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Prevalence of Creatine Use
There are many incentives in today’s society to increase physical performance and appearance. Creatine is able to provide many adolescents the ability to do this legally. For that reason use of the substance is widespread. Between 5 and 50% of the adolescent athletic population uses the substance, and the majority report positive side effects with only minimal negative side effects, most seemingly connected with other ailments. Also, the vast majority, nearly three quarters, of creatine users received their information on the substance from friends, teammates or coaches. For that reason, information on creatine needs to be more readily available and provided to prevent any harm to its users.
In today’s world of over-stressed body image and extremely competitive sports arenas, many people, especially athletes, are attempting to determine ways to increase their muscular strength and appearance. Considering the human body alone can only do so much to aid in the quest, many people are turning to ergogenic methods to assist them. To illustrate this, the dietary supplement industry is growing with annual sales of $18 billion (Lattavo, 2007). The techniques range from the mildest forms, like dieting, to more extreme measures, like Human Growth Hormone or anabolic steroids. One substance that has garnered much attention is creatine.
To begin, the supplement should be explained. The International Society of Sports Nutrition (ISSN) states that “creatine monohydrate is the most effective nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity and lean body mass during training.” The ISSN also explains that the energy used to convert adenosine diphosphate (ADP) into adenosine triphosphate (ATP), usable energy, during intense exercise is very dependent on the amount of phosphocreatine (PCr) present in the muscle. As you exercise, the creatine stores are depleted, and the availability of energy decreases. The use of creatine supplements to increase muscular creatine stores gives the user the ability to work out for longer and more strenuous periods of time, and in doing so realize greater strength and fitness gains. Additionally, the non-protein nitrogen is found naturally in the skeletal muscular system (about 120 grams in an average individual) and can be found in various red meats and fish. Creatine supplements provide an inexpensive and more direct way to increase the natural levels.
The debate lies in the safety, effectiveness, and knowledge of creatine. To summarize many of the common thoughts on creatine, the following should be stated. Many believe that the weight gained during supplementation is merely retained water, that it causes cramping or an electrolyte imbalance, that the long-term effects are unknown, and that it is unethical or illegal to use it (ISSN). The weight gained is attributed to increased muscle mass due to the ability to exercise more efficiently. The cramping or electrolyte imbalance has not been supported through any scientific observation, and in fact, many studies have shown that creatine can decrease the risk of musculoskeletal injuries, and enhance rehabilitation and is therefore beneficial from a health standpoint. And creatine use is just as unethical as increasing carbohydrate intake to increase glycogen stores. But although the benefits of creatine supplementation exist, there is still cause for concern in proper dosage usage and the need to use it. To better explain this concept, this paper will available literature to focus on the use of creatine today as opposed to its effects; who is using it, how they are using it, and whether or not they are using it properly or for the right reasons.
Prevalence of Use
In researching the prevalence of creatine use, many different statistics were found from different sources. In one mid-south NCAA Division 1 institution, creatine usage was reported by 41% of athletes (much more common among males). Of the creatine users, 89% reported weight gain, 81% quicker recovery, and 47% increased strength. Only 10% reported no positive effects (Greenwood). In a survey of athletes at the University of North Carolina Chapel Hill, 68% of athletes had heard of creatine, and 28% reported using it. 48% of men used it as compared to only 4% of women. 33% and 30% of women and men respectively who use creatine began to do so in high school. In a study of 902 athletes in Northwestern Iowa high schools, 6% of men and less than 1% of women were using creatine. Also, in this study it should be noted that only 3% of male athletes and less than 1% of females use amino acid complexes, or, protein supplements (Mason). In a study of 78 students in a co-educational government high school, 5.2% of students had used creatine in the previous 2 weeks. Additionally, only 3.9% of the sample reported using high-protein milk supplements (O’Dea, 2003). Another commonly noted study in 1997 found that 32% of 14,000 collegiate athletes had used creatine in the past 12 months. Also, in a study of collegiate athletes, 39.6% used creatine. Also, in this study, 70.4% were reported to have used protein products (Lattavo, 2007). Additionally, in this study, data was also recorded for the use of creatine products in general samples of the population, not just athletes. Various studies show somewhere between 4.7 and 8% of adolescents as having used creatine in the past. In short, creatine use is wide spread and increasing.
