Victorious Veteran: Creatine Monohydrate Still First Class! Usefulness & Safety of “Innovative” Creatine Formulas Questionable.

If we discount a high protein intake as a regular constituent of a healthy diet, creatine is unquestionable the King of Natural Ergogenics. Its impact on athletics way beyond the Gold’s Gyms of the bodybuilding world is evident from its being cited as “effective and safe” in almost each and every “position stand” published in one of the journals of the various sports & nutritional societies all over the world in regular intervals. Thus, with the (nephro-)toxity myth being finally dispelled, creatine has become a stable in the supplement regimen of both recreational, as well as professional athletes.

Now, the financial revenue you can make from a non-patentable amino acid that is commonly found in fish and meat products is obviously limited. Thus, the steadily increasing number of players on the supplement market is continuously trying to “reinvent the wheel”, by putting forward a new, better-absorbed, more effect, side-effect free or whatever else the marketing guys had on their minds forms of N-(aminoiminomethyl)-N-methyl glycine (=chemical formula of creatine). These “superior” forms of creatine are then put forward as the must have for every seriously training athlete and/or creatine non-responders (these are people, where – due to various not fully understood mechanisms – creatine has no measurable effect on performance, (intracellular) water retention and body weight) and usually disappear from the market just about at the same time, the first batch has been sold and disappointed customers begin to vent their anger on the blogs and bulletin boards of the fitness world.

With reference to the purported superiority of novel forms of creatine R. Jäger, one of the leading researchers in the field writes in a recently published paper (Jaeger. 2011), the results of which have previously been presented at the 2010 Creatine in Health and Sports conference:

[…] the efficacy, safety, and regulatory status of most of the newer forms of creatine found in dietary supplements have not been well established. Additionally, there is little to no evidence supporting marketing claims that these newer forms of creatine are more stable, digested faster, and more effective in increasing muscle creatine levels and/or associated with fewer side effects than CM.

In their extensive review of the literature Jäger et al. dissect many of the commonly held views on the purported “instability” and “low absorbtion rate” of creatine monohydrate, evaluate the different creatine contents of various supplemental forms and their individual solubility, stability and bioavailability. And while some other forms are in fact more soluble…

Creatine monohydrate dissolves at 14 g/L at 20°C resulting in a neutral pH of 7. A saturated solution of tricreatine citrate in water has a pH of 3.2; whereas a saturated solution of creatine pyruvate even has a pH of 2.6 (pyruvic acid is a stronger acid than citric acid). The decrease in pH results in an increase in solubility: 29 g/L creatine citrate at 20°C, and 54 g/L creatine pyruvate at 20°C. Normalized by the relative amount of creatine per molecule (monohydrate 87.9%, citrate 66%, pyruvate 60%), creatine citrate (19.14 g/L) shows a 1.55-fold and creatine pyruvate (32.4 g/L) a 2.63-fold better solubility when compared with the monohydrate (12.3 g/L).

The acidity of your stomach is high enough, anyway, so that even if you just swallow the powder it will eventually dissolve, when it comes in contact with your gastric acid - for monohydrate [CM] Jaeger reports the absorption to be as high as 99%.

Furthermore, pre-solving of creatine in water is counter-indicated, because, as Jaeger et al. write, …

[…] solution precludes the manufacture of shelf-stable standard ingredient. If creatine is not consumed immediately after it has been dissolved in water, it should be stored at a low temperature to retard the degradation.

So you better throw away your liquid creatine - chances are its 99% degraded even before you bought it from your retailer.

The instability is even more of concern in the case of Creatine Ethyl Ester (CEE) which has been found to be “actually less stable than CM.” (Child & Tallon. 2007).

CEE is mostly converted into creatinine under physiological conditions encountered during transit through the various tissues, suggesting no ergogenic effect is to be expected from supplementation of CEE.

The latter, i.e. creatine ethyl esther, is also less bioavailable, 

Figure 1:Changes in total muscle creatine content in response to placebo (PLA), creatine monohydrate (CRT), and creatine ethyl ester(CEE) supplementation (Spillane et al. 2009, cf, fig. 1).

and studies (Spillane. 2009) suggest that its higher rate of degradation to creatinine may pose a possible health risk.

