Should Creatine Supplements be Banned? - Part 5 of 5

Should Creatine Supplements be Banned? Opponents of creatine supplementation have claimed that it is not safe for children and adolescents. While fewer investigations have been conducted in using younger participants, no study has shown creatine monohydrate to have adverse effects in children.

In fact, long-term creatine monohydrate supplementation (e.g., 4 – 8 grams/day for up to 3 years) has been used as an adjunctive therapy for a number of creatine synthesis deficiencies and neuromuscular disorders in children. Clinical trials are also being conducted in children with Duschenne muscular dystrophy.

However, as less is known about the effects of supplemental creatine on children and adolescents, it is the view of the International Society of Sports Nutrition (ISSN) that younger athletes should consider a creatine supplement only if the following conditions are met:

1. The athlete is past puberty and is involved in serious/competitive training that may benefit from creatine supplementation;

2. The athlete is eating a well-balanced, performance-enhancing diet;

3. The athlete and his/her parents understand the truth concerning the effects of creatine supplementation;

4. The athlete's parents approve that their child takes supplemental creatine;

5. Creatine supplementation can be supervised by the athlete’s parents, trainers, coaches, and/or physician;

6. Quality supplements are used; and,

7. The athlete does not exceed recommended dosages.

If these conditions are met, then it would seem reasonable that high school athletes should be able to take a creatine supplement. Doing so may actually provide a safe nutritional alternative to illegal anabolic steroids or other potentially harmful drugs.

Conversely, if the above conditions are not met, then creatine supplementation may not be appropriate. It appears that this is no different than teaching young athletes' proper training and dietary strategies to optimize performance.

Creatine is not a panacea or short cut to athletic success. It can, however, offer some benefits to optimize training of athletes involved in intense exercise in a similar manner that ingesting a high-carbohydrate diet, sports drinks, and/or carbohydrate loading can optimize performance of an endurance athlete.

The Ethics of Creatine

Several athletic governing bodies and special interest groups have questioned whether it is ethical for athletes to take creatine supplements as a method of enhancing performance. Since research indicates that creatine monohydrate can improve performance, and it would be difficult to ingest enough creatine from food in the diet, they rationalize that it is unethical to do so.

In this age of steroid suspicion in sports, some argue that if you allow athletes to take creatine, they may be more predisposed to try other dangerous supplements and/or drugs. Still others have attempted to directly lump creatine in with anabolic steroids and/or banned stimulants and have called for a ban on the use of creatine monohydrate and other supplements among athletes.

Finally, fresh off of the ban of dietary supplements containing ephedra, some have called for a ban on the sale of creatine monohydrate citing safety concerns.

Creatine supplementation is not currently banned by any athletic organization although the NCAA does not allow institutions to provide creatine monohydrate or other "muscle building" supplements to their athletes (e.g., protein, amino acids, HMB, etc). In this case, athletes must purchase creatine containing supplements on their own.

The International Olympic Committee considered these arguments and ruled that there was no need to ban creatine supplements since creatine is readily found in meat and fish and there is no valid test to determine whether athletes are taking it.

In light of the research that has been conducted with creatine monohydrate, it appears that those who call for a ban on it are merely familiar with the anecdotal myths surrounding the supplement, and not the actual facts.

We see no difference between creatine supplementation and ethical methods of gaining athletic advantage such as using advanced training techniques and proper nutritional methods.

Carbohydrate loading is a nutritional technique used to enhance performance by enhancing glycogen stores. We see no difference between such a practice and supplementing with creatine to enhance skeletal muscle creatine and phosphocreatine stores.

If anything, it could be argued that banning the use of creatine would be unethical as it has been reported to decrease the incidence of musculoskeletal injuries, heat stress, provide neuroprotective effects, and expedite rehabilitation from injury.

Conclusion

It is the position of the International Society of Sports Nutrition that the use of creatine as a nutritional supplement within established guidelines is safe, effective, and ethical. Despite lingering myths concerning creatine supplementation in conjunction with exercise, creatine monohydrate remains one of the most extensively studied, as well as effective, nutritional aids available to athletes.

Hundreds of studies have shown the effectiveness of creatine monohydrate supplementation in improving anaerobic capacity, strength, and lean body mass in conjunction with training. In addition, creatine monohydrate has repeatedly been reported to be safe, as well as possibly beneficial in preventing injury.

Finally, the future of creatine research looks bright in regard to the areas of transport mechanisms, improved muscle retention, as well as treatment of numerous clinical maladies via supplementation.

Reproduced with minor omissions, including references for ease of reading, from: Buford TW, Kreider RB, Stout JR, Greenwood M, Campbell B, Spano M, Ziegenfuss T, Lopez H, Landis J, Antonio J. International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition 2007, 4:6 (30 August 2007). doi:10.1186/1550-2783-4-6. © 2007 Buford et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0).


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