Can creatine help you build muscle?

Usually, when it comes to ergogenic supplements, most health professionals will dissuade athletes from taking them citing lack of research, questionable safety, unwanted side effects. For this reason, it surprised me to read about creatine. Turns out that creatine is one of the best researched ergogenic aids on the market, was called by one well-known sport dietitian as "the most important natural fuel-enhancing supplement yet to be discovered for strength trainers" and can produce significant improvement in sports requiring high levels of power and strength.

What is creatine?

Creatine is a compound naturally found in meat and fish. We also synthesize it in our liver and kidney from amino acids. 95% of creatine is stored in our muscles where it becomes creatine phosphate, the primary fuel for short, high-intensity bursts of activity lasting 1-10 seconds like weight lifting, sprinting, ice hockey etc.
Just like endurance athletes carb-load to increase muscle glycogen stores, creatine-loading can increase muscle creatine stores. Creatine won't build muscle directly but will allow you to increase the duration and intensity of your workout, resulting in muscle gain.

How much?

We get about 1-2 g creatine from food daily (vegetarians get less) but supposedly that's not enough to improve strength training performance. Creatine supplements usually come in the form of powder under the name creatine monohydrate. Studies show that taking four to five 5 gram (1 tsp) doses a day for 5 days- or 0.3g/kg body weight per day- will result in rapid loading. From there, 2 grams (1/2 tsp) a day will keep muscles saturated. A more gentle loading regimen is 2 grams a day for 28 days. Taking more than 40grams daily may cause possible liver and kidney damage. .

Creatine stays in the muscles for 4-5 weeks after a loading phase without extra supplementation. Coordinate creatine supplementation with your training schedule, starting just before you begin a high intensity training session.

20-30% of people don't respond to creatine-loading. Interestingly, creatine works best in combination with a liquid carbohydrate supplement and this may help non-responders to get creatine into their muscles. Ingesting 75-100 grams carbohydrates can boost the amount of creatine loaded in muscles by up to 60%.
75 grams carbohydrate = 3 cups orange juice or 5 cups gatorade.

Side Effects

Creatine is non-toxic and so far there is no evidence to suggest that it's unsafe when taken by healthy adults in the recommended doses for a short term period of ~8 weeks (safety of prolonged use has not been determined yet). Nonetheless, the American College of Sports Medicine recommends that all athletes check with their doctor before taking creatine.

Creatine supplementation is not advised for people with pre-existing kidney disease. There's also no research done on the effect of creatine supplementation on growing kids under the age of 18.

Weight gain of 2-5 lbs is commonly seen in creatine users and is partly due to water weight but evidence now shows that much of the weight gain is a result of increased muscle mass. Anecdotal reports suggest that creatine may cause cramping, nausea, GI problems and higher rates of muscle tearing. The cramping may be the result of dehydration therefore it's recommended that athletes supplementing with creatine drink more water than usual.

As with any supplement, quality of the product is poorly controlled- what you buy is not necessarily what you get.

Creatine and Endurance

Creatine supplementation has been shown to have no effect on VO2max or to improve endurance. However, some researchers believe that creatine supplementation can indirectly improve endurance performance by lifting the lactate threshhold, allowing a more intensive interval-type training. Moreover, increasing muscle mass can potentially help certain endurance athletes like swimmer and rowers... but may hinder others that don't want extra muscle mass, like marathoners and long-distance cyclists.

Is it Legal?

Yes. Creatine actually became public when it was reported that Linford Christie, 100m gold-medal winner, used creatine during the 1992 Barcelona Olympics. Sally Gunnell, 400m hurdle gold-medalist and many British rowers used creatine in preparation for the Barcelona games as well. However, there is concern for cross-contamination since athletes taking creatine have tested positive for banned prohormone products.
The NCAA does not condone the use of creatine.

Sources

Kleiner SM, Greenwood-Robinson M. Power Eating: Build muscle, boost energy, cut fat, 2nd ed. Human Kinetics. 2001.

