1
|
Baltic S, Nedeljkovic D, Todorovic N, Ratgeber L, Betlehem J, Acs P, Stajer V, Ostojic SM. The Impact of Short-Term Supplementation With Guanidinoacetic Acid and Creatine Versus Creatine Alone on Body Composition Indices in Healthy Men and Women: Creatine-Guanidinoacetic Acid Affects Body Composition. J Nutr Metab 2024; 2024:7815807. [PMID: 39434888 PMCID: PMC11493483 DOI: 10.1155/2024/7815807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 09/19/2024] [Indexed: 10/23/2024] Open
Abstract
The main objective of this pilot study was to compare the effects of short-term supplementation with a mixture containing creatine and guanidinoacetic acid (GAA) versus creatine alone on body composition indices in men and women. Twenty-three apparently healthy young adults (mean age: 21.4 ± 0.6 years; 10 females) were randomly assigned to receive either a mixture (consisting of 2 g of creatine monohydrate and 2 g of GAA) or an equimolar amount of creatine monohydrate in a pretest-posttest control group experimental crossover design. After the intervention period, participants entered a 2-week washout phase to minimize any residual effects of the treatment. Body composition was assessed using a multifrequency bioelectrical impedance analysis at baseline (preadministration) and at the 7-day follow-up (postadministration). A significant interaction effect was found for extracellular mass (p=0.009), with creatine-GAA outperforming creatine in augmenting extracellular mass across the whole sample. In the male subsample, creatine was superior to the mixture in increasing intracellular water (p=0.049), whereas the mixture increased extracellular mass, contrasting with the reduction observed with creatine alone (p=0.008). No significant differences between interventions were reported in the female subsample (p > 0.05), indicating that adding GAA to creatine may produce unique, sex-specific effects on body composition. Further studies are needed to validate our findings across different demographic cohorts and various interventional regimens.
Collapse
Affiliation(s)
- Sonja Baltic
- Applied Bioenergetics Lab, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - David Nedeljkovic
- Applied Bioenergetics Lab, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Nikola Todorovic
- Applied Bioenergetics Lab, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Laszlo Ratgeber
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Jozsef Betlehem
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Pongrac Acs
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Valdemar Stajer
- Applied Bioenergetics Lab, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Sergej M. Ostojic
- Applied Bioenergetics Lab, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| |
Collapse
|
2
|
Warrier AA, Azua EN, Kasson LB, Allahabadi S, Khan ZA, Mameri ES, Swindell HW, Tokish JM, Chahla J. Performance-Enhancing Drugs in Healthy Athletes: An Umbrella Review of Systematic Reviews and Meta-analyses. Sports Health 2024; 16:695-705. [PMID: 37688400 PMCID: PMC11346223 DOI: 10.1177/19417381231197389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
CONTEXT Many clinicians, trainers, and athletes do not have a true understanding of the effects of commonly used performance-enhancing drugs (PEDs) on performance and health. OBJECTIVE To provide an evidence-based review of 7 commonly used pharmacological interventions for performance enhancement in athletes. DATA SOURCES PubMed and Scopus databases were searched on April 8, 2022. STUDY SELECTION Systematic reviews (SRs) and meta-analyses (MAs) assessing the performance-enhancing effects of the following interventions were included: androgenic anabolic steroids (AAS), growth hormone (GH), selective androgen receptor modulators (SARMs), creatine, angiotensin-converting enzyme (ACE)-inhibitors, recombinant human erythropoietin (rHuEPO), and cannabis. STUDY DESIGN Umbrella review of SRs and MAs. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION Primary outcomes collected were (1) body mass, (2) muscle strength, (3) performance, and (4) recovery. Adverse effects were also noted. RESULTS A total of 27 papers evaluating 5 pharmacological interventions met inclusion criteria. No studies evaluating SARMs or ACE-inhibitors were included. AAS lead to a 5% to 52% increase in strength and a 0.62 standard mean difference in lean body mass with subsequent lipid derangements. GH alters body composition, without providing a strength or performance benefit, but potential risks include soft tissue edema, fatigue, arthralgias, and carpel tunnel syndrome. Creatine use during resistance training can safely increase total and lean body mass, strength, and performance in high-intensity, short-duration, repetitive tasks. Limited evidence supports rHuEPO benefit on performance despite increases in both VO2max and maximal power output, and severe cardiovascular risks are documented. Cannabis provides no performance benefit and may even impair athletic performance. CONCLUSION In young healthy persons and athletes, creatine can safely provide a performance-enhancing benefit when taken in controlled doses. AAS, GH, and rHuEPO are associated with severe adverse events and do not support a performance benefit, despite showing the ability to change bodily composition, strength, and/or physiologic measures. Cannabis may have an ergolytic, instead of ergogenic, effect.
