Nov. 6, 2020

"Creatine Myths and Common Questions" with Dr Scott Forbes PhD

"Creatine Myths and Common Questions" with Dr Scott Forbes PhD

Episode 147 of the Institute of Performance Nutrition's "We Do Science" podcast! In this episode, I (Laurent Bannock) discuss "Creatine Myths and Common Questions" with Dr Scott Forbes PhD (Brandon University, Canada).

Discussion Topics Include:

  • Creatine: a brief overview of the science and the myths
  • Why creatine has become such a popular supplement
  • The evidence base behind creatine use in exercise science and health promotion (i.e. muscle mass, strength and power, age, gender, clinical uses etc)
  • Safety profile of creatine to include risk of kidney damage, water retention etc
  • Creatine Monohydrate vs. other forms off creatine
  • Creatine dosing strategies

Key Paper(s) Discussed / Referred to:

Related Podcast Episodes:

Check out our other podcasts, publications, events, and professional education programs for current and aspiring sports nutritionists at www.TheIOPN.com and follow our social media outputs via @TheIOPN


Transcript

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We Do Science Podcast

EPISODE 147

NOV. 6, 2020

"Creatine Myths and Common Questions" with Dr Scott Forbes PhD

 

[INTRO]

 

[00:00:00] LB: Hi, and welcome to episode 147 of the Institute of Performance Nutrition’s We Do Science Podcast. I am Dr. Laurent Bannock. If you are an ardent listener, if you've been listening to this podcast over the years, welcome back. I’m excited to have you back. I know it's been a while since my last episode. If you're new to the We Do Science Podcast, welcome. I hope that you enjoy this episode and you continue to listen to future episodes and catch up on the huge catalogue of episodes that I have managed to amass over the last few years, on all things sport and exercise, nutrition and related topics, like exercise science and exercise physiology.

 

Doing my best to make this as interesting as I can, because like you guys, I love this stuff. I love sport and exercise nutrition as a practitioner of many years and more recently, as a researcher, it's a real pleasure for me to be able to have these conversations with all these great experts and researchers and academics and practitioners that I am lucky enough to get onto these podcasts.

 

Just to have these conversations here in my office is something that I know many of you enjoy with me. That's awesome. This is already a slightly different type of podcast as you may have gathered. I’m trying to up my game when it comes to my podcasting efforts here. In addition to a whole new series of guests that I’m going to be regularly pushing out these podcasts, you're also going to find a lot of new resources that are associated with these podcasts, show notes, transcripts and other cool resources that you'll be able to find on the podcast page.

 

All you've got to do is go to our website, which is theiopn.com and simply click on the podcast tab, which will signpost you to the podcast website that has all of these resources. Now bear with me, there's a lot of episodes that go back a number of years and I am slowly but surely going to be updating those, or most of those. Not all of them, but most of those will be updated with a re-edited episode, along with transcripts and other resources that you'll see going forward for every episode. I hope you find those of use and do contact me if you've got some ideas, or thoughts about the podcast that you think could help improve it.

 

I’m always looking to make this as beneficial as I can to you as sports nutritionist, performance nutritionist, sports dietitians, sports scientists, personal trainers and just generally, people who love the science as much as I do about this area of sports science, sport and exercise and nutrition.

 

Anyway, in today's conversation we're going to be talking about creatine. You say, "Creatine again?" Yes, creatine again, because for reasons that will be obvious to most of you. I’m sure there's a lot to talk about with creatine and I’ve had some great conversations with experts recently and over the years with people like Professor Darren Candow, Professor Eric Rawson and Professor Craig Sale, some big names in creatine research. You'll want to listen to those, because they are all in their own right very, very useful and important podcasts, I feel, for you to benefit from.

 

In today's podcast with Dr. Scott Forbes, I had a fantastic conversation, which I really enjoyed and I hope you enjoyed as much as I did, about the myths and common questions that relate to creatine. We're going to look at things like the concerns that people have had with creatine's potential impact to affect dehydration, water retention, does it cause cramping? What about the different types of creatine? Are they all the same, or is it creatine monohydrate is the king? You can find out in a few minutes when we get into this conversation.

