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Creatine supplementation has an ergogenic effect in an acute complex training bout, but the benefits of chronic creatine supplementation during long-term complex training remain unknown. The study aimed to evaluate the effects of 4-week complex training combined with creatine supplementation on sport performances and muscle damage biomarkers. Thirty explosive athletes were assigned to the creatine or placebo group, which consumed 20 g of creatine or carboxymethyl cellulose, respectively, per day for 6 days followed by 2 g of the supplements until the end of the study. After 6 days of supplementation, subjects performed tests of one repetition maximum (1-RM) strength of half squat and complex training bouts to determine the optimal individual post-activation potentiation time. Thereafter, all subjects performed a complex training programme consisting of six sets of 5-RM half squats and plyometric jumps 3 times per week for 4 weeks. Body composition, 30-m sprint and jump performances were assessed before and after the training period. Moreover, blood creatine kinase (CK) activity was analysed at the first and the last training bout. After the training, the 1-RM strength in the creatine group was significantly greater than in the placebo group (p < 0.05). CK activity after the complex training bout in the creatine group was significantly reduced compared with the placebo group (p < 0.05). No differences were noted for other variables. This study concluded that creatine supplementation combined with complex training improved maximal muscular strength and reduced muscle damage during training.

Background/Objectives: Creatine monohydrate (CrM) is considered to be one of the most effective supplements for enhancing lean body mass during resistance training. However, CrM may influence body water content, potentially confounding lean body mass measurements. Therefore, this randomised controlled trial assessed the effect of CrM alone on lean body mass following a supplement wash-in, and when combined with a resistance training program. Methods: Sixty-three (34 females, 29 males, 31 ± 8 years) participants were randomised to supplement with CrM (5 g/day for 13 weeks: wash-in + 12-week resistance training) or serve as a control (received no creatine or placebo). Lean body mass was measured using dual X-ray absorptiometry at baseline, post 7-day wash-in, and post 12 weeks of resistance training. Both groups began the same training program post CrM wash-in. Results: After the 7-day wash-in, the supplement group gained 0.51 ± 1.79 kg more lean body mass than the control group (p = 0.03). Following the wash-in, both groups gained 2 kg after resistance training (p < 0.0001), with no between-group difference in lean body mass growth (p = 0.71). Sex-disaggregated analysis showed that the supplement group, only in females, gained 0.59 ± 1.61 kg more lean body mass than the controls (p = 0.04). There were no group differences in lean body mass growth following resistance training in females (p = 0.10) or males (p = 0.35). Conclusions: A 7-day CrM wash-in increased lean body mass, particularly in females. Thereafter, CrM did not enhance lean body mass growth when combined with resistance training, likely due to its short-term effects on lean body mass measurements. A maintenance dose of higher than 5 g/day may be necessary to augment lean body mass growth.

Creatine is a widely used ergogenic aid that enhances muscle strength and lean mass. However, concerns have been raised about the potential role in promoting hair loss by increasing dihydrotestosterone (DHT). Currently, there is no direct evidence examining the relationship between creatine supplementation and hair follicle health. Therefore, the purpose was to determine the effects of 12 weeks of creatine supplementation on androgen levels and hair follicle health in healthy young males. Forty-five resistance-trained males (ages 18-40 years) were recruited and randomly assigned to either a creatine monohydrate (5 g/day) or placebo (5 g maltodextrin/day) group. Participants maintained their habitual diets and training routines. Blood samples were collected at baseline and after 12 weeks to measure total testosterone, free testosterone, and DHT. Hair follicle health was assessed using the Trichogram test and the FotoFinder system (hair density, follicular unit count, and cumulative hair thickness). Statistical analyses were performed using repeated measures ANOVA, and potential outliers were examined through sensitivity analysis. Thirty-eight participants completed the study, with no significant differences in baseline characteristics between groups. There were no group-by-time interactions observed for any hormones or hair-related outcomes (  > 0.05). While total testosterone increased (∆ = post value minus pre value: creatine = ∆124   ±   149 ng/dL; placebo = ∆216   ±   203 ng/dL) and free testosterone decreased (creatine = ∆-9.0   ±   8.7 pg/mL; placebo = ∆-9   ±   6.4 pg/mL) over time, these effects were independent of supplementation. There were no significant differences in DHT levels, DHT-to-testosterone ratio, or hair growth parameters between the creatine and placebo groups. This study was the first to directly assess hair follicle health following creatine supplementation, providing strong evidence against the claim that creatine contributes to hair loss.

