Creatine Supplementation in Endurance Sports

Is creatine useful in endurance sports?

Yes. Current scientific evidence indicates that creatine supplementation can improve the ability to perform repeated high-intensity efforts, promote muscle recovery and support the maintenance of muscle mass in endurance athletes, especially in athletes who combine aerobic volume with intense sessions.

What is creatine and what are its benefits?

Creatine is not an amino acid as such, but a combination of three amino acids (arginine, glycine and methionine) that is mainly found in skeletal muscle, although it is also present in smaller amounts in other tissues such as the brain. This compound can be synthesized in part by our own body, although it also needs to be administered exogenously through the diet (being present especially in foods such as meat, fish and seafood). And that's where supplementation comes into play, as we can help maximize creatine deposits in the body, but what are the benefits of creatine?

The main function of creatine is the production of energy (aiding in the synthesis of ATP, which is the "currency" we use to exchange energy), especially in short and very intense efforts such as a sprint, a heavy lift or a jump. Therefore, the most well-known benefits of creatine supplementation are those related to improved performance in strength/power efforts. For example, two meta-analyses published in the prestigious journal Sports Medicine that included more than 50 scientific studies showed that creatine supplementation resulted in significant benefits in various markers of strength and power (efforts of less than 3 minutes) of both upper and lower body (1, 2). In addition, it has been suggested that these increases in the ability to perform strength training could result in greater muscle mass gains in the long term. However, this gain in muscle mass could also be partly due to the increase in osmotic permeability of the muscle fibre after creatine consumption (with the consequent increase in plasma volume, which has been called muscle "swelling"), which could in turn stimulate the satellite cells responsible for muscle regeneration (3).

Creatine in endurance sports?

Although its use is less popular in this population, this supplement can be very interesting for endurance athletes. As we know, many endurance sports such as cycling require the ability to perform numerous intermittent high-intensity efforts (e.g. to hold or perform attacks, or to be able to climb hills that require high power values), with success often being marked by the power generated in these efforts and/or by the ability to perform a final sprint. In these cases, creatine supplementation could be an "extra" energy, and in fact there is scientific evidence to support these benefits. For example, one study evaluated the effect of creatine supplementation (4 grams per day for 6 weeks) on cyclists who performed five sprints of 15 seconds each separated by 2 minutes of rest. The results showed that, compared to taking a placebo, creatine resulted in an increase of 4 – 5% in both peak power and average power during sprints (4). These benefits are consistent with the benefits observed in other populations that have performed repeated sprint tests, such as in runners or team athletes (5, 6). In addition, it is important to mention that these benefits seem to be present despite the possible slight gains in body weight that may occur in some athletes with their intake (due to the increase in muscle mass or the increase in intracellular fluid mentioned above) (5).

Creatine and recovery after training?

As we discussed in a previous post, creatine could also provide benefits in muscle recovery after workouts. On the one hand, creatine has been shown to increase various markers related to muscle anabolism, i.e. muscle "creation" and "regeneration", while decreasing markers of muscle catabolism or "destruction" (3). In addition, due in part to this increase in intracellular osmosis mentioned above, creatine could favor the passage of nutrients into the muscle cell. In this sense, creatine could be beneficial by facilitating one of the key processes in recovery after exercise: facilitating muscle glycogen recovery. This hypothesis seems to be confirmed by a study that observed that, after a very fatiguing exercise session in which glycogen stores decreased, creatine supplementation (20 g per day for 6 days) together with a high-carbohydrate diet allowed glycogen stores to recover much faster than carbohydrate intake alone ( 7).

Conclusions and recommendations

Creatine is not likely to provide great benefit in long-term efforts in endurance athletes, such as in a time trial or in a stress test (8). However, creatine supplementation can increase muscle strength and power values, improving the ability to sprint and perform short high-intensity efforts repeatedly (which has been shown to be a determinant of performance in numerous sports such as cycling). In addition, creatine could facilitate recovery processes during periods of high load. Therefore, taking into account that its safety is well established (within the recommended doses), taking into account the doses most commonly prescribed in scientific studies, it is advisable to consume 3 – 5 grams daily, or 20 grams daily if a loading phase is carried out (for example, 1 – 2 weeks during which a high physical load is expected, such as during a training camp or stage competition) (9).

References

1. Lanhers C, Pereira B, Naughton G, Trousselard M, Lesage FX, Dutheil F. Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses. Sport Med. 2015;45(9):1285–94.
2. Lanhers C, Pereira B, Naughton G, Trousselard M, Lesage FX, Dutheil F. Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis. Sport Med. 2017;47(1):163–73.
3. Candow DG, Forbes SC, Chilibeck PD, Cornish SM, Antonio J, Kreider RB. Effectiveness of creatine supplementation on aging muscle and bone: Focus on falls prevention and inflammation. J Clin Med [Internet]. 2019;8(4) doi:10.3390/jcm8040488.
4. Crisafulli DL, Buddhadev HH, Brilla LR, Chalmers GR, Suprak DN, San Juan JG. Creatine-electrolyte supplementation improves repeated sprint cycling performance: A double blind randomized control study. J Int Soc Sports Nutr. 2018;15(1):1–11.
5. Bogdanis GC, Nevill ME, Aphamis G, et al. Effects of Oral Creatine Supplementation on Power Output during Repeated Treadmill Sprinting. Nutrients. 2022;14(6):1–14.
6. Mielgo-Ayuso J, Calleja-Gonzalez J, Marqués-Jiménez D, Caballero-García A, Córdova A, Fernández-Lázaro D. Effects of creatine supplementation on athletic performance in soccer players: A systematic review and meta-analysis. Nutrients. 2019;11(4):1–17.
7. Roberts PA, Fox J, Peirce N, Jones SW, Casey A, Greenhaff PL. Creatine ingestion augments dietary carbohydrate mediated muscle glycogen supercompensation during the initial 24 h of recovery following prolonged exhaustive exercise in humans. Amino Acids. 2016;48(8):1831–42.
8. Fernández-Landa J, Santibañez A, Todorovic N, Stajer V, Ostojic S. Effects of Creatine Monohydrate on Endurance Performance in a Trained Population: A Systematic Review and Meta-analysis. Sport Med [Internet]. 2023;In press.
9. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14(1):1–18.