Knowledge of Creatine
There is major discussion and concern as to how and why many athletes are using creatine supplements. Some of the major concerns lie in the fact that many begin their regimen thanks to information provided by friends. In Lattavo’s study in 2007, 74% of adolescent athletes’ primary source of information on creatine use was friends. Also, 55% did not know how much of the supplement they were consuming, and 23% responded as taking doses higher than that which is recommended. In the study conducted by UNC, friends and teammates were found to be the most common sources of information on the supplement. Also, one third of the creatine users began doing so, and learning about it, in high school. Also, only 29% of the users were able to describe the dosage they were consuming in grams, and the most commonly reported dosage was well below the recommended maintenance level, and was lacking any loading phase. The study of high school students yielded an incredibly vast array of supplementation strategies with nearly no two answers resembling each other. A Brown University School of Medicine survey also showed that 75% of creatine users had no idea how much creatine they were taking, or they were overdosing on the regular dosage period. Also, it was made very evident throughout all of the studies collectively that the effects of creatine or the process by which it functions were not well known.
Discussion of Prevalence and Knowledge of Use
It should be noted that there is a lot of discrepancy as to the prevalence of the use of creatine. Some studies show that nearly half of athletes use creatine, whereas others suppose that closer to one tenth of that do. The large difference could be explained by unrepresentative sample spaces, mainly because of the accompanying data. For instance, in the study regarding high school students, 5.2% had used creatine, but only 3.9% had used protein supplements. A representative sample would be more likely to show that more people use protein supplements than creatine because protein is more accepted: it’s found in meat, nuts and various other products that consumers enjoy regularly. For this reason, studies that yielded results like that could be more or less cast aside. Above all, creatine use is widespread, and is growing, and will continue to grow. In order for this growth to act positively on the youth that will experience it, knowledge must be incorporated into the equation. People cannot continue to increase use without increasing how much they know about, or are familiar with the process and methods of the supplement.
With regards to knowledge of use, the large paucity of sufficient knowledge was staggering. Such high numbers of confusion of dosage sizes and absences of loading phases could prove to be injurious to adolescents. Also, since the majority of survey respondents have learned of creatine through friends, teammates and coaches, there is a major lack of scientific knowledge of the substance. Much like other drugs, like marijuana or alcohol, many teens are consuming creatine with only a minimal understanding of how to use it or how it affects them.
Because of this, there could serious repercussions in the future as people who overused creatine for extended periods of time because they learned of the substance from people who barely knew how it worked begin to experience possible negative results. At the least, since they are not using the supplement properly, they will realize diminished positive results, which may influence the idea that creatine is not that effective and limit its use without having much to do with actual facts.
Creatine is a popular substance because it has potential to provide significant strength and fitness benefits. For this reason, many people will continue to use it, and even more will begin to experiment with it. This growth should also be met with increased awareness of how to properly consume the supplement. Parents should be more involved with the sorts of items that their children are using to enhance their physical performance, coaches should understand more of the scientific aspect of creatine as opposed to a cursory knowledge of its physical benefits, and the stores (GNC, Vitamin World, NutriShop) that sell these products should be more aware of the side effects, dosage recommendations and scientific aspects of the supplement. With proper awareness of creatine, its reputation as a “gateway supplement” could diminish. Athletes and adolescents could begin to use creatine to aid them physically without opening up doors to misunderstood paths riddled with more serious substances like Human Growth Hormone or steroids. The young mind is a delicate thing, and for that reason, it should be guarded safely, protected from potentially detrimental practices.
Buford, T., Kreider, R., Stout, J., Greenwood, M., Campbell, B., Spano, M., et.at. (2007). International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition, 4:6.
Calfee, R. & Fadale, P. (2006). Popular ergogenic drugs and supplements in young athletes. Official Journal of the American Academy of Pediatrics, 117.
Greenwood, M., Farris, J., Kreider, R., Greenwood, L., Byars, A. (2000). Creatine supplementation patterns and perceived effects in select division I collegiate athletes. Clinical Journal of Sport Medicine, 10(3), 191-194.
LaBotz, M. & Smith, B. (1999). Creatine supplement use in an NCAA Division I athletic program. Clinical Journal of Sports Medicine, 9, 167-169. Retrieved from
Lattavo, A., Kopperud, A., Rogers, P.D. (2007). Creatine and other supplements. Pediatric Clinics of North America, 54 (4).
Doi: 10.1016/ j.pcl.2007.04.009
Mason, M., Giza, M., Clayton, L., Lonning, J., Wilkerson, R.D. (2001). Use of nutritional supplements by high school football and volleyball players. The Iowa Orthopoadic Journal, 21, 43-48. Retrieved from:
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