Creatine Monohydrate (Sport)

BACKGROUND: There is robust evidence that creatine monohydrate supplementation can enhance short-term high-intensity exercise in athletes. However, the effect of creatine monohydrate supplementation on aerobic performance and its role during aerobic activities is still controversial. OBJECTIVE: The purpose of this systematic review and meta-analysis was to evaluate the supplementation effects of creatine monohydrate on endurance performance in a trained population. METHODS: The search strategy in this systematic review and meta-analysis was designed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and PubMed/MEDLINE, Web of Science, and Scopus databases were explored from inception until 19 May, 2022. Only human experimental trials, controlled with a placebo group, evaluating the effects of creatine monohydrate supplementation on endurance performance in a trained population were analyzed in this systematic review and meta-analysis. The methodological quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: A total of 13 studies satisfied all the eligibility criteria and were included in this systematic review and meta-analysis. The results for the pooled meta-analysis showed a non-significant change in endurance performance after creatine monohydrate supplementation in a trained population (p = 0.47), with a trivial negative effect (pooled standardized mean difference = - 0.07 [95% confidence interval - 0.32 to 0.18]; I2 = 34.75%). Further, after excluding the studies not evenly distributed around the base of the funnel plot, the results were similar (pooled standardized mean difference = - 0.07 [95% confidence interval - 0.27 to 0.13]; I2 = 0%; p = 0.49). CONCLUSIONS: Creatine monohydrate supplementation was shown to be ineffective on endurance performance in a trained population. CLINICAL TRIAL REGISTRATION: The study protocol was registered in the Prospective Register of Systematic Review (PROSPERO) with the following registration number: CRD42022327368. © 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

BACKGROUND: Several studies have examined the effect of creatine monohydrate (CrM) on indirect muscle damage markers and muscle performance, although pooled data from several studies indicate that the benefits of CrM on recovery dynamics are limited. OBJECTIVE: This systematic review and meta-analysis determined whether the ergogenic effects of CrM ameliorated markers of muscle damage and performance following muscle-damaging exercises. METHODS: In total, 23 studies were included, consisting of 240 participants in the CrM group (age 23.9 ± 10.4 years, height 178 ± 5 cm, body mass 76.9 ± 7.6 kg, females 10.4%) and 229 participants in the placebo group (age 23.7 ± 8.5 years, height 177 ± 5 cm, body mass 77.0 ± 6.6 kg, females 10.0%). These studies were rated as fair to excellent following the PEDro scale. The outcome measures were compared between the CrM and placebo groups at 24-36 h and 48-90 h following muscle-damaging exercises, using standardised mean differences (SMDs) and associated p-values via forest plots. Furthermore, sub-group analyses were conducted by separating studies into those that examined the effects of CrM as an acute training response (i.e., after one muscle-damaging exercise bout) and those that examined the chronic training response (i.e., examining the acute response after the last training session following several weeks of training). RESULTS: According to the meta-analysis, the CrM group exhibited significantly lower indirect muscle damage markers (i.e., creatine kinase, lactate dehydrogenase, and/or myoglobin) at 48-90 h post-exercise for the acute training response (SMD - 1.09; p = 0.03). However, indirect muscle damage markers were significantly greater in the CrM group at 24 h post-exercise (SMD 0.95; p = 0.04) for the chronic training response. Although not significant, a large difference in indirect muscle damage markers was also found at 48 h post-exercise (SMD 1.24) for the chronic training response. The CrM group also showed lower inflammation for the acute training response at 24-36 h post-exercise and 48-90 h post-exercise with a large effect size (SMD - 1.38 ≤ d ≤ - 1.79). Similarly, the oxidative stress markers were lower fo

