Endurance and Ultra science explained #3: creatine monohydrate supplements
Creatine and Its Use
You’ve more than likely heard of creatine monohydrate. If you’ve ever done any strength work or even chatted to someone in a gym locker room, then you’ll know it’s a common supplement on the resistance exercise scene. You’ll also find it with those competing in team and sprint sports, but what about endurance and ultra-endurance runners, cyclists and triathletes? Is creatine of any use when going long? In this article, I explain some of the science, and potential use for creatine within a specific time frame in a periodized plan.
Creatine at the Olympics
The use of creatine became popular following the success of British athletes competing in the 1992 Barcelona Olympic Games (Jeukendrup and Gleeson, 2019). Gold medal-winning athletes provided testimonials that included the use of creatine, drawing the attention of the wider athletic community (Burke and Deakin, 2015). By the 1996 Atlanta Olympic Games, 80% of competing athletes were using creatine supplements (Williams, Kreider, and Branch, 1999). However, unlike other supplements, creatine had scientific support (Burke and Deakin, 2015). In their ground-breaking 1992 paper, Harris et al provided evidence that creatine stores could be increased in the muscle by orally administering large doses as a dietary supplement (Harris et al., 1992). In the years following, creatine has become one of the most popular ergogenic aids for athletes (Kreider, 2017), with an estimated 3,000,000kg consumed each year (Jeukendrup and Gleeson, 2019). The literature on creatine has consistently demonstrated that supplementation increases intramuscular stores of creatine, supporting training adaptations, improved athletic performance and enhanced recovery (Kreider, 2017).
What is creatine?
Creatine is a non-protein amino acid (Kreider, 2017) produced endogenously in the liver, pancreas and kidneys and consumed through the diet (Castell, Stear and Burke, 2015). Meat and fish are the main nutrient sources of creatine, with 3 to 5g of creatine contained in one kg of red meat and up to 10 g per kg contained in herring (Heaton et al., 2017). Creatine is absorbed into the blood and then taken up by the tissue (Kreider, 2017), where 95 percent is stored in skeletal muscle tissue (Heaton et al., 2017). Creatine, along with phosphocreatine (Pcr) and the enzyme creatine kinase (CK), is used to produce ATP when energy demand is high (Heaton et al., 2017). In the muscle, creatine is phosphorylated, with 60%-70% stored as PCr (Jeukendrup and Gleeson, 2019). The hydrolysis of PCr into creatine and Pi produces free energy that can be used to resynthesises ATP (Kreider, 2017). For a 70kg athlete, total creatine (including Pcr) is about 120mmol per kg of muscle, however, an upper limit of 160mmol is possible with supplementation (Kreider, 2017). Therefore, supplementation increases muscle creatine stores and aids in sustaining high-intensity exercise, keeping pace with energy demands and augmenting PCr resynthesis (Maughan et al., 2018). The use of creatine is most ‘effective for high intensity or maximal exercise <30 seconds’ (Peeling et al., P. 202., 2019).
Creatine: The Rationale
Along with an appropriate training stimulus, the rationale for creatine supplementation is to improve muscular strength and power (Maughan et al., 2018), enhancing training adaptations by allowing athletes to do more quality work, providing gains in sprint performance, strength and muscle mass (Kreider, 2017). High intensity and repeated bouts of performance are generally increased by 10-20% following creatine loading (Kreider, 2003). Supplementation can also provide benefits for the endurance athlete and enhance athletic performance and capacity in a number of other less documented ways (Maughan et al., 2018), these include post-exercise recovery, glycogen storage, muscle protein synthesis, enhanced growth factor expression, improved thermoregulation and reduction in muscle damage and inflammation. (Kerksick et al. 2018; Heaton et al. 2017). In addition, creatine supports high-intensity work and repeated sprints, enabling athletes to maintain power in short intervals.
How to Take
Effective supplementation relies on an appropriate loading and dosing strategy. The loading phase is generally an intake of 20 g of creatine monohydrate per day, split into four equal doses of 5 g per day over five days. 3 g per day is enough to maximally saturate creatine stores. Following a loading stage, a typical single daily dose is 3 - 5 g (Peeling et al., 2019). As with many supplements, there are varying levels of responders and non-responders. Those who gain the most benefits of creatine are athletes following a vegetarian or vegan diet (Kaviani, Shaw & Chilibeck, 2020). Vegetarians are typically higher responders to creatine supplementation due to lower intramuscular creatine stores through the absence of dietary creatine containing meat and fish. Vegetarian and vegan athletes therefore have the greater gains to make through creatine supplementation (Kreider, 2017). Over a number of long-term studies, creatine supplementation has been proved safe (Kerksick et al., 2018; Schilling et al., 2001). However, the negative consequences are increased water retention, leading to an initial weight gain of up to 2kg. This is usually decreased after the loading phase.
Any Use for Endurance and Ultra-Endurance Athletes?
