JULY 30, 2004

'Creatine' a stir

Supplement muscles in on the market

Extract enhances performance but efficacy and safety remain fuzzy

When Mississauga homemaker, Susan Hrenchuk, overheard her 17-year-old son talking to his friends about taking creatine to boost his athletic performance, she was concerned. Her son quoted an ad that boasted creatine nutritional supplements are "nature's muscle builders." Susan knew creatine wasn't a steroid or an herbal agent, such as the recently banned ephedra, but was it safe and effective?

"Creatine is found in foods such as chicken, fish and meat, and is part of most people's diets," explains Dr Andrew Pike of the Ottawa Heart Institute and medical advisor at the Canadian Centre for Ethics in Sport (CCES). "The effect of creatine on exercise is well established. It can help in the regeneration of adenosine triphosphate (ATP) from adenosine diphosphate (ADP). That's important in rapid sequences of muscular activity."

Creatine supplements gained worldwide attention during the 1992 Barcelona Summer Games when two creatine-taking British sprinters, Linford Christie and Sally Gunnell, won gold medals. That year, a report in Clinical Science showed the supplements could increase creatine levels in muscles. Since then, several studies have shown that creatine enhances activities such as weightlifting, sprinting, and rowing that require short periods of intense power and strength.

"Creatine will not help everyone in every situation," cautions Dr Pike. "It is osmotically active, so it tends to cause muscles to swell and retain water. It adds body weight and might hinder performance of some activities."

"Creatine in supplements is isolated from meat extracts," says Professor Joe Schwarcz, PhD, Director of the McGill University Office for Science and Society. "We ingest roughly one to two grams a day in a typical diet, although vegetarians may consume less," adds Dr Schwarcz. "The supplement dosage is 20 grams a day, taken in four five-gram doses to saturate tissues, followed by two to five grams daily to maintain saturation."

Creatine supplements are perfectly legal in Canada, and eager athletes can saunter into any of our nation's many pharmacies or fitness shops and procure a 120g bottle for about $20. But just because the supplements are readily available, it doesn't mean those considering creatine should throw caution to the wind. There have been reports of contamination, in some rare cases, with toxic metals and small amounts of androstenedione. "Although there have been no consistent serious side effects noted in healthy individuals, there have been reports of dizziness, skin rash, diarrhea, anxiety, migraine, muscle pain and irregular heartbeat," warns Dr Schwarcz. "Certainly anyone suffering from kidney problems should stay away from creatine."

"Creatine supplementation is acceptable to sports' governing bodies and there's no way to tell if creatine in an athlete's blood came from a supplement or from a steak," says Dr Schwarcz. "Oral creatine can lead to modest improvement in repetitive, high intensity activities that last less than half a minute. Mild side effects have been reported, and anyone suffering from kidney problems should stay away from it."

"Longterm effects from creatine supplement use are largely unknown," adds Dr Pike. "A solid nutritional foundation is essential for successful athletic performance, and that doesn't mean that you have to go out and purchase all sorts of nutritional supplements."



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