Also, while Jaeger et al. report some evidence for the beneficial effects of co-supplementation with glucose, protein or (low dose) D-pinitol, I personally doubt that either of them is necessary to take advantage of the repeatedly proven ergogenic effects you can get from the cheapest, most researches, safest and easiest to obtain form of creatine – creatine monohydrate.

On a side note: My friends @ironmagazine.com have found an interesting study on the effect of creatine + nitrate, which is currently hyped as “the next big thing”. Although, I suppose that the amount of the carcinogen N-nitrososarcosine, which is a byproduct of their reaction, is hardly high enough to trigger cancerous growth, the lack of direct scientific evidence that creatine nitrate has any beneficial effect over the individual use of nitrates (for pump) and creatine (for performance) at least makes me wonder if you could not eat a buckload of beet roots (high in nitrate) with your creatine monohydrate to achieve the same effect ;-)

Connelly, Andrich, Norton, Arnold, Lenore, Andro - BodyRX #17: Carbohydrate Intake For People Who Will NEVER Settle for Being "Normal"

BodyRX guest: Pete Ciccone, 
national-level NPC
competitive bodybuilder

For those who missed out on yesterday's episode of the new, totally revamped BodyRX Radio Show, episode #17 "Carbohydrate Intake For People Who Will NEVER Settle for Being 'Normal'" is now available for download.

 The Body RX Show - Episode #17

I will compile a write up of the most significant facts and include links to some research on the coming weekend. So stay tuned!

If you wanna be Super Human,
the SuppVersity is the place to read
and SHR and BodyRX the shows to listen to ;-)

More on Putting Carbs to Good Use: Scott Connelly's BodyRX Show - Tune in Live at 12:00pm PDT

Who listened to my interview on Super Human Radio, yesterday, may have heard my advice to tune in to today's BodyRX Show with Dr. Scott Connelly, Vince Andrich, Layne Norton, Patrick Arnold and (this is new) me, ProfDrAndro, being the brains behind a completely overhauled show concept, I promise you won't be disappointed.

BodyRx Radio Show #017

Tune in Live @ 12pm PDT

Here is a short glimpse onto what is waiting for you:

On our last BodyRx Radio show (#016) we learned that by reducing carb intake from levels at the top of the food pyramid (>60% of energy) to a modest 35-40% of energy, you can effectively “teach” your body to preferentially store the carbs you eat into muscle cells and NOT your fat cells [cf. Effect of Macronutrient Composition]. But, when does reducing carb intake negatively impact your performance in the gym, where the work to build muscle takes place? More importantly, does that number change if you alter your training program? We take this age old question head on with:

• A revealing interview with renowned researcher Dr. Kevin Tipton by our very own Dr. Scott Connelly.
  
• Next, Vince Andrich taps into the minds of two of the industries top physique competitors and personal trainer/coaches; Pete Ciccone and his wife Meriza Deguzman––listen for their practical advice that men and women can use right NOW!
  
• Lastly,  renowned chemist Patrick Arnold will take on a list of hard hitting questions that will give listeners an inside look at the popular diet and energy compound; geranium. We know you’ll agree this is a one-of-a-kind interview since it was Patrick Arnold himself who brought this compound to the market several years ago, and is now the darling of the supplement world.

The prominent line-up alone makes it worth listening - no doubts about that, folks!

3g BCAA + Arginine + Carbs Pre-Workout Modulates Hormonal Response to Single Bout of Treadmill Running to Exhaustion

BCAAs + Arginine + Carbohydrates before workout!? Sounds familiar, doesn't it? In fact many of the first generation preworkout products were either formulated like that or consumers were advised to stack them with a branched amino acid (BCAA) product of the same company. Studies which investigated the combined ergogenic effect of these nutrients are yet scarce. So, I thought that it would be worth posting the results of a recent study from China (Hsu. 2011).

Before they started exercising on a treadmill, the subjects, 14 male physical active college students, received a beverage containing either 3g of BCAA (2:1:1) + 0.5g Arginine + 12.1g carbohydrates or placebo. Blood samples of each subject were collected before exercise, 0, 10, 20, 40, 60, 120 min and 24 h after exercise and the procedure was repeated after two weeks (cross-over design). The results were as follows:

No significant differences in the levels of lactate, ammonia, creatine kinase and glycerol between the two groups were observed at any of the time points. However, the levels of glucose and insulin were significantly higher in the BA trial as compared to those in the PL trial at the 40 and 60 min recovery points. Furthermore, the testosterone to cortisol ratio at the 120 min recovery point was significantly higher in the BA trial as compared to that in the PL trial.

