Why the interest in creatine?
When 100-meter British sprinter Linford Christie won the gold medal the 1992 Olympic Games at the age of 32, he was the oldest athlete to accomplish that feat. To the sporting world, even more memorable than his winning time of 9.96 seconds was his use of creatine (pronounced Cree-ah-teen) and its introduction as a power supplement for athletes. Creatine became an overnight success, generating hundreds of media stories hailing its benefit or warning about its harm and kicking off a wave of research on this new dietary supplement.
What is creatine?
Creatine is a regenerator of the high-energy compound adenosine triphosphate (ATP); creatine combined with phosphate forms creatine phosphate (CP) and is used to make more ATP from adenosine diphosphate (ADP) under anaerobic conditions. In other words, when exercising at high intensity, when oxygen delivery to muscles is limited, CP can help regenerate the cell’s currency of ATP. When we need a rapid, high-power, short burst of energy, we draw on ATP and CP in muscle to allow for about a 5- to 6-second all-out performance. The sprint to the finish line, an all-out effort in track and field, and a breakaway slam dunk rely on the ATP and CP energy system. About 95% of our supply of creatine is found in skeletal muscles.
Is creatine found in food?
Creatine is consumed by eating meat, and the average intake of meat eaters is about 1 gram per day. The body has a limited ability to make creatine, with the kidney the major site of production. In this way, non-meat eaters make some creatine. Creatine supplementation can increase muscle CP content by about 20% and is usually accomplished by taking 3 to 5 grams per day, in a powder form.
Athletes have been using creatine for decades improve performance in high intensity activities and as a training aid to help increase lean mass when performing resistance exercise. Recently, researchers have studied its effect on older adults. Here’s what we know so far:
Muscle function and strength
Various studies have shown that creatine supplementation plus resistance exercise (weight training) improves upper and lower body strength and increases lean mass. It appears that supplementing with creatine on resistance training days increases measures of lean tissue mass and strength compared to those taking a placebo.
What does this mean for you?
If you are a serious resistance trainer, creatine supplements might help you get a bit stronger and allow you to train a bit harder. But, before you rush out to buy creatine, consider your food strategies. I’ve heard from several older adults who complain of fatigue and lack of results from exercise. But, when asked about eating habits, they are dismal. One 78-year-old man was eating only one meal a day…not enough calories and protein to support increased muscle strength. Another was practicing intermittent fasting and working out on fasting days, depriving muscles of needed energy and nutrients.
The most important take away message is that creatine by itself will not help you get stronger and improve function. Consistent, resistance, progressive exercise coupled with sufficient protein and calories consumed throughout the day might be all you need to improve muscle mass and strength.
Bone health
Bone is not a static tissue; it undergoes constant turnover, called bone remodeling, to deposit calcium into bones and remove it to keep blood calcium levels normal. When we are young, we are in the bone-building phase of life. As we age, we start to lose more bone than we build, a loss that is greater for women than for men. Estrogen—important for bone health–starts to decline around menopause and women can lose up to 20% of their bone density in the first 5 to 7 years after menopause. The loss slows after that, but never fully recovers. While we think of osteoporosis as a woman’s issue men are also affected, but usually at later ages. Weight-bearing exercise and resistance exercise help build stronger bones so if creatine supplementation supports muscle mass, will it also protect bone?
A few small studies show that creatine supplementation increases bone strength and can mitigate the rate of minerals lost from bone. Researchers suggest that is “highly plausible” that creatine may help, along with other interventions, to treat those with severe muscle weakness, muscle wasting, and frailty, but research is limited.
What does this mean for you?
Don’t expect creatine (or any other supplement) to prevent or reverse bone loss with aging. Do expect that getting stronger and performing exercises that improve ABC’s (agility, balance, and coordination) can help minimize bone loss and decrease risk of falls, a major reason older adults break bones. Yoga, Tai chi, or simply practicing balance by standing on one foot for a minute (tree pose, anyone?) can help your balance.
Nutrient-rich foods help with bone health, too. It takes about 15 nutrients to build bone, so get sufficient protein, calcium, vitamin D, and eat a variety of fruits, veggies, whole grains, and nuts to feed your bones.
Cognitive health
Worried about your brain health? As we age, our memory seems to falter, and our cognitive skills are not as sharp. With hundreds of supplements claiming to improve brain function, is creatine on that list? Our brain requires a lot of energy to keep humming along. While we think of creatine for muscle strength, creatine supplementation also increases brain levels of creatine. Some studies have found that supplementing with creatine (from 5 grams to 20 grams a day) improves memory tasks in older adults. Also, of interest, vegetarians have lower creatine levels (remember, dietary creatine comes from meat) and a few studies found that supplementing the non-meat eater’s diet with creatine improved some tests of memory. Recently, researchers conducted a systematic review of the studies on creatine and memory (click here for the study) and concluded that the literature is conflicting on the effects of creatine supplementation on cognitive performance. Some studies found a benefit in some cognitive tests while others found no effect.
The authors conclude that there is potential for creatine to help with cognition but there are many gaps in what is known about the effects of creatine on brain health.
What does this mean for you?
Don’t rely on creatine for brain health. Focus on what we know promotes good brain health: get quality sleep, eat foods rich in nutrients (greens, berries, fruit, lean meat, fish, whole grains, nuts, seeds, veggies, and herbs and spices), and stay fit with aerobic exercise and strength-training.
For more on healthy aging, click here to follow my blog. Dr. Chris Rosenbloom is a registered dietitian, nutrition professor emerita at Georgia State University, and co-author of Food & Fitness After 50. Remember, it is never too late to eat well, move well, and be well.