Creatine Monohydrate (CrM) is a dietary supplement routinely used as an ergogenic aid for sport and training, and as a potential therapeutic aid to augment different disease processes. Despite its increased use in recent years, studies reporting potential adverse outcomes of CrM have been mostly derived from male or mixed sex populations. A systematic search was conducted, which included female participants on CrM, where adverse outcomes were reported, with meta-analysis performed where appropriate. Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%). Twenty-nine studies monitored for adverse outcomes, with 951 participants. There were no deaths or serious adverse outcomes reported. There were no significant differences in total adverse events, (risk ratio (RR) 1.24 (95% CI 0.51, 2.98)), gastrointestinal events, (RR 1.09 (95% CI 0.53, 2.24)), or weight gain, (mean difference (MD) 1.24 kg pre-intervention, (95% CI -0.34, 2.82)) to 1.37 kg post-intervention (95% CI -0.50, 3.23)), in CrM supplemented females, when stratified by dosing regimen and subject to meta-analysis. No statistically significant difference was reported in measures of renal or hepatic function. In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females. Nor does the use of creatine supplementation increase the risk of total adverse outcomes, weight gain or renal and hepatic complications in females. However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.

BACKGROUND: While the long-term ergogenic benefits of creatine monohydrate (CrM) supplementation are well-documented, the potential advantages of acute ingestion followed by short-term consumption remain relatively underexplored. This double-blind, randomized crossover study investigated the acute and short-term effects of CrM supplementation on strength performance, heart rate variability (HRV) responses, and recovery of lower limbs strength and muscle soreness in resistance-trained males. METHODS: A total of eleven physically active participants were recruited; however, due to incomplete data, one participant was excluded, and ten participants (age: 21.3 ± 1.9 years) were analyzed. Participants ingested either creatine monohydrate (CrM: 0.3 g·kg-1·d-1) or a placebo (PLA) for three days, with the first day's dose consumed 2 h pre-test and subsequent doses divided into three daily doses. Participants completed two test sessions in a randomized order, separated by a seven-day washout period. Each session included bench press (BP) and back squat (BS) tests performed at 60%, 70%, and 80% of one-repetition maximum (1RM) under either CrM or PLA conditions. Strength performances (repetitions, velocity, power), HRV and peak heart rate (HR), jump tests (Countermovement Jump (CMJ) and Squat Jump (SJ)), and delayed-onset muscle soreness (DOMS) were assessed. RESULTS: Compared to PLA, CrM supplementation significantly increased repetitions completed at 60-80% 1RM in BP and BS (p ≤ 0.041, d = 0.72-1.6) during both test sessions. CrM reported higher velocity compared to PLA at all intensities (60-80% 1RM) for both exercises and sessions (p ≤ 0.035, d = 0.78-4.09). CrM reduced cardiovascular strain compared to PLA at 60% 1RM during back squat (p = 0.017, d = 1.05). Peak HR increased with intensity for both conditions (d = 1.1-4.28), with CrM showing lower HR at 60% (p = 0.017, d = 1.05) and higher HR at 80% (p = 0.047, d = 0.82) compared to PLA. CrM enhanced post-exercise parasympathetic reactivation in the 1st session demonstrating higher favorable response in RMSSD (p = 0.015, d = 2.99) and HF power (p = 0.022, d = 2.76) compared to PLA. CMJ performance was higher in CrM co

Background/Objectives: Creatine monohydrate (CrM) supplementation is well-established for enhancing physical performance and accelerating recovery in several sporting contexts. However, beyond these traditional performance benefits, its effects on sleep metrics and cognitive function have not been thoroughly investigated. This investigation aimed to determine the effect of a loading phase of CrM on sleep metrics, physical performance, psycho-cognitive aspects, and recovery in physically active men. Methods: In a randomized, double-blind, placebo-controlled crossover design, 14 physically active men ingested 20 g/day of CrM or placebo (PL) for 7 days, during which their habitual exercise routines were maintained and standardized across both intervention phases. Sleep metrics were monitored throughout the interventions using wrist-worn actigraphy. On the day following the completion of each supplementation phase, participants rated their sleep quality using the Sleep Subjective Quality (SSQ) scale, and the Hooper questionnaire was used to monitor participants' well-being status. Physical performance was assessed using the 5 m shuttle run test (5mSRT), which measured total distance (TD), best distance (BD), performance decrement (PD), fatigue index (FI), and the rating of perceived exertion (RPE). Affective valence was determined using the feeling scale (FS) and cognitive function was evaluated using the digit cancellation test (DCT). Recovery and muscle soreness perceptions were evaluated at multiple time points (pre-exercise, 5 min, 24 h, 48 h, and 72 h post-exercise) using the perceived recovery status (PRS) and the delayed onset muscle soreness (DOMS) scales, respectively. Results: During the supplementation, CrM improved sleep quality compared to PL, as measured with the SSQ scale (d = 0.81, p = 0.009), and was associated with an earlier in-bed time (r = 0.60; p = 0.026). However, CrM did not affect sleep latency (t = 0.98; p = 0.35), sleep efficiency (t = 0.018; p = 0.98), or total sleep time (t = 0.25; p = 0.81). After the supplementation phase, CrM resulted in significantly lower muscle soreness scores, as measured by the Hooper questionnaire (d = -0.59; p