 

What about females? What about young people? What about older people, athletes, non-athletes? Is creatine only for gaining muscle and strength and power? What are other benefits of it? And much more. As you'll see, Dr. Scott Forbes has a wealth of information gained from his own significant research into this area. As I said, all you've got to do is go to our website at www.theiopn.com to get access to all those extra goodies I’ve talked about. Where also, you will find information about our 100% online diploma program; practice, focus training program in sport and exercise and nutrition, specifically aimed at performance nutrition practitioners; people not just looking for science, but those that are looking to be taught the science as is relevant to the practice of sport and exercise and nutrition in the real world. 

 

You can learn about that course there. Also, you can learn about our new SENPRO platform. SENPRO is our sport and exercise nutrition coaching and practice management system; a full set of tools that you will find enable practitioners of sport and exercise nutrition to be highly effective in how they work with their clients and with their teams, etc.

 

That's that for my little plugs of the things that we do at The IOPN. I hope you really enjoy this conversation with Dr. Scott Forbes. Now we're going to roll onto our discussion.

 

[INTERVIEW]

 

[00:05:40] LB: Hi and welcome back to the Institute Performance Nutrition’s We Do Science Podcast. Today's guest is Dr. Scott Forbes. Hi, Scott. How are you doing?

 

[00:05:51] SF: I’m doing fantastic. Thanks for having me.

 

[00:05:54] LB: Yeah. Well, I’m really pleased that I could find someone to actually talk to me. I say this in the in the typical British way of subtly being sarcastic, but I’m really enjoying all these lockdowns and so on, because ultimately, it means I get to talk to some really fascinating people, such as yourselves about stuff that I find interesting, but the rest of my family don't. These lockdowns give me the excuses to start up new series of these podcasts.

 

I know people listening will go, "Yeah, it's been a few months," but I am pleased to tell everyone that I have a bunch of new episodes lined up. Scott, you are the first of this new series. Today, we're going to talk about the common questions and misconceptions that relate to creatine, creatine monohydrate, specifically. Although, we'll dig deeper into the variations of creatine.

 

As people will know, I’m fascinated by what is evidence and what constitutes as evidence that's actually relevant to real-world practice. Not just what's good science, but what actually is the information we should be using to inform practice in the field, in the in the gyms with our athletes and so on. That's why I think this is going to be an interesting chat with you, because creatine is one of the supplemental tools that will be in every nutritionist's toolbox, performance nutritionist, sports nutritionist, sports dietitians, depending on how you want to call yourself, or what your interests are as a sports scientist or whatever.

 

I’m really excited to get into this. Before we delve into this topic, why don't you give us a bit of background about who you are, Dr. Scott Forbes? Who is Dr. Scott Forbes and why creatine? What got you into this topic anyway?

 

[00:07:44] SF: Yeah. I am an Associate Professor at Brandon University in Canada, which is in the prairies, so there's not much around us and it's actually very cold for about 10 months of the year.

 

[00:07:57] LB: Yeah. Sorry to butt in there, but that's what I love about. Over here in England, everyone likes to moan about the weather and it's so cold. It's not cold. It's not Canada cold, is it? You guys get it really cold.

 

[00:08:09] SF: Yeah. It gets down to about minus 40 in the winter time, so it's incredibly cold.

 

[00:08:15] LB: Wow. Anyway, sorry. I distracted you. Sorry.

 

[00:08:18] SF: Yeah. I’m an Associate Professor. I study sport nutrition, perhaps, I should say performance nutrition, because I also do a variety of populations, including young individuals to enhanced performance, but older adults to enhanced performance, but function as well. I did my master's degree at the University of Saskatchewan under the supervision of Dr. Phil Chilibeck. He was one of the top researchers in the area of creatine and resistance training in older adults. I was introduced to creatine at that point.

 

Then I also got connected with Dr. Darren Candow, who's a professor at University of Regina and you've had him on your podcast. He does a lot of creatine research as well. I was thrown into the creatine research world. I’ve really just gained an interest in creatine, because it seems to be beneficial for so many different things.

 

[00:09:18] LB: Oh, I’m looking forward to delving into that with you. Since you mentioned Professor Darren Candow, yeah, he and I had a great conversation about creatine. Specifically, we talked about creatine monohydrate from the exercise sport and health applications perspective. That episode alone is a really good review and I highly recommend everyone go check that one out. That was episode 141, back in in May of this year, 2020.

