CREATINE: The Ultimate Anti-Aging Supplement

by Dr. Joseph Debe

Creatine is primarily known as a supplement used by athletes and bodybuilders to increase strength and muscle mass, but it truly is the real king of "anti-aging" supplements. No other nutritional supplement builds strength and muscle the way creatine does.

Creatine supplementation has been found in numerous studies to increase power and muscular strength, as well as muscle mass. About 70 to 80% of studies have shown positive results. Typical responses to creatine supplementation are an additional 10 to 15% increase in strength and an additional 5 to 10 pounds increase in muscle mass over one to three months of resistance exercise (weight) training.

In Biomarkers: The 10 Keys to Prolonging Vitality, Evans and Rosenberg rank the top ten modifiable biomarkers (measurable biological parameters) associated with biological aging. The number one biomarker, the most important change that occurs with aging, is loss of muscle mass. From age 20 to 80, the average person loses 20 to 30% of their muscle mass. Loss of muscle mass, also known as sarcopenia, produces a multitude of negative metabolic changes, which are incompatible with good health. The number two biomarker is strength.

The importance of strength in the elderly is exemplified by simple, yet critical actions such as being able to arise from a chair or avoid a fall. Inability to carry on activities of daily living due to muscular weakness is a major cause for loss of independence. Creatine is, by far, the most effective nutritional supplement for improving these top two biomarkers of aging: muscle mass and strength.

Aging is associated with lower skeletal muscle creatine levels and a reduction in skeletal muscle protein synthesis. Several studies have provided different lines of evidence that creatine supplementation increases muscle protein synthesis. Not surprisingly, most studies have found creatine supplementation to benefit elderly subjects. One study found five days of creatine supplementation to restore youthful levels of phosphocreatine (the body's "active" form of creatine). Low phosphocreatine levels result in lower levels of ATP (the body's primary energy molecule). Greater phosphocreatine levels translate into greater cellular energy production. Creatine's most important role in human physiology is to contribute to maintenance of ATP levels.

A double-blind, placebo-controlled study of thirty men, average age 70.4 years, who underwent a weight training program, found greater increase in fat-free mass, knee extension strength and endurance, leg press endurance and overall power in the creatine group. Another double blind placebo-controlled study of 7 days of creatine supplementation in elderly individuals found increases in body weight, fat-free mass, and strength. Importantly, this study also included two assessments of lower extremity functional capacity, including a timed repetitive sit-stand test, which simulates arising from a chair. On this measure too, creatine supplemented subjects outperformed those given placebo. The authors of this study concluded, "Creatine supplementation may be a useful therapeutic strategy for older adults to attenuate loss in muscle strength and performance of functional living tasks."

Creatine supplementation has been found to produce gains in strength, energy and muscle mass in people with various conditions and diseases. Congestive heart failure patients supplemented with creatine have exhibited signs of enhanced skeletal muscle metabolism with reduced lactate and ammonia accumulation. Creatine improved both strength and endurance in these patients.

In a double-blind placebo-controlled study, in which subjects had a leg immobilized for two weeks then underwent an exercise rehabilitation program, creatine supplementation resulted in more rapid restoration of strength and muscle mass. Creatine should therefore benefit older individuals who are recovering from bed-rest or immobilization of a limb due to injury, surgery or illness. If these were creatine's only "anti-aging" attributes, it would be enough to earn the title of "the ultimate anti-aging supplement.” But creatine's benefits don't stop here.

Creatine has other physiological effects that are consistent with healthy aging. Creatine supplementation has been found to lower elevated serum cholesterol and triglyceride levels. One study found a 6% reduction in total cholesterol and a 23% reduction in triglycerides and VLDL cholesterol after eight weeks of creatine supplementation. Combining creatine with exercise appears to be synergistic in lowering cholesterol.

Many of creatine's effects are enhanced when combined with exercise. A combination of creatine supplementation and resistance training was found to increase arm and leg blood flow. A double-blind placebo-controlled study divided subjects into three groups. One was given creatine and underwent a resistance-training program, the second exercised but received a placebo. The third group was given creatine but did not exercise. At the end of this 28-day trial, only the group that exercised and took creatine had a significant increase in calf and forearm limb blood flow. This has implications for people with impaired circulation. Additionally, both creatine groups had a significant increase in resting metabolic rate, which is the number three biomarker of aging according to Evans and Rosenberg. There is some evidence that creatine favorably influences other "top ten" biomarkers, including body fat percentage, aerobic capacity, the body's ability to regulate its internal temperature, and glucose tolerance.

