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A–Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance Part 11
  1. J R Poortmans1,
  2. E S Rawson2,
  3. L M Burke3,
  4. S J Stear4,
  5. L M Castell5
  1. 1Laboratory of Applied Nutrition to Exercise, Free University of Brussels, Brussels, Belgium
  2. 2Department of Exercise Science, Bloomsburg University, Bloomsburg, Pennsylvania, USA
  3. 3Australian Institute of Sport, Canberra, Australia
  4. 4Performance Influencers Limited, London, UK
  5. 5University of Oxford, Oxford, UK
  1. Correspondence to L M Castell, University of Oxford, Green Templeton College, Oxford OX2 6HG, UK; lindy.castell{at}gtc.ox.ac.uk

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Introductory remarks

Those who are old enough to have been working in the world of sports science/medicine in 1992 will remember a watershed moment: the publication of a paper by Roger Harris and co-workers1 on the capacity of the muscle to increase its phosphocreatine concentration following supplementation with a creatine product. With the genie out of the bottle, we bore witness to an explosion of interest in this unique ergogenic aid—a product of apparently genuine value to biochemists, sports scientists, athletes, coaches, clinicians and the supplement industry. This review will outline why the production and sales of creatine have increased exponentially over the past two decades, and will summarise which of the claims made about creatine supplements are evidence based.

Creatine

J R Poortmans, E S Rawson

Creatine, a derivative from three amino acids, is distributed at approximately 95% in skeletal muscle mass; the remainder is located in the brain, the testes and the kidneys. Its synthesis starts mainly in the kidneys from glycine and arginine, forming α-methylguanidoacetic acid, which is conducted through the blood to the liver where it reacts with S-adenosylmethionine to synthesise creatine. Approximately 1–2 g of creatine is produced over 24 h and released mainly to the skeletal muscle system. Some creatine is also added to the pool by adequate dietary intake, predominantly from meat and fish, with a typical diet supplying approximately 1–2 g of …

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