subjects loaded with creatine (25 g/day creatine with 25 g/day glucose) or placebo (50 g/day glucose) for 7 days followed by 14 days of maintenance (5 g/day creatine with 25 g/day glucose or 30 g/day glucose placebo). MAIN OUTCOME MEASURES Serum T and DHT were measured and ratio calculated at baseline and after 7 days and 21 days of creatine supplementation (or placebo). Body composition measurements were taken at each time point. RESULTS After 7 days of creatine loading, or a further 14 days of creatine maintenance dose, serum T levels did not change. However, levels of DHT increased by 56% after 7 days of creatine loading and remained 40% above baseline after 14 days maintenance (P < 0.001). The ratio of DHT:T also increased by 36% after 7 days creatine supplementation and remained elevated by 22% after the maintenance dose (P < 0.01). CONCLUSIONS Creatine supplementation may, in part, act through an increased rate of conversion of T to DHT. Further investigation is warranted as a result of the high frequency of individuals using creatine supplementation and the long-term safety of alterations in circulating androgen composition. STATEMENT OF CLINICAL RELEVANCE: Although creatine is a widely used ergogenic aid, the mechanisms of action are incompletely understood, particularly in relation to dihydrotestosterone, and therefore the long-term clinical safety cannot be guaranteed.
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Herda TJ, Beck TW, Ryan ED, Smith AE, Walter AA, Hartman MJ, Stout JR, Cramer JT. Effects of creatine monohydrate and polyethylene glycosylated creatine supplementation on muscular strength, endurance, and power output. J Strength Cond Res 2009; 23:818-26. [PMID: 19387397 DOI: 10.1519/jsc.0b013e3181a2ed11] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to examine the effects of a moderate dose of creatine monohydrate (CM) and two smaller doses of polyethylene glycosylated (PEG) creatine on muscular strength, endurance, and power output. Fifty-eight healthy men (mean +/- SD: age, 21 +/- 2 years; height, 176 +/- 6 cm; body mass [BM], 75 +/- 14 kg) volunteered and were randomly assigned to 1 of 4 groups: (a) placebo (PL; 3.6 g of microcrystalline cellulose; n = 15), (b) CM (5 g of creatine; n = 13), (c) small-dose PEG creatine (1.25 g of creatine: PEG1.25; n = 14), or (d) moderate-dose PEG creatine (2.50 g of creatine: PEG2.50; n = 16). Testing was conducted before (pre-) and after (post-) a 30-day supplementation period. Measurements included body mass, countermovement vertical jump (CVJ) height, power output during the Wingate test (peak power [PP] and mean power [MP]), 1 repetition maximum bench press (1RMBP), 1RM leg press (1RMLP) strength, and repetitions to failure at 80% of the 1RM for bench press (REPBP) and leg press (REPLP). BM and MP (W) increased (p <or= 0.05) from pre- to postsupplementation for the CM group only, whereas 1RMBP and 1RMLP increased (p <or= 0.05) for the CM, PEG1.25, and PEG2.50 groups. CVJ height (cm and cm.kg), MP (W.kg), PP (W and W.kg), REPBP, and REPLP increased (p <or= 0.05) for all groups. These findings indicated that the recommended safe dose of 5 g.d of CM increased BM and improved muscle strength (1RMBP and 1RMLP). Smaller doses of PEG creatine (1.25 and 2.50 g.d) improved muscle strength (1RMBP and 1RMLP) to the same extent as 5 g.d of CM, but did not alter BM, power output, or endurance. When compared to the PL group, neither CM nor PEG creatine supplementation improved peak power output (CVJ or PP), MP, or muscle endurance (REPBP or REPLP). Thus, PEG creatine may have ergogenic effects that are comparable to those of CM, but with a smaller dose of creatine.