Ryan, M. Sports Nutrition for Endurance Athletes, 2nd ed. VeloPress 2007.

Girard-Eberle S. Endurance Sports Nutrition. Human Kinetics 2000.

Clark N. Sports Nutrition Guidebook, 3rd ed. Human Kinetics 2003.

Creatine supplements. http://en.wikipedia.org/wiki/Creatine_supplements

Part 2: What do Olympians eat?

I didn’t really answer my own question yesterday- how do these Olympians get the bodies they have... and what do they eat?

Pretty simply, these elite athletes train hard to look the way they do.

That picture of 41 year old swimmer Dara Torres that appeared in the NY Time had some critics speculating that she’s taking performance-enhancing drugs- something she vehemently denies, of course. She’s gone so far as to request that her blood and urine be tested regularly for illegal substances. But how do you explain the fact that she not only is leaner than when she was younger (at 6’0” she weighs 149 lbs, 12 lbs lighter than she was in Sydney in 2000) but more chiseled and faster too, despite the fact that she’s in the pool only 5 times a week totalling 25 000m compared to 10-12 times- totalling 65 000m- when she was in her 20s? Check out how her times have improved with age:

So what is she doing? And what is she eating?

Firstly, she has a head coach, a sprint coach, a strength coach (who happens to also be the Florida Panthers coach and has Sidney Crosby as a client), 2 stretchers, 2 masseuses, a chiropractor and a nanny- a cost of 100 000$ a year.

Torres works with her strength coach 4 days a week, 60-90 minutes each time. Her strength coach has veered Torres away from static heavy weight training and more towards dynamic exercises. According to her coach, weight training- low-rep/high-weight- is not good for sprinters since a lot of energy is wasted trying to move a body of big muscles that have been trained to work in isolation. Instead, she does core work, uses swiss balls, medicine balls, resistance cables and bands. Despite the fact that she doesn’t use dumbbells, she gets a great workout- her legs quiver and her arms are aching at the end.

In the year and a half that she started this new weight training regimen, her muscles have become longer and leaner and she’s become faster in the water.

She then swims- 5 times a week for about 2 hours each time.

However, Torres calls her resistance stretching her secret weapon. She has 2 stretchers come to her house about 5 days a week to basically pull and stretch her body vigorously for 2 hours in order to flush out the toxins and lactic acid and help in recovery and flexibility. According to a journalist, the stetching sequence looks like a cross between a yoga class, a massage and a Cirque du Soleil performance!

Torres also gets massages 3 times a week.

Clearly time and money are also important factors that help you get a 6-pack like Torres!

But what does she eat? That was a bit harder to find out. Because of her past experience with bulimia, she says she doesn’t count calories and she indulges in her cravings... whatever that means. She takes a German-made amino-acid supplement for muscle recovery and strength. That’s pretty much all I could find. Oh, and her favourite power breakfast is a berry-flavored Living Fuel shake with some milk and real fruit.

Just as actors are coached by their publicists to downplay the time it takes to make them look flawless for an event, I found that most athletes seem to downplay their nutrition and workout regimen- maybe to keep their training secrets to themselves?

For example, Erik Vendt, also an American swimmer, the first American to break 15 minutes in the mile and 2-time Olympic silver medalist, credits his return from retirement, at age 27, to an organic diet. So now, if I eat all organic, will I too be a top 5 ranked swimmer in the world? I don’t think so.

Marion Jones, Track and Field phenom at the 2000 Sydney games, credited her amazing performance to nutritional supplements that included flaxseed oil and iron. I guess we learned they contained a bit more than that...

I also found that many athletes don’t eat that much (I discussed this yesterday)... but maybe some are just unaware or downplaying what they eat?

