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Copyright: Nancy Clark, MS, RD

What Athletes Need to Know about Creatine

For years, athletes, coaches, and sports scientists alike have searched for "legal" ergogenic aids that will enhance performance with no harmful side effects. The search has culminated in creatine--a naturally occurring compound found in meat that enhances the ability to do repeated bouts of intense exercise.

Although creatine may "work", it's presence creates other concerns, such as an uneven playing field and promotion of the "play sports to win" philosophy. What happened to "sports for fun"? The following article offers some food for thought regarding creatine and sports.

What is creatine and what does it do? Creatine exists in muscles as creatine phosphate, a compound essential for generating energy during anaerobic exercise. High creatine levels enhance recovery during repeated bursts of exercise. People who take creatine commonly gain, on average, one to four pounds. The weight may be extra water held in the muscles, an increase in muscle mass, or both. "Weight gain varies from person to person" reports BJ Baker, strength trainer for the Boston Red Sox. Athletes with low creatine stores (often vegetarians or low meat eaters) often show the biggest response.

Are there harmful side effects? Because creatine is "natural" most athletes deem it safe. Creatine has been studied for 20 years; to date, there have been no documented side effects. Anecdotally, you might hear rumors about increased muscle cramps (likely due to dehydration not creatine) and pulled muscles (perhaps due to the rapid increase in strength and power--too much, too soon without the muscles, tendons and joints being able to gradually adjust to the increased workload). "We've had athletes stop using creatine because of cramping and muscle problems," reports Chris Rosenbloom, RD, sports nutritionist at Georgia Tech Univ.. But conscientious researchers have seen no such evidence in their studies.

The bigger problem may relate to the changes in physique. Baker warns his baseball players to stay focused on their sport, and not switch their mindset and workouts to that of a bodybuilder. "I see guys spending more time in front of mirrors, admiring their new muscles."

Which athletes are using creatine? Creatine has been shown to be most effective in sports involving repeated bouts of exercise--weight lifting, football, soccer, hockey, basketball, rowing. Creatine helps improve the quality of, and recovery from, repeated bouts of hard training, as well as promotes muscle growth which may, in turn, enhance gains in strength and power. "Just about every athlete wants to jump on the creatine bandwagon," comments Rosenbloom. "Incoming college freshman love creatine because it helps them bulk up quickly so they can compete with the older players."

Many female athletes, however, tend to shy away from creatine due to it's weight-gain effects. Potential weight gains also concern athletes such as wrestlers, light-weight rowers, and others in weight-restricted sports.

What's the best dose? Dr. Rick Kreider, exercise physiologist and researcher at Univ. Memphis suggests raising muscle creatine levels with 20 grams creatine (or more precisely 0.3 grams/kg body weight) taken in 5 gram doses, four times per day for 7 to 9 days (as a powder mixed with juice). Then follow this loading dose with a maintenance dose of 3 to 5 grams creatine/day.

Despite knowing a prescribed dose, many athletes believe if some is good, than more is better. Are there dangers to creatine overdosing? Will the body adjust to a sustained high creatine intake and reduce it's effectiveness?

How much does creatine cost? The cost of creatine is coming down as popularity and brand competition increases. At Georgia State Univ., the athletic department supplies it to all athletes who want it. If you're buying it yourself, expect to pay about $3/day for 20 grams, $0.75/day for maintenance, or about $35 per month--what you might spend on sports drinks or energy bars.

Should you or your child take creatine? Provocative question. For young team players, perhaps the parents should meet and make a group decision. After all, if one player takes creatine, the others will want to, too. Will this "magic bullet" undermine efforts to teach a strong work ethic and athletic improvement via proper fueling and dedicated training? Is "win at any price" the message coachers are conveying to their athletes? Can/should society put more emphasis on playing sports for enjoyment? Will taking creatine lead the way to taking steroids and other performance enhancing drugs? Or, is creatine loading as acceptable as carbohydrate loading? Is it simply an additional way to help athletes train well and get better gains?

Food First. The foundation to top sports performance remains breakfast, lunch, healthful snacks, and adequate fluids that fuel you for stellar workouts. Before any athlete contemplates taking creatine, s/he should first have a nutrition check-up. To find a sports nutritionist in your zip code area, call the American Dietetic Association's referral network (1-800-366-1655). Or visit their website http//www.eatright.org). You'll always win with good nutrition.

Nancy Clark, MS, RD specializes in nutrition for exercise. She offers private nutrition consultations at Sports Medicine Brookline. Her popular Sports Nutrition Guidebook, 2nd edition ($14.36) and The New York City Marathon Cookbook ($23) are available via Amazon.com