The World Health Organization estimates that > 140 million people worldwide are exposed to arsenic (As)-contaminated drinking water. As undergoes biologic methylation, which facilitates renal As elimination. In folate-deficient individuals, this process is augmented by folic acid (FA) supplementation, thereby lowering blood As (bAs). Creatinine concentrations in urine are a robust predictor of As methylation patterns. Although the reasons for this are unclear, creatine synthesis is a major consumer of methyl donors, and this synthesis is down-regulated by dietary/supplemental creatine. Our aim was to determine whether 400 or 800 μg FA and/or creatine supplementation lowers bAs in an As-exposed Bangladeshi population. We conducted a clinical trial in which 622 participants were randomized to receive 400 μg FA, 800 μg FA, 3 g creatine, 3 g creatine+400 μg FA, or placebo daily. All participants received an As-removal filter on enrollment, and were followed for 24 weeks. After the 12th week, half of the two FA groups were switched to placebo to evaluate post-treatment bAs patterns. Linear models with repeated measures indicated that the decline in ln(bAs) from baseline in the 800-μg FA group exceeded that of the placebo group (weeks 1-12: β= -0.09, 95% CI: -0.18, -0.01; weeks 13-24: FA continued: β= -0.12, 95% CI: -0.24, -0.00; FA switched to placebo: β= -0.14, 95% CI: -0.26, -0.02). There was no rebound in bAs related to cessation of FA supplementation. Declines in bAs observed in the remaining treatment arms were not significantly different from those of the placebo group. In this mixed folate-deficient/replete study population, 12- and 24-week treatment with 800 μg (but not 400 μg) FA lowered bAs to a greater extent than placebo; this was sustained 12 weeks after FA cessation. In future studies, we will evaluate whether FA and/or creatine altered As methylation profiles.

There is evidence that both intra-serial variable resistance (I-sVR), as pre-activation within the post-activation performance enhancement cycle (PAPE), and creatine and caffeine supplementation increase athletic performance in isolation. However, the effect of the three conditioning factors on 30 m repeated sprint ability (RSA) performance in young soccer players is unknown. This study determined the summative and isolation effect of ergogenic aids and pre-activation in half-back squats (HBSs) with I-sVR on performance in an RSA test in young soccer players. Twenty-eight young soccer players were randomly assigned to either EG1 (n = 7, creatine + caffeine + I-sVR), EG2 (n = 7, creatine + placebo2 + I-sVR), EG3 (n = 7, placebo1 + caffeine + I-sVR), or EG4 (n = 7, placebo1 + placebo2 + I-sVR), using a factorial, four-group-matched, double-blind, placebo-controlled design. Creatine supplementation included 0.3 g/kg/day for 14 days, caffeine supplementation included 0.3 mg/kg per day, and pre-activation in HBS with I-sVR (1 × 5 at 30% 1RM [1.0–1.1 m/s] + 1 × 4 at 60% 1RM [0.6–0.7 m/s]). The RSA test and HBS outcomes were evaluated. Three-way ANOVA showed non-significant differences for the RSA test and HBS outcomes (p > 0.05). At the end of this study, it was found that the three ergogenic aids, together, do not generate a summative effect on the physical performance of young soccer players. However, it is important to analyze individual responses to these specific protocols.

Background/Objectives: In this study, we aimed to examine the effect of creatine monohydrate (CrM) supplementation on recovery from eccentric exercise-induced muscle damage (EIMD) in diverse populations, including different sexes and age groups. EIMD decreases maximal voluntary contraction (MVC), restricts the range of motion (ROM), and increases muscle stiffness and delayed-onset muscle soreness, all of which negatively impact athletic performance. Therefore, developing effective recovery strategies is essential. Methods: A double-blind, randomized, placebo-controlled trial was conducted with 40 healthy male and female participants. After 33 days of supplementation with either CrM or placebo (crystalline cellulose), the participants performed eccentric exercises. Recovery indices, including MVC, muscle stiffness, subjective muscle extensive soreness, fatigue, and upper arm circumference, were measured at baseline, immediately after exercise, 48 h post-exercise, and 96 h post-exercise. Results: The creatine supplementation group (CRE) demonstrated a significantly quicker recovery of MVC than the placebo group (PLA). Furthermore, reductions in shear modulus and muscle fatigue were observed in the CRE group. Notably, females in the CRE group exhibited a significant suppression of post-exercise edema, suggesting a sex-specific response. Conclusions: These findings indicate that CrM supplementation may enhance recovery from EIMD, contributing to the maintenance of muscle function and the reduction of discomfort after exercise. CrM has the potential to serve as a practical nutritional strategy to promote recovery, not only for athletes, but also for a broader population.

The purpose was to examine the effects of creatine supplementation during resistance training sessions on skeletal muscle mass and exercise performance in physically active young adults. Twenty-two participants were randomized to supplement with creatine (CR: n = 13, 26 ± 4 yrs; 0.0055 g·kg−1 post training set) or placebo (PLA: n = 9, 26 ± 5 yrs; 0.0055 g·kg−1 post training set) during six weeks of resistance training (18 sets per training session; five days per week). Prior to and following training and supplementation, measurements were made for muscle thickness (elbow and knee flexors/extensors, ankle plantarflexors), power (vertical jump and medicine ball throw), strength (leg press and chest press one-repetition maximum (1-RM)) and muscular endurance (one set of repetitions to volitional fatigue using 50% baseline 1-RM for leg press and chest press). The creatine group experienced a significant increase (p < 0.05) in leg press, chest press and total body strength and leg press endurance with no significant changes in the PLA group. Both groups improved total body endurance over time (p < 0.05), with greater gains observed in the creatine group. In conclusion, creatine ingestion during resistance training sessions is a viable strategy for improving muscle strength and some indices of muscle endurance in physically active young adults.