Collapse
Affiliation(s)
- Alec A. Warrier
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Eric N. Azua
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Luke B. Kasson
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Sachin Allahabadi
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Zeeshan A. Khan
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Enzo S. Mameri
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Hasani W. Swindell
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
| | | | - Jorge Chahla
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| |
Collapse
|
3
|
Aguiar Bonfim Cruz AJ, Brooks SJ, Kleinkopf K, Brush CJ, Irwin GL, Schwartz MG, Candow DG, Brown AF. Creatine Improves Total Sleep Duration Following Resistance Training Days versus Non-Resistance Training Days among Naturally Menstruating Females. Nutrients 2024; 16:2772. [PMID: 39203908 PMCID: PMC11357324 DOI: 10.3390/nu16162772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/14/2024] [Accepted: 08/16/2024] [Indexed: 09/03/2024] Open
Abstract
Females historically experience sleep disturbances and overall poor sleep compared to males. Creatine has been proposed to impact sleep; however, the effects are not well known. The purpose of this study was to examine the effects of creatine supplementation on sleep among naturally menstruating females. Twenty-one participants completed a double-blind, randomized controlled trial in which they consumed 5 g creatine + 5 g maltodextrin or placebo, 10 g maltodextrin, daily for 6 weeks. Participants completed resistance training 2x/week using the TONAL® (Tonal Systems Inc., San Francisco, CA, USA) at-home gym. Pre- and post-testing assessed body composition, Pittsburgh Sleep Quality Index (PSQI), dietary intake, and muscular strength. Sleep was assessed nightly using an ŌURA® (Oulu, Finland) ring. Compared to the placebo group, those consuming creatine experienced significant increases in total sleep on training days (p = 0.013). No significant changes in chronic sleep and PSQI (pre-post) were observed. There was a significant increase in TONAL® strength score over time (p < 0.001), with no between-group differences. Participants reduced their total calorie (kcal) (p = 0.039), protein (g/kg) (p = 0.009), carbohydrate (g/kg) (p = 0.023), and fat (g) (p = 0.036) intake over time. Creatine supplementation increases sleep duration on resistance training days in naturally menstruating females.
Collapse
Affiliation(s)
- Ariel J. Aguiar Bonfim Cruz
- Department of Movement Sciences, College of Education, Health & Human Sciences, University of Idaho, Moscow, ID 83844, USA; (A.J.A.B.C.); (S.J.B.); (K.K.); (C.J.B.); (G.L.I.)
| | - Samantha J. Brooks
- Department of Movement Sciences, College of Education, Health & Human Sciences, University of Idaho, Moscow, ID 83844, USA; (A.J.A.B.C.); (S.J.B.); (K.K.); (C.J.B.); (G.L.I.)
| | - Katelyn Kleinkopf
- Department of Movement Sciences, College of Education, Health & Human Sciences, University of Idaho, Moscow, ID 83844, USA; (A.J.A.B.C.); (S.J.B.); (K.K.); (C.J.B.); (G.L.I.)
| | - C. J. Brush
- Department of Movement Sciences, College of Education, Health & Human Sciences, University of Idaho, Moscow, ID 83844, USA; (A.J.A.B.C.); (S.J.B.); (K.K.); (C.J.B.); (G.L.I.)
| | - Gena L. Irwin
- Department of Movement Sciences, College of Education, Health & Human Sciences, University of Idaho, Moscow, ID 83844, USA; (A.J.A.B.C.); (S.J.B.); (K.K.); (C.J.B.); (G.L.I.)
| | - Malayna G. Schwartz
- WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844, USA;
| | - Darren G. Candow
- Aging Muscle & Bone Laboratory, Faculty of Kinesiology & Healthy Studies, University of Regina, Regina, SK S4S 0A2, Canada;
| | - Ann F. Brown
- Department of Movement Sciences, College of Education, Health & Human Sciences, University of Idaho, Moscow, ID 83844, USA; (A.J.A.B.C.); (S.J.B.); (K.K.); (C.J.B.); (G.L.I.)