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. © 2025 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.

BACKGROUND: Basketball games involve numerous cognitive-motor dual-task (CMDT) situations, where athletes must execute technical skills while processing complex on-court information. However, adolescent athletes often experience performance declines under CMDT conditions due to increased cognitive load. Creatine supplementation has been shown to enhance both physical and cognitive functions, but its acute effects on basketball skill performance under CMDT conditions remain unclear. This study investigates the impact of acute creatine supplementation on the technical performance of adolescent basketball players under single-task (ST) and CMDT conditions. METHODS: A randomized counterbalanced crossover design with a Latin square arrangement was used to recruit 40 male adolescent basketball players (13-14 years old) with provincial-level competitive experience. Participants received either creatine monohydrate (0.3 g/kg/day for 5 days, plus 0.1 g/kg pretest) or placebo, with a 4-week washout period between phases. To minimize learning and order effects, a standardized familiarization session was conducted prior to testing, and the sequence of ST and CMDT conditions was counterbalanced using a Latin square design. The CMDT condition required players to perform a continuous subtraction task while executing dribbling, passing, and shooting tasks. Performance metrics, subtraction task accuracy, heart rate, and ratings of perceived exertion (RPE) were collected. Two-way repeated measures ANOVA and paired t-tests were conducted for statistical analysis (α = 0.05, Bonferroni-corrected). RESULTS: Under CMDT conditions, creatine supplementation significantly improved performance in dribbling, passing, and shooting tasks (all p < 0.05), while only dribbling and shooting performance improved under ST conditions (p < 0.05). Dual-task cost significantly decreased in dribbling and passing (p < 0.05), but not in shooting (p > 0.05). Subtraction task accuracy improved only during shooting (p = 0.013). Additionally, creatine supplementation significantly reduced heart rate and RPE scores across all tasks and both conditions (p < 0.05). CONCLUSION: Acute creatine supplementation enh

Tactical athletes and military personnel engaged in intense exercise need to consume enough quality protein in their diet to maintain protein balance and promote recovery. Plant-based protein sources contain fewer essential amino acids (EAAs), while pork loin contains a higher concentration of EAAs and creatine than most other animal protein sources. This study aimed to determine whether the ingestion of plant-based or pork-based military-style meals ready-to-eat (MREs) affects recovery from and subsequent Army Combat Fitness Test (ACFT) performance. Methods: Twenty-three (n = 23) University Corps of Cadets members participated in a randomized, double-blind, placebo-controlled, and crossover-designed study. Diets were prepared by a dietitian, food scientist, and chef to have similar taste, appearance, texture, and macronutrient content. The chef also labeled the meals for double-blind administration. Participants refrained from intense exercise for 48 h before reporting to the lab in a fasted condition with a 24 h urine sample. Participants donated a blood sample, completed questionnaires and cognitive function tests, and consumed a pre-exercise meal. After four hours, participants performed the ACFT according to military standards. Participants were fed three MREs daily while returning to the lab in a fasted condition at 0600 with 24 h urine samples after 24, 48, and 72 h of recovery. On day 3, participants repeated the ACFT four hours after consuming an MRE for breakfast. Participants resumed normal training and returned to the lab after 2-3 weeks to repeat the experiment while consuming the alternate diet. Data were analyzed using general linear model statistics with repeated measures and percent changes from baseline with 95% confidence intervals. Results: Results revealed that 3 days were sufficient for participants to replicate ACFT performance. However, those consuming the pork-based diet experienced less muscle soreness, urinary urea excretion, cortisol, inflammation, and depression scores while experiencing a higher testosterone/cortisol ratio and appetite satisfaction. There was also evidence of more favorable changes in red and white blood cells. Conv

