Darren G. Candow

Effect of creatine and weight training on muscle creatine and performance in vegetarians.

PURPOSE To compare the change in muscle creatine, fiber morphology, body composition, hydration status, and exercise performance between vegetarians and nonvegetarians with 8 wk of creatine supplementation and resistance training. METHODS Eighteen VG and 24 NV subjects (19-55 yr) were randomly assigned (double blind) to four groups: VG + creatine (VGCr, N=10), VG + placebo (VGPl, N=8), NV + creatine (NVCr, N=12), and NV + placebo (NVPl, N=12). Before and at the end of the study, muscle biopsies were taken from the vastus lateralis m, body composition was assessed by DXA, and strength was assessed using 1-RM bench press and leg press. Subjects participated in the same 8-wk resistance-training program. Creatine dosage was based on lean tissue mass (0.25 g.kg(-1) LTM.d(-1) x 7 d; 0.0625 g.kg(-1) LTM.d(-1) x 49 d). RESULTS Biopsy samples indicated that total creatine (TCr=free Cr + PCr) was significantly lower in VG compared with NV at baseline (VG=117 mmol.kg(-1); NV=130 mmol.kg(-1); P<0.05). For Cr subjects, there was a greater increase in PCr, TCr, bench-press strength, isokinetic work, Type II fiber area, and whole-body lean tissue compared with subjects on placebo (P<0.05). Vegetarians who took Cr had a greater increase in TCr, PCr, lean tissue, and total work performance than nonvegetarians who took Cr (P<0.05). The change in muscle TCr was significantly correlated with initial muscle TCr, and the change in lean tissue mass and exercise performance. These findings confirm an ergogenic effect of Cr during resistance training and suggest that subjects with initially low levels of intramuscular Cr (vegetarians) are more responsive to supplementation.

Low-dose creatine combined with protein during resistance training in older men.

PURPOSE To determine whether low-dose creatine and protein supplementation during resistance training (RT; 3 d x wk(-1); 10 wk) in older men (59-77 yr) is effective for improving strength and muscle mass without producing potentially cytotoxic metabolites (formaldehyde). METHODS Older men were randomized (double-blind) to receive 0.1 g x kg(-1) creatine + 0.3 g x kg(-1) protein (CP; n = 10), creatine (C; n = 13), or placebo (PLA; n = 12) on training days. Measurements before and after RT included lean tissue mass (air-displacement plethysmography), muscle thickness (ultrasound) of elbow, knee, and ankle flexors and extensors, leg and bench press strength, and urinary indicators of cytotoxicity (formaldehyde), myofibrillar protein degradation [3-methylhistidine (3-MH)],and bone resorption [cross-linked N-telopeptides of type I collagen (NTx)]. RESULTS Subjects in C and CP groups combined experienced greater increases in body mass and total muscle thickness than PLA (P < 0.05). Subjects who received CP increased lean tissue mass (+5.6%) more than C (+2.2%) or PLA (+1.0%; P < 0.05) and increased bench press strength (+25%) to a greater extent than C and PLA combined (+12.5%; P < 0.05). CP and C did not differ from PLA for changes in formaldehyde production (+24% each). Subjects receiving creatine (C and CP) experienced a decrease in 3-MH by 40% compared with an increase of 29% for PLA (P < 0.05) and a reduction in NTx (-27%) versus PLA (+13%; P = 0.05). CONCLUSIONS Low-dose creatine combined with protein supplementation increases lean tissue mass and results in a greater relative increase in bench press but not leg press strength. Low-dose creatine reduces muscle protein degradation and bone resorption without increasing formaldehyde production.

Exercise and nutritional interventions for improving aging muscle health

Skeletal muscle mass declines with age (i.e., sarcopenia) resulting in muscle weakness and functional limitations. Sarcopenia has been associated with physiological changes in muscle morphology, protein and hormonal kinetics, insulin resistance, inflammation, and oxidative stress. The purpose of this review is to highlight how exercise and nutritional intervention strategies may benefit aging muscle. It is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. Additional research is needed to determine whether skeletal muscle adaptations to increased activity in older adults are further enhanced with effective nutritional interventions and whether this is due to enhanced muscle protein synthesis, improved mitochondrial function, and/or a reduced inflammatory response.