| |
Collapse
|
4
|
Rivero-Pino F, Casanova AG. Hepatotoxicity due to dietary supplements: state-of-the-art, gaps and perspectives. Crit Rev Toxicol 2023; 53:601-610. [PMID: 38062980 DOI: 10.1080/10408444.2023.2282415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/23/2023] [Indexed: 12/22/2023]
Abstract
Food supplements are products intended to complement the normal diet and consist of concentrated sources of nutrients or other substances with a nutritional or physiological effect. Although they are generally considered safe if the manufacturer's recommendations are followed, many of them have shown hepatotoxic properties. This can cause many diseases (e.g. steatohepatitis and cirrhosis) characterized by progressive damage and malfunction of the liver that in the long term can lead to death. A review of the literature was carried out to elucidate which dietary supplements have been associated with cases of hepatotoxicity in recent years, with emphasis on those relevant to the consumer and the new trends (e.g. cannabidiol). It has been reported that the supplements described as hepatotoxic are mainly of botanical origin (e.g. green tea or turmeric) and those used in sports (mainly anabolic androgenic steroids). There is a great variability of compounds described as causing liver damage, although sometimes it is not possible to identify them, because they are contaminants or adulterants of the products. In addition, the prevalence of toxic effects after the administration of supplements is difficult to define due to underreporting and the lack of specific studies. Globally regarding hepatotoxicity of dietary supplements, there is a paucity of well-conducted clinical trials on the efficacy of these compounds and the frequency of related liver damage, as the use of these products is largely uncontrolled.
Collapse
Affiliation(s)
- Fernando Rivero-Pino
- Department of Medical Biochemistry, Molecular Biology, and Immunology, School of Medicine, University of Seville, Seville, Spain
| | - Alfredo G Casanova
- Toxicology Unit, Universidad de Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), Salamanca, Spain
| |
Collapse
|
5
|
Tran NT, Muccini AM, Hale N, Tolcos M, Snow RJ, Walker DW, Ellery SJ. Creatine in the fetal brain: A regional investigation of acute global hypoxia and creatine supplementation in a translational fetal sheep model. Front Cell Neurosci 2023; 17:1154772. [PMID: 37066075 PMCID: PMC10097948 DOI: 10.3389/fncel.2023.1154772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/15/2023] [Indexed: 04/18/2023] Open
Abstract
Background Creatine supplementation during pregnancy is a promising prophylactic treatment for perinatal hypoxic brain injury. Previously, in near-term sheep we have shown that fetal creatine supplementation reduces cerebral metabolic and oxidative stress induced by acute global hypoxia. This study investigated the effects of acute hypoxia with or without fetal creatine supplementation on neuropathology in multiple brain regions. Methods Near-term fetal sheep were administered continuous intravenous infusion of either creatine (6 mg kg-1 h-1) or isovolumetric saline from 122 to 134 days gestational age (dGA; term is approx. 145 dGA). At 131 dGA, global hypoxia was induced by a 10 min umbilical cord occlusion (UCO). Fetuses were then recovered for 72 h at which time (134 dGA) cerebral tissue was collected for either RT-qPCR or immunohistochemistry analyses. Results UCO resulted in mild injury to the cortical gray matter, thalamus and hippocampus, with increased cell death and astrogliosis and downregulation of genes involved in regulating injury responses, vasculature development and mitochondrial integrity. Creatine supplementation reduced astrogliosis within the corpus callosum but did not ameliorate any other gene expression or histopathological changes induced by hypoxia. Of importance, effects of creatine supplementation on gene expression irrespective of hypoxia, including increased expression of anti-apoptotic (BCL-2) and pro-inflammatory (e.g., MPO, TNFa, IL-6, IL-1β) genes, particularly in the gray matter, hippocampus, and striatum were identified. Creatine treatment also effected oligodendrocyte maturation and myelination in white matter regions. Conclusion While supplementation did not rescue mild neuropathology caused by UCO, creatine did result in gene expression changes that may influence in utero cerebral development.