Although creatine monohydrate (CM), leucine, and polyphenols have been independently researched, there is a lack of research on the effects of a supplementation blend containing trisodium citrate, CM, leucine, and blueberry extract (TCLB) on muscle strength, endurance, and size. This study compared the effects of 8 wk of supplementation with TCLB versus CM and placebo (PLA) combined with resistance training on leg extension strength, endurance, and muscle size. Twenty-eight recreationally active men ingested either TCLB (n = 10), CM (n = 10), or PLA (n = 8) during 8 wk of resistance training. Leg extension 1-repetition maximum (1RM), leg extension repetitions-to-failure at ∼80% of pre-training 1RM, individual quadriceps cross-sectional area (CSA) values, and the sum of the CSA values (CSAsum) were assessed at pre-training and post-training. Separate one-way ANCOVAs covaried for pre-training values were used to analyze differences in adjusted post-training means. Separate Chi-squared tests were used to analyze differences between groups in the proportion of subjects that exceeded the minimal important difference (MID). There were no group differences (p > 0.05) for leg extension 1RM, leg extension repetitions-to-failure, rectus femoris CSA, vastus lateralis CSA, or vastus medialis CSA. The TCLB group demonstrated greater (p ≤ 0.05) adjusted post-training means and proportions of subjects who exceeded the MID for the CSAsum and vastus intermedius CSA than the PLA group, but the TCLB group did not differ (p > 0.05) from the CM group for those variables. The CM group (p ≤ 0.05) exhibited a greater proportion of subjects who exceeded the MID for the CSAsum than the PLA group. These findings indicated that 8 wk of supplementation with TCLB and CM combined with resistance training increased the overall quadriceps muscle size greater than the PLA, but TCLB did not differ from CM. Furthermore, the groups did not differ in the training-induced increases in leg extension strength and endurance.

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.

BACKGROUND: 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. METHODS: 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. RESULTS: 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 (p > 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. CONCLUSION: 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.

PURPOSE: Athletes often use sport supplements to improve their physical and physiological performance. This randomized, double-blind, placebo (PL) -controlled study aimed to investigate the effects of combined versus single supplementation of creatine (Cr), beta-alanine (BA), and L-citrulline (L-Cit) during short sprint interval training (SSIT) on basketball players' physical and physiological performance over a period of 28 days. METHODS: Forty-eight basketball players were equally assigned to 6 groups of Cr (0.1 g/kg of Cr monohydrate daily), BA (4.8 g daily), L-Cit (6 g daily), combined supplementation, PL, and an active control group, and each group consisted of 8 participants. The training groups participated in SSIT (3 sets of 10 repetitions of 5-s all-out runs) sessions 3 times a week for 4 weeks. Physical (vertical jump, 20-m sprint, Illinois change of direction) and physiological (Wingate anaerobic power and cardiorespiratory fitness test) performance were evaluated before and after the training period. RESULTS: All training groups (Cr, BA, L-Cit, combined, and PL) showed significant improvements in physical and physiological performance over the 4-week intervention (P < .05). Interestingly, the supplement groups displayed significantly (P = .001) greater changes than the PL group, indicating better outcomes in performance adaptations. However, significant differences in performance variables were observed among the supplement groups. CONCLUSION: Our findings indicate that short-term supplementation with Cr, BA, and L-Cit, as well as a combination of them during SSIT, can significantly improve the physical and physiological performance of basketball players compared to a PL.

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.

