Creatine: is there truth behind the hype?

0:00This is The Guardian.

0:13Creatine, once the supplement of choice for bodybuilders and elite athletes, it's now officially broken out of the gym and hit the mainstream. But like a lot of supplements, it's hard to get to the bottom of whether it actually does what it says on the tin. So we're here to help. Today, does creatine live up to the hype? From The Guardian, I'm Madeleine Finlay and this is Science Weekly.

0:51Ian, I've heard so many claims about creatine and I know a lot of people taking it as well and doing the job that we do it's really hard not to be skeptical of any kind of supplement at all so i want you to tell me is creatine worth bothering with but first i guess i need to know

1:11Madeleine Finlay: what it is sure so creatine is a naturally occurring compound okay it's made from amino acids three different types of amino acid glycine arginine and methionine and people might think of amino acids as the building blocks of proteins. They are the building blocks of proteins, but creatine itself isn't a protein. It's too small to be a protein, but it's made out of amino acids. What's it doing in our bodies? What do we need it for? Creatines really sort of comes into its own in your body when you're doing sort of high intensity activity. But let me give you some background first of the sort of what's going on inside cells when they're doing this, and then we'll see how creatine slots in.

1:53So scientists talk about

1:55Madeleine Finlay: a sort of an energy currency in cells and that energy currency is a compound called adenosine triphosphate ATP and as the name suggests adenosine triphosphate has three phosphate groups attached to each molecule okay when a cell wants some energy it can split off one of those phosphate groups and that releases a bit of energy that the cell can put to good work so you know that can be use to contract muscles say and it leaves you with adp adenosine diphosphate okay because you've lost one you go try to die now when you're doing a lot of intense exercise you can burn through your atp very quickly you can do this in seconds so where does creatine come in well creatine in your cells it binds to phosphate it forms a compound called phosphocreatine and in fact that's how most creatine is stored in your cells and what phosphocreatine can do is it's really good at donating the phosphate back to adp to rebuild it to atp so it's almost like a recharges the adenosine triphosphate so you've used it goes down to adp phosphocreatine comes in gives it the phosphate back back to atp you can then use it again to do things so that is how creatine is is working and it's enabling the cell to kind of replenish the ATP when it's burning through it really quickly.

3:20Okay so when you're doing high intensity exercise in particular creatine has this role where it can help the cells release more energy for longer but how do we actually make creatine in our bodies?

3:33Madeleine Finlay: We make some of our creatine in our pancreas, liver and kidney okay and we make probably one to two grams and a lot of that goes to your sort of skeletal muscles and a little bit goes to your brain, your heart and some other tissues. So we're making, probably a lot of us anyway, we'll be making about half of our creatine. The rest you're going to get from your diet. Now, it depends what you eat, obviously. Foods like red meat and fish are rich in creatine because it's in the muscles. And what's good about creatine is because it's a small molecule, it can kind of get absorbed straight into your system.

4:09Madeleine Finlay: It doesn't get broken down as it goes through into your bloodstream and so on. obviously if you're vegan or vegetarian they tend to have lower creatine levels in their cells because plants don't have creatine in them but they can eat foods which will have the three amino acids in with which to build creatine in their bodies and so if you're eating like a lot of nuts and legumes you're going to get the amino acids you're going to need to build creatine in your body and if you're vegetarian dairy foods and eggs as well are going to help

4:48right ian so we know that creatine has this useful role in our bodies we can make it through the foods that we eat so how well studied is it as a supplement creatine's got a really long

5:02Madeleine Finlay: history. It was discovered by a French scientist in 1832. And, you know, really since then, it has become one of the most studied supplements out there, often in the context of sort of building muscle in training. When you do a quick search under creatine, you'll find thousands of research papers looking at creatine and what it does and what it doesn't do. When you look at the effects specifically on women, actually, it's not as impressive. I mean, you'll find maybe only a few hundred papers so the research is definitely skewed and there's less known about the actual specific effects in women.

5:40When you hear that there are thousands of papers it sounds very impressive but then the question is when you go and look at those papers how many of them are going to be those high quality gold standard research studies that you always look for and one of the big problems in any kind of supplement research is you go to the paper You look at the affiliations and the declarations and you see, ah, OK, this has actually been paid for by a company that makes the supplement. And of course, you understand why that is. But then at the same time, it's a big pinch of salt on any kind of result that you see.

6:16So, look, I think it's fair to say I'm still a bit of a sceptic on this. But give me the big picture on the evidence for supplementing creatine.

6:25Madeleine Finlay: totally i mean whenever you're looking at research and particularly when you're looking at research on supplements you want to check whether that research has been conducted by a company that happens to sell supplements okay absolute conflict of interest 101 that you want to check out but you know having said that the evidence that you know creatine supplementation can give you this sort of training boost does seem to be pretty reliable there seems to be as good as a consensus that that is happening and it all makes a lot of sense i think the question then becomes okay well how big a deal is that right and what's interesting here is if you think about how much creatine does a particular person store in their muscle cells like just from the diet they have already and so on and then you think about how much could they potentially store in those cells.

7:18Madeleine Finlay: And that gap is quite interesting. So, you know, most people would be able to store more creatine if they were having supplementation. And you'd imagine they would get some effect then if they needed this intense energy for doing intense exercise. But we're all different. And so that is where it becomes a bit tricky as to knowing how much of an effect an individual is going to experience. And this is something I spoke to Justin Roberts about and he's a professor of nutritional physiology at Anglia Ruskin University in Cambridge. If you're doing high intensity activities going to the gym and you're doing every day or every other day where there's a high demand on the body that's where creatine probably has a role to play but also when you look at the amount of physical work that can be performed what you often see is a faster rate of recovery between exercises meaning chances are you're able to do more.