English heptathlete Kelly Sotherton eats 2 toasts with butter and marmite and a cup of tea for breakfast... and nothing else until lunch 4.5 hours later! Kevin Tan, American gymnast, eats eggs and toast for breakfast, a light lunch and a healthy dinner- usually chicken. That’s it- despite the fact that he trains 2-4 hours a day 6 days a week! American weight lifter Tara Nott Cunningham- the first American woman to win an Olympic gold in her sport (in 2000) and US record holder in snatch, clean and jerk and total weight lifted- will have 2 hard-boiled eggs, grapefruit, cottage cheese and decaf coffee. A typical supper for mountain biker Susan Haywood would be grilled salmon with roasted peppers and organic low fat yogourt for dessert. Doesn’t seem much to me...

I did find examples of athletes who seem to place a large importance on nutrition and seem to eat to compete:

Apolo Anton Ohno, reigning American short track speedskating champ since 2001claims to constantly be working to improve his nutrition knowledge and attributes his newfound ab definition to his food intake. He doesn’t count calories but states to be in tune with his nutrition and can feel when he needs to add more grams of fat, protein or carbs.

Canadian triathlete and 2008 Olympic hopeful Lauren Groves claims to be very aware of the foods she eats... and she does eat... very healthily it seems. She usually has three breakfasts- because she finds breakfast food easier to digest. She starts her morning, pre-swim- with a couple of pieces of sprouted-grain bread with some almond butter and a cup of coffee. Post-swim she’ll have some scrambled eggs and fruit- and maybe some more toast. After her second workout, midafternoon, she’ll have a bowl of goat’s milk yogurt with some fruit added, or a turkey sandwich. For supper she’ll have a really big salad and some kind of grilled chicken or fish.

You’d think that given the large amount of calories they spend, these athletes would indulge a bit. However, these are elite athletes and their bodies are their livelihoods. US rower Jennifer Devine has said that just because she needs 3500 to 4000 calories a day doesn’t mean she can eat whatever she likes. She stays away from processed, pre-packaged foods because they are high in salt and fat. Wrestler Patricia Miranda, first American woman in Olympic history to receive a medal in woman's wrestling (in Athens), stated that although she doesn’t count calories, she doesn’t want to waste them on "foods that don’t provide positive fuel".

However, there are always exceptions:

Michael Phelps, American swimmer, 7-time Olympic gold medalist (most recent win just a few hours ago!) and current world record holder in a few events, reportedly eats 8,000 to 10,000 calories per day when training and says "I just eat pretty much whatever I want and as much as I want, because I burn so much."

He says he swims 6-7 days a week, 2-5 hours a day, about 50 miles a week, and- this is the downplaying part- he once said, "I've never lifted a single weight in my life". However, he does admit that since the Athens games he’s added a strength training regimen, three times a week, to put on 14 pounds of muscle.

1500 and 5000m runner Bernard Lagat loves steak and has steak before race day. He is aware that most people avoid steak before a competition for fear of it digesting slowly and slowing them down. However, before his win at the 2007 World Championships, he had gone to Outback and ordered the biggest steak he could! "You have to do what works for your body" he says.

Professional distance runner, 2 mile record holder (8:07:07) and fourth fastest American 5000m runner of all time, Matt Tegenkamp, has ice cream and peanut butter 3-4 times a week... and doesn’t use a bowl!

American middle-distance runner Nick Symmonds has a burger every Tuesday and pizza on the weekend- and will even have 3-4 beers on Saturday!

American swimmer and 2-time Olympic gold medalist Lindsay Benko admits to having eaten McDonald’s for lunch the day she set the world record in the 1200m freestyle...although she doesn’t recommend that. She actually tries to keep her protein intake high and carb intake low... which is actually contrary to what the science shows us- that carbs should be an athlete’s predominant fuel.

American gymnast Stephen McCain is another proponent of the low carb diet claiming that since gymnastics is an anaerobic sport, his body needs more protein. 60-70% of his diet actually comes from protein: egg whites for breakfast, chicken for lunch, small snacks of cheese and vegetables and maybe fish and fruit for dinner.

“I’m years old, so I’m going to do what I’m going to do,” he says. “But I think I’ve finally got a real good grip on what’s right”.

