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SPORT I ZDRAVLJE
http://sportizdravlje.rs.ba/
URL: https://doisrpska.nub.rs/index.php/SIZ
ISDN 1840-152X
UDK 796
1
Sport i Zdravlje, No. IX, Volume II, Year 2020
EFFFECTS OF CREATINE MONOHYDRATE TO STRENGTH AND BODY
COMPOSITION
Bojan Bjelica1,
Borislav Cicović1,
Nikola Aksović2,
Radica Alempijević3,
Milan Zelenović1
Ivan Dragović4
1Faculty of Physical Education and Sport, university of East Sarajevo
2Faculty of Sport and Physical Educytion, University of Niš
3Faculty of Pharmacy, University of Belgrade
4Faculty of Physical Education and Sport, University of East Sarajevo, Master studies student
ARTICLE
Abstract: Creatine has become highly popular supplement among athletes. Contemporary
research also suggests that there is also a large number of potential therapeutic
applications of creatine. Aim of this systematic overview is to test the effects of CR to
muscle strength and body composition on the basis of the collected data and analysed
papers published in the period 2018–2020. Literature research was performed in the
following data bases: PubMed, Scholar Google and DOAJ. Papers were selected according
to multiple criteria and they suggest that CR in combination with an exercise program
produces results in increase of muscle mass and strength and it reduces time required for
execution of a specific activity. Changes in body composition were observed in increase of
total mass and muscle mass, as well as amount of water in body composition. Use of CR in
amount of 10–20 g per day and frequency of 4–5 days a week is an efficient tool used for
increase in sport performances and positive changes in body composition.
Key words: weight, bench press, 1RM, body, BIA, supplements
1. Introduction
According to manuscripts human race has always reached for the most efficient
non-hormonal supplements for amplification of physical abilities and possibilities. The
firs written data originates from the Olympic games in Greece in 776 BC. (Grivetti &
Applegate, 1997). Use of supplements is widespread all over the world. In addition to
common food products designed for athletes and physically active people, many
companies developed supplements, mostly claiming that the sport effect can be increased.
Supplements used for the purpose of increasing effects of exercise and sport
performances come in various shapes, including pills, capsules, liquids and powders.
Many of the aforementioned products also contain variety of ingredients in different
combinations and percentages. The most common ingredients are amino acids, proteins,
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Sport i Zdravlje, No. IX, Volume II, Year 2020
creatine and caffeine (LaBotz & Griesemer, 2009). There is a large number of studies
observing the influence of supplementation to physical abilities (El Khoury & Antoine,
2012; Morrison, Gizis, & Shorter, 2004; Rocha & Pereira, 1998; Pereira, Jajolo, &
Hirschbruch, 2003; Gomes, Degiovanni, Garlipp, & Chiarello, 2008; Goston & Correlia,
2010; Oliver, Leon, & Hernandez, 2008) amnd changes of body composition (Earnest et
al., 1995; Kreider, Ferreira, et al., 1998; Kreider, Klesges, et al., 1996; Vandenberghe et al.,
1997). CR is also a part of diet and is mostly found in meat and fish and when consumed
98% is deposited in the muscles and the remaining part in the brain, heart and other
organs, while the excess is processed by kidneys and excreted in the form of creatinine
(Cannan & Shore, 1928). CR is one of most commonly used supplements for increase of
exercising effects and sport performances (Kreider, et al., 2017). It facilitates the
production of ATP and delivers energy into muscles, especially in case of short-term
activities (Salomons, et al., 2010). CR may have four-fold positive effects to muscle
performances: by increasing the cells of phosphocreatine which is used for generating the
ATP at the start of intensive exercise, by increasing the speed of phosphocreatine re-
synthesis after exercising, by depressing the degradation of adenine nucleotides and
accumulation of lactates and/or by increasing the glycogen depositing into skeletal
muscles (Salomons, et al., 2010). Oral ingestion of CR increases the creatinine and PCR
(Polymerase Chain Reaction) content of human skeletal muscles (Casey, et al., 1996;
Febbraio, Flanagan, Snow, Zhao, & Carey, 1995; Greenhaff, Bodin, Soderlound, Hultman,
1994; Harris, Soderlund, & Hultman, 1992; Vandenberghe, et al., 1997). Typical protocol
for the start of CR intake for adults, regardless of sex and body size, consists of the loading
phase in the period of 5–7 days when CR is consumed in the amount of 20 g/day divided
into four parts (5 g), followed by the maintenance phase of 3–5 g/day (Cooper, Naclerio,
Allgrove, & Jimenez, 2012). Impact of CR to strength and changes to body composition
were also mentioned in other studies (Haff, et al., 2000; Meyer, et al., 2000). Regarding the
fact that strength is one of the most important motoric factors, it was defined many times.