 

Also, I had a great chat with Professor Eric Rawson, a few years ago now; episode 73 on creatine for health and performance. Very early on into the history of this podcast with my good friend, Professor Craig Sale, who of course, worked under Roger Harris, who's a huge god in the world of creatine. They're all worth a good listen.

 

In this case, we're going to talk about something quite specific, which I know you're a co-author of an upcoming paper, hopefully, on this topic. Of course, you've published in various areas, of course, not just in creatine, but we'll hopefully delve into that a little bit, particularly with things like creatine and its use in combat sports, for example. I think that'll be fascinating, if we've got time.

 

I know this paper hasn't come out yet and I know that there's a wide variety of experts that have contributed to this paper that I’m loosely basing this conversation off. Many of whom I know, or have published, like Dr. Jose Antonio, of course. Oh, and of course Abbie Smith-Ryan, who I’ve actually interviewed on a previous podcast there, not just Eric Rawson.

 

Wy did you guys feel that we needed a paper to be published on this topic anyway? I mean, surely, surely everything we know about creatine is well-established, well-known and there is absolutely no controversies, whatsoever, I say sarcastically about supplements in general. What happened there?

 

[00:11:19] SF: We do a lot of creatine research, but there seems to be a lot of resistance with creatine in particular and there's a lot of misconceptions, things like, people believe that creatine causes baldness, or creatine's a steroid, for example. I think in the general public, there seems to be this fear of creatine. We really felt strongly that we should probably write a paper, an evidence-based paper to look at some of those myths and misconceptions and try to come up with a evidence-based answer.

 

[00:11:55] LB: Yeah. This reminds me of emphasising why I like the term performance nutrition, more than I like sport and exercise nutrition, or sports nutrition is the most common term, because the thing about sports nutrition is it so leads everyone down this path of thinking that our nutritional recommendations, or our supplements, or whatever are entirely about sports performance and it's not.

 

I think that's the great thing about creatine is that it isn't just about sports performance. Of course, that's something that you addressed and we'll discuss is a good question about creatine that you can ask, is it just for building muscles? Is it just for getting you stronger? No. That was something that came up a lot when I talked to Eric Rawson, for example, when we were talking about the impact that that can have on ageing and brain function even, is absolutely fascinating. With Craig Sale’s work on bone health, not just the work they did on protein and bone health, but also the relevance that creatine has on that. There's so many questions, so many questions that come up that researchers are attempting to answer. Of course, the general public and our athletes don't necessarily understand what those questions are, or the contexts that are behind all of that. Hopefully, we can set some of these things straight in this conversation.

 

Now in the unlikely event that a listener hasn't heard those other podcasts that I’ve done, or maybe they will in the future, we best just bring them back to some basics about what actually is creatine and you know where to go from here. Take it from there.

 

[00:13:36] SF: Yeah. Creatine is formed from three amino acids; arginine, glycine and methionine. In your kidneys and liver, it's put together in a two-step process and it forms creatine. That's one way that we can actually get creatine is by our bodies actually producing creatine. We can also get creatine from our diet as well. Things like meat, for example, fish, poultry, they all contain creatine. We can also get it through food sources, but we can also get it through dietary supplements. Those are the three ways that we can get creatine.

 

Once it gets into our bloodstream, about 95% of it is actually taken up by the muscle. Some of it is converted to phospho-creatine. Essentially, that's stored potential energy, which can be utilised for high-intensity exercise performance.

 

[00:14:34] LB: Would you describe creatine as a food, an ergogenic aid? How would you respond to that type of question? Because I know it's an interesting answer.

 

[00:14:46] SF: That's definitely an interesting question for sure. Typically, when I think of a food, I would think of macronutrients, so things like proteins, fats and carbohydrates. Creatine's used as an energy source as well, just like fats, proteins and carbohydrates could be. I think of it as an ergogenic aid as well, because it definitely enhances exercise performance in both younger and older individuals. As you've already mentioned, it seems to affect more than just muscle performance. It can also impact bone health and perhaps, cognitive function as well, or brain health.