Collapse
Affiliation(s)
- Nhi T. Tran
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- *Correspondence: Nhi T. Tran,
| | - Anna M. Muccini
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Nadia Hale
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Mary Tolcos
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Rod J. Snow
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - David W. Walker
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Stacey J. Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
6
|
Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
Collapse
|
7
|
Creatine Supplementation for Muscle Growth: A Scoping Review of Randomized Clinical Trials from 2012 to 2021. Nutrients 2022; 14:nu14061255. [PMID: 35334912 PMCID: PMC8949037 DOI: 10.3390/nu14061255] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023] Open
Abstract
Creatine supplementation is the most popular ergonomic aid for athletes in recent years and is used for improving sport performance and muscle growth. However, creatine supplementation is not always effective in all populations. To address these discrepancies, numerous studies have examined the use of creatine supplementation for muscle growth. This scoping review aimed to investigate the effects of creatine supplementation for muscle growth in various populations, in which Arksey and O'Malley's scoping review framework is used to present the findings. For this study, we performed a systematic search of the PubMed, Embase, and Web of Science databases for theses and articles published between 2012 and 2021. A manual search of the reference lists of the uncovered studies was conducted and an expert panel was consulted. Two reviewers screened the articles for eligibility according to the inclusion criteria. Methodological quality was assessed using the National Heart, Lung and Blood Institute's (NHLBI's) quality assessment tool. A total of 16 randomized controlled trials (RCTs) were finally included. All the authors extracted key data and descriptively analyzed the data. Thematic analysis was used to categorize the results into themes. Three major themes related to muscle growth were generated: (i) subjects of creatine supplementation-muscle growth is more effective in healthy young subjects than others; (ii) training of subjects-sufficient training is important in all populations; (iii) future direction and recommendation of creatine supplementation for muscle growth-injury prevention and utilization in medical practice. Overall, creatine is an efficient form of supplementation for muscle growth in the healthy young population with adequate training in a variety of dosage strategies and athletic activities. However, more well-designed, long-term RCTs with larger sample sizes are needed in older and muscular disease-related populations to definitively determine the effects of creatine supplementation on muscle growth in these other populations.
Collapse
|
8
|
Tran NT, Kelly SB, Snow RJ, Walker DW, Ellery SJ, Galinsky R. Assessing Creatine Supplementation for Neuroprotection against Perinatal Hypoxic-Ischaemic Encephalopathy: A Systematic Review of Perinatal and Adult Pre-Clinical Studies. Cells 2021; 10:2902. [PMID: 34831126 PMCID: PMC8616304 DOI: 10.3390/cells10112902] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/09/2022] Open
Abstract
There is an important unmet need to develop interventions that improve outcomes of hypoxic-ischaemic encephalopathy (HIE). Creatine has emerged as a promising neuroprotective agent. Our objective was to systematically evaluate the preclinical animal studies that used creatine for perinatal neuroprotection, and to identify knowledge gaps that need to be addressed before creatine can be considered for pragmatic clinical trials for HIE. METHODS We reviewed preclinical studies up to 20 September 2021 using PubMed, EMBASE and OVID MEDLINE databases. The SYRCLE risk of bias assessment tool was utilized. RESULTS Seventeen studies were identified. Dietary creatine was the most common administration route. Cerebral creatine loading was age-dependent with near term/term-equivalent studies reporting higher increases in creatine/phosphocreatine compared to adolescent-adult equivalent studies. Most studies did not control for sex, study long-term histological and functional outcomes, or test creatine post-HI. None of the perinatal studies that suggested benefit directly controlled core body temperature (a known confounder) and many did not clearly state controlling for potential study bias. CONCLUSION Creatine is a promising neuroprotective intervention for HIE. However, this systematic review reveals key knowledge gaps and improvements to preclinical studies that must be addressed before creatine can be trailed for neuroprotection of the human fetus/neonate.
Collapse
Affiliation(s)
- Nhi Thao Tran
- School of Health & Biomedical Sciences, STEM College, RMIT University, Melbourne 3083, Australia; (N.T.T.); (D.W.W.)
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (S.B.K.); (S.J.E.)
| | - Sharmony B. Kelly
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (S.B.K.); (S.J.E.)
- Department of Obstetrics & Gynecology, Monash University, Melbourne 3168, Australia
| | - Rod J. Snow
- Institute for Physical Activity & Nutrition, Deakin University, Melbourne 3125, Australia;
| | - David W. Walker
- School of Health & Biomedical Sciences, STEM College, RMIT University, Melbourne 3083, Australia; (N.T.T.); (D.W.W.)