While higher glucose and insulin levels are hardly surprising in view of the fact that the placebo contained no calories whatsoever, the improved hormonal recovery (measured as testosterone / cortisol ratio) in the supplemented group appears to be pretty interesting.

A closer look at the exact data does yet reveal that the supplemented group had a higher testosterone / cortisol ratio to begin with. So, if we calculate the relative changes in the T/C ratio 120min after exercising to exhaustion, these are +13.2% in the placebo group and only +6.8% in the supplemented group.
Does that mean that the money you are spending on preworkout products is wasted? From a hormonal perspective, maybe. From a psychological perspective, we do yet still have another result of the study: "Fatigue score increased immediately at exhaustion in both groups, but the decrease in the fatigue score at 120 min recovery point was significant only in BA trial." Consequently, even if it does not improve the hormonal milieu in the early recovery period, supplementation with branched chain amino acids, arginine and carbohydrates could provide the psychological edge you need to drag yourself to the gym regularly ;-)

On a side note: It would have been interesting to see T/C levels measured beyond the 120 minutes post exhaustion. Based on the fact that the recovery of the T/C levels of the supplemented group sped up from T=60min to T=120min, one may well hypothesize that there would be measurable (hormonal) advantages for the BA group at T=180min and beyond.

Scientific Evidence Links High Carbohydrate Intake to the Development of Alzheimer's and Other Neurological Diseases

"Fats are bad, carbs are healthy!" I hope nobody out there still believes this late 20th Century slogan. If you do, chances are you will soon forget about it due to the neuronal damage you are inflicting to your brain by eating a high carb diet.

In a very recent review, a group of international scientists (Seneff. 2011) summarize the current state of research as follows:

[...] an excess of dietary carbohydrates, particularly fructose, alongside a relative deficiency in dietary fats and cholesterol, may lead to the development of Alzheimer's disease. A first step in the pathophysiology of the disease is represented by advanced glycation end-products in crucial plasma proteins concerned with fat, cholesterol, and oxygen transport. This leads to cholesterol deficiency in neurons, which significantly impairs their ability to function. Over time, a cascade response leads to impaired glutamate signaling, increased oxidative damage, mitochondrial and lysosomal dysfunction, increased risk to microbial infection, and, ultimately, apoptosis. 

They also compiled a comprehensive list of take-home-massages, some of which may have far reaching consequences:

• Researchers have identified mitochondrial dysfunction and brain insulin resistance as early indicators of Alzheimer's disease.

• ApoE-4 is a risk factor for Alzheimer's disease, and ApoE is involved in the transport of cholesterol and fats, which are essential for signal transduction and protection from oxidative damage.

• The cerebrospinal fluid of Alzheimer's brains is deficient in fats and cholesterol.

• Advanced glycation end-products (AGEs) are present in significant amounts in Alzheimer's brains.

• Fructose, an increasingly pervasive sweetening agent, is ten times as reactive as glucose in inducing AGEs.

• Astrocytes play an important role in providing fat and cholesterol to neurons. [...]

• Glycation damage interferes with the LDL-mediated delivery of fats and cholesterol to astrocytes, and therefore, indirectly, to neurons. [...]

• Synthesis of the neurotransmitter, glutamate, is increased when cholesterol is deficient, and glutamate is a potent oxidizing agent.

• Over time, neurons become severely damaged due to chronic exposure to glucose and oxidizing agents, and are programmed for apoptosis due to highly impaired function. [...]

• Simple dietary modification, towards fewer highly-processed carbohydrates and relatively more fats and cholesterol, is likely a protective measure against Alzheimer's disease.

So, if you have not already forgotten what you just read, make sure to cut back your carbohydrate consumption, limit fructose intake and stop being afraid of fats and cholesterol before you cannot remember anymore.

Lower Protein to Carb Ratio Impairs Akt/TOR Signaling Pathway after Fasting in Rainbow Trout

"Boy, you need your carbs post workout!" This cornerstone of conventional bodybuilding wisdom is crumbling and a new study, if it had been done in humans, not in rainbow trout, would potentially refute this myth once and for all - at least, if one follows the popular (but false) assumption that it is because you are in a carb depleted or overall fasted state after a strenuous workouts.