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Affiliation(s)
- Trent J Herda
- Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma, USA
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Petróczi A, Naughton DP, Pearce G, Bailey R, Bloodworth A, McNamee M. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy. J Int Soc Sports Nutr 2008; 5:22. [PMID: 19077317 PMCID: PMC2654424 DOI: 10.1186/1550-2783-5-22] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 12/15/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective was to study nutritional supplement use among young elite UK athletes to establish whether a rationale versus practice incongruence exists, and to investigate the sources of information. Survey data were analysed for association between supplements used and motives for using such substances among young athletes along with the sources of advice and literature precedents on supplement effects. METHODS Participants were elite UK male and female athletes, within the age range between 12 and 21 (n = 403), mean age 17.66 +/- 1.99. Associations between type of supplements and reasons for using supplements were tested by calculating Pearson's chi2 and the strength of these symmetric associations shown by phi association coefficients. RESULTS Single supplement use was reported by 48.1%, with energy drinks being the most popular, consumed by 41.7% of all athletes and 86.6% of the supplement users in the sample. No agreement was observed between athletes' rationale and behaviour in relation to nutritional supplements except for creatine. Among health professionals, nutritionists and physiotherapists, followed by coaches, were most frequently consulted. Answers regarding reasons and supplements used showed incongruence and suggest widespread misinformation regarding supplements and their effects is an issue for the young athlete. CONCLUSION Widespread supplement taking behaviour was evidenced in the young elite athlete population with the most notable congruence between rationale and practice among young athletes being performance-related. Young athletes in the present sample appear to be less 'health conscious' and more 'performance focused' than their adult counterparts. Further research, using a full list of supplements, is warranted to test the hypothesis that health consciousness is less dominant in supplement choice by young athletes.
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Affiliation(s)
- Andrea Petróczi
- Faculty of Science, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE, UK.
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Hathcock JN, Shao A. Expanded approach to tolerable upper intake guidelines for nutrients and bioactive substances. J Nutr 2008; 138:1992S-1995S. [PMID: 18806113 DOI: 10.1093/jn/138.10.1992s] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The original tolerable upper intake level (UL) method greatly improved the application of risk assessment to the evaluation of nutrient safety for humans, but a UL is only set where the data establish a hazard resulting from high intakes. Absence of a UL for those nutrients with no established hazard has been misinterpreted by regulators and resulted in overly restrictive policies. To prevent such misinterpretation, the observed safe level (OSL) was developed and defined as "the highest intake with convincing evidence of safety, even if there are no established adverse effects at any level." More recently, a FAO/WHO report gave a similar definition for the highest observed intake (HOI). Another disadvantage of the UL method is the application of arbitrary uncertainty factors (UF). An alternative to the traditional adjustment for uncertainty involves arranging the data in decreasing order of daily intake, followed by evaluation of each trial for quantity and quality of data. Studies are selected downward until no adverse effects are observed in a trial of sufficient quality to justify no further correction for uncertainty (i.e. selection of data that qualify for UF = 1). Thus, the no observed adverse effect level or OSL selected requires no further adjustment for uncertainty. For supplemental intakes of some vitamins, many bioactive substances, and most amino acids, no adverse effects that are clearly related to high intakes have been established, but where the dataset is sufficiently robust, application of the OSL-HOI technique can provide risk assessment values.
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Affiliation(s)
- John N Hathcock
- Council for Responsible Nutrition, Washington, DC 20036, USA.
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Gualano B, Ugrinowitsch C, Seguro AC, Lancha Junior AH. A suplementação de creatina prejudica a função renal? REV BRAS MED ESPORTE 2008. [DOI: 10.1590/s1517-86922008000100013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Enquanto o consumo de creatina por atletas e praticantes de atividade física tem crescido vertiginosamente, os efeitos adversos desse suplemento continuam sendo alvos de calorosos debates científicos, sobretudo no que se refere à função renal. O objetivo dessa revisão é descrever as falhas metodológicas e lacunas na literatura, que contribuem para a divergência do tema. Relatos de caso sugerem que a creatina é um potencial agente nefrotóxico. Em contrapartida, estudos longitudinais, embora possuam diversas limitações, indicam o oposto. Pesquisas com humanos não demonstram efeitos deletérios da suplementação de creatina à função renal, porém a falta de controle experimental e o caráter retrospectivo da maioria delas comprometem as conclusões dos autores. Já os estudos experimentais com ratos empregam bons marcadores de função renal e possuem controle de variáveis satisfatório. Contudo, os resultados destes são contraditórios. Estudos futuros devem investigar os efeitos da suplementação de creatina em diversas patologias renais, assim como em idosos, diabéticos do tipo 2 e hipertensos, cuja propensão a nefropatia é bem descrita. Não há evidências de que a suplementação de creatina prejudique a função renal em sujeitos saudáveis, quando consumida na dosagem preconizada. Diante disso, questiona-se a legitimidade científica da proibição do comércio de creatina no Brasil.
