Creatine Explained: 5 Science-Backed Benefits You Didn’t Know | The Proof Podcast EP #344

when it comes to supplements only a select few make my must have list and at the very top of that list is creatine but here's the thing creatine isn't just for bodybuilders or gym enthusiasts it's really a game Cher for almost everyone in this episode I'm breaking down five compelling evidence-based reasons why creatine deserves a spot in your daily supplement routine whether you've heard about before or perhaps this is your first introduction stick around because I'll be covering several new studies including one hot off the press that explores how creatine might boost your cognition after a poor night's sleep but first my team tells me that more than 55% of all watch time on the proof YouTube channel is from people who are not subscribed so if you haven't yet please hit subscribe so we can keep you up to date with new episodes and you'll also be doing us a huge favor by helping the show reach more people let's start with some Basics what exactly is creatine creatine is a nonprotein amino acid that the body produces mostly in the liver but also the pancreas and the kidneys which plays an important role in cellular metabolism and energy production within important organs that have high energy demands such as muscle brain heart and Bone tissues essentially having creatin around helps cells in these tissues produce more ATP our cells need this ATP on hand to function optimally about 95% of the body's creatine is found in muscle cells and most of the remainder is found in brain bone and heart cells so keeping it very very simple creatine is an amino acid that allows your cells to function as they should a nonprotein amino acid means that unlike amino acids like Lucine and veine which you may have heard of creatine is not used to synthesize proteins but rather has Direct effects on physiology as an amino acid itself the key takeaway here being that creatine is important for energy production and metab ISM and the body is able to manufacture it in fact the liver pancreas and kidneys produce about 1 gr of creatine per day from the amino acids Arginine Glycine and methionine and the average person eating an omnivorous Western diet gets another 1 gr or so per day through animal foods such as red meat and fish which are relatively rich in creatin in fact quick bit of history for you while we're here cretan was discovered in meat In 1832 by a French scientist Mel Eugene chevil he named it creatine from the Greek word creus which means meat because we can make creatine it's considered non-essential but as we will come to later that doesn't mean that an additional intake even above what's typically achieved with food isn't preferred or more beneficial so to speak in the rare case where someone has a genetic mutation that impairs their ability to make or transport creatine so-called creatine deficiency disorders or cdds patients typically present with delays in cognitive and physical development speech and language disorders cognitive dysfunction behavioral disorders seizures and or muscle weakness now that you know what creatine is let's get into the five reasons why I believe just about everyone should supplement with it and then we can finish with my supplementation recommendations dose type of creatine Etc reason number one to supplement with creatine creatine improves strength muscle mass and body composition several large metaanalyses of clinical trials have concluded that supplementing with creatine monohydrate improves strength muscle mass and body composition the main mechanism that explains these benefits is increased time to exhaustion but simply creatine allows you to do more work at a high intensity before you fatigue and more work equals greater training adaptations this is a finding that's been reproduced over decades in men and women during adulthood and late adulthood importantly these clinical trials suggest that these improvements in strength muscle mass and body composition are mostly observed when someone supplements creatine in conjunction with resistance training and while these body composition results have been observed in both men and women men do seem to respond a little more favorably to creatine supplementation it's not fully understood why men seem to respond better to creatine supplement mentation when it comes to this outcome of body composition but it is thought that it may be to do with Baseline creatine levels with some evidence and I quote here that females may have higher intramuscular creatine stores which may blunt their responsiveness to creatine supplementation the idea being that because men's Baseline creatine levels are relatively lower they may benefit more from an exogenous source of creatine broadly speaking men see about a 1 to 1. 5 kg increase in fat free mass and women about a half a kilogram increase in fat free mass and on average there's a little less than a 1% reduction in body fat percentage the key takeaway here is that creatine can improve body composition but it's not magic similar to protein unless the stimulus is there I. E resistance training while you may see some modest improvements in strength physical performance function and body composition they will be much more limited than if you combine creatine with resistance training so in that sense you can kind of consider creatine as an amplifier it's going to amplify the results that you get from your resistance training to give you an idea of how consistent this result is the international Society of Sports Nutrition said this in a 2018 review and I quote creatine monohydrate is the most effective erogenic which means performance-enhancing nutritional supplement currently available to athletes in terms of increasing high-intensity Exercise capacity and lean body mass during training end quote would I supplement with creatine if I couldn't do resistance training the data here is quite mixed but yes I probably still would but I also would be realistic about the results that I expect they're going to be much less than if I was combining creatine with resistance training the dose used in the majority of these studies is 3 to 5 G per day or .