 

[00:15:25] LB: That's what I find so interesting about creatine. Also, listeners will know I’m totally into context. My new extension to context is relevant as well, but I’ll come back to some of that in a minute. The reason why I’m mentioning that is because some of this depends, doesn't it? If you're a vegan or a vegetarian, then I guess, the answer to that question changes slightly, because of reasons you'll help us understand in a minute.

 

Also, potentially male or female, old or young, would influence the potential for that to be a supplement, a food supplement, or whether or not it's going to be an ergogenic aid. This is actually something that maybe later on in the paper is discussed, but since we've raised it, I think this is a fascinating area when it comes to should I or shouldn't I take creatine? Is it even relevant to me? How does that fit with you?

 

[00:16:21] SF: Yeah. First of all, yeah, so if you don't consume meat in your diet as you're a vegetarian or vegan, typically, you have lower creatine levels within your muscle. Typically, respond better to creatine supplementation. Vegetarians seem to respond better. There's a study done by Darren Burke and Darren Candow in the early 2000s, looking at vegetarians versus non-vegetarians and how they responded to creatine over a training program.

 

Those that were vegetarian gains in strength and the gains in muscle size were greater in the vegetarian group than the non-vegetarian group. There seems to be some greater effectiveness in vegetarians than non-vegetarians. Actually, my PhD supervisor, Gordon Bell, did a study looking at responders and non-responders to creatine. What they actually showed was individuals who tended to respond better to creatine had lower creatine levels in their muscle to start out with and they also had more fast-twitch fibres, or type 2 fibres. Again, that's possibly why creatine would respond better in vegetarians.

 

The one thing to think – I don't really like the term responders and non-responders, because creatine actually does so many different things, as well. Just because maybe they didn't respond from a muscle performance standpoint, it might have had an impact on their bone health and it might have had an impact on their cognitive function. It's hard to say if creatine shouldn't be taken by the non-responders in that particular study, because potentially, it could have had a benefit in other areas that weren't measured.

 

[00:18:12] LB: Yeah. I mean, that's a great point, because people have expectations by virtue of I took a pill, I’ve got big muscles. There might be an element of that with steroids, the super physiological doses of that. Actually, I had a great chat with Stu Phillips all about the hormone hypothesis, which is a really interesting podcast we did a few years ago now.

 

You make a good point. I think this is an important aspect to creatine and other supplements, generally, is if your expectation is for it to have an effect, well, it depends on the situation that this starts out at. If for example you are like you say, a vegan or vegetarian, you're having an insufficient intake of creatine if you like. Therefore, taking supplemental creatine clearly just normalises that situation, doesn't it? It's not magic. It's a normalisation process.

 

Whereas, I think as where people who are already eating a bunch of say, fish and animal protein, they're getting some creatine, so maybe there's less magic there. Again, if all you're going to do is focus on one area like you point out, then I think you – yeah, you don't quite get the bigger picture, do you? Now that I’ve mentioned that, is there a difference between somebody taking creatine for a chronic period of time and there is some degree of adaptation to that by the body, as opposed to an acute intake of creatine, where the body is suddenly put into a situation where it's only just taken this stuff in, hasn't had enough time to adapt over weeks or months? Is that something that is relevant with creatine intake and our expectations of taking it?

 

[00:20:16] SF: Common question is do you have to cycle creatine, like go on and off creatine? There's actually been no research to examine the effectiveness of creatine when you cycle creatine, versus when you don't cycle creatine. It's a difficult question to answer from that perspective. It seems like with creatine, what you need to do is you need to load the muscle. There's a few different ways that you can load the muscle. You can take 20 grams a day and typically, you do that in four different doses. You just make 5 grams four times a day to get 20 grams. You load the muscle for five days. Essentially, that just saturates the muscle with creatine.

 

We also know, Harris for example, seminal studies looking at creatine supplementation and Paul Greenhaff showed that if you take a lower dose of creatine by just a little bit longer period of time, you can also saturate the muscle with creatine. Both those strategies are effective to enhance creatine levels within the muscle. They'll be equally effective at the end of the day.

 

[00:21:25] LB: Yeah. I think that's an important point is there are several ways in which you can achieve the result. I guess, the main question you have to ask yourself in order to determine which of those is relevant is how quickly that process happens. Maybe you could talk about that. Take us through that situation.

