Creatine supplementation strategies aimed at acutely increasing and maintaining skeletal muscle total creatine content in healthy, young volunteers
George Pittas Translational Exercise Biomedicine 2024
Objectives
Insight regarding dietary creatine (Cr) supplementation strategies to acutely increase and maintain muscle total creatine (TCr) content is missing.
Methods
Healthy, young, men ingested 4 × 5 g Cr/day (d) for 5d, followed by 5 g/d for 28 d (Cr group, n=8). To achieve insulin mediated muscle Cr transport, another group (n=16) ingested 4 × 5 g Cr plus 95 g dextrose/d for 5d (CrCHO), and thereafter two sub-groups ingested 5 g of Cr (CrCHO1, n=8) or 5 g Cr plus 95 g dextrose/d for 28 d (CrCHO2, n=8). A fourth group ingested 4 × 5g of Cr plus 14 g protein, 7 g phenylalanine, 7 g leucine and 57 g dextrose/d for 5 d, and once/d thereafter for 28 d (CrPAC, n=8). Muscle biopsies were obtained at 0, and after 5 and 33 d.
Results
After 5 d, muscle TCr increased in Cr (p<0.001), CrCHO (p<0.001), and CrPAC (p<0.05) groups, and was numerically greatest in CrCHO; achieving a content reported to be an average maximum (150 mmol/kg). After 33 d, TCr also increased to ~150 mmol/kg in the Cr group (p<0.05), remained unchanged from 5 d in CrCHO2, and tended to decline in CrCHO1. Muscle TCr remained unchanged from 5 d in CrPAC after 33 d, being less than the Cr group (p<0.05). Muscle Cr transporter mRNA expression changed modestly, but the increase in muscle TCr after 5 d was inversely associated with fold-change in mRNA expression (r=0.502, p<0.05).
Conclusions
A maximum increase in muscle TCr is achieved after 5 d Cr ingestion alongside 95 g dextrose, and continued consumption of Cr with dextrose will maintain this maximum. Ingestion of Cr alone will achieve a high muscle TCr content too, but takes longer.