1 G per kilogram of body mass the ladder being a little more individualized because it considers your muscle mass so for someone who's 80 kg that would be 8 G per day for someone who's 50 kg that would be 5 G per day you may have heard of creatine loading phases some Studies have used this to quickly get creatine levels in muscle tissue to a point of saturation i. eat the maximum amount of creatine within muscle cells this protocol typically involves dosing with 20 to 25 G of creatin per day for 5 to 7 days when first starting and then shifting to that maintenance dose I just mentioned of 3 to 5 G per day or . 1 G per kilog while you can do that to get your creatine levels up sooner we Now understand that it's not really that necessary if you just begin with 3 to 5 G per day or .

1 G per kilogram you will get to the same point of creatine saturation within muscle cells within about 28 days importantly and we'll revisit this if for some reason you really quickly want to increase creatine stores and so you do choose to do this loading phase it's a good idea to split this 20 to 25 G dose up throughout the day into two or three serves if you're someone that gets gastrointestinal distress following creatine consumption nausea diarrhea Etc which isn't that uncommon while we're talking about an increase in lean body mass you may have heard that creatine increases water retention is it possible that the increase in fat-free Mass is from water is it actually muscle tissue while there is some data that suggests cre does indeed increase water retention in the first few weeks or so when you begin supplementing which is why someone may see their scale weight go up in those early weeks this water is mostly confined to within muscle cells now this is a good thing because not only does it make you look more dare I say toned or firm but the extra water in muscle cells improves cell signaling resulting in more protein synthesis and more muscle tissue over time simply put more water in muscle cells more protein synthesis more muscle and this certainly isn't just about Aesthetics if you're a regular listener and or you've done our zeroc cost living proof challenge you will know being strong and having good body composition is crucial for maintaining optimal metabolic health and functional Independence as we age the other perk with supplementing creatine alongside resistance training is that there is some recent evidence suggesting it will improve your sleep on the days you do resistance training a fast fasinating new study hot off the press randomized premenopausal women to 5 G of creatine per day for 6 weeks or Placebo with resistance training performed twice a week subjects were wearing a fitness tracker to track their sleep sleep duration was significantly longer about 50 minutes or more per night on resistance training days in the subjects supplementing with creatine reason number two to supplement with creatine improved recovery and performance for endurance athletes this might be one of the less discussed benefits of adding creatine to your supplement stack creatine appears to not only be beneficial for people who are doing resistance training where you have high-intensity efforts for 20 or 30 seconds or so depending on the number of reps being performed in your set but also people who do certain types of prolonged endurance exercise this is thought to be explained by a few mechanisms the main one being enhanced glycogen SCE glycogen is how we store glucose considerate carbohydrate that resides in your muscle cells that's used up during intense and prolonged exercise Studies have shown that when you add creatine to dietary carbohydrates glycogen stores are restored more quickly and you store more glycogen compared to ingesting carbohydrates without creatin more glycogen means more available carbohydrate to be used to generate energy at high intensities and then there's also evidence that suggests having gred glycogen stores can help prevent overtraining during intense training periods the age-old debate about creatin for indurance athletes however is whether or not this Improvement in glycogen replenishment and storage outweighs the extra lean body mass that comes with creatine supplementation if you're going to run a marathon do you really want to be half a kilogram or 1 kg heavier how in inurance athlete makes this decision will largely rest on the type of endurance activity that they are engaging in and of course some self-experimentation if the exercise or sport requires low intensity sustained activity without surges of high-intensity work studies suggests that creatine is probably not going to be a net positive that extra weight will just slow the athlete down however if the endurance activity and by endurance here I mean activity over 3 minutes long requires surges of high-intensity work like Triathlon CrossCountry skiing rowing Etc studies suggest physical performance could in fact be improved with creatine supplementation the benefit here being that you have more glycogen on board which means more available glucose for Rapid ATP synthesis and with high creatine stores you can recycle more ATP and thus be a little more resistant to fatigue during those high-intensity surges there's also some evidence suggesting that creatine can improve recovery and muscle pain after prolonged exercise with with a study that I found in the early 2000s showing reduced cell damage and inflammation after a 30 km run with five gr of creatine per day for the 4 days leading up to the event overall it is certainly true that there is less evidence to support creatine for urance exercise however as I said if your urance activity involves surges or Sprints high-intensity work where you are absolutely blowing up then you might want to experiment with creatine track your performance and see if you have improved stayed the same or gone backwards if you choose to go with the 3 to 5 G per day or . 