 

[00:21:44] SF: Yeah, absolutely. If your goal is to increase performance in a week, for example, then perhaps, you'd want to load your muscles with as much creatine as possible, so perform that 20 grams a day. If you're just looking for general health and you're just interested in increasing your performance, maybe beyond 30 days, then just doing the lower doses is perfectly fine and sufficient. It comes down to I guess, context or relevance to the individual and what their goals are.

 

[00:22:20] LB: Just to add a layer of complexity then, because since we've already mentioned there is a difference between someone whose habitual diet, or lifestyle, if you like, has led them down the path of not eating animal-sourced protein for example, what are the implications of that, on this process of do I take an acute learning protocol, or do I just go about it the other way? 

 

From your perspective, bearing in mind that it's not just a lifestyle choice. There might be religious reasons. There might be practical reasons why someone is not eating those types of foods, what are the things that you think that we need to be thinking about as sports nutritionists, or sports scientists that are considering using this and need to be aware of this factor in their decision-making?

 

[00:23:17] SF: Yeah, definitely. If you're suggesting that somebody takes a supplement, for example, it'd be nice to know where that supplement came from, first of all. There are plant-based companies that sell creatine. If somebody is a vegan or a vegetarian, there's a plant-based sources of creatine that they've extracted and they put into a supplement. That's one possibility to yeah, basically just from an ethical, moral or whatever reason that they're choosing to be vegetarian, or vegan, then you can provide them a supplement.

 

The other thing to be aware of though with supplements is that there's obviously some risk of contamination. They are regulated, but they’re not regulated to the same degree as medicine, or things of that nature. Typically, you'd want to find a product that you can trust ultimately. Whether it's MSF certified, or trusted in sport, or has some third-party independent testing, to basically show that the product is what the product says it is.

 

[00:24:23] LB: Yeah. That's just critical, obviously, for the elite professional tested athletes that goes with any supplement is always make sure they're batch tested and all that stuff. I mentioned that with my guests many a time, so that's just a given. We'll put a link, actually in the show notes. We're going to have show notes, by the way, folks. Do come back to the podcast website, so you can get access to all of these things that we're talking about, including the papers we're discussing.

 

Let me just circle back a bit, because yes, I think you've made it clear that the great thing about this conversation is even if you are a vegan, or vegetarian, or for whatever reason you don't want to eat meat and you're going, “Look, this is all very interesting, guys. But I’m not going to eat this stuff, because it comes from animals.” No, you don't have to, because it is possible to get this from non-animal sources. That's the great thing.

 

Also, you mentioned that there are sources that are contaminated. Of course, like in anything nowadays, you can buy supplements from anywhere. Am I right in saying that there is a particular part of the world which tends to be the place that creatine comes from, where it is made at a much higher standard that is very likely to be contaminant-free as opposed to other places? Maybe you could just give us a bit of background on that when we're looking for our creatine supplements.

 

[00:25:52] SF: I’m actually not too sure about that. Are you suggesting that Canada is the safest place to get creatine?

 

[00:25:57] LB: I’m too much of a grey area in that question. I’m merely pointing out that for example, the bulk of the creatine that is used in research, for example, and is deemed to be the highest quality source of that comes from Germany, doesn't it?

 

[00:26:15] SF: Yeah, Creapure. That's what we use in most of our studies. Again, just because it's yeah, independently tested and seems to be the purest form of creatine out there. We've just used that product for quite a few of our studies and a lot of other creatine researchers use the same product.

 

[00:26:36] LB: Look, neither of us have got shares in Creapure or whatever. That's just the thing when it comes to creatine, unlike many other supplements, which you can get from lots of different sources and suppliers and labs and so on. The ultimate bulk, raw ingredient does tend to be Creapure, so you do want to be looking for that on the label.

 

I don't know if you know the answer to this question, but if you do, it'd be great to share with us why that might be relevant, because I know some other sources of creatine and we can tie this into the different types of creatine as well. It's not just creatine monohydrate, is it? The purity and the types, why is this conversation relevant?

 

[00:27:16] SF: Yeah. The different types of creatine might have different levels of creatine in them. We know creatine monohydrate has been the most studied form of creatine. We know that it's really effective. We know that it's safe and it's also cheap as well. It's one of the cheapest forms of creatine that you can buy if you go to a supplement store. It's been a common question as well, so are different forms of creatine superior or better? The research is pretty clear that no other form of creatine is actually better than creatine monohydrate.