PURPOSE: The authors examined the combined effects of conjugated linoleic acid (CLA), creatine (C), and whey protein (P) supplementation during strength training. METHODS: Sixty-nine participants (52 men, 17 women; M +/- SD age 22.5 +/-2.5 yr) were randomly assigned (double-blind) to 1 of 3 groups: CCP (6 g/d CLA + 9 g/d C + 36 g/d P; n = 22), CP (C + P + placebo oil; n = 25), or P (P + placebo oil; n = 22) during 5 wk of strength training (4-5 sets, 6-12 repetitions, 6 d/wk). Measurements were taken for body composition (air-displacement plethysmography), muscle thickness (ultrasound) of the flexors and extensors of the elbow and knee, 1-repetition-maximum (1-RM) strength (leg press and bench press), urinary markers of bone resorption (N-telopeptides, NTx), myofibrillar protein catabolism (3-methylhistidine; 3-MH), oxidative stress (8-isoprostanes), and kidney function (microalbumin) before and after training. RESULTS: Contrast analyses indicated that the CCP group had a greater increase in bench-press (16.2% +/- 11.3% vs. 9.7% +/- 17.0%; p < .05) and leg-press (13.1% +/- 9.9% vs. 7.7% +/-14.2%; p < .05) strength and lean-tissue mass (2.4% +/- 2.8% vs. 1.3% +/-4.1%; p < .05) than the other groups combined. All groups increased muscle thickness over time (p < .05). The relative change in 3-MH (CCP -4.7% +/- 70.2%, CP -0.4% +/- 81.4%, P 20.3% +/- 75.2%) was less in the groups receiving creatine (p < .05), with the difference for NTx also close to significance (p = .055; CCP -3.4% +/- 66.6%, CP -3.9% +/- 64.9%, P 26.0% +/- 63.8%). There were no changes in oxidative stress or kidney function. CONCLUSION: Combining C, CLA, and P was beneficial for increasing strength and lean-tissue mass during heavy resistance training.

Alpha-lipoic acid has been found to enhance glucose uptake into skeletal muscle in animal models. Studies have also found that the co-ingestion of carbohydrate along with creatine increases muscle creatine uptake by a process related to insulin-stimulated glucose disposal. The purpose of this study was to determine the effect of alpha-lipoic acid on human skeletal muscle creatine uptake by directly measuring intramuscular concentrations of creatine, phosphocreatine, and adenosine triphosphate when creatine monohydrate was co-ingested with alpha-lipoic acid. Muscle biopsies were acquired from the vastus lateralis m. of 16 male subjects (18-32 y) before and after the experimental intervention. After the initial biopsy, subjects ingested 20 g x d(-1) of creatine monohydrate, 20 g x d(-1) of creatine monohydrate + 100 g x d(-1) of sucrose, or 20 g x d(-1) of creatine monohydrate + 100 g x d(-1) of sucrose + 1000 mg x d(-1) of alpha-lipoic acid for 5 days. Subjects refrained from exercise and consumed the same balanced diet for 7 days. Body weight increased by 2.1% following the nutritional intervention, with no differences between the groups. There was a significant increase in total creatine concentration following creatine supplementation, with the group ingesting alpha-lipoic acid showing a significantly greater increase (p < .05) in phosphocreatine (87.6 --> 106.2 mmol x kg(-1) dry mass [dm]) and total creatine (137.8 --> 156.8 mmol x kg(-1) dm). These findings indicate that co-ingestion of alpha-lipoic acid with creatine and a small amount of sucrose can enhance muscle total creatine content as compared to the ingestion of creatine and sucrose or creatine alone.