So, is creatine useful for endurance and ultra-endurance athletes? If you want to rinse every last drop out of short high-intensity bouts, then yes, it could be used as part of a wider strategy to maximize training adaptations. Possible use could be early in a training plan. Short sprint sessions and strides improve mitochondrial respiration and VO2max (Hughes et al., 2018; Izumi et al., 1996). An all-out short sprint or stride will rely heavily on PCr stores as a substrate for energy production. The greater the creatine stores the greater the consistency of intensity over these short intervals. Another positive impact of creatine use is the augmented response to carbohydrate loading, providing a greater capacity glycogen (Roberts, et al., 2016). A potential downside of creatine use is weight gain through increased fluid retention, however, this is usually during the loading period. Creatine use could be effective endurance and ultra-endurance athletes, particularly in the early season training and outside of competition.
Paul B - Sport and Performance Nutritionist
References
Burke, L., and Deakin, V., (2015) Clinical sports nutrition (5th ed). Sydney: McGraw Hill
Castell, L.M., Stear, S.J., and Burke, L., (2015) Nutritional supplements in sport, exercise and health. London: Routledge
Gunnarsson, T. P., Brandt, N., Fiorenza, M., Hostrup, M., Pilegaard, H., & Bangsbo, J. (2019). Inclusion of sprints in moderate intensity continuous training leads to muscle oxidative adaptations in trained individuals. Physiological Reports, 7(4), e13976. https://doi.org/10.14814/phy2.13976
Harris, R.C., Söderlund, K. and Hultman, E. (1992) “Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation,” Clinical Science, 83(3), pp. 367–374. doi:10.1042/cs0830367.
Heaton, L. E., Davis, J. K., Rawson, E. S., Nuccio, R. P., Witard, O. C., Stein, K. W., Baar, K., Carter, J. M., & Baker, L. B. (2017). Selected In-Season Nutritional Strategies to Enhance Recovery for Team Sport Athletes: A Practical Overview. Sports Medicine, 47(11), 2201–2218. https://doi.org/10.1007/s40279-017-0759-2
Hughes, D. C., Ellefsen, S., & Baar, K. (2018). Adaptations to Endurance and Strength Training. Cold Spring Harbor Perspectives in Medicine, 8(6), a029769. https://doi.org/10.1101/cshperspect.a029769
Izumi, T., Kouji, N., Motoki, K., Yuusuke, H., Futoshi, O., Motohiko, M. and Kaoru, Y. (1996) Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and ˙VO2max, Medicine & Science in Sports & Exercise, 28(10), pp. 1327–1330. doi:10.1097/00005768-199610000-00018.
Jeukendrup, A.E., and Gleeson, M., (2019) Sport nutrition (3rd ed). Champaign, IL: Human Kinetics
Kaviani, M., Shaw, K., & Chilibeck, P. D. (2020). Benefits of Creatine Supplementation for Vegetarians Compared to Omnivorous Athletes: A Systematic Review. International Journal of Environmental Research and Public Health, 17(9), 3041. https://doi.org/10.3390/ijerph17093041
Kerksick, C. M., Wilborn, C. D., Roberts, M. D., Smith-Ryan, A., Kleiner, S. M., Jäger, R., Collins, R., Cooke, M., Davis, J. N., Galvan, E., Greenwood, M., Lowery, L. M., Wildman, R., Antonio, J., & Kreider, R. B. (2018). ISSN exercise & sports nutrition review update: research & recommendations. 1–57. https://doi.org/10.1186/s12970-018-0242-y
Kreider, R. B. (2003). Effects of creatine supplementation on performance and training adaptations. Molecular and Cellular Biochemistry, 244(1–2), 89–94. https://doi.org/10.1023/a:1022465203458
Maughan, R. J., Burke, L. M., Dvorak, J., Larson-Meyer, D. E., Peeling, P., Phillips, S. M., Rawson, E. S., Walsh, N. P., Garthe, I., Geyer, H., Meeusen, R., Loon, L. J. C. van, Shirreffs, S. M., Spriet, L. L., Stuart, M., Vernec, A., Currell, K., Ali, V. M., Budgett, R. G., … Engebretsen, L. (2018). IOC consensus statement: dietary supplements and the high-performance athlete. British Journal of Sports Medicine, 52(7), 439–455. https://doi.org/10.1136/bjsports-2018-099027
Peeling, P., Castell, L. M., Derave, W., Hon, O. de, & Burke, L. M. (2019). Sports Foods and Dietary Supplements for Optimal Function and Performance Enhancement in Track-and-Field Athletes. International Journal of Sport Nutrition and Exercise Metabolism, 29(2), 198–209. https://doi.org/10.1123/ijsnem.2018-0271
Roberts, P. A., Fox, J., Peirce, N., Jones, S. W., Casey, A., & Greenhaff, P. L. (2016). Creatine ingestion augments dietary carbohydrate mediated muscle glycogen supercompensation during the initial 24 h of recovery following prolonged exhaustive exercise in humans. Amino Acids, 48(8), 1831–1842. https://doi.org/10.1007/s00726-016-2252-x
Williams, M.H., Kreider, R.B., and Branch, J.D., (1999) Creatine: The power supplement. Champaign, IL: Human Kinetics