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Shao A, Hathcock JN. Risk assessment for the amino acids taurine, L-glutamine and L-arginine. Regul Toxicol Pharmacol 2008; 50:376-99. [PMID: 18325648 DOI: 10.1016/j.yrtph.2008.01.004] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Revised: 12/19/2007] [Accepted: 01/09/2008] [Indexed: 12/18/2022]
Abstract
Taurine, glutamine and arginine are examples of amino acids which have become increasingly popular as ingredients in dietary supplements and functional foods and beverages. Animal and human clinical research suggests that oral supplementation of these amino acids provides additional health and/or performance benefits beyond those observed from normal intake of dietary protein. The increased consumer awareness and use of these amino acids as ingredients in dietary supplements and functional foods warrant a comprehensive review of their safety through quantitative risk assessment, and identification of a potential safe upper level of intake. The absence of a systematic pattern of adverse effects in humans in response to orally administered taurine (Tau), l-glutamine (Gln) and l-arginine (Arg) precluded the selection of a no observed adverse effect level (NOAEL) or lowest observed adverse effect level (LOAEL). Therefore, by definition, the usual approach to risk assessment for identification of a tolerable upper level of intake (UL) could not be used. Instead, the newer method described as the Observed Safe Level (OSL) or Highest Observed Intake (HOI) was utilized. The OSL risk assessments indicate that based on the available published human clinical trial data, the evidence for the absence of adverse effects is strong for Tau at supplemental intakes up to 3 g/d, Gln at intakes up to 14 g/d and Arg at intakes up to 20 g/d, and these levels are identified as the respective OSLs for normal healthy adults. Although much higher levels of each of these amino acids have been tested without adverse effects and may be safe, the data for intakes above these levels are not sufficient for a confident conclusion of long-term safety, and therefore these values are not selected as the OSLs.
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Affiliation(s)
- Andrew Shao
- Council for Responsible Nutrition, 1828 L Street, NW, Suite 900, Washington, DC 20036-5114, USA.
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Gualano B, Ugrinowitsch C, Novaes RB, Artioli GG, Shimizu MH, Seguro AC, Harris RC, Lancha AH. Effects of creatine supplementation on renal function: a randomized, double-blind, placebo-controlled clinical trial. Eur J Appl Physiol 2008; 103:33-40. [PMID: 18188581 DOI: 10.1007/s00421-007-0669-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2007] [Indexed: 01/17/2023]
Abstract
Creatine (CR) supplementation is commonly used by athletes. However, its effects on renal function remain controversial. The aim of this study was to evaluate the effects of creatine supplementation on renal function in healthy sedentary males (18-35 years old) submitted to exercise training. A randomized, double-blind, placebo-controlled trial was performed. Subjects (n = 18) were randomly allocated to receive treatment with either creatine (CR) ( approximately 10 g day(-1) over 3 months) or placebo (PL) (dextrose). All subjects undertook moderate intensity aerobic training, in three 40-min sessions per week, during 3 months. Serum creatinine, serum and urinary sodium and potassium were determined at baseline and at the end of the study. Cystatin C was assessed prior to training (PRE), after 4 (POST 4) and 12 weeks (POST 12). Cystatin C levels (mg L(-1)) (PRE CR: 0.82 +/- 0.09; PL: 0.88 +/- 0.07 vs. POST 12 CR: 0.71 +/- 0.06; PL: 0.75 +/- 0.09, P = 0.0001) were decreased over time, suggesting an increase in glomerular filtration rate. Serum creatinine decreased with training in PL but was unchanged with training in CR. No significant differences were observed within or between groups in other parameters investigated. The decrease in cystatin C indicates that high-dose creatine supplementation over 3 months does not provoke any renal dysfunction in healthy males undergoing aerobic training. In addition, the results suggest that moderate aerobic training per se may improve renal function.