8:14So if you look at some of the more recent studies, particularly in older people, the driving factor that seems to be in play is that the training volume increases because they're able to do more. Okay, so supplementing with creatine, there is this possibility that you can get this benefit of being able to train a little bit harder or maybe a little bit longer. Is that why it's associated with gaining muscle?

8:37Madeleine Finlay: That's right. But I spoke to Justin about this, And he really wanted to make clear that, you know, just taking the creatine alone is not going to affect your muscle mass. People might think, well, creatine equals muscle mass. It doesn't. There are hypothesized theories around whether creatine may relate to or trigger muscle growth. But fundamentally, it comes back to the training. If you're not physically undertaking some sort of training that's going to stimulate the muscle, that resistance training, then creatine is unlikely going to have a profound effect. But beyond the sort of the big guns there's also more limited evidence for benefits in other areas.

9:17There are some emerging studies that have shown that you can potentially with high amounts of creatine increase creatine in the brain because it's a highly active tissue in terms of energy demand. So there have been a few studies that suggest that in a sleep deprived state and that's a key factor that you might actually be able to have better mental or cognitive functioning in a sleep deprived state with high amounts of creatine.

9:46Madeleine Finlay: Creatine's also been used in the skincare industry for about 20 years and the claim there is that it helps with the production of collagen and we actually have a podcast coming up on collagen specifically. But the research on creatine and effects on collagen looks pretty shaky to me. And there's just so much that we still don't understand.

10:17Coming up, if you want to experiment with taking creatine, where should you start?

10:35okay ian if somebody does want to start taking creatine what's the best way to do that how

10:41Madeleine Finlay: should they do it well the way it's done in a lot of the studies when they're looking for an impact from taking it when people are training is they they do a kind of a a loading phase at the beginning where you take quite a high dose of creatine for a few days to sort of really sort of push your levels up and then you drop down to a sort of a maintenance dose. But you know, you don't have to do it that way. You can take a lower dose and maybe it will take a bit longer to have any sort of real effects. One thing people might get confused about when they're looking at creatine is it just comes in so many different forms, right?

11:13Madeleine Finlay: I mean, first of all, you know, there are powders, there are gummies, there are drinks, but also there are different names. I mean, you can have like creatine hydrochloride, you can have creatine ethyl ester. Most of the research has been done on a form called creatine monohydrate but you know i think these all are making sort of slightly different claims about how well they're absorbed and things like that and again this is something else i spoke to justin about when i first got into nutrition creatine was available in powder form only and as time's gone on kind of the the concept of creatine has changed from powders into tablets into gummies and even skin patches the first thing i would say is where's the science on a lot of these and if you look at the literature probably the overwhelming amount of science has been done on creatine monohydrate which is highly absorbed it's like 95 to 99 absorbed and it's generally stable in a fairly solid form like a powder so when i see claims that uh you know another type of creatine is suddenly miraculously a lot better a lot better than creatine monohydrate i'm very skeptical because it's already highly absorbed are there any risks or side effects from taking creatine the evidence so far suggests that creatine at the doses people take it out when they're doing supplementation it's actually pretty safe i mean certainly you know in people who are who are healthy there are some case reports in sort of a bit of the older literature of people with existing kidney problems having some side effects but apart from that really the only thing i've seen is that some people can get like bloating from from taking it and i spoke again to justin on that so if you're taking high amounts of creatine or you're taking it with carbohydrates for example in a sports drink then your body will hold on to some of the water actually because of creatine retains a bit more water and for some people they get a little bit more gut bloating and a little bit more water retention.

13:18So Ian I kind of can't believe that I'm saying this because always on Science Weekly we just recommend healthy diets and more beans and nuts but it looks like there is something in creatine. So for somebody who is not an elite athlete who is just doing a normal amount of exercise going down to the gym like the rest of us is it worth going back to that original question taking creatine you know it's not it's not necessarily cheap to get the supplements so is it going to help them do one extra rep or or 10 so that's like you know an

13:52Madeleine Finlay: active area of research is to does creatine supplementation really help people who aren't going to the gym and are just sort of carrying on with their lives as normal right and i think that's going to be an interesting one to watch. But for the moment, certainly the evidence is way in favour of people who are needing that burst of energy and doing it in part of their training and getting the health benefits and the strength benefits that come from the training. So I think it's going to be really interesting to see though, does it help older people who are losing muscle mass? Would it help slow that?

14:27Madeleine Finlay: Would it help other people who are having muscle problems or what have you and i think that again is where we need to see more research but yeah i think for the moment definitely if you're doing exercise and you need to be sort of want to be pushing yourself more in your exercise but i think as a sort of something for the general sort of person who isn't doing any of that i don't think the evidence is really there yet so depends on the circumstance another nuanced conclusion from science weekly ian thank you very much thank you Thanks again to Ian and to Professor Justin Roberts.

15:10And that's all from us today. This episode was produced by Ellie Sands, the sound design was by Joel Cox, and the executive producer was Ellie Bury. We'll be back on Thursday. See you then.

15:28This is The Guardian.

16:00Madeleine Finlay: The End Load a photo or voice note and we'll diagnose your project and match you with the right pro for the job. Thumbtack. We know homes. Hire the right pro today.