 

One of the reasons for that is that creatine-monohydrate is absorbed almost completely, about 99% of it's absorbed and taken up. Even if you can find something to enhance the absorption of creatine, it's not going to have a big impact relative to creatine monohydrate.

 

[00:28:14] LB: Yeah. Let's just really get into that, because it is an interesting area. Of course, you've got various manufacturers will have you believe that their special format of creatine, which you've mentioned, there are variations on this, but really, only creatine monohydrate is the one you want to take, because as you said, it's basically the cheapest anyway, so why would you go for the other things?

 

The creatine monohydrate is ultra-effective as is. As is though, is it as good in a capsule, just as powder, do you take it on its own? Can you bind it in your protein shake? Or what about hot and cold drinks? I know there's some interest there too. Tell us about that.

 

[00:28:58] SF: Yeah. That's another common question as well, so what form do you get and things like that. Typically, most the research is done on creatine monohydrate powder. With that, you just mix it with water. It depends on the temperature of the water, how easily it mixes actually. If you have room temperature water, you can mix about 14 grams of creatine monohydrate in a litre of water. That's something to be considered.

 

Most people supplement with 5 grams. To do that, you would have to mix it with about 350 millilitres of water to completely dissolve that creatine monohydrate. That's really important as well for people to understand is that you need to mix it with water and it depends on the temperature of the water, that's really going to affect whether it dissolves or not.

 

[00:29:57] LB: Yeah. That's where you find if it's in an ice-cold glass of water, you're going to find some of the crystals are still in the bottom of the glass after you've slugged it. You just need to be mindful of that. It's still going to work though, isn't it? Even if it's in a cold drink, which many of us will have from time to time and we knock that back. Even if we do manage to make sure that we swish it around a bit and make sure we've got those last bits at the end, it's still going to work though, right?

 

[00:30:26] SF: Yeah, it will still work, but it might not work as effectively. Just something to be aware of. Then again, if it's left at the bottom of your shake, then if you're not ingesting it, then of course, it's not going to work in that situation. A lot of the original studies actually mix creatine with hot tea. That was a really effective way to dissolve creatine and to ingest creatine.

 

[00:30:51] LB: It doesn't ruin the tea, or the hot coffee, or the hot drink. It's pretty tasteless, isn't it?

 

[00:30:57] SF: Absolutely. Yeah, creatine tastes like nothing. Whenever people try creatine for the first time, they're usually surprised like, this doesn't taste like anything — I know.

 

[00:31:08] LB: If you're like me, you're a real coffee snob. I mean, putting milk in my coffee is the best way to ruin a coffee, as far as I’m concerned. I’m a Frenchman, so that's basically how that works. I have actually, in one of my crazy lockdown experiments, put some creatine in my coffee and I couldn't tell the difference. I can vouch for that, for those of you that are looking to experiment. I guess, that's one thing that is good for researchers, because when you give product supplements to your participants, that can be an issue, can't it? I guess, that's a major pro when it comes to creatine.

 

[00:31:48] SF: For sure. Yeah. Yeah, if it tastes bad, then that's not going to be a viable product. For example, beetroot juice.

 

[00:31:58] LB: Oh, yeah. It’s horrible.

 

[00:32:00] SF: It's a very effective supplement and Andy Jones has shown clearly that it's beneficial for a lot of reasons. I don't think it will ever truly catch on, because it just tastes awful.

 

[00:32:11] LB: Joking aside, I think this is an important factor. It's not just us having a pleasant conversation about how much it doesn't impact taste. That is an important factor when it comes to compliance. I’ve worked with a lot of athletes over the years and I can think of lots of reasons why an athlete won't take something, including the colour of the bottle, of the drink, sports drink that they're taking, they just don't like the look of the bottle, they won't take it. I mean, it's amazing. That is of course, football players, as in soccer players.

 

When it comes to creatine, it's something that you can get in a 110 different ways and it's not going to be an issue. I think given, and we'll dig even deeper into this, but given just how useful creatine potentially is, the fact that there's almost no barrier to how you can take it is a major plus for it, which is why it's for me, it's one of the essential things I would have in my toolbox of supplements, of food supplements, ergogenic aids, etc.

