exercise

Creatine Supplementation: Is it safe?

/ Jame A. Agapoff, MD, MS (she/they) / 5 Comments

Creatine Monophosphate is a very common supplement used by body builders and athletes. There are many rumors out there about creatine’s safety and efficacy. In this blog post, I’ll discuss what creatine is, whether it’s safe, and what are some of the potential benefits for it’s use based on the scientific literature.

What is it?

Creatine (methylguanidine-acetic acid) is an amino acid. It is not a steroid. In the diet creatine comes primarily from meat or supplementation. The body stores creatine as phosphocreatine in the muscle where it is used to make adenosine triphosphate (ATP), the energy molecule of the cell. Supplementation has been shown to increase muscle performance and growth over a training period.

Is it safe?

Greater than 20 years of research shows that in healthy individuals, there is no evidence of adverse effects at the recommended daily doses 2-5 grams per day. Case studies that have shown possible negative effects of creatine on the kidneys are confounded by pre-existing kidney disease, medications, and higher than normal doses of creatine. According to the International Society of Sports Nutrition (ISSN), “There is no scientific evidence that the short- or longterm use of creatine monohydrate has any detrimental effects on otherwise healthy individuals.”

Can it prevent muscle loss and improve bone mineral density?

Sarcopenia is the loss of muscle mass, strength, and functionality. It is associated with increased morbidity and mortality. Sarcopenia is increased on those on androgen blockade or those who are post-menopausal.

Resistance weight training is considered the cornerstone treatment for sarcopenia Growing evidence shows that adding creatine to weight training can have a substantial added benefit. Creatine without weight training do not appear to increase lean mass.

Studies show that creatine supplementation when combined with weight training can increase bone mineral density and attenuate the rate of bone mineral loss. A two-year study of post-menopausal women who took creatine without resistance training resulted in no improvements in bone mass.

What are some other potential benefits of creatine use?

There is evidence that creatine supplementation may reduce muscle damage, injury, and enhance recovery time following intense exercise. Supplementing with creatine may reduce inflammation and muscle soreness after exercise. Creatine supplementation may improve hydration and thereby increase heat tolerance during training. Additionally, There is also evidence creatine may be neuroprotective and can reduce spinal cord injury, cerebral ischemia, and concussion/traumatic brain injury.

Conclusions:

At a recommended range of 2-5 grams per day, creatine supplementation when combined with weight training is safe and can provide myriad benefits!

References:

Antonio, J., Candow, D.G., Forbes, S.C., Gualano, B., Jagim, A.R., Kreider, R.B., Rawson, E.S., Smith-Ryan, A.E., VanDusseldorp, T.A., Willoughby, D.S. and Ziegenfuss, T.N., 2021. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. Journal of the International Society of Sports Nutrition, 18(1), p.13. Article Link

Buford, T.W., Kreider, R.B., Stout, J.R., Greenwood, M., Campbell, B., Spano, M., Ziegenfuss, T., Lopez, H., Landis, J. and Antonio, J., 2007. International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition, 4(1), pp.1-8. Article Link

About me: I am a medical doctor living in Northern California. I received a Master’s Degree in Nutrition from Columbia University in 2010. I’ve been a practicing vegetarian since 2007.

Neurogenesis & Nutrition — Part 1: Promoting Factors

/ Jame A. Agapoff, MD, MS (she/they) / 1 Comment

A significant scientific breakthrough in neuroscience was the discovery that neuron growth (neurogenesis) continues in the adult brain. Prior to this research, it was believed that neuron growth was largely absent in the adult brain, providing little hope for those who suffered traumatic brain injuries or other neurodegenerative diseases. This finding also intrigued nutritional scientists who began to wonder what nutritional factors promoted and inhibited neurogenesis, and whether promoting neurogenesis could enhance wellness and performance.

In the subsequent two decades, much has been learned about what environmental factors promote and inhibit/impair adult human neurogenesis (AHN).

Promotors of AHN:

  1. Exercise
  2. Healthy Diet
  3. Learning
  4. Stimulating Environments

Inhibitors of Neurogenesis:

  1. Sleep Deprivation
  2. Chronic Stress
  3. Aging
  4. Poor Diet

Nutritional Factors Promoting Neurogenesis:

  1. Calorie Restriction: Animal studies show that a 30% calorie restriction can increase lifespan, increase memory, and lead to increased neuron proliferation.
  2. Omega 3 Fatty Acids (Fish Oil, Algae Oil, Flaxseed Oil, Krill Oil): Studies on omega 3’s are mixed, but are thought to reduce inflammation, which is a product of chronic stress states. Omega 3s may also have a role in treating mood disorders. I recommend algae oil as this is the most sustainable and contains relatively high amounts of the active omega 3 DHA.
  3. Flavonoids: These are a collection of chemicals found in fruits and vegetables. They are generally considered to be ‘antioxidants,’ which play a role in decreasing the oxidative stress at the level of the cell. Diets rich in fruits and vegetables, and thus flavonoids, have been shown to increase AHN. Significant research has shown that the flavonoids in blueberries have neuroprotective effects. I recommend everyone adopt a mostly plant based diet.
  4. Turmeric (Curcurmin): Human and animal trials show improved cognitive performance with curcurmin. This may explain why India has one of the lowest rates of degenerative neurological diseases of aging. If you like to cook with turmeric spices, make sure you add black pepper, which contains bioperine, which improves the absorption.
  5. Aerobic Exercise: Not quite a nutrient but profoundly important for long term health and wellness. Exercise along with practices like meditation promote frontal lobe activity, decrease oxidative stress, and promoted neurogenesis. I consider them as essential parts of any brain power diet.

I hope this article provides some much needed motivation for 2021. Remember, mistakes are failures only if you give up. 🙂

References:

Eriksson PS, Perfilieva E, Björk-Eriksson T, et al. Neurogenesis in the adult human hippocampus. Nat Med. 1998;4(11):1313–1317.

Kumar, A., Pareek, V., Faiq, M. A., Ghosh, S. K., & Kumari, C. (2019). Adult neurogenesis in humans: a review of basic concepts, history, current research, and clinical implications. Innovations in clinical neuroscience, 16(5-6), 30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659986/

Zainuddin, M. S. A., & Thuret, S. (2012). Nutrition, adult hippocampal neurogenesis and mental health. British medical bulletin, 103(1), 89-114.

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The Transformative and Protective Effects of Daily Exercise on the Brain

/ Jame A. Agapoff, MD, MS (she/they) / Leave a comment

The COVID-19 pandemic has changed many of our day-to-day routines. Previously enjoyed activities like going to the gym are still out of reach. We find ourselves spending more time at home, eating, watching Netflix, and barely moving. This lack of exercise can have a significant impact on our psychology and brain physiology.

Short Term Benefits of Exercise:

  1. One workout can cause a surge of neurotransmission that leads to improved mood and focus for several hours.
  2. A single workout will improve your reaction times.

Long Term Benefits of Exercise:

  1. Increase in hippocampal and pre-frontal cortex volume (new brain cells!) leading to better long-term memory storage and protection from diseases of cognitive decline like dementia
  2. Regular exercise leads to an overall improvement in concentration and attention and resilience against mood disorders like depression

Bottom Line: Exercise grows and protects your brain. According to exercise and neuroscience researcher Dr. Wendy Suzuki, it only takes 30 minutes of aerobic exercise, 3-4 times per week, to get the brain-beneficial effects of exercise.

 

woman girl silhouette jogger

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