Maximum strength is the maximal ability of muscle or a group of muscles to produce
force. It is frequently measured by one-repetition maximum (1RM), which is operatively
defined as the maximum amount of weight that a person can possibly lift for one
repetition in provided time and in technically correct manner (Pereira & Gomes, 2003).
With this systematic overview we will try to point out benefits of supplementation by CR
in terms of increase in strength, all changes in body composition shall also be followed.
Jose & Ciccone (2013) examined the effects of CR (5g/day) to strength and body
composition in their study. Research was conducted on 19 participants who did body
building aged 23.1±2.9. Over the course of four weeks five trainings were applied. In
addition to body composition one-repetition maximum (1RM) was also tested at bench
press and 3 repetitions at leg press. Significant differences were noted in increase of
muscle mass, while the increase of total fat and body weight was not significant. Increase
in strength was noted in all applied variables. Similar research results were obtained by
Cribb, & Hayes (2006). CR consumption before and after training results in higher gain in
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Sport i Zdravlje, No. IX, Volume II, Year 2020
fat body weight, size of muscle fibers and muscle strength. Similar results were obtained
in other research (Soderlung, Balsom, & Ekblom, 1994; Hultman, Soderlung, Timmons,
Cederblad, & Greenhaff, 1996; Volek, 1997; Bemben,et al., 2010). Aim of the systematic
overview is to test the effects of CR to muscle strength and body composition.
2. Method
Electronic databases PubMed, Scholar Google and DOAJ were used for the purpose
of obtaining data for this research. Search for papers was performed in the period 2018–
2019. Following key words were used in the search: weight training, muscle mass, 1RM,
placebo, BIA, supplements. Found titles of the research papers, abstracts and full texts,
were then examined and analysed. Research paper had to meet two criteria in order to be
accepted for final analysis: the first criterion is in connection with the issues related to
creatinine monohydrate and the second one to conducting analysis of papers issued in the
defined period. Research that met the criteria was then analysed and represented through
the following parameters: reference (first letter of the author, publishing year, year when
the research was performed), sample (age, number of participants and groups of
participants), exercise program, duration of program and research findings.
3. Results
Procedure of data collection, analysis and elimination is presented graphically
(Graph 1). Using the key words 136 papers were obtained. Number of research
immediately eliminated on the basis of title, double papers, and publishing date (before
2018) was 94, while 42 papers proceeded to further analysis which resulted in
elimination of 35 papers according to various criteria: abstract, because they were
systematic overviews and lack of adequate information relevant to our research.
Remaining seven papers (Table 1) met the criterion that it was issued in period 2018–
2020.
In four papers the research was performed on around 133 male participants istraživanja
(Amirsasan, Nabilpour, Pourraze, Curby, 2018; Wang, Fang, Lee, & Yang, 2018; Vilar-Neto
et al., 2018; Bjelica et al., 2020), in two papers research participants were 54 women. In
the paper by Mills et al. (2020) it was combination of male and female participants. All the
participants used creatinine monohydrate as supplement to regular diet, in addition to
activity. Program duration varied. In the research performed by Farah & Dos Santos
(2018) CR treatment was performed in the course of 5 days, and in case of Atakan,
Karavelioğlub, Harmancıb, & Bulut (2019) it was seven days.
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Sport i Zdravlje, No. IX, Volume II, Year 2020
Graph 1.Procedure for collection, analysis and elimination of obtained papers
In the research by Vilar-Neto et al. (2018) experimental treatment was in duration of 35
days. In a large number of studies were emphasised positive effects of short-term use of
CR (5–7 days) to performing of exercises. In majority of studies it was suggested that
creatine supplementation can significantly amplify strength, power, performances such as
sprint or activities where a large number of muscle groups is engaged (Williams & Branch,
1998; Kraemer & Volek, 1999; Kreider, 1999; Balsom, Soderlund, & Ekblom, 1994;
Hultman, Soderlund, Timmons, Cederblad, & Greenhaff, 1996; Greenhaff, 1997). Other
authors mentioned significantly longer duration of experimental treatment, specifically in
case of Wang et al. (2018) it was four weeks, Mils et al. (2020) six weeks, Amirsasan et al.
(2018) eight weeks, Bjelica et al. (2020) sixteen weeks. CR intake was in range 0.1g/kg –
0,3g/kg or in total 5–20g per day. At weekly level CR intake was 4–7 times a week.
Seven accepted papers that met the required criteria are presented in Table 1. The
research is comprised of contemporary research which dealt with the selected topic.
References in the table are represented in the following manner: first author, age, sex and
division of groups, type of treatment, scope, duration of experimental protocol and results
of each study respectively.