 

Scott, we briefly mentioned, or you briefly mentioned 5 grams. Let let's just talk about dosing. When you go back to my analogy of you take your steroid and it has an impact, or you take your painkiller and it has an impact, that's where you start also needing to go into the fact that it is a dose-dependent situation, because the dose does matter. The dose is influenced by a number of factors to include the size of the person, but also, where we were just coming from that conversation about the fact that an individual's habitual diet may not have much creatine in it in the first place, which course, changes the baseline, if you like.

 

Let's look at this from several perspectives then. Number one, how much is a dose that needs to be effective? I know you talked about cycling, but you can come back to that as well. Also, what about that perspective of varying baselines and the size and age and even gender of an individual? What are all those different things that can impact that dose?

 

[00:34:16] SF: Yeah. Most of the individuals lose about 2 grams of creatine a day. It's broken down into creatinine. You need to replace that. There's been studies, for example, the seminal study by Harris, for example, and Paul Greenhaff that showed that if you take 3 grams a day for 28 days, you can saturate muscle creatine content.

 

Most people take 5 grams a day, just out of simplicity and to ensure that they're getting enough creatine. That's usually the most common dosing strategy is just 5 grams a day and you'll be perfectly fine. It's also, again from a perspective of trying to give that information to your athletes is telling them to take 5 grams is a simple number to remember. We know that that's very effective.

 

In a lot of our research, we actually give 0.1 grams per kilogram of body weight per day. That just might control for if somebody has more muscles, a bigger person, then they might need a little bit more creatine than a smaller person. That's our relative dosing strategy. No one's actually ever looked at taking a relative dose versus an absolute dose and whether that actually impacts performance, or bone health, or cognitive function any differently. That's maybe one area of research that needs to be done.

 

[00:35:51] LB: It's amazing when you think how many studies have been done with creatine. There's still more questions than answers. That's what I love about all of this.

 

[00:35:59] SF: Yeah, absolutely. There’s those two strategies. One is if you're really concerned if somebody's really big, maybe take 0.1 grams per kilogram per day. For the general public and for most individuals, just taking 5 grams a day will be perfectly fine.

 

[00:36:15] LB: Should an important take home from that conversation be then that the dose is critical, or at least consuming enough is critical, relative to too much? What's the situation with that one?

 

[00:36:31] SF: Basically, if you consume too much creatine, you're just going to excrete that. Some people think that it's going to be damaging to your kidneys and liver, but the evidence for that is pretty strong that it does not do any damage to your kidneys and liver, similar to a high-protein diet. I know Stu Phillips has been a proponent of high-protein diets and that's really effective for enhancing a lot of different health-related things.

 

A lot of people will say that it's bad for your kidneys and liver. He's clearly showing that it's not. Similarly, with creatine, it's not bad for your kidneys and liver. You're just going to essentially waste your money, because you're just not utilising that product and you're just not absorbing it into your muscles.

 

[00:37:20] LB: It's so cheap, that it's fun to be throwing the pound notes, or dollar notes up in the air metaphorically, because there’s not really a risk, one way or the other. The cost of benefit of that situation is you're better off with it than without, so don't worry. Just make sure you don't under-dose, is that what you would suggest?

 

[00:37:40] SF: Absolutely. Yeah. That's why perhaps, if you only lose 2 grams a day, in theory you should only need 2 grams a day to replace, but that's why we suggest 5 grams a day. Basically, you can err on the high side and there's no real risk of that, versus consuming too little.

 

[00:37:59] LB: Right. For the folks out there that they dip their scoop into the bag and they literally look at that spoon under a microscope to see whether it's completely packed full, or they start getting anxiety because it's three grains under a full dose, it's not going to be a big problem, is it?

 

[00:38:17] SF: No. That's not required.

 

[00:38:20] LB: Thank you. One of the things I was going to get into is the safety profile of creatine, which as you pointed out is in healthy, normal healthy people, there's zero evidence of any relevance. That's just a knock that one dead scenario. What about the other side effects? Some of which are good, some of which are potentially not so good from a strategic perspective. I guess, the first one I would go down in that conversation would be the concern that some people have with the idea that supplementation in creatine often, allegedly, often will lead to water retention. What's going on there and why do people even think that's a concern? Is there some truth to that and where is that a problem and where could that be an advantage, you think?