BACKGROUND: Wrestling is a popular combat sport that requires muscular strength, power, agility, and endurance. Weight classes have motivated wrestlers to compete at a lower weight to optimise power-to-weight ratio and performance. To achieve these characteristics, athletes may use dietary supplements, however, their efficacy in wrestlers has not been systematically evaluated. OBJECTIVE: The purpose was to systematically review the literature to determine the efficacy of dietary supplements to improve body composition, physiological status, and performance in wrestlers. METHODS: A systematic search was conducted in PubMed, ProQuest Medline, Web of Science, Cochrane Library, and Scopus on the 21st of January 2024 and updated on the 6th of January 2025. Studies were included if the participants were healthy wrestlers ingesting any type of dietary supplement in comparison to a control. Data associated with intervention type and characteristics, target populations, outcomes, and analysis methods were extracted. RESULTS: A total of 24 eligible original articles were included that assessed various supplementation strategies on body composition, exercise performance, and metabolic markers in wrestlers. Individual studies revealed significant effects of sodium citrate, creatine monohydrate, spirulina, green tea and oolong tea extracts, and branched-chain amino acids on body mass or composition. β-Hydroxy-β-methylbutyrate (HMB-FA), creatine monohydrate, and iron supplementation improved recovery and may improve exercise performance. Beet-root juice supplementation enhanced muscular strength and balance. BCAA supplementation produced mixed results on muscle damage biomarkers and performance, while sodium citrate, creatine, and spirulina can act as buffering agents. Thyme tea appears to improve antioxidant capacity. CONCLUSIONS: Overall, individual studies show some promise for several dietary supplements to alter body mass and body composition, improve exercise recovery and performance, delay fatigue, and modify serum biomarkers; nevertheless, effect sizes were often small, and results were often mixed. © 2025. The Author(s).

It is estimated that three to five million sports injuries occur worldwide each year. The highest incidence is reported during competition periods with mainly affectation of the musculoskeletal tissue. For appropriate nutritional management and correct use of nutritional supplements, it is important to individualize based on clinical effects and know the adaptive response during the rehabilitation phase after a sports injury in athletes. Therefore, the aim of this PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science PERSiST-based systematic integrative review was to perform an update on nutritional strategies during the rehabilitation phase of musculoskeletal injuries in elite athletes. After searching the following databases: PubMed/Medline, Scopus, PEDro, and Google Scholar, a total of 18 studies met the inclusion criteria (Price Index: 66.6%). The risk of bias assessment for randomized controlled trials was performed using the RoB 2.0 tool while review articles were evaluated using the AMSTAR 2.0 items. Based on the main findings of the selected studies, nutritional strategies that benefit the rehabilitation process in injured athletes include balanced energy intake, and a high-protein and carbohydrate-rich diet. Supportive supervision should be provided to avoid low energy availability. The potential of supplementation with collagen, creatine monohydrate, omega-3 (fish oils), and vitamin D requires further research although the effects are quite promising. It is worth noting the lack of clinical research in injured athletes and the higher number of reviews in the last 10 years. After analyzing the current quantitative and non-quantitative evidence, we encourage researchers to conduct further clinical research studies evaluating doses of the discussed nutrients during the rehabilitation process to confirm findings, but also follow international guidelines at the time to review scientific literature.

Fazio, C, Elder, CL, and Harris, MM. Efficacy of alternative forms of creatine supplementation on improving performance and body composition in healthy subjects: a systematic review. J Strength Cond Res 36(9): 2663-2670, 2022-Novel forms of creatine have appeared in the marketplace with substantial claims of improved efficacy compared to creatine monohydrate (CrM). The purpose of this study was to conduct a systematic review on alternative forms of creatine to determine (a) whether they are effective ergogenic aids and (b) whether they outperform CrM. A separate comparison was conducted to determine average cost of various forms of creatine. Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Medline, and Google Scholar were systematically reviewed according to PRISMA guidelines. The design of the review was set to answer the PICOS model (subjects, interventions, comparators, outcomes, and study design). Seventeen randomized placebo controlled clinical trials examining exercise performance outcomes and body composition were included in the analysis. Magnesium-creatine chelate and creatine citrate, malate, ethyl ester, nitrate, and pyruvate were the only forms researched in the literature. Of these studies, only 3 studies compared the alternative creatine form to CrM, making it difficult to compare efficacy to CrM. There were no consistent findings of performance enhancement among alternative forms of creatine when compared to placebo. A review of the marketplace shows that CrM is the lowest cost form of creatine. Due to the paucity of studies on alternative forms of creatine as well as high prices on the market of these alternative forms, CrM remains as the most extensively studied form of creatine that shows efficacy, safety, and lowest cost to consumer.