Electronic databases search
results: 136 papers
as
94 papers were eliminated
as double papers and papers
issued in the period before
2014 (2018??)
42 papers proceeded to
further analysis on the basis
of abstract and text
35 papers were eliminated
on the basis of the following
criteria: abstract, examined
research, inadequate topic
7 papers met the criteria
Identification
Screening of
papers
Acceptability
Accepted
papers
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Sport i Zdravlje, No. IX, Volume II, Year 2020
4. Discussion
Many studies which dealt with the effects of CR confirmed that the body weight
increases after a period of oral ingestion (Fairman, Kendall, Hart, Taaffe, Galvao, &
Newton, 2019; Vilar-Neto, et al., 2018; Earnest, Snell, Rodriguez, Almada, & Mitchell,
1995; Hultman, Sijderlund, Timmons, Cederblad, & Greenhaff, 1996; Kreider, Ferreira, &
Wilson, 1998). Previous studies confirm that 10–20g of CR at daily level with the
frequency of five days a week is sufficient for increase in strength and number of
repetitions (Urbanski, Loy, Vincent, & Yaspelkis, 1999; Izquierdo, Ibañez, & González-
Badillo, 2002). Such statements are in line with the selected research papers presented in
the systematic overview (Amirsasan et al., 2018; Farah et al., 2018; Wang et al. 2018;
Atakan et al., 2019; Bjelica et al., 2020). The research papers have confirmed that with
Table 1.Overview of the analysed papers
Reference
Population/sex
Treatment
Protocol
Results
Amirsasan et al.
2018
Football players
♂
EG+CR=10;
EG+PG=10.
SG=18-26yo
1RM/BP, 1RM/BS, TK-
InBody 300
8 weeks,
EG+CR=0.3g/kg,
EG+PG=MD
In EG+CR, increase 1RM, TT,
MM, reduction in TM compared
to EG+PG.
Farah et al. 2018
Cyclers ♀
EG1=5;
EG2=5;KG=5
SG=26.57
±7.09yo
EG1,EG2,KG-crease,
size, TT,MM,
strength(W/Kg),
resistance (W/Kg)
5 days,
EG1=CR;EG2=CR+
MD; 4x10g; KG=/
EG1+EG2-changes in TK,
increase in MS, TT, TM. KG
without significant changes.
Wang et al. 2018
Athletes ♂
EG=15 ; PG=15
SG=20 ± 2yo
EG/PG - squats 5RM,
jumps, TK, sprint 30m
4 weeks, EG=20g
CR+ 2g dex. PG - 5g
dex.
Increase of 1RM in EG, improved
MMS and faster recovery after
training.
Vilar-Neto et al.
2018
Students ♂
EG1=12;EG2=12;
PG=12;
SG=22,5 ± 4,3yo
1RM/BP, PU/1min.,
SU/1min.
35 days, PG, EG1-3g
CR, EG2-5g CR
In EG1-Eg2 increase of 1RM,
endurance only in EG2
Atakan et al.
2019
Football players
♀
EG=15; PG=15;
SG=19.83 ±
1.13yo
SP 10,20,30m,
1RM/BS, AGL
7 days, EG= CR 0.25
g/kg; PG=MD
In EG improved AGL, SP
10,20,30m, no increase in TT.
Bjelica et al
2020
Body builders ♂
EG=6; PG=8
SG=24±6yo
1RM/BP, 1R;/BS,
SB/max, TK-Tanita bc-
545n
16 weeks,
EG=CR/7days/5g
after+dex;
PG=dex/20g
Changes of TK in EG, increased
MM, reduced TM, increased W.
Increase of strength in all
variables.
Mills et al. 2020
Physically active
population ♂♀
CR=13; PG=9;
SG=26 ± 4 yo
1RM/BP; 1RM/BS; VS;
BK; 1RM/BPmax;
1RM/Bsmax.
6 weeks,
EG= CR/0.1g x kg−1
x d−1
PG=CR/0,0055g x
kg -1
Changes in TK, increased
strength in variable 1RM/BP,
1RM/BS. PG with no significant
changes.
MM –muscle mass,; MT – body mass; CR– creatinine monohydrate; EG– experimental group; KG– control group; 1RM–one-
repetition maximum; PG– placebo group; , dex.–dextrose; SG– age group; MMS– maximum muscle strength; MD– maltodextrine;
TK– body composition; MS –muscle strength; TT– body weight; TM– body fat; MM– muscle mass; BP– Bench press; BS– barbell
squats; PU–push-ups; SU– sits-ups; SP– speed; AGL– agility; W– water; VS– vertical jump; BK– ball throw.