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Affiliation(s)
- Bruno Gualano
- Laboratory of Applied Nutrition and Metabolism, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil.
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Petróczi A, Naughton DP, Mazanov J, Holloway A, Bingham J. Performance enhancement with supplements: incongruence between rationale and practice. J Int Soc Sports Nutr 2007; 4:19. [PMID: 17997853 PMCID: PMC2214727 DOI: 10.1186/1550-2783-4-19] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Accepted: 11/12/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Athletes are expected to consider multiple factors when making informed decision about nutritional supplement use. Besides rules, regulations and potential health hazards, the efficacy of different nutritional supplements in performance enhancement is a key issue. The aim of this paper was to find evidence for informed decision making by investigating the relationship between specific performance-related reasons for supplement use and the reported use of nutritional supplements. METHODS The 'UK Sport 2005 Drug Free Survey' data (n = 874) were re-analysed using association [chi2] and 'strength of association' tests [varphi] to show the proportion of informed choices and to unveil incongruencies between self-reported supplement use and the underlying motives. RESULTS Participants (n = 520) reported supplement use in the pattern of: vitamin C (70.4%), creatine (36.1%), whey protein (30.6%), iron (29.8%), caffeine (23.8%), and ginseng (8.3%) for the following reasons: strength maintenance (38.1%), doctors' advice (24.2%), enhancing endurance (20.0%), ability to train longer (13.3%), and provided by the governing body (3.8%). Of thirty possible associations between the above supplements and reasons, 11 were predictable from literature precedents and only 8 were evidenced and these were not strong (varphi < .7). The best associations were for the ability to train longer with creatine (reported by 73.9%, chi2 = 49.14, p < .001; varphi = .307, p < .001), and maintaining strength with creatine (reported by 62.6%, chi2 = 97.08, p < .001; varphi = .432, p < .001) and whey protein (reported by 56.1%, chi2 = 97.82, p < .001; varphi = .434, p < .001). CONCLUSION This study provided a platform for assessing congruence between athletes' reasons for supplement use and their actual use. These results suggest that a lack of understanding exists in supplement use. There is an urgent need to provide accurate information which will help athletes make informed choices about the use of supplements.
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Affiliation(s)
- Andrea Petróczi
- School of Life Sciences, Faculty of Science, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE, UK
| | - Declan P Naughton
- School of Life Sciences, Faculty of Science, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE, UK
| | - Jason Mazanov
- School of Business, UNSW@ADFA, Northcott Drive, Canberra ACT 2600, Australia
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Abstract
Ergogenic dietary supplement use is highly prevalent among adolescent and collegiate athletes, and use is increasing. To make appropriate recommendations for or against use by individual athletes, physicians who work with adolescent athletes should be knowledgeable about the most commonly used supplements and be able to access high-quality information about others. This article first discusses the legal and regulatory environment of dietary supplements. Several of the most commonly used supplements are then discussed in detail, including creatine, beta-hydroxy-beta-methylbutyrate, protein, amino acids, stimulants, alkalotic agents, glycerol, vitamins, and minerals. Finally, the "Gateway Theory" as it may relate to adolescent supplement and other drug use is discussed.
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Affiliation(s)
- Anthony Lattavo
- Department of Medical Education, Grant Medical Center, 285 East State Street, Suite 670, Columbus, OH 43215-4354, USA.