However, he said this during a 2004 interview... maybe he's since changed his tune and reverted back to a higher carb diet?

Someone who is known to have been obessed with his diet is Lance Armstrong, 7-time Tour de France winner. He used to weigh his food and calculate, calorie for calorie, how much food he needed during his training and competition.

According to Armstrong’s coach, Chris Carmichael, athletes need to eat in correspondence to the period they are in in their training- periodization is a training technique where your training is broken down into periods, each with a different goal. The nutrients you need varies between periods- and, according to Carmichael, it’s not as simple as adding a granola bar or 2 when the training gets tougher- the ratio of carbohydrates, protein and fat changes as well.

For example,leading up to the Tour de France, Armstrong used to up his caloric intake from 3000 to 6000 or more calories- the average rider burns between 7000-10 000 calories per day of the 21-dayTour that covers about 2200 miles- and his carbohydrate intake increased frm 60% to 70% of his total calories.

Sources:

"A swimmer of a certain age" http://www.nytimes.com/2008/06/29/magazine/29torres-t.html?pagewanted=6&ref=olympics

"Torres is getting older, but swimming faster" http://www.nytimes.com/2007/11/18/sports/othersports/18torres.html?pagewanted=2&_r=1&adxnnlx=1218294193-NgzQccK3nGG7lC3/N/N7lA

"What's driving Dara Torres" http://www.time.com/time/world/article/0,8599,1825304,00.html

"41 and ripped: I want abs like hers" http://www.theglobeandmail.com/servlet/story/RTGAM.20080808.wlabs08/BNStory/specialScienceandHealth/home

"Weight no problem for Cunningham" http://www.usatoday.com/sports/olympics/athens/fight/2004-07-01-cunningham-weightlifting-oly-glory_x.htm

"How Olympians Eat" http://health.msn.com/nutrition/articlepage.aspx?cp-documentid=100205413

"Eat to win" http://www.webmd.com/fitness-exercise/features/eat-to-win?page=4

"Eat like a champion" http://www.runnersworld.com/article/0,7120,s6-242-301--6686-1-1-2,00.html

"Slideshow: What it takes to get an Olympic body" http://www.webmd.com/fitness-exercise/slideshow-olympic-body

"Canada's Olympic women eat to compete" http://www.straight.com/article-156506/medalhungry-olympic-women-eat-compete

http://en.wikipedia.org/wiki/Matt_Tegenkamp

"What does Lance eat for breakfast" http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2004/07/27/hlance27.xml

"How many cheeseburgers does Lance Armstrong need to eat?" http://scienceline.org/2008/07/25/blog-mahan-cheeseburgers/

"The inside edge: 41 Olympians share 84 insights into training, eating & competing" http://findarticles.com/p/articles/mi_m0KGB/is_6_5/ai_n6110824

"What do Olympic gymnasts eat anyway?" http://nbcsports.msnbc.com/id/5317716/

http://www.doubleazone.com/images/marionjones.jpg

http://images.google.ca/imgres?imgurl=http://img2.timeinc.net/people/i/2004/04/startracks/040920/mphelps.jpg&imgrefurl=http://www.people.com/people/gallery/0,,695143_8,00.html&h=400&w=300&sz=41&hl=en&start=3&um=1&tbnid=qlzVOcjl13lh-M:&tbnh=124&tbnw=93&prev=/images%3Fq%3Dmichael%2Bphelps%26um%3D1%26hl%3Den%26client%3Dfirefox-a%26rls%3Dorg.mozilla:en-US:official%26sa%3DN

http://i.pbase.com/g4/02/589102/2/63551373.orgzJh9g.jpg

http://www.adrenalinefitnessny.com/content/lancearmstrong.jpg

True or False? Exercising on an empty stomach will help you burn more fat

Generally False… for a few reasons:

Weight and body fat loss or gain is determined by caloric balance. If, over the course of the day, you eat more calories than you spend, you’ll gain weight and body fat. If you spend more calories than you eat, you’ll lose weight and body fat. Your weight is not determined simply by what you burn during exercise.