1 G per kilogram protocol I would allow at least a month to monitor your results so you can see how your performance is when your muscle cells are fully saturated with creatine or do the loading phase of 20 to 25 G per day for 7 days before shifting to that maintenance phase reason number three to supplement with creatine creatine may help improve osteoarthritis this one's close to heart as many of you know I started my career as a physiotherapist there was an interesting clinical trial published in 2011 in the Journal of Medicine and Science in sports and exercise by nees etal and in this study they took 26 postmenopausal women with knee osteoarthritis and they randomized them to creatine and lower limb resistance training or Placebo and lower limb resistance training this was a 12we double blind randomized control trial so neither the subjects or the coaches helping with the resistance training and Performing the measurements of function were aware who was given creatine and who was given the placebo until after the study a nice study design the subjects in the arm received 20 G of creatin monohydrate per day for the first week followed by 5 G of creatine per day for the next 11 weeks the placebo group was given the exact same doses only they were given dextrose not creatine all participants reported 100% compliance with the supplementation protocol both groups did lower limb resistance training three times per week over the 12 weeks under the supervision of a fitness professional by the end of the trial only the subject supplementing with creatine had a significant Improvement in physical function stiffness lower limb lean mass and quality of life both groups did have a significant reduction in pain indicating that resistance training alone is a great idea for postmenopausal women with knee osteoarthritis to reduce pain which is consistent with many other studies but better again is combining it with creatine monohydrate for physical function and quality of life improvements it's worth noting that the researchers did mention in their discussion that none of the 26 subjects in this particular study had severe osteoarthritis so we really cannot generalize these results to subjects who are candidates for joint replacement surgery more research would be needed there that said I did include this as one of the five reasons to supplement with creatine because almost 10% of adults in countries like USA and Australia do suffer from osteoarthritis many of whom who are not candidates for joint replacement surgery or don't want to have surgery so there is a lot of people maybe you listening or someone you know whose quality of life could significantly improve by supplementing creatine in conjunction with resistance training reason number four to supplement with creatine creatine may help your brain recover after periods of stress this is another new study hot off the press I've brought you a couple of those today you're welcome a really really cool study it's well described in the scientific literature that cognitive performance is impaired after sleep deprivation in fact I bet you've experienced that yourself the old brain being a little sluggish after being kept up all night this was a double blind randomized crossover trial there was 15 subjects eight were female seven male average age of 23 years and they were brought into an impatient setting and completed brain scans and cognitive tests at 600 p. m.

to get a baseline before being kept awake all night after the Baseline testing at 600 p. m. they were given either 35 G per kilog of creatine monohydrate or 35 G per kilog of placebo before being kept awake all night and undergoing brain scans and completing cognitive tests at 2hour intervals from 11:30 p.

m. to 5:30 a. m.

this is quite a high dose of creatin for someone who weighs 70 kg it's 25 G the rationale being that neurons a type of cell in our brains appear to have increased energy requirements after sleep deprivation and in order to get enough creatine into the brain you have to administer a very high dose that first saturates muscle cells with enough left over to then cross the bloodb brain barrier here's what they found firstly the oral creatine monohydrate was bioavailable to the brain meaning that this single dose significantly raised brain creatine levels secondly when given creatine subjects had significantly less subjective fatigue they didn't feel as tired third creatine supplementation significantly improved short-term memory and reaction speed the maximum cognitive effect was observed at 4 hours post creatine ingestion but lasted up to 9 hours post ingestion surprising to me here was that the was well tolerated in subjects with no reports of gastrointestinal symptoms despite the very high dose so overall a compelling study that supports high does creatine supplementation after getting insufficient sleep if you're wanting to feel less fatigued and feel more mentally switched on while we're talking about creatine and cognition a lot has been made in recent years about high dose creatine supplementation for cognition more broadly with many on social media now recommending 10 to 30 gr of creatine per day even for healthy individuals my view here is perhaps slightly different to what you've come across online I'm not yet fully convinced that outside of days where you are affected by something like sleep deprivation there's enough evidence to support highd does creatine supplementation for cognition especially in healthy adults a theoretical case can be made that in people who have insufficient brain levels of creatine during periods of of high mental stress for example or chronic brain conditions such as Alzheimer's and depression that high do creatine may be beneficial especially in older adults but