The American College of Sports Medicine (ACSM) has released a comprehensive study on the effects of creatine supplementation on exercise and athletics performance.

The study is a product of the ACSM's scientific round-table discussion entitled, "The Physiological and Health Effects of Oral Creatine Supplementation," which was conducted in Indianapolis in 1999. The NCAA and the National Federation of State High School Associations were among groups that helped support the round-table discussion.

The study provides information on a number of issues related to creatine use, including how creatine is metabolized in the body, whether creatine supplementation increases energy during exercise or enhances performance during athletics endeavors and whether there are potential side effects.

The study's findings reveal that creatine ingestion enhances exercise performance involving short periods of extremely powerful anaerobic activity as well as strength gains during strength training programs.

But Ronald Terjung, professor of biomedical sciences at the University of Missouri, Columbia, and chair of the round-table session who authored the report's introductory comments, said those improvements were found only under rigorously defined conditions that are not necessarily coincident with sport activity.

"There is some correspondence of that improvement to what would be expected by what creatine is supposed to do biochemically," Terjung said. "But not all people respond to creatine supplementation the same way."

The report also indicates that creatine supplementation does not increase maximal isometric strength, the rate of maximal force production nor aerobic exercise performance. In addition, the report said that creatine supplementation was found to increase weight gain within the first few days, likely due to water retention, and that creatine supplementation should not be expected to replace the necessity and value of athletics training.

Terjung said that creatine supplementation in recent years has been considered to be relatively safe, but that there has been little critical evaluation of its health implications.

"There's an incredible and unrealistic expectation of creatine supplementation," he said. "More than 2,000 tons of creatine were consumed last year, which says something about the mentality of that behavior without understanding what this stuff does or doesn't do."

Ethical concerns

Terjung also said that the apparent lack of health risks does not necessarily make creatine supplementation safe and appropriate. He said the report summarized that just because creatine is a naturally occurring compound does not make supplementation safe since numerous compounds are good, even essential, in moderation but detrimental in excess. Further, the lack of adverse affects does not equal safety since unending research must be performed to eliminate the possibility of all theoretical complications.

As with anything that is not subject to a certification process such as conducted by the Food and Drug Administration, purity and safety are not assured.

Terjung also said the report, in addition to providing a scientific analysis of the effects of creatine on athletics performance, expressed some ethical concerns related to the use of creatine in the athletics arena.

He said the report challenged any attempt to enhance sports performance by external means when athletics skill, dedicated training and personal effort remain the stellar quality of the true athletics competition.

"Any view that ergogenic agents are essential to achieve that competitive edge in sports events undermines the spirit of athletics competition," Terjung said. "Such a view may even foster a misguided drive that more is better and/or external dependence is essential."

While the ACSM's review focused broadly on a variety of issues associated with creatine supplementation, the NCAA has funded three studies to look more specifically at the physiological effects other than performance of creatine supplementation in intercollegiate athletics. Preliminary results from those three studies will be summarized in the April 2000 Sports Sciences Education Newsletter, which will be included in the April 10 issue of The NCAA News.

Proceedings from the ACSM's round-table discussion will be published in the March 2000 issue of Medicine & Science in Sports & Exercise. To obtain a copy of the study, contact the ACSM at 317/637-9200.