There are several lines of evidence to suggest creatine supplementation improves glucose tolerance and insulin sensitivity. Insulin resistance appears to be a fundamental metabolic aberration contributing to unhealthy aging and reduced lifespan. The effects of creatine supplementation that point toward improved insulin sensitivity include lowering of elevated plasma triglyceride and VLDL and total cholesterol levels, increasing muscle glycogen stores, and a trend toward lower fasting blood glucose levels. Additionally, levels of Glut 4 protein were found to increase by 40% in response to creatine supplementation compared to placebo. Glut 4 protein is involved in insulin-stimulated muscle glucose uptake. What's more, a recent study found when creatine was combined with supplemental protein and resistance training, glucose tolerance improved.

Oxidative stress (free radical excess) is another fundamental mechanism of biological aging improved by creatine. Antioxidants defuse free radicals and reduce the damage they inflict upon body tissues. Creatine has been found in several studies to possess antioxidant properties, protecting against a variety of very toxic free radicals.

A number of animal studies have found creatine supplementation to protect neurological tissue against ischemic, traumatic, and toxic insults. Protection against ischemic (reduced blood supply) brain damage has obvious implications for defense against stroke. In animal models of traumatic brain injury, creatine supplementation appeared to protect brain cells by maintaining mitochondrial bioenergetics. Brain damage was reduced by 36% in mice and 50 % in rats. In an animal model of Parkinson's disease induced by administration of a toxin called MPTP, animals pre- supplemented with creatine experienced only a 10% decrease in brain dopamine levels compared to 70% reduction in non-supplemented animals. Creatine also protects brain cells in animal models of Alzheimer's disease.

Genetic conditions of creatine deficiency are associated with both physical and mental underdevelopment, which are favorably altered by creatine supplementation. Therefore, it is reasonable to expect creatine supplementation in healthy subjects to improve mental performance as it has been shown to dramatically improve physical performance. This area of investigation is still in its infancy. In a study of healthy humans, creatine supplementation at 5 grams four times daily for four weeks produced an average 8.7 % increase in brain creatine. Another study, using a double-blind placebo-controlled protocol, examined the effect of supplementing with creatine on mental fatigue. Subjects were asked to perform as many mathematical calculations as possible within a certain time period. Creatine supplementation was found to reduce mental fatigue and improve performance. Additionally, testing by near infrared spectroscopy revealed signs that creatine increased brain oxygen utilization. These effects are of obvious benefit for aging individuals.

Although creatine supplementation has been found in many studies to have no impact on cancer, there are several positive notable exceptions. In test tubes, creatine has inhibited both colon and breast adenocarcinoma growth. In animal studies, it has been found to inhibit rat mammary tumors, rat sarcoma, and human colon adenocarcinoma and neuroblastoma cell lines implanted in mice. Virtually all of the published research has been done with pharmaceutical grade creatine monohydrate powder dissolved in liquid. Few supplements produce a noticeable change in health as rapidly as creatine monohydrate. Typically, results are experienced within a few days. Weight training enhances many effects of creatine supplementation. Weight training and creatine supplementation should be a cornerstone of every "Anti-Aging" program.

To conclude, there is much more to healthy aging than maintaining adequate growth hormone levels. Nutritional supplements purported to increase growth hormone levels are heavy on hype but light on science. By contrast, the "anti-aging" effects of creatine monohydrate have been demonstrated in hundreds of published scientific studies. The powerful and wide-ranging properties of creatine make it the ultimate "anti-aging" supplement.

Dr. Joseph Debé and Donna Caruso are coauthors of “The Ultimate Creatine Handbook: The Safe Alternative For Healthy Muscle Building,” which has just been released by Woodland Publishing. Dr. Debé is a sports chiropractor and board certified nutritionist practicing in North Shore Fitness in Great Neck. Dr. Debe will be giving a lecture on the benefits of creatine in the near future. Call 516-829-1515 to reserve a seat. Visit www.drdebe.com and to learn more about the health care of the future.