this is far from proven at a clinical level as we sit here today what about vegetarians and vegans you might come across this idea online that when it comes to cognition vegetarians will benefit more from creatine supplementation than omnivores because of their lower dietary creatine index even if they are otherwise healthy there's actually no good evidence to support that there's a single study by Benton eile that people often point to as evidence that vegetarians benefit more from creatine than omnivores when it comes to cognitive performance but what people are not appreciating is that the result in this study was driven by a decline in performance between tests in the omnivore group not improved performance in the vegetarian group there's a bit of physiology here that is important to understand while it was once hypothesized that vegetarians may have lower brain creatine levels that's actually been studied and it's now understood that vegetarians do not have lower brain creatine levels than omnivores at least in healthy subjects when your brain is functioning properly your brain Creatine level seems to almost entirely be determined by creatine synthesis that occurs in astrocytes cells that reside in the brain not from creatine in your diet this is different to muscle tissue muscle tissue creatin levels are much more affected by our diet and it is true that vegetarians and vegans tend to have lower muscle creatine levels than omnivos this is why vegetarians tend to benefit more from creatine supplementation when it comes to Performance than omnivores but that said omnivores still don't get enough creatine in their diet to fully saturate their muscle cells which is why even folks like my friend Paul saladino who eats a very meat heavy diet supplements with creatine isn't that right Paul here's a day of eating for me poov edition first thing in the morning pre- surf I'll have some raw goat milk add some creatine to that and a little bit of raw organic glyphosate free honey and then I'm off to the ocean to chase some waves thank you Paul for that Cameo coming back to the brain and cognition here as soon as you have some sort of brain injury be it from acute insults from concussion or chronic from depression Alzheimer's Etc it is certainly plausible that dietary creatine or creatine supplementation becomes more more important in this context as we've just seen with the recent study on sleep deprivation this is an area of active research so I suspect over the coming years this is something that we will all better understand perhaps there will be a creatine protocol for those with depression Alzheimer's postconcussion Etc or not we'll see what the data shows either way make sure that you are subscribed to the show here and I'll be sure to keep you updated in the meantime given that creatine monohydrate has a good safety profile at doses up to 30 G per day for a wide range of people except those with pre-existing kidney disease and is relatively inexpensive it might be something you're comfortable experimenting with until we have more data especially if you're an older adult or you're someone who has a history of acute brain injury like concussion Andor chronic brain conditions like Alzheimer's or depression reason number five to supplement with creatine creatine May improve your bone health for years scientists have speculated that creatine may be beneficial for increasing bone mineral density and reducing risk of fractures there are two main mechanisms that brought about this hypothesis first creatine has been shown in preclinical studies to increase the activity of osteoblasts cells that produce bone tissue second we know that creatine increases strength and muscle mass which means more force is transferred from muscle and tendon to bone that increased Force could then stimulate the bone to grow stronger DrDarren kandal a previous guest of the proof and colleagues said out to investigate this their recent study found that postmenopausal women randomized to 2 years of creatine supplementation at a dose of . 14 G per day alongside resistance training 3 days per week did not improve bone mineral density but did improve bone geometry at the femoral head compared to Placebo we don't know if this Improvement in bone GE ometry means less risk of Falls and fractures because the study wasn't long enough to track that but it's suggestive that this will be the case the authors of this study concluded and I quote collectively creatine with strength training May enhance bone strength via altered bone geometry but has no effect on bone mineral future research examining the potential of creatine to reduce the impact on Falls is warranted end quote for the meantime if you are a post menop or woman particularly if you have low bone mineral density a history of Falls or a family history of osteopenia osteoporosis you may want to consider supplementing with . 14 G of creatine monohydrate per kilogram per day alongside a good resistance training program for a 70 kg woman that's around 10 G per day if you're interested to hear more on Creatine and bone health check out my episode with DrDarren kandal okay now that we've discussed five reasons to supplement with cre creatine let's talk about what type of creatine is best what dose is most optimal and what the safety profile of creatine is like there are a bunch of different types of creatine that you'll find online and in your local supplement stores creatine monohydrate is the most common but you may also see creatin ethylester or CE creatine hydrochloride or HCL magnesium keate and buffed also called cre in so what is the most effective form of creatin well there's no science to my knowledge that suggests any of these less Common forms of are more effective than creatine monohydrate at inducing the health benefits we've gone through in this episode in fact