The International Society of Sports Nutrition published in 2017 a position stand (see reference below) on the safety and efficacy of creatine supplementation in the context of exercise, sports and medicine.

Creatine supplementation, one of the most popular and studied nutritional supplements, has in fact been shown to be effective in improving athletic performance (especially in high intensity exercise) and inducing relevant training adaptations. The consequent increase in intramuscular creatine (and phosphocreatine) reserves facilitates the rapid re-synthesis of ATP, the so-called energy “currency” of the body, which is essential for almost every reaction in our body. Thus, the increased availability of creatine in the cell through supplementation contributes to improve performance because it increases the energy availability in order to exercise (i.e. muscle contraction) as well as a whole range of other muscle cell related reactions. Creatine supplementation can in fact enhance strength production, muscle work, accelerate recovery and help preventing injury.

Additionally, creatine supplementation appears to be highly safe and effective not only in athletes but also in non-athletes (such as the so-called exercise enthusiasts), as well as in various clinical populations. In fact, several studies (see ISSN article, reference below) point to benefits of creatine supplementation in various populations and clinical settings, such as:

– Accelerating injury rehabilitation (because it attenuates muscle atrophy);

– Protection of neuronal injuries (spinal and cerebral);

– Mitigation of debilitating consequences in people with congenital syndromes of creatine synthesis deficiency;

– Attenuating the progression of neurodegenerative diseases (e.g. Huntington’s disease, disease, Parkinson’s disease, mitochondrial diseases, amyotrophic lateral sclerosis);

– Prevention and / or improvement of bioenergetics in patients with myocardial ischemia or stroke victims;

– Improving metabolic and functional indicators associated with aging;

– Possible benefit during pregnancy for optimal growth, development and health of the fetus.

In conclusion, creatine does indeed appear to be a safe and beneficial nutritional supplement for a wide range of populations and ages. Indeed, this is a supplement that actually works!

Take creatine and power to you!

Nuno Correia

References:

Kreider, R.B. et al., 2017. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1), p.18. Available at: http://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z.

 

In order to maintain physical function, recover better from injury, maintain lean mass and stay healthier overall, older individuals need a higher protein intake than younger individuals. Higher protein intake contributes for attenuating inflammatory and catabolic processes, as well as ameliorating the decreased efficiency in protein metabolism associated with age.

According to the recommendations advanced by the PROT-AGE Study Group (2013) (reference below), older individuals should:

– eat at least 1 to 1.2g/kg body weight of protein per day;
– eat MORE protein if suffering from acute or chronic illness, between 1.2-1.5g/kg body weight of protein per day;
– ingest EVEN MORE if malnourished and / or suffering from severe illness or injury, ~2g/kg body weight of protein per day;
– limit protein intake if suffering from SEVERE KIDNEY DISEASE and NOT following hemodialysis. These individuals are therefore an EXCEPTION concerning protein intake;
– use supplementation to the achieve desired protein intake levels;
– and, of course, DO the type of exercise that most effectively promotes the maintenance or increases in lean mass, which is strength training.

And no, kidney disease is NOT caused by protein intake. In a one-year follow-up study with resistance-trained men consuming ~2.51-3.32 g/kg of body weight per day for one year, there were no harmful effects on measures of blood lipids as well as liver and kidney function (Antonio et al, 2016).

Maintaining strength and lean mass (including muscle mass, bone and connective tissue mass) are identified as the first and most relevant biomarkers of health and longevity. Improving these markers produces a positive and powerful “domino effect” on most (probably all) of the other health markers. Proper protein intake and strength training is essential for building lean mass. And even more crucial as we age in order to counteract the inevitable progressive loss of efficiency in our metabolism.

Do not fear protein nor strength training. These are probably two of your best allies to live better and longer.

Don’t forget the protein at your next meal!

Nuno Correia

References:

Bauer, J. et al., 2013. Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the prot-age study group. Journal of the American Medical Directors Association, 14(8), pp.542–559.

Antonio, J., Ellerbroek, A., Silver, T., Vargas, L., Tamayo, A., Buehn, R., & Peacock, C. A. (2016). A High Protein Diet Has No Harmful Effects: A One-Year Crossover Study in Resistance-Trained Males. Journal of nutrition and metabolism, 2016, 9104792.