Background/Objectives: A pilot study was conducted to investigate the effect of four weeks of creatine monohydrate (CrM) on vascular endothelial function in older adults. Methods: In a double-blind, randomized crossover trial, twelve sedentary, healthy older adults were allocated to either the CrM or placebo (PL) group for four weeks, at a dose of 4 × 5 g/day for 5 days, followed by 1 × 5 g/day for 23 days. Macrovascular function (flow-mediated dilation [FMD%], normalized FMD%, brachial-ankle pulse wave velocity [baPWV], pulse wave analysis [PWA]), microvascular function (microvascular reperfusion rate [% StO2/sec]), and biomarkers of vascular function (tetrahydrobiopterin [BH4], malondialdehyde [MDA], oxidized low-density lipoprotein [oxLDL], glucose, lipids) were assessed pre- and post-supplementation with a four-week washout period. Results: CrM significantly increased FMD% (pre-CrM, 7.68 ± 2.25%; post-CrM, 8.9 ± 1.99%; p < 0.005), and normalized FMD% (pre-CrM, 2.57 × 10−4 ± 1.03 × 10−4%/AUCSR; post-CrM, 3.42 × 10−4 ± 1.69 × 10−4%/AUCSR; p < 0.05), compared to PL. Microvascular reperfusion rates increased following CrM (pre-CrM, 2.29 ± 1.42%/sec; post-CrM, 3.71 ± 1.44%/sec; p < 0.05), with no change following PL. A significant reduction in fasting glucose (pre-CrM, 103.64 ± 6.28; post-CrM, 99 ± 4.9 mg/dL; p < 0.05) and triglycerides (pre-CrM, 99.82 ± 35.35; post-CrM, 83.82 ± 37.65 mg/dL; p < 0.05) was observed following CrM. No significant differences were observed for any other outcome. Conclusions: These pilot data indicate that four weeks of CrM supplementation resulted in favorable effects on several indices of vascular function in older adults.

Athletes use creatine monohydrate (CM) to enhance high‐intensity exercise performance by increasing creatine phosphate availability. While CM supplementation is known to raise muscle creatine levels in vegans and vegetarians, its impact on exercise performance remains uncertain. We examined the effects of CM supplementation on muscle creatine content and exercise performance in vegans and vegetarians. In a randomized, double‐blind placebo‐controlled design, 15 healthy vegans and vegetarians consumed CM (0.3 g/kg/day, n = 7) or placebo (PLA, 0.3 g maltodextrin/kg/day, n = 8) four times a day for 7 days. Before and after supplementation, repeated sprint capacity was determined. Body mass and fat‐free mass (FFM) were assessed by dual‐energy x‐ray absorptiometry. The CM group increased body mass (1.56 ± 0.57 kg, p < 0.01) and FFM (1.15 ± 0.94 kg, p < 0.05), while the PLA group showed no changes. In the CM group, muscle creatine (Cr) and total muscle creatine (TCr) increased by 18.8 ± 13.1 mmol/kg (p < 0.05) and 30.8 ± 21.2 mmol/kg (p < 0.01), respectively. The PLA group showed no changes in Cr and TCr (−4.6 ± 13.1 mmol/kg and 2.9 ± 11.6 mmol/kg, respectively). Phosphocreatine levels remained consistent within and between groups. There were no observed changes in peak and mean power output during repeated sprints. A seven‐day CM supplementation in healthy vegans and vegetarians increased Cr and TCr whereas Phosphocreatine, peak and mean power output during repeated sprints was unchanged.

Androgen deprivation therapy (ADT) leads to loss of lean mass (LM) and reduced strength and physical function. Resistance exercise alone can counteract these changes; however, it is unknown if the addition of creatine supplementation can further protect against these ADT-induced toxicities. We compared the effects of creatine supplementation with resistance exercise versus resistance exercise alone in patients with prostate cancer undergoing ADT on LM, muscle strength, and physical function. A 12-week randomized trial. Men with prostate cancer receiving ADT (n = 30) were randomized to either resistance exercise + placebo (PLA) or resistance exercise + creatine (SUPP), with both groups undertaking supervised exercise 3 days per week. Outcomes included whole body and appendicular LM and fat mass (FM) assessed by dual-energy X-ray absorptiometry, as well as muscle strength (chest press, seated low, leg press), and physical function (timed up-and-go, chair rise, 400-m walk) assessed at baseline and following the intervention. Patients were aged 59–84 years with a BMI of 28.6 kg·m−2. PLA completed a mean of 30 sessions (83 %) and SUPP a mean of 33 sessions (92 %). Despite similar within-group improvements (p < 0.05) in whole-body LM (PLA +0.6 kg, SUPP +1.3 kg), appendicular LM (PLA +0.5 kg, SUPP +0.6 kg), muscle strength (PLA +8.8–49.3 kg, SUPP +9.4–40.4 kg) and physical function, there were no between group differences (p = 0.078–0.951). No adverse events were reported due to creatine supplementation or resistance exercise. A short-term program of resistance exercise alone results in meaningful improvements in LM, muscle strength and physical function, with no additional effects of creatine supplementation.