Effect of sugar-free Red Bull energy drink on high-intensity run time-to-exhaustion in young adults.

Candow, DG, Kleisinger, AK, Grenier, S, and Dorsch, KD. Effect of sugar-free Red Bull energy drink on high-intensity run time-to-exhaustion in young adults. J Strength Cond Res 23(4): 1271-1275, 2009-Consuming sugar-free Red Bull energy drink before exercise has become increasingly popular among exercising individuals. The main purported active ingredient in sugar-free Red Bull is caffeine, which has been shown to increase aerobic exercise performance. The purpose of this study was to determine the effects of sugar-free Red Bull energy drink on high-intensity run time-to-exhaustion in young adults. Physically active university students (n = 17, 9 men, 8 woman; 21 ± 4 years, 73.4 ± 3.1 kg, 175.1 ± 3.2 cm) participated in a double-blind, crossover, repeated-measures study where they were randomized to supplement with sugar-free Red Bull (2 mg·kg−1 body mass caffeine or ∼147 mg caffeine; 4 kcal/250 mL) and noncaffeinated, sugar-free placebo (lemon-lime flavored soft drink, tonic water, lime juice; 4 kcal/250 mL) separated by 7 days. Exercise capacity was assessed by a run time-to-exhaustion test at 80% &OV0312;o2max, perceived exertion was assessed immediately after exercise, and blood lactate was measured before and after exercise. There were no differences in run time-to-exhaustion (Red Bull: 12.6 ± 3.8 minutes, placebo: 11.8 ± 3.4 minutes), perceived exertion (Red Bull: 17.1 ± 2.0, placebo: 16.6 ± 1.8), or blood lactate between groups. In conclusion, sugar-free Red Bull energy drink did not influence high-intensity run time-to-exhaustion in young adults.

Effect of nutritional interventions and resistance exercise on aging muscle mass and strength

Sarcopenia, defined as the age-related loss of muscle mass, has a negative effect on strength, functional independence and overall quality of life. Sarcopenia is a multifactorial phenomenon characterized by changes in muscle morphology, protein and hormonal kinetics, oxidative stress, inflammation, physical activity and nutrition. It is well known that resistance exercise increases aging muscle mass and strength and these physiological adaptations from exercise may be further enhanced with certain nutritional interventions. Research indicates that essential amino acids and milk-based proteins, creatine monohydrate, essential fatty acids, and vitamin D may all have beneficial effects on aging muscle biology.

Timing of creatine or protein supplementation and resistance training in the elderly

Muscle loss with age has a negative effect on strength and functional independence. Age-related loss of muscle is the result of decreased muscle fiber number and size, which are functions of altered hormonal status, physical inactivity, and variations in nutritional intake. Resistance training has a positive effect on muscle mass and strength in the elderly. Studies of protein or creatine supplementation for increasing muscle mass and strength in older individuals are equivocal. The timing of nutritional supplementation may be more important than the absolute daily intake of supplements. Protein or creatine ingestion proximate to resistance-training sessions may be more beneficial for increasing muscle mass and strength than ingestion of protein or creatine at other times of the day, possibly because of increased blood flow and therefore increased transport of amino acids and creatine to skeletal muscle.

Insulinotropic and Muscle Protein Synthetic Effects of Branched-Chain Amino Acids: Potential Therapy for Type 2 Diabetes and Sarcopenia

The loss of muscle mass and strength with aging (i.e., sarcopenia) has a negative effect on functional independence and overall quality of life. One main contributing factor to sarcopenia is the reduced ability to increase skeletal muscle protein synthesis in response to habitual feeding, possibly due to a reduction in postprandial insulin release and an increase in insulin resistance. Branched-chain amino acids (BCAA), primarily leucine, increases the activation of pathways involved in muscle protein synthesis through insulin-dependent and independent mechanisms, which may help counteract the “anabolic resistance” to feeding in older adults. Leucine exhibits strong insulinotropic characteristics, which may increase amino acid availability for muscle protein synthesis, reduce muscle protein breakdown, and enhance glucose disposal to help maintain blood glucose homeostasis.

