The NCAA News - News & Features

Energy supplement stirs debate

BY SALLY HUGGINS
STAFF WRITER

For those athletes always looking for that extra edge to enhance their performance in competition, a relatively new supplement is gaining popularity.

Whether it is safe to use over the long term or even in the short term still is open to debate.

Considered a food supplement, creatine is a compound produced by the body that helps release energy in muscles. It has been found to enhance performance and decrease fatigue.

Creatine has been shown to enhance performance in repeated periods of short-duration, high-intensity activity such as sprints and some team competition, said Priscilla M. Clarkson, associate dean of the school of public health and health sciences at the University of Massachusetts, Amherst.

"Creatine is one of the few supplements that is actually shown to work," said Clarkson, a member of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports. "Most supplements are taken and excreted out."

But it also may be linked to cramping and muscle spasms, according to athletic trainers. Ross Bailey, head athletic trainer at Texas Christian University, said he suspects creatine to be the culprit in frequent cramping and pulled hamstrings among athletes at Texas Christian.

"We have no scientific evidence, but use of creatine is the only thing that has changed," Bailey said. He first started hearing of creatine being used by athletes at Texas Christian last spring, and the use continued through the summer.

The frequent cramping and hamstring troubles began occurring this fall, Bailey said. He is hearing from other trainers who are encountering the same symptoms.

Frank Randall, head trainer at Iowa State University, said he also has seen a significant increase in cramping and muscle spasms. Like Bailey, the only change in the training routine of the athletes has been use of creatine.

"It's not the calf cramps like you get with dehydration," Randall said. "This is cramps of the torso and the large muscle groups. It's nothing scientific, but that is the only thing that has changed."

But studies so far have not shown significant side effects resulting from use of the supplement.

Studies reveal no negatives

Jeff Volek, a doctoral student at the Center for Sports Medicine at Pennsylvania State University, recently completed a study that found no negative side effects to creatine use.

Volek said there are another 10 peer-review studies out that also have not found negative side effects.

Randall suspects that the problems he is seeing among Iowa State athletes may be related to an insufficient intake of fluids by athletes using creatine.

Retailers of creatine supplements encourage persons using the supplement to drink additional eight ounces of water daily, because the creatine pulls water from other parts of the body to perform cell volumization of the muscles.

Cell volumization leads to more water inside the muscle cells, making muscles look bigger and firmer -- unlike water retention, which involves cells outside of the muscles.

Creatine is manufactured by the liver at a rate of about two grams per day and also is readily available in red meat. Thus, creatine levels in the average person are fairly easily maintained.

But the amount produced within the human body is not sufficient to support intense, long periods of exercise.

The creatine sold commercially is produced synthetically because it is not economical to extract it from raw beef.

Creatine can enhance performance and decrease fatigue because it helps muscles make and circulate more adenosine triphosphate (ATP), the energy fuel the body uses for quick, intense activity of short duration such as weightlifting or sprinting.

Because it is a naturally occurring compound, side effects are not as likely, Volek said. And it has proven to be readily handled by the kidneys, he added.

Creatine is recommended to be taken four times a day at five grams per dosage over five days, Clarkson said. At the conclusion of the five-day "loading" phase, the body will have increased its fast energy production.

'Looking for an angle'

Bailey said he is seeing usage among his student-athletes that varies from ingesting two grams a day to 10 grams. And while two grams might be of benefit, he feels 10 is too much.

"But the athlete mentality is if a little is good, a lot is better. Every athlete is looking for an angle," he said.

Creatine has been compared to steroids, but it is not a banned substance.

It usually is sold as a powder that is mixed with water. Some athletes have mixed the supplement with fruit juice, but manufacturers warn the citrus juice will neutralize the creatine monohydrate and negate the benefits of taking the supplement.

Volek said creatine loading first came to prominence in 1992, when a group of researchers in Sweden wrote a paper about creatine's effect. The researchers were the same ones who developed the carbohydrate-loading concept, he said.

Studies indicate that supplemental use of creatine can increase creatine levels in muscles as much as 20 to 30 percent, Volek said.

The accompanying increased body mass is what makes creatine popular with body builders, Clarkson said.

"It is unclear what the increase in body mass is," Clarkson said. "It could be water. The increase is too quick to be muscle. Body builders use it for appearance."

Clarkson said use of creatine may be of particular benefit to persons who do not have much meat in their diet, such as vegetarians, because their natural level of creatine is lower.

'Could disturb the balance'

Whether there are any negative aspects of creatine from long-term use is unknown. But Clarkson urged caution.

"It probably is not a good idea to use it for a long time," she said. "Our bodies are finely tuned and this could disturb the balance."

Using creatine for the five-day loading period just before a competition would be the ideal use of the supplement, Clarkson said, with use then discontinued until five days before the next competition.

Manufacturers of creatine recommend a five-day loading period, followed by a maintenance program involving about five grams daily.

Creatine has been mostly strongly marketed among weightlifters and body builders, but strength coaches also are encouraging its use now.