To increase muscle mass, strength, and power, one of the goals of training is to manipulate and increase the training stimulus or the physical work that is performed. At its essence, physical training depends on the coordinated balance between an imposed physical stressor, the manipulation of training variables (volume, intensity, and frequency), adequate rest intervals, and recovery between training sessions. Recovery is perhaps the most difficult to manipulate and gauge owing to the amount of time necessary to achieve it. Furthermore, barring the use of anabolic steroids for muscle repair and growth, nutritional interventions are often necessary to promote a more efficient recovery following training. Although many supplements have been extolled for their anabolic and ergogenic effects, to date, only a few have withstood the rigors of science. The most notable of these is creatine monohydrate (creatine). Though most other supplements do not elicit as powerful an effect as creatine, a few are worthy of notation and future research efforts.
Creatine Supplements
Although several anecdotal adverse effects have been attributed to creatine supplementation, only a few minor scientific studies have been documented. Some of these have linked creatine supplementation to gastrointestinal upset. This is attributed to osmotic distress if the crystalline creatine is not adequately dissolved into a solution before ingestion. Another common reported side effect is body weight gain due to increased creatine storage and the associated gain in fat-free mass. However, many athletes do not consider body weight gain to be a negative effect of creatine supplementation. Also interesting to note is that recent studies in infants between 2 to 4 years of age who have genetic disturbances in creatine synthesis have shown remarkable clinical, biochemical, and functional improvements following creatine supplementation in doses ranging from 136.4 to 227.3 mg/lb body weight (350 to 500 mg/kg body weight) that were maintained for over 25 months. This dose is up to 1.67 times the recommended loading dose. No adverse effects were reported, including no aggravation of seizures in one infant who presented with intractable seizures (including rare grand mal seizures) before being treated with creatine.
Muscle Strains/Pulls
Anecdotal reports from some athletic trainers and coaches suggest that creatine supplementation may promote a greater incidence of muscle strains or pulls. Because creatine supplementation may promote relatively rapid gains in strength and body mass, additional stress may be placed on bone, joints, and ligaments, leading to injury. To date, no study has documented an increased rate of injury following creatine supplementation, even though many of these studies evaluated highly trained athletes during heavy training periods.
Muscle Cramping
Some anecdotal claims have suggested that athletes training intensely in hot or humid conditions might experience severe muscle cramps while taking creatine. Proponents of this theory suggest that creatine supplementation may cause large fluid shifts in the muscle, serving to alter electrolyte status, promote dehydration, and/or increase thermal stress. No study has reported that creatine supplementation causes cramping, dehydration, or changes in electrolyte concentrations, although one study evaluated highly trained athletes undergoing intense training in hot and humid environments. Furthermore, the causes of muscle cramping are not fully understood so it is premature to suggest that creatine supplementation may elicit such an effect.
Dehydration
Numerous reports in the media suggest that creatine supplementation can produce dehydration even though there are no published studies supporting this assertion. No studies to date have demonstrated an increase or decrease in whole body hydration as determined via bioelectric impedance analysis. Recently, Ziegenfuss et al. addressed these issues in ten crossÂtrained and aerobically trained men. At a dose of 0.16 g/day (approximately 32 g/day for a 200 lbÂperson), coupled with a multifrequency bioelectrical impedance analyzer, they found that total body water increased by 2% and paralleled the increase in total body mass associated with the 5-day loading sequence. Interestingly, extracellular water content did not change significantly, but intracellular water content changed by 3%. Kreider et al. also calculated plasma volume from the ratio of blood hemoglobinJhematocrit from available published data and found no alterations in blood volume.
Death
One of the most shameful and poorly researched press reports suggested that creatine supplementation may have been involved in the sudden deaths of three wrestlers. These athletes died suddenly while exercising in the heat in rubber suits in an attempt to cut weight before competition. Based on these reports, the Centers for Disease Control and Prevention (CDCP) and the Food and Drug Administration (FDA) launched investigations to determine whether creatine was involved in these deaths. Results of this investigation conducted by the CDCP revealed two of the wrestlers had not taken creatine and one of the athletes had stopped taking creatine at least 3 months before his death. The deaths of the wrestlers were officially attributed to hyperthermia, heart failure, and heat exhaustion/dehydration.
Tags:Dehydration, Muscle Cramping, Muscle Strains/Pulls Supplement and its Effects
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