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (S.B.K.); (S.J.E.)
| | - Stacey J. Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (S.B.K.); (S.J.E.)
- Department of Obstetrics & Gynecology, Monash University, Melbourne 3168, Australia
| | - Robert Galinsky
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (S.B.K.); (S.J.E.)
- Department of Obstetrics & Gynecology, Monash University, Melbourne 3168, Australia
| |
Collapse
|
9
|
dos Santos EEP, de Araújo RC, Candow DG, Forbes SC, Guijo JA, de Almeida Santana CC, do Prado WL, Botero JP. Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13113757. [PMID: 34836013 PMCID: PMC8619193 DOI: 10.3390/nu13113757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/15/2022] Open
Abstract
Sarcopenia refers to the age-related loss of muscle strength and muscle mass, which is associated with a reduced quality of life, particularly in older females. Resistance training (RT) is well established to be an effective intervention to counter indices of sarcopenia. Accumulating research indicates that the addition of creatine supplementation (Cr) to RT augments gains in muscle strength and muscle mass, compared to RT alone. However, some evidence indicates that sex differences may alter the effectiveness of Cr. Therefore, we systematically reviewed randomized controlled trials (RCTs) investigating the efficacy of Cr + RT on measures of upper- and lower-body strength and muscle mass in older females. A systematic literature search was performed in nine electronic databases. Ten RCTs (N = 211 participants) were included the review. Overall, Cr significantly increased measures of upper-body strength (7 studies, n = 142, p = 0.04), with no effect on lower-body strength or measures of muscle mass. Sub-analyses revealed that both upper-body (4 studies, n = 97, p = 0.05) and lower-body strength (4 studies, n = 100, p = 0.03) were increased by Cr, compared to placebo in studies ≥ 24 weeks in duration. In conclusion, older females supplementing with Cr experience significant gains in muscle strength, especially when RT lasts for at least 24 weeks in duration. However, given the level of evidence, future high-quality studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Ellem Eduarda Pinheiro dos Santos
- Post-Graduate Program in Human Movement Sciences and Rehabilitation, Federal University of São Paulo (UNIFESP) Campus Baixada Santista, Santos 11015-020, Brazil; (E.E.P.d.S.); (J.A.G.)
| | | | - Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4SOA2, Canada;
| | - Scott C. Forbes
- Department of Physical Education Studies, Brandon University, Brandon, MB R7A6A9, Canada
- Correspondence: (S.C.F.); (J.P.B.)
| | - Jaddy Antunes Guijo
- Post-Graduate Program in Human Movement Sciences and Rehabilitation, Federal University of São Paulo (UNIFESP) Campus Baixada Santista, Santos 11015-020, Brazil; (E.E.P.d.S.); (J.A.G.)
| | | | - Wagner Luiz do Prado
- Department of Kinesiology, California State University San Bernardino, San Bernardino, CA 92407, USA;
| | - João Paulo Botero
- Department of Human Movement Sciences and Rehabilitation, Federal University of São Paulo (UNIFESP) Campus Baixada Santista, Santos 11015-020, Brazil
- Correspondence: (S.C.F.); (J.P.B.)
| |
Collapse
|
10
|
Sheridan HC, Parker LJF, Hammond KM. DIETARY SUPPLEMENTS FOR CONSIDERATION IN ELITE FEMALE FOOTBALLERS. Eur J Sport Sci 2021; 22:733-744. [PMID: 34623938 DOI: 10.1080/17461391.2021.1988149] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The physical demands of professional female football have intensified in recent years. Supplements are only advised in addition to a healthy, balanced diet, but may warrant a greater prevalence in the professional game to support well-being, recovery, and performance. Supplements used by players should be safe, legal, and scientifically proven to be effective. An individual approach should be taken to using supplements dependant on the needs and goals of the player. Female players should aim to improve the frequency of protein intake throughout the day, whilst tailoring doses to individual body mass. Vitamin D supplementation is vital throughout the winter months in countries with limited sun exposure, however doses should be administered based on individual blood test results. Iron is likely to be important to the well-being of female athletes throughout the season, in particular during the menses. Omega-3 and collagen may be of greater benefit to female than male athletes during recovery from soft tissue injury, whilst probiotics and creatine are beneficial throughout the season for reducing risk of illness and optimising recovery, respectively. Ergogenic supplements for football include beta-alanine, nitrate and caffeine. Caution should be taken with caffeine use due to the varying tolerance of difference athletes and sleep impairments that can follow.
