Our bodies make creatine, but we also need to supplement—and it’s not only for bodybuilders and athletes. It’s for all of us, especially as we get older. Bryan Hubbard reports
Search for the best supplements for healthy aging, and the usual suspects pop up. High on the list are omega-3 fatty acids, which slow biological aging according to a major study out this year.
Then there are magnesium, B12, calcium, curcumin, CoQ10 and vitamin C. But no list includes creatine, which improves muscle strength and mental capacity, according to a growing group of advocates.
But then creatine is something of a Cinderella supplement. For years, it’s been the preserve of athletes and bodybuilders who use it as a performance enhancer, and critics say it can cause dehydration, bloating and cramping. Researchers, however, think the downsides haven’t been proven and creatine is something we all should be taking, especially as we get older.
Our bodies naturally create creatine, a compound made up of amino acids. It’s stored in muscle tissue as phosphocreatine, which helps regenerate ATP, the body’s main energy source, especially during intense activity. It also helps support muscles and keeps us flexible.
We produce about a gram of creatine every day, although one of its biggest champions, Dr Richard Kreider, professor and director of the Exercise & Sport Nutrition Lab at Texas A&M University, reckons we need 2–4 g, depending on our muscle mass and activity levels.
Most people fall short of getting enough from diet alone—the best dietary sources are meat and fish—which is why he recommends we top up levels with supplements. “You only get about a gram of creatine per pound (0.45 kg) of red meat or fish, like salmon, so it’s expensive and takes a lot of calories to get a gram,” Kreider said.
When we get older and our bodies produce less creatine, supplementing becomes more important because it can protect aging muscles and bones, a study by researchers from the University of Regina in Canada has established.1
Specifically, it can combat sarcopenia, the age-related decrease in muscle strength and physical performance associated with reduced bone mass and chronic low-grade inflammation. Creatine supplementation can increase aging muscle mass and muscle performance. It can also reduce the risk of falls and even slow inflammation and bone loss, the researchers found.
Adding resistance training to the mix produces an even better result, say researchers from the University of Saskatchewan. They found a significantly greater increase in lean tissue mass and upper- and lower-body maximal strength in people with average ages of 57–70 who supplemented with creatine during resistance training for up to a year, compared to those who only did resistance training.2
Even without resistance training, supplementing creatine significantly improves hand-grip strength and muscle power and endurance, researchers found when they gave older men and women 20 g supplements every day for just a week.3 Taking the supplements for a month reduced lower body muscle fatigue in older men, another study showed.4
Power to the brain
Although it’s usually seen as a support for muscles and bones, creatine also helps maintain memory and cognitive function. Just 5 percent of creatine makes its way to the brain, but it seems to play a vital role in cognitive abilities and functioning.
The brain needs plenty of energy, taking up around 20 percent of the body’s energy stores every day, and insomnia, hypoxia (oxygen depletion) and cognitive decline are all signs of an inadequate energy supply to the brain.
Creatine may even help prevent neurodegenerative diseases like Alzheimer’s, in which creatine levels in the brain diminish. In mouse models, supplementing for up to nine weeks helped protect the brain, a meta-analysis by Brazilian researchers reported.5
Conversely, when creatine levels are low enough to deplete creatine stores in the brain, the result is mental and developmental disorders such as learning delays and seizures. However, taking creatine supplements can help to reverse these problems, researchers from Liverpool University have found. They also discovered that, in older people, supplements helped improve feats of memory such as number recall as well as long-term memory challenges.6
Best of all, creatine could even help us live longer. People who supplement creatine enjoy greater longevity, although the benefit isn’t so clear when we factor in a poor diet and lifestyle choices, which can mitigate its positive effects, says a researcher from the University of Agder in Norway. He followed more than 4,000 Americans for nearly 20 years and found those who were supplementing with at least 1 g of creatine a day were living longer than those getting less.7
Looking deeper, other researchers think creatine slows aging at the cellular level. It improves cellular homeostasis (balance), reduces oxidative stress and interferes with nerve signaling that promotes the aging process, say other researchers at Agder.8
Not all good news
Despite the good news, creatine gets bad press, although stories about its safety or claims that it causes bloating and cramping don’t stand up to scientific scrutiny, says Kreider. He has spent more than 30 years investigating the effects of creatine, and his latest research has explored adverse reactions to the supplement. After analyzing 685 human clinical trials involving 13,452 participants, he found few reports of side effects.9
Other researchers aren’t so sure. Having too much creatine could cause hypertension (high blood pressure), an international team of researchers says. They studied over 3,000 people for a median of seven years and analyzed their levels of creatine; those with higher levels were more likely to have developed hypertension, they found, though the effect was significant only in the men after adjusting for other factors.10
Kreider is also concerned about pressure to restrict creatine supplementation among young athletes. The American Academy of Pediatrics and the American College of Sports Medicine advise against under-18s taking creatine because of potential side effects, but he argues there’s no evidence to support their concerns.
We can all benefit
In fact, the very reverse is true, he argues. Children and adolescents who consume less than 1.5 g of creatine a day tend to be shorter and weigh less. They have less lean body mass and lower bone mineral content.
Low creatine intake affects all ages. People over age 60 consuming less than 0.95 g a day have poorer cognition test scores.
Supplementing could benefit women in the third trimester of pregnancy, but it’s required throughout the lifespan to help maintain strength, achieve lean mass and maintain cognitive function. Supplementation also improves immunity and can promote mitochondrial, heart, vascular and brain health, says Kreider.
Therapeutic benefits have also been reported in the management of type 2 diabetes, though some reports suggest that sufferers shouldn’t be supplementing. It may also benefit those who have sarcopenia, osteoporosis or neuromuscular diseases.
Although meat and fish are rich sources of creatine, they’re also expensive ones, especially as it takes substantial amounts to get the levels of creatine the body needs. Instead, creatine monohydrate supplements are a relatively inexpensive alternative, and doses of 25 g can be safely taken for 10 days or so before reducing the amount. Supplementing is especially important for vegetarians and vegans, as there are no plant-based sources of creatine with amounts worth mentioning.
Only people who have kidney or liver diseases, type 2 diabetes or bipolar disorder should not supplement. Some researchers suggest that women who are pregnant or breastfeeding should also avoid it, although others believe there is little evidence to support the warning.
It’s a pity that creatine has found itself in the ghetto of performance-enhancing supplements when it’s something from which all of us could benefit. Creatine is a fuel for our energy cells and helps support our muscles and bones as we age, which could prevent falls.
Although creatine clusters around our muscles, some gets to the brain, and it’s enough to help maintain memory and cognition. Taking 3–4 g a day seems to be the optimum to compensate for lower production as we age, help us stay healthy and possibly even help us live longer, just as long as we’re getting all the other stuff right, too.
Dietary sources of creatine
These values are for raw foods. Cooking, especially at high temperatures, can lower the amount of creatine they contain. Creatine occurs in only trace amounts in plant foods, though eating those that contain the three amino acids in creatine (glycine, arginine and methionine) can help the body make more.
Herring: 1.25 g per 4 oz serving
Salmon: 0.50 g per 4 oz serving
Plaice: 0.23 g per 4 oz serving
Tuna: 0.45 g per 4 oz serving
Cod: 0.35 g per 4 oz serving
Pork: 0.57 g per 4 oz serving
Beef: 0.50 g per 4 oz serving
Chicken: 0.41 g per 4 oz serving
Turkey: 0.30 g per 4 oz serving
Milk: 0.30 g per 8 fl oz serving
Cheese: 0.83 g per 1 oz serving
Eggs: 0.10 g per large egg