This systematic review aimed to identify nutritional interventions and supplements that improve the performance for wheelchair athletes. Intervention trials involving high-performance wheelchair athletes were analyzed, including those that comprised a nutritional intervention, defined as any intervention related to food, beverages, and supplementation aiming at evaluating the performance of wheelchair athletes. Of the included studies, four evaluated caffeine supplementation, of which one also evaluated sodium citrate supplementation; two studies evaluated vitamin D supplementation; one study assessed creatine monohydrate supplementation; and one assessed carbohydrate supplementation. Most studies were conducted on athletes with spinal cord injury. Athletes who consumed caffeine exhibited an improvement in performance, but this finding is not strong enough to become a recommendation.

BACKGROUND: Creatine monohydrate is a nutritional supplement often consumed by athletes in anaerobic sports. Creatine is naturally found in most meat products; therefore, vegetarians have reduced creatine stores and may benefit from supplementation. OBJECTIVE: to determine the effects of creatine supplementation on vegetarians. DATA SOURCES: PubMed and SPORTDiscus. Eligibility criteria: Randomized controlled trials (parallel group, cross-over studies) or prospective studies. PARTICIPANTS: Vegetarians. INTERVENTION: Creatine supplementation. Study appraisal and synthesis: A total of 64 records were identified, and eleven full-text articles (covering nine studies) were included in this systematic review. RESULTS: Creatine supplementation in vegetarians increased total creatine, creatine, and phosphocreatine concentrations in vastus lateralis and gastrocnemius muscle, plasma, and red blood cells, often to levels greater than omnivores. Creatine supplementation had no effect on brain levels of phosphocreatine. Creatine supplementation increased lean tissue mass, type II fiber area, insulin-like growth factor-1, muscular strength, muscular endurance, Wingate mean power output, and brain function (memory and intelligence) in vegetarian participants. Studies were mixed on whether creatine supplementation improved exercise performance in vegetarians to a greater extent compared to omnivores. LIMITATIONS: Studies that were reviewed had moderate-high risk of bias. CONCLUSIONS: Overall, it appears vegetarian athletes are likely to benefit from creatine supplementation.

Although there are many studies showing the isolated effect of creatine monohydrate (CrM) and β-hydroxy β-methylbutyrate (HMB), it is not clear what effect they have when they are combined. The main purpose of this systematic review was to determine the efficacy of mixing CrM plus HMB in comparison with their isolated effects on sports performance, body composition, exercise induced markers of muscle damage, and anabolic-catabolic hormones. This systematic review was carried out in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines and the PICOS model, for the definition of the inclusion criteria. Studies were found by searching PubMed/MEDLINE, Web of Science (WOS), and Scopus electronic databases from inception to July 3rd 2019. Methodological quality and risk of bias were assessed by two authors independently, and disagreements were resolved by third-party evaluation, in accordance with the Cochrane Collaboration Guidelines samples. The literature was examined regarding the effects of the combination of CrM plus HMB on sport performance using several outcome variables (athletic performance, body composition, markers of muscle damage, and hormone status). This systematic review included six articles that investigated the effects of CrM plus HMB on sport performance (two on strength performance, showing improvements in one of them; three on anaerobic performance, presenting enhancements in two of them; and one on aerobic performance, not presenting improvements), body composition (three on body mass, showing improvements in one of them; two on fat free mass, presenting increases in one of them; and two on fat mass, showing decreases in one of them) and markers of muscle damage and hormone status (four on markers of muscle damage and one on anabolic-catabolic hormones, not showing benefits in any of them). In summary, the combination of 3-10 g/day of CrM plus 3 g/day of HMB for 1-6 weeks could produce potential positive effects on sport performance (strength and anaerobic performance) and for 4 weeks on body composition (increasing fat free mass and decreasing fat mass). However, this combination seems