Collapse
Affiliation(s)
| | - Lloyd J F Parker
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Kelly M Hammond
- School of Health & Society, University of Salford, Manchester, M54WT
| |
Collapse
|
11
|
Crawford C, Boyd C, Deuster PA. Dietary Supplement Ingredients for Optimizing Cognitive Performance Among Healthy Adults: A Systematic Review. J Altern Complement Med 2021; 27:940-958. [PMID: 34370563 DOI: 10.1089/acm.2021.0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Dietary supplements promoted for brain health and enhanced cognitive performance are widely available. Claims made for these products are directed not only to the elderly wishing to prevent or mitigate cognitive decline, but also young healthy populations looking to boost their cognitive performance. It is unclear whether these claims made on product bottles and through advertising match the science. Objectives: To explore the evidence on the efficacy and safety of single dietary supplement ingredients frequently marketed with claims of enhanced cognitive performance among healthy adults. Design: A systematic review. Results: Nine of 54 dietary supplement ingredients identified through a scoping review met the eligibility criteria with at least 3 published studies identified per ingredient, yielding 69 unique publications. Ingredients evaluated included Bacopa monnieri, choline, creatine, omega-3 fatty acids, Ginkgo biloba, ginseng, Rhodiola rosea, tyrosine, and valerian root, all in supplement form and compared with a placebo, at various serving sizes and durations of use. Conclusions: The low level of certainty in the state of the science, coupled with not always knowing what is in a dietary supplement product, make weighing risks and benefits difficult; these data hinder the ability to develop recommendations about using such ingredients for consumers interested in boosting their cognitive performance. Whereas certain trends regarding promising serving sizes or duration for use, are pointed to in this synthesis, when combined, studies are inconsistent and imprecise, and many are methodologically flawed. Potential solutions to address research gaps are offered, for future research next steps, which is needed to strengthen the evidence and inform decisions.
Collapse
Affiliation(s)
- Cindy Crawford
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Courtney Boyd
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA
| |
Collapse
|
12
|
Sheyholislami H, Connor KL. Are Probiotics and Prebiotics Safe for Use during Pregnancy and Lactation? A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13072382. [PMID: 34371892 PMCID: PMC8308823 DOI: 10.3390/nu13072382] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
Probiotic and prebiotic products have shown potential health benefits, including for the prevention of adverse pregnancy outcomes. The incidence of adverse effects in pregnant people and their infants associated with probiotic/prebiotic/synbiotic intake, however, remains unclear. The objectives of this study were to evaluate the evidence on adverse effects of maternal probiotic, prebiotic, and/or synbiotic supplementation during pregnancy and lactation and interpret the findings to help inform clinical decision-making and care of this population. A systematic review was conducted following PRISMA guidelines. Scientific databases were searched using pre-determined terms, and risk of bias assessments were conducted to determine study quality. Inclusion criteria were English language studies, human studies, access to full-text, and probiotic/prebiotic/synbiotic supplementation to the mother and not the infant. In total, 11/100 eligible studies reported adverse effects and were eligible for inclusion in quantitative analysis, and data were visualised in a GOfER diagram. Probiotic and prebiotic products are safe for use during pregnancy and lactation. One study reported increased risk of vaginal discharge and changes in stool consistency (relative risk [95% CI]: 3.67 [1.04, 13.0]) when administering Lactobacillus rhamnosus and L. reuteri. Adverse effects associated with probiotic and prebiotic use do not pose any serious health concerns to mother or infant. Our findings and knowledge translation visualisations provide healthcare professionals and consumers with information to make evidence-informed decisions about the use of pre- and probiotics.