It’s commonly believed that if you exercise on an empty stomach, you’ll burn more fat since your carbohydrate stores are almost empty. As such, your body will use up your fat stores to fuel your workout.

Before we discuss that, here’s an overview:

Fuel for exercise

When we eat carbohydrates (grains, breads, pastas, rice, cereal, fruits, sweets) it gets stored in our liver- to control blood sugar- and in our muscles- to fuel our exercise. The stored form of carbs is called glycogen. If you run out of glycogen when you exercise, you will “hit the wall” and have to stop.

Glycogen is one of the only fuels we can burn during anaerobic exercise- exercise that doesn’t require oxygen, i.e. short bouts of high intensity activities like sprinting, hockey, weight lifting. When there’s oxygen present, i.e. when you do aerobic activities like walking, running, biking, fat can be used as a source of fuel. However, to burn fat, you need to have some glycogen.

It takes 24-48 hours for your muscle glycogen stores to fully replenish- even if you’re eating a high carb diet. An endurance athlete will use up all of their muscle glycogen stores in 1-3 hours of continuous moderate-high intensity workout (depending on fitness level) if they don’t take in any carbs during exercise.
A weight lifter will deplete as much as 26% of their overall muscle glycogen during high-intensity strength training- however, research has shown that muscle glycogen depletion is localized in the muscles that are worked. As a result, if you train your legs, you may have lost 26% of your overall muscle glycogen but the glycogen in your leg muscles can be totally depleted.

So, if you didn’t deplete your glycogen stores in the last 2 days and have been eating a high carb diet and drinking enough fluids, when you wake up in the morning, regardless of whether you eat or not, your muscle glycogen stores will be full. However, your liver glycogen stores will be pretty much empty meaning your blood sugar may be low. The reason we tell people to have a pre-exercise snack or meal is to replenish liver glycogen stores which will maintain blood glucose levels, helping you feel more alert and energetic. However, this snack is not really used as fuel. When you workout, you’re burning what you’ve eaten and stored over the last 24-48 hours.

A single carbohydrate-rich meal will quickly restore your liver glycogen stores: an energy bar, a glass of OJ and a toast, a bagel, a sports drink, a meal supplement like ‘Boost’, a small bowl of cereal.

Burning fat

As for burning more fat when you exercise on an empty stomach- some small studies have shown that this is possible… but there’s a tradeoff: you can run low on energy. A 2000 study published in the International Journal of Sport Nutrition and Exercise Metabolism found that performance of moderate-to-high-intensity exercise lasting 35-40 min was significantly improved in those that consumed a moderately-high carbohydrate, low fat, low protein meal 3-hr before exercise compared to a similar meal consumed 6 hr prior to exercise. Various other studies have demonstrated the same thing. Exercisers are not able to exercise as hard or as long when exercising on an empty stomach.

If you’re not able to work out as long or as hard, you’re going to burn less total calories. So, regardless of the fact that you may be burning a little more fat calories, the total calories burned will be less and you will not lose more body fat. Moreover, because your blood sugar will fall as a result of your liver glycogen depletion, chances are you’ll be famished after your workout. Hunger is a side effect of low blood sugar. Experts point out that you’re more likely to overeat post-workout and therefore consume more calories, leading to weight and body fat gain!

Bottom line

The research has consistently shown that, for both endurance and power athletes, performance will suffer if you don’t consume enough carbohydrates during the day (you should be aiming for more than 50% of your total calories coming from carbs) since muscle glycogen is the limiting factor for any type of activity.
As for pre-exercise, it’s recommended you have a small snack or meal to top off your liver glycogen stores and ensure peak performance or peak calorie-burning.