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Petróczi A, Naughton DP. Supplement use in sport: is there a potentially dangerous incongruence between rationale and practice? J Occup Med Toxicol 2007; 2:4. [PMID: 17535442 PMCID: PMC1904455 DOI: 10.1186/1745-6673-2-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Accepted: 05/29/2007] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Supplement use by athletes is complex and research supports the alarming notion of misinformed decisions regarding supplements. HYPOTHESIS A frequent divergence between the type of supplements chosen by athletes and the rationale dictating the supplement use is hypothesized. Thus, a potentially dangerous incongruence may exist between rationale and practice. TESTING THE HYPOTHESIS In the continued absence of reliable data on supplement use, an alternative approach of studying the reasons underlying supplement use in athletes is proposed to determine whether there is an incongruence between rationale and practice. Existing data from large scale national surveys can be used to investigate this incongruence. IMPLICATIONS OF THE HYPOTHESIS In this report, analyses of distinctive patterns between the use and rationale for use of supplements among athletes are recommended to explore this potentially dangerous phenomenon.
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Affiliation(s)
- Andrea Petróczi
- School of Life Sciences, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey KT1 2EE, UK
| | - Declan P Naughton
- School of Life Sciences, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey KT1 2EE, UK
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Abstract
BACKGROUND Progressive muscle weakness is a main symptom of most hereditary muscle diseases. Creatine is a popular nutritional supplement among athletes. It improves muscle performance in healthy individuals and might be helpful for treating myopathies. OBJECTIVES To evaluate the efficacy of oral creatine supplementation in muscle diseases. SEARCH STRATEGY We searched the Cochrane Neuromuscular Disease Group Register in May 2004 for randomised trials using the search term 'creatine'. We also searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2005) using the same search term. We adapted this strategy to search MEDLINE (PubMed, from January 1966 to September 2005) and EMBASE (from January 1980 to May 2004). We reviewed the bibliographies of the randomised trials identified, contacted the authors and known experts in the field and approached pharmaceutical companies to identify additional published or unpublished data. SELECTION CRITERIA Types of studies: randomised or quasi-randomised controlled trials. TYPES OF PARTICIPANTS people of all ages with hereditary muscle disease. Types of intervention: any creatine supplementation of at least 0.03 g/kg body weight/day. PRIMARY OUTCOME MEASURE change in muscle strength measured by quantitative muscle testing. SECONDARY OUTCOME MEASURES change in muscle strength measured by manual muscle testing, change in energy parameters assessed by 31 phosphorous spectroscopy, change in muscle mass or a surrogate for muscle mass, adverse events. DATA COLLECTION AND ANALYSIS Two authors independently applied the selection criteria, assessed trial quality and extracted data. Some missing data were obtained from investigators. MAIN RESULTS Twelve trials, including 266 participants, met the selection criteria. One trial compared creatine and glutamine treatment with placebo. In trials with 138 participants with muscular dystrophies treated with creatine, there was a significant increase in maximum voluntary contraction in the creatine group compared to placebo, with a weighted mean difference of 8.47% (95% confidence intervals 3.55 to 13.38). There was also an increase in lean body mass during creatine treatment compared to placebo (weighted mean difference 0.63 kg, 95% confidence intervals 0.02 to 1.25). No trial reported any clinically relevant adverse event. In trials with 33 participants with metabolic myopathies treated with creatine, there was no significant difference in maximum voluntary contraction between the creatine and placebo group (weighted mean difference -2.26%, confidence intervals -6.29 to 1.78). One trial reported a significant increase in muscle pain during high-dose creatine treatment (150 mg/kg body weight) in glycogen storage disease type V. AUTHORS' CONCLUSIONS Evidence from randomised controlled trials shows that short- and medium-term creatine treatment improves muscle strength in people with muscular dystrophies, and is well-tolerated. Evidence from randomised controlled trials does not show significant improvement in muscle strength in metabolic myopathies. High-dose creatine in glycogenosis type V increased muscle pain.
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Affiliation(s)
- R A Kley
- Kliniken Bergmannsheil, Ruhr University Bochum, Department of Neurology, Buerkle-de-la-Camp-Platz 1, Bochum, Germany, 44789.
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