Creatine is naturally synthesised within the body, from the amino acid building blocks glycine, arginine and methionine. Along with dietary intake from meats and fish, this is normally adequate to maintain day-to-day levels within the body, including muscle and brain tissue. In most people, however, with a typical diet the creatine levels in muscles can be boosted* easily just by a regular supplementation with high bioavailability creatine monohydrate. Creatine, whether it comes from your diet in meat or as a supplement of creatine monohydrate, is identical to the creatine naturally synthesised within the body.

The effect of such an increase is an increased capacity to perform sustained high intensity or intermittent exercise, which in many sports means a significant increase in the level of performance. In a study conducted on 10 runners, 13 seconds (or 55 metres) were gained during sprints (4 x 1000 m) during the week following the beginning the supplement intake. 5.5 seconds of this gain was recorded during the last 1000 m only.

It’s quite possibly the most studied single supplement in the ergogenic category with many hundreds of papers now published. Its efficiency could be compared to the use of carbohydrates, aiming at increasing their levels in muscles. Creatine has an extremely low toxicity and its moderate use is not associated with any reported adverse side effect for a healthy subject. It is, after all, a regular (if not daily) part of a normal mixed diet. For lacto-ovo vegetarian/vegan people the dietary intake of creatine is effectively nil.

At the beginning, the recommended intake is 5 g four times a day over 5 days, in order to enable a quick increase and to reach elevated levels. This ‘starting up’ phase can be followed by a maintenance period with 2 or 3 g a day. Each 5 g intake can be compared to the quantity of creatine from 1kg of steak. The combination of creatine with carbohydrates enables the starting up phase to be accelerated: the carbohydrate stimulating the release of the insulin that makes the absorption of the creatine a lot easier for the body. Furthermore, the presence of creatine increases the quantity of stocked carbohydrates.

Owing to its efficiency in increasing the performance during exercise at the top athletic level, creatine is placed above the majority of ergogenic aids.

Some people may wonder why creatine wasn’t banned from sports if it’s so effective. Phosphorylcreatine (the phosphorylated form of creatine) is an integral part of the muscle energy system (and in other tissues too), acting as an intermediary, enabling the metabolic energy to be made more available. Unlike carbohydrates and fats, phosphorylcreatine is not used up during this process, just cycled round over and over. But, when energy demands are suddenly too high for food burning to keep up, the creatine reservoir can rapidly deliver its stored energy, directly resynthesising ATP. This can go on until either the phosphorylcreatine levels fall too low, or, lactic acid builds up. You can think of carbs and fats being the fuel of an engine and creatine acting like a gear-cog transferring the energy along.

Increasing the creatine available, either by supplementing or through regular food intake, can enable an increase in muscle efficiency.

Optimal nutrition to increase the body’s performance, rather than maintaining nutrition only to stay healthy could be an important discussion in the future.

Dr HARRIS
Professor at the University College Chichester Great Britain