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Sport i Zdravlje, No. IX, Volume II, Year 2020
aging changes start to occur in overall body composition and that the level of water
(fluids) also drops (Ritz, et al., 2001). One should keep in mind that human body consists
of 50–70% of water (Sawka & Coyle, 1999). In the research performed by Bjelica et al.
(2020) increase in body water was detected in both groups of participants (CR and
placebo), which was the result of physical stress caused by applied training with load.
Although there is small number of research papers where body water level was observed,
all the data is in favour of training on platform of aerobic exercising or training with load
leads to increase in body fluids (water) in human organism (Francaux & Poortmans, 1999;
Ho et al., 2012; Davidson et al., 2009; Church et al., 2010; Park & Randone, 2003). Muscle
mass, as an integral part of overall mass is significantly increased with CR
supplementation. In some papers it was noted that there is also increase in total mass in
range 0.7–1.6 kg after short-term CR intake in combination with exercises with load
(Becque, Lochmann, Melrose, 2000; Earnest, Snell, Rodriguez, Almada, & Mitchell, 1995;
Vandenberghe, Van-Hecke, Leemputte, Vanstapel, & Hespel, 1999). LaBotz & Griesemer
(2009) established significant increase of body mass of 0.84 kg in CR group, in relation to
the control group. It is important to note that no changes occurred in fat percentage in any
of the groups of participants, which is an additional confirmation that CR affects only
increase of muscle mass and to certain extent body water levels. Such findings were
noted in other studies (Aedma, Timpmann, Lätt, & Ööpik, 2015; Soderlund, Balsom, &
Ekblom, 1994; Saab, Marsh, Casselman, & Thompson, 2002; Abdi, et al., 2012; Ferneti, et
al., 2018). Studies on supplementation by creatinine show positive effect on performances
and strength in duration of short-term maximum exercising intensity measured in one-
repetition maximum and effect on mscle endurance and speed (Becque, Lochmann, &
Melrose, 2000; Volek & Rawson, 2004; Vandenberghe, 1997; Vandenberghe et al., 1997;
Volek & Rawson, 2004). Increased strength on bench press after CR supplementation was
mentioned in some of the papers (Amirsasan et al., 2018; Vilar-Neto et al., 2018; Bjelica et
al., 2020; Mills et al., 2020). Other research demonstrated similar improvements in bench
press performances (Camic et al., 2014;Kilduff et al., 2002; Rawson & Volek, 2003).
Regardng sports which require combination of aerobic and anaerobic sources with
participation of strength and endurance, fatigue may occur and hence efficiency reduces.
With CR supplementation it is possible to prevent loss of strength due to aerobic and
anaerobic activity of the athlete. Earnest, Snell, Rodriguez, Almada, & Mitchell (2005)
established that creatine supplementation (20 g / day x 4 days and 10 g / day x 6 days)
improves activity performances to exhaustion in two cycles in duration of approximately
90 seconds. Smith, Stephens, Hall, & Jackson (1998) established that creatine
supplementation (20 g / day x 5 days) increases the time of performance of exercises
which last 90–600 secons, mostly in short, more intensive activities. Nelson et al., (2000)
established that cretaine supplementation (20 g / day x 7 days) reduces sub-maximal
number of heart pulses and oxygen intake volume (VO2), while the ventilation anaerobic
threshold increases (VANT) as well as total time to exhaustion during maximum
exercising program in 36 adults. Rico-Sanz & Mendez (2000) established that creatinine
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Sport i Zdravlje, No. IX, Volume II, Year 2020
supplementation (20 g / day x 5 days) increases time to exhaustion (29,9 ± 3,8 do 36,5 ±
5,7 min), simultaneously reducing the ammonia levels (marker of adenine nucleotides
decomposition) in cycling to30% and 90% from maximum load threshold. Upon the
literature overview, it was established that CR, in combination with an exercising
program, results in increase of muscle mass (Hultman, Sijderlund, & Timmons, 1996;
Harris, Soderlund, & Hultman, 1992), strength (Birch, Noble, & Greenhaff, 1994;
Vandenberghe, et al., 1997), and that it reduces time required for performing an activity
(Balsom, Soderlund, & Ekblom, 1994).
5. Conclusion
Results of this study suggest that CR supplementation in combination with any form
of training may be efficient in improving sport performances of male and female
population of participants. However, additional research is required in order to test the
long-term effects of supplementation. CR in combination with an exercising program
results in increase of muscle mass and strength, and it also reduces time required for
performing an activity. Changes in body composition are observed in increase of total
mass and muscle mass, as well as in body water levels. CR supplementation in amount of
10–20g at daily level with the frequency of 4–5 days a week is an efficient tool for
improvement of sport performances and positive changes in body composition.
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