Collapse
|
13
|
Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients 2021; 13:nu13030877. [PMID: 33800439 PMCID: PMC7998865 DOI: 10.3390/nu13030877] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/14/2022] Open
Abstract
Despite extensive research on creatine, evidence for use among females is understudied. Creatine characteristics vary between males and females, with females exhibiting 70–80% lower endogenous creatine stores compared to males. Understanding creatine metabolism pre- and post-menopause yields important implications for creatine supplementation for performance and health among females. Due to the hormone-related changes to creatine kinetics and phosphocreatine resynthesis, supplementation may be particularly important during menses, pregnancy, post-partum, during and post-menopause. Creatine supplementation among pre-menopausal females appears to be effective for improving strength and exercise performance. Post-menopausal females may also experience benefits in skeletal muscle size and function when consuming high doses of creatine (0.3 g·kg−1·d−1); and favorable effects on bone when combined with resistance training. Pre-clinical and clinical evidence indicates positive effects from creatine supplementation on mood and cognition, possibly by restoring brain energy levels and homeostasis. Creatine supplementation may be even more effective for females by supporting a pro-energetic environment in the brain. The purpose of this review was to highlight the use of creatine in females across the lifespan with particular emphasis on performance, body composition, mood, and dosing strategies.
Collapse
|
14
|
Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2021; 18:13. [PMID: 33557850 PMCID: PMC7871530 DOI: 10.1186/s12970-021-00412-w] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/28/2021] [Indexed: 01/01/2023] Open
Abstract
Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine 'loading-phase' required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.
Collapse
Affiliation(s)
- Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, Florida, USA.
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Andrew R Jagim
- Sports Medicine Department, Mayo Clinic Health System, La Crosse, WI, USA
| | - Richard B Kreider
- Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, USA
| | - Eric S Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
| | | |
Collapse
|
15
|
Creatine Metabolism in Female Reproduction, Pregnancy and Newborn Health. Nutrients 2021; 13:nu13020490. [PMID: 33540766 PMCID: PMC7912953 DOI: 10.3390/nu13020490] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 12/12/2022] Open
Abstract
Creatine metabolism is an important component of cellular energy homeostasis. Via the creatine kinase circuit, creatine derived from our diet or synthesized endogenously provides spatial and temporal maintenance of intracellular adenosine triphosphate (ATP) production; this is particularly important for cells with high or fluctuating energy demands. The use of this circuit by tissues within the female reproductive system, as well as the placenta and the developing fetus during pregnancy is apparent throughout the literature, with some studies linking perturbations in creatine metabolism to reduced fertility and poor pregnancy outcomes. Maternal dietary creatine supplementation during pregnancy as a safeguard against hypoxia-induced perinatal injury, particularly that of the brain, has also been widely studied in pre-clinical in vitro and small animal models. However, there is still no consensus on whether creatine is essential for successful reproduction. This review consolidates the available literature on creatine metabolism in female reproduction, pregnancy and the early neonatal period. Creatine metabolism is discussed in relation to cellular bioenergetics and de novo synthesis, as well as the potential to use dietary creatine in a reproductive setting. We highlight the apparent knowledge gaps and the research “road forward” to understand, and then utilize, creatine to improve reproductive health and perinatal outcomes.
Collapse
|
16
|
Kreider RB, Stout JR. Creatine in Health and Disease. Nutrients 2021; 13:nu13020447. [PMID: 33572884 PMCID: PMC7910963 DOI: 10.3390/nu13020447] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/14/2022] Open
Abstract
Although creatine has been mostly studied as an ergogenic aid for exercise, training, and sport, several health and potential therapeutic benefits have been reported. This is because creatine plays a critical role in cellular metabolism, particularly during metabolically stressed states, and limitations in the ability to transport and/or store creatine can impair metabolism. Moreover, increasing availability of creatine in tissue may enhance cellular metabolism and thereby lessen the severity of injury and/or disease conditions, particularly when oxygen availability is compromised. This systematic review assesses the peer-reviewed scientific and medical evidence related to creatine's role in promoting general health as we age and how creatine supplementation has been used as a nutritional strategy to help individuals recover from injury and/or manage chronic disease. Additionally, it provides reasonable conclusions about the role of creatine on health and disease based on current scientific evidence. Based on this analysis, it can be concluded that creatine supplementation has several health and therapeutic benefits throughout the lifespan.
Collapse
Affiliation(s)
- Richard B. Kreider
- Human Clinical Research Facility, Exercise & Sport Nutrition Lab, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843, USA
- Correspondence:
| | - Jeffery R. Stout
- Physiology of Work and Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, School of Kinesiology and Physical Therapy, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA;
| |
Collapse
|