Sources:

Girard Eberle, Suzanne. Endurance Sports Nutrition. IL: Human Kinetics. 2000.
Kleiner, SM; Greenwood-Robinson, M. Power Eating: Build Muscle, Boost Energy, Cut Fat, 2nd ed. IL: Human Kinetics. 2001.
http://www.jeffgalloway.com/nutrition/nancy/excercise_weight.html
Maffucci, DM; McMurray, RG. Towards optimizing the timing of the pre-exercise meal. Int J Sport Nutr Exerc Metab. 2000 Jun; 10(2): 103-13.
Smith, Heidi. Nutrition for the Long Run. Copyright “October 2003” by Heidi Smith.

Fat loss & Muscle gain

A frequent commenter on my blog, Jme asked the following question:

What if I do not want to lose ANY muscle while trying to lose fat? Then what intensity and duration would be good for me?

This is my answer:

The best way to gain muscle (or prevent muscle loss) is to lift weights. The optimal way to burn calories (lose weight) is to do aerobic activity (but I know you knew that!).

(Because nutrition wasn't part of the question, I'm not going to talk about that today. Suffice to say that macronutrient breakdown doen't change much between exercisers and non-exerciser: ~50% calories from carbs, ~20% from protein and <30%).

There's no research available to predict what percent of weight gain or loss is muscle and how much is fat. The best tool you can use to know you're losing fat and building/maintaining muscle is to have your body composition measured and to re-measure it every 1-3 months. It's a great tool to have to track your progress.

Remember that calipers are not as accurate as bioimpedence measurements (these are the 2 that are more common- there are better methods available though).

Body fat percentage normally changes slightly over time, but only by 1 or 2% over several months.

You have to work to maintain muscle and if you don't work out, your body looses muscle and deposits more fat if you continue to eat the same amount of food.

As for intensity of aerobic activity, it depends on your current fitness level.

A beginner (very low to low level of fitness) can lose weight and improve fitness level by exercising 1-3 times a week at 55-64% of their Max HR*.

A person of average fitness should exercise 3-5 times a week at 65-74% of their Max HR* to see some weight loss and see some improvements in fitness level.

A competitive athlete's goals are generally a bit different in that weight loss is secondary to improving performance (VO2max), competition and training. It's generally recommended that competitive athletes not focus on weight loss too much as that may affect performance.

In order to meet training goals, these athletes should workout 4-7 times a week at 75-90% MaxHR*.

Of course, these are just a general guidelines and can vary depending on training goals and sport.

In terms of resistance training, common goals include wanting to build muscle, muscle definition and to improve overall functional strength and power.

If you want to maintain your muscle mass and develop definition and endurance, it's recommended that you work at an intensity of 70% or less of your 1 RM** (Repetition Maximum- the max amout of resistance you can lift one time) and lift between 12-20 repetitions.

If building muscle is a goal for you, you should be working at ~80% of 1RM** and perform 6-10 reps.

If increasing power is a goal for you, lift at 100% 1RM**!

The more sets you do, the more you fatigue your muscle fibres, the more you encourage muscle growth during the recovery stage. So, if muscle building is a goal for you, use multiple sets. If you're new to lifting weights, current research shows that you can see results with 1 set of each exercise.

Fibre type is also important when talking about resistance training. Slow twitch fibres are the ones that provide most of the movement during low-intensity, long duration activities (50-70% of your 1RM**). To recruit the fast-twitch fibres that that capable of muscle growth, you should exercise with greater force or at higher intensities (>70% of 1 RM**).

Hope this answered your question, Jme!

* To calculate your Target Heart Rate, use the Heart Rate Reserve Method:
Max HR= 220-age

Target HR= {(Max HR-Resting HR) x Range(%) + Resting HR}
Ex. 40 year old with a resting HR of 68 BPM exercising at 60% :
Target HR= {(220-40) – 68 x (0.60) + 68}
Target HR = 135 BPM

** To find your 1RM and % of your 1RM, visit:
http://www.exrx.net/Calculators/OneRepMax.html

Source: Hutton, J. CanFit Pro Personal Trainer Specialist Certification Manual. Toronto: CanFitPro.