Sarcopenia: current theories and the potential beneficial effect of creatine application strategies

Sarcopenia, defined as the age-related loss of muscle mass, subsequently has a negative effect on strength, metabolic rate and functionality leading to a reduced quality of life. With the projected increase in life expectancy, the incidence of muscle loss may rise and further drain the health care system, with greater need for hospitalization, treatment, and rehabilitation. Without effective strategies to counteract aging muscle loss, a global health care crisis may be inevitable. Resistance training is well established to increase aging muscle mass and strength. However, muscle and strength loss is still evident in older adults who have maintained resistance training for most of their life, suggesting that other factors such as nutrition may affect aging muscle biology. Supplementing with creatine, a high-energy compound found in red meat and seafood, during resistance training has a beneficial effect on aging muscle. Emerging evidence now suggests that the timing and dosage of creatine supplementation may be important factors for aging muscle accretion. Unfortunately, the long-term effects of different creatine application strategies on aging muscle are relatively unknown.

Effect of creatine supplementation during cast-induced immobilization on the preservation of muscle mass, strength, and endurance.

Johnston, APW, Burke, DG, MacNeil, LG, and Candow, DG. Effect of creatine supplementation during cast-induced immobilization on the preservation of muscle mass, strength, and endurance. J Strength Cond Res 23(1): 116-120, 2009-Muscle and strength loss will occur during periods of physical inactivity and immobilization. Creatine supplementation may have a favorable effect on muscle mass and strength independently of exercise. The purpose of this study was to determine the effects of creatine supplementation on upper-limb muscle mass and muscle performance after immobilization. Before the study, creatine-naïve men (n = 7; 18-25 years) were assessed for lean tissue mass (dual-energy X-ray absorptiometry), strength (1-repetition maximum [1RM] isometric single arm elbow flexion/extension), and muscle endurance (maximum number of single-arm isokinetic elbow flexion/extension repetitions at 60% 1RM). After baseline measures, subjects had their dominant or nondominant (random assignment) upper limb immobilized (long arm plaster cast) at 90° elbow flexion. Using a single-blind crossover design, subjects received placebo (maltodextrin; 4 × 5 g·d−1) during days 1-7 and creatine (4 × 5 g·d−1) during days 15-21. The cast was removed during days 8-14 and 22-29. The dependent measures of lean tissue mass, strength, and endurance were assessed at baseline, postcast, and after the study. During immobilization, compared with isocaloric placebo, creatine supplementation better maintained lean tissue mass (Cr +0.9% vs. PLA −3.7%, p < 0.05), elbow flexor strength (Cr −4.1% vs. PLA −21.5%, p < 0.05), and endurance (Cr −9.6% vs. PLA −43%, p < 0.05), and elbow extensor strength (Cr −3.8% vs. PLA −18%, p < 0.05) and endurance (Cr −6.5% vs. PLA −35%, p < 0.05). These results indicate that short-term creatine supplementation attenuates the loss in muscle mass and strength during upper-arm immobilization in young men.

Creatine supplementation and aging musculoskeletal health.

Sarcopenia refers to the progressive loss of muscle mass and muscle function and is a contributing factor for cachexia, bone loss, and frailty. Resistance training produces several physiological adaptations which improve aging musculoskeletal health, such as increased muscle and bone mass and strength. The combination of creatine supplementation and resistance training may further lead to greater physiological benefits. We performed meta-analyses which indicate creatine supplementation combined with resistance training has a positive effect on aging muscle mass and upper body strength compared to resistance training alone. Creatine also shows promise for improving bone mineral density and indices of bone biology. The combination of creatine supplementation and resistance training could be an effective intervention to improve aging musculoskeletal health.