creatin monohydrate is the form of creatine that is Far and Away the most studied and science supported form of creatine here's a conclusion from a recent review of clinical trials investigating creatine and I quote based on the current met analysis creatine monohydrate is well studied effective has a well-developed safety profile and is economical additionally confirmed by a previous review creatine monohydrate is the only source of creatine that has substantial evidence to support bioavailability efficacy and safety recommended by professional societies and organizations future research may be warranted to explore Alternative forms of creatine however presently it is clear that other forms of creatine are not Superior to creatine monohydrate end quote my assumption is that these other forms of creatine have popped up and often claim to be superior without strong evidence because creatine monohydrate is a very cheap supplement to make and there are literally thousands of Brands globally selling it which makes it relatively inexpensive to the consumer choosing to go with a more novel form of creatine with a fancy story about absorption for example is how brands create a unique selling proposition which then allows them to make sales in a competitive market and increase their margin by selling at a higher retail price all based on the unsubstantiated claim that their form of creatine is somehow Superior to creatine monohydrate the take own point is to save your money and stick with the trusty creatine monohydrate the true evidence-based brands use this form of creatine When selecting a creatine monohydrate there are a few things to consider the first is the supplier of the creatin not the supplement brand but who they Source from my preference for a supplier of creatine monohydrate is Korea pure which is the most well studied highquality creatine monohydrate produced by a German supplier it is the creatin monohydrate that is used in the majority of peer-reviewed creatine studies so first things first I'm looking for creapure on the label but I also go a step further these days and look for an NSF certified creatine there's been some recent controversy where Brands selling creatine especially creatine gummies claim to have x g of creatine per dose but allegedly have skimped on their formulation and instead use other ingredients that are cheaper again than creatine to improve their margins for this reason I personally supplement with momentous creatine monohydrate they use the Crea pure creatine monohydrate from German and their product is also NSF certified for sport which means it's third party tested for Purity contaminants Etc this is the third party testing that is recommended by the NFL NBA PGA Iron Man Etc and many other organizations that are seeking to mitigate the risks of contaminated dietary supplements if it's good enough for professional athletes it's good enough for me so that's the type of creatine and my recommended brand brand momentous but what about dose well this really comes down to the benefit that you are personally chasing the strongest evidence is for 3 to 5 G per day or .

1 G per kilogram per day for building strength muscle and improving body composition if as we discussed earlier you're wanting to experiment with highd dose creatine supplementation for cognition it is important to remember that the first five or so gram of creatine that you consume per day is taken up by muscle so you need to fill that tissue up first before creatine starts to go to other tissues like brain and Bone that's why the typical dose in studies looking at increasing brain creatine levels are 10 to 30 gam of creatine per day and then there's the dose for improving cognition on specific days after sleep deprivation which was 35 G per kilogram for someone like me that weighs around 90 kilograms that's roughly 30 grams of creatin quite a high dose personally my regular dose of creatine is 10 gram per day split over two 5 gram servings with food I find that I tolerate that best why 10 G well I weigh 90 kg and so using the . 1 G per kilog calculation I get to 9 G and then I round that up to 10 G to make it simple with one scoop providing an even 5 G like the subjects in the recent sleep deprivation study you may well be perfectly fine with a high dose of creatine in a single serve that is something that you would need to experiment with if for whatever reason I personally have a poite sleep and I have an important day of cognitive tasks I would try and split that 30 G dose over two to three doses again with food if I had a history of concussions high stress depression or Alzheimer's I would strongly consider doubling my typical daily dose to 20 G per day as I mentioned earlier there's not convincing dating here yet but there's a signal to suggest that when our brain health is compromised brain creatine levels can Decline and various aspects of cognition can be improved with high do creatine supplementation importantly 20 to 30 gram per day taken ongoing has been shown to be safe except for people with pre-existing kidney disease if you're healthy you need not worry about your kidneys or liver and no you also do not need to worry about creatine causing hair loss that is not an adverse effect that's well supported by evidence at all despite what you may read online so to summarize for me creatine supplementation looks something like this 10 G of creatine per day split across two 5 G servings each with food to improve glycogen replenishment and decrease the chance of those gastrointestinal symptoms to calculate this for yourself use the1 G per kog of body weight formula 30 G of creatine on days where I have inadequate sleep and need my brain running on all cylinders days when I'm in meetings recording podcasts Etc and if you're worried about fractures the dose used to improve bone geometry was .