A group of European scientists (Seiliez. 2011) investigated the effect of diets with different protein to carbohydrate ratios on the Akt/TOR Signaling Pathway after fasting for 48h. What they found contradicts conventional wisdom:

Activation of the Akt/TOR signaling pathway by refeeding was severely impaired by decreasing the proteins/carbohydrates ratio. Similarly, post-prandial regulation of several genes related to glucose (Glut4, glucose-6-phosphatase isoform 1), lipid (fatty acid synthase, ATP-citrate lyase, sterol responsive element binding protein, carnitine palmitoyltransferase 1 and 3-hydroxyacyl-CoA dehydrogenase) and amino acid metabolism (serine dehydratase and branched chain α-keto acid dehydrogenase E2 subunit) only occurred when fish were fed the high protein diet. On the other hand, diet composition had a low impact on the expression of genes related to muscle protein degradation.

So, not only did an increase in carbohydrates negatively impact muscle protein synthesis stimulated by the Akt/TOR signaling pathway, interestingly it also failed to reduce muscle protein degradation, which is the second reason people use in favor of a high carb meal after workouts (/fasting). 

For people following the research and writings of low carb proponents such as Mauro di Pasquale these results may not be surprising. However, before flushing your weight gainer down the toilette, you should really reevaluate your personal and training goals. For an athlete whose exercise bouts are long and frequent, carbohydrate repletion may well turn out to be beneficial. If not for muscle growth, then for performance maintenance. A general demonization of carbs would thus be similarly inappropriate as the "fat scare" of the late 20th century. It all depends on who you are and what your athletic and aesthetic goals are.

Eat Rice, Stay Healthy!?

A recently published study (Fulgoni. 2010) analyzing data from 25 374 eligible participants identified as rice consumers study on the correlation of rice-eating to several markers of metabolic health showed that people who ate at least one serving of rice (white or brown) a day tend to have

better health and diet parameters including less total fat, saturated fat, and added sugars; higher amounts of more than 12 essential vitamins and minerals, including iron, folate, and other B vitamins; more fruit and legumes; nearly 4 tsp (16 g) less added sugar; and 7 g less solid fats. For the 19- to 50-year-old subgroup, main results (P < .05) also showed rice consumption associated with reduced likelihood of being overweight or obese, 34% reduced risk of high blood pressure, 27% reduced likelihood of having an increased waist circumference, and 21% reduced risk of metabolic syndrome.

This, however, should not encourage you to just add one serving of rice to your bad diet habits, because the most important information coming from the study is the first one: Rice eaters tend to have better diet parameters. In other words their general dietary regimen is more healthy, no wonder they have a reduced likelihood of obesity and health issues. Overall, rice is still a very dense source of energy and overeating on it would not be advisable, both from a caloric, as well as (this is more important) from a nutritious point of view - with its high amount of carbohydrate one serving of rice may well amount to all the carbs you may eat, if you follow a heart healthy low carbohydrate diet. Bottom line: Moderation is the key!

25g Whey Protein or 10g of EAAs Maximize Post Workout Protein Synthesis Without Additional Carbs

While this probably won't end the debate on whether post-workout carbohydrate intake is a good or a bad thing, a recent review of the literature presented by Steward M. Phillips at the The Summer Meeting of the Nutrition Society (Phillips. 2010) suggests that the addition of carbs to your post-workout shake is at least unnecessary, as long as you have a sufficient amount of leucine and EAAs in it:

The increment in [muscle protein synthesis] MPS is maximally stimulated at a dose of protein of approximately 25 g or 10 g EAA. This rise is based solely on protein consumption and is not augmented by carbohydrate, at least when protein is adequate.

Also, the type of protein is of utmost importance. Phillips recommends whey protein or (please note that it is not whey and EAAs) a blend of EAAs at dosages of 25g and 10g, respectively.

Figure 1: Whole blood leucine concentration (μM) following resistance exercise from subjects who consumed 500 ml fluid skim (low fat) milk and an isonitrogenous and isoenergetic quantity of a soya drink (drawn with data from Wilkinson et al.).

As can be seen from figure 1, even skimmed milk, which is only partially whey, produces a larger increase in whole blood leucine than soy protein (soy is for girls only, anyway ;-) Consequently, you should prefer dairy proteins or whey concentrates, isolates or hydrosolates as your post workout protein sources.