With nearly 2 decades of solid research, most athletes are well versed in the performance benefits of creatine supplementation.  But there is more to the story. Emerging research has revealed some new and exciting outcomes linked to creatine supplementation. Here’s a recap of novel findings from new studies showing benefits of creatine extend beyond muscle performance.

Better Glucose Control
An estimated 1 in 3 adults struggles to maintain a healthy level of blood glucose (blood sugar). The major problem is a defect in insulin action which normally facilitates uptake of sugar into muscle and other tissues. The impaired insulin action therefore results in high blood sugar levels.  A recent study examined the effects of creatine supplementation in type 2 diabetics. Subjects with insulin resistance and high blood glucose performed 12 weeks of exercise training while consuming either creatine (5 grams per day) or placebo. The creatine supplemented group showed improvements in several measures of their disease. Glycosylated hemoglobin (HbA1c), which is a measure of average blood sugar levels over several weeks, decreased by 14%, with creatine supplementation and did not change in the placebo group. When challenged with a carbohydrate meal, the creatine group showed less of a response in blood sugar. They also showed increased glucose transporters on the surface of muscle cells which means greater capacity to take up sugar from the blood. These findings indicate that creatine in conjunction with exercise training improves insulin sensitivity and blood glucose control. An increase in insulin sensitivity and disposal of glucose into muscle translates into better fuel utilization and improved recovery. For example, greater rates of muscle glucose uptake will facilitate increased rates of glycogen storage and decrease the likelihood of converting dietary carbs to fat.

Live Stronger as You Age
Muscle mass and strength peak between the ages of 20 and 35 years and steadily decline thereafter until the sixth decade of life where a sharp decline occurs. This loss in muscle mass and function adversely affects normal activities of daily living, like getting up from a chair, for many older people.  Can you offset these effects of aging or are they inevitable? Recent studies provide a strong case for creatine supplementation in promoting healthy aging.

After just 7 days of creatine supplementation (20 g per day divided in 3 equal doses) or placebo, women between the ages of 58 and 71 years showed a remarkable improvement in several measures of muscular performance. Creatine supplementation led to significant increases in maximal bench press and leg press strength, upper and lower body power, and two functional performance tasks encountered during everyday life - a sit and stand test and a tandem gait test.  These improvements in functional performance occurred despite no physical training during the 7 day period and no side effects were reported, highlighting the simple yet effective use of creatine to enhance physical performance in older individuals.

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The ability of creatine supplementation to promote healthy aging is even more dramatic when combined with resistance training. Canadian researchers had older men and women (>65 years) perform a supervised resistance training program (2 days/week) for 6 months while supplementing with either placebo or creatine + conjugated linoleic acid (CLA). The reason for including CLA was to potentiate improvements in body composition since creatine increases in fat-free mass and CLA targets fat loss. After 6 months, the creatine+CLA group had a two-fold greater increase in fat-free mass (4.6 pounds) compared to placebo (2.0 pounds). Fat mass was also reduced more in the creatine+CLA group (4.2 pounds) compared to placebo (-0.9 pounds). The greater muscle gains translated into improved functional performance in the creatine+CLA group.

These two recent studies in older adults, one short-term (7 days) and one long-term (6 months), clearly show the power of creatine to enhance muscle gain and fat loss, and improve several measures of functional performance including activities of daily living. These studies in humans are also supported by animal work. Using an animal model of aging, it was shown that creatine supplementation extended maximum "healthy" life span (defined as the age before animals were classified as suffering from disease) which significantly increased by 9%. These studies point to creatine as an effective supplement to extend peak performance into your middle years.

Support Brain Power
A new line of research has investigated possible benefits of creatine in other tissues besides muscle. One area that has sparked interest is the brain. Creatine is an important source of energy for cells in the brain that have high metabolic needs required for processes like working and long-term memory. Prior work using sophisticated analytical equipment like magnetic resonance spectroscopy has shown that creatine supplementation results in significant increases in creatine levels in the human brain. Following up on this work, British researchers supplemented older adults with placebo or creatine for one week. Subjects completed a battery of cognitive tests that assessed verbal and spatial short- and long-term memory. Creatine supplementation enhanced several of the tests including forward number recall, forward and backward spatial recall, and long-term memory. These findings add to a line of research indicating that creatine supplementation improves cognitive functioning.

Summary
There is overwhelming evidence that creatine supplementation enhances exercise performance and helps build bigger muscles in athletes and younger men and women. Recent work has extended these benefits to include increased insulin sensitivity, better glucose control, maintaining strength longer, and improved memory.

Work Cited
Gualano B, de Salles Painneli V, Roschel H, Artioli GG, Junior MN, Lúcia de Sá Pinto A, Rossi da Silva ME, Cunha MR, Otaduy MC, da Costa Leite C, Ferreira JC, Pereira RM, Brum PC, Bonfá E, Lancha AH Junior. Creatine in Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Trial. Med Sci Sports Exerc. 2010 Sep 24. [Epub ahead of print]

Gotshalk LA, Kraemer WJ, Mendonca MA, Vingren JL, Kenny AM, Spiering BA, Hatfield DL, Fragala MS, Volek JS: Creatine supplementation improves muscular performance in older women. Eur J Appl Physiol 2007.

Tarnopolsky M, Zimmer A, Paikin J, Safdar A, Aboud A, Pearce E, Roy B, Doherty T: Creatine monohydrate and conjugated linoleic Acid improve strength and body composition following resistance exercise in older adults. PLoS ONE 2007, 2(10):e991.

Bender A, Beckers J, Schneider I, Holter SM, Haack T, Ruthsatz T, Vogt-Weisenhorn DM, Becker L, Genius J, Rujescu D et al: Creatine improves health and survival of mice. Neurobiol Aging 2007.

Lyoo IK, Kong SW, Sung SM, Hirashima F, Parow A, Hennen J, Cohen BM, Renshaw PF: Multinuclear magnetic resonance spectroscopy of high-energy phosphate metabolites in human brain following oral supplementation of creatine-monohydrate. Psychiatry Res 2003, 123(2):87-100.

McMorris T, Mielcarz G, Harris RC, Swain JP, Howard A: Creatine supplementation and cognitive performance in elderly individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2007, 14(5):517-528.