 

[00:39:12] SF: Yeah, so that's one of the most common side effects with creatine is a little bit of weight gain and water retention. That tends to happen typically in that loading phase. If you take 20 grams a day for the first five days, there's some evidence to show that you increase both total body water and intracellular water. Creatine is going to affect the osmolarity. The way that it actually transports into the muscle is through a sodium-dependent transporter.

 

If you bring sodium into the muscle cell, it actually brings water with it. We know that as that's one of the mechanisms, whereby creatine functions and how it actually works. There's actually been quite a few longer-term studies, where they look at total body water and it actually doesn't change as much as people think it does.

 

Actually, there's a recent study and one of the co-authors was Brad Schoenfeld. I know you've worked with him, or chatted with him before. He actually showed that individuals gained muscle and they also increased their intracellular water, but that was correlated with each other. Those that gained more muscle also gained more intracellular water.

 

There's also been some research by Mark Tarnopolsky, who's a Canadian researcher from McMaster University. He's done a lot of research looking at creatine from a clinical perspective. He actually showed that increase in water content within the muscle actually stimulates a bunch of molecular events within the muscle that lead to muscle growth. Increasing things like myogenic regulatory factors and that leads to satellite cell and increased myonucleic, things that.

 

That's actually a good thing to increase water content within the muscle. People are always worried about that, or they think it's just a benign thing that, “Oh, now I took creatine, I have all this water weight.” It's actually, that's going to be stimulating muscle growth.

 

[00:41:27] LB: Speaking of muscle growth, look, it doesn't matter what conversation you're intending to have about creatine, the intersection, all these conversations will come to at some point is the fact that it has an impact, a positive impact on muscle growth and muscle strength. Going back to muscle growth in particular, is creatine an anabolic steroid, or – I know that's an answer in itself. Or if it's not an anabolic steroid, well, how does it work anyway? Just does taking it make your muscles grow? What was the physiology behind that?

 

[00:42:06] SF: Yeah. It's definitely not an anabolic steroid, but it does have anabolic properties. It does stimulate muscle growth. Actually, the way that creatine works is through – there's a whole bunch of different mechanisms. It's not just by increasing the amount of phosphocreatine within the muscle, which would increase the capacity for the muscle to basically, perform and support that high-intensity exercise.

 

Creatine does other things as well. It actually brings in glycogen to the muscle, which could be a benefit, especially for endurance athletes, or athletes that are trying to increase glycogen re-synthesis as quickly as possible. Creatine also works through IGF-1, it affects intracellular water content and influences myogenic regulatory factors. It also has been shown to inhibit myostatin, which is a inhibitor of muscle growth. Creatine works through a whole bunch of different pathways besides just increasing phospho-creatine, which is pretty exciting from my standpoint. For individuals to understand is that it can impact muscle in a variety of ways that can ultimately lead to muscle growth.

 

We've done a few meta-analysis now that show that if you combine creatine with resistance exercise, so that's an important point as well, because we've done studies where we've just given creatine and people don't get bigger muscles. If you combine it with resistance exercise, they get bigger and stronger muscles compared to if they just performed resistance training with a placebo.

 

[00:43:48] LB: Yeah. Creatine, I guess the way you look at that is it's the ultimate dance partner, isn't it, to exercise. You can lift, you can do your various forms of resistance training and just through that process alone, we know you'll get a good result. As you've already pointed out, if you're not necessarily getting enough creatine in your diet, then the creatine can make a pretty noticeable difference in that situation. I guess, it's that correlation between exercise and the consumption, one way or the other, of an optimal amount of creatine that's going to have your best bang for your buck, right?

 

[00:44:32] SF: Absolutely. I actually had somebody the other day, I told them they should be taking creatine. He said, “Well then, I’m going to have to start exercising.” I was like, “What? You're not exercising? That's a mandatory thing in life that you have to exercise.” I was also pretty surprised that he put that correlation together that you have to exercise when you're consuming creatine to get the best benefits.

 

[00:44:59] LB: Yeah. Well, that's going to be another chat we'll get into in a minute, because there are reasons to take creatine, even if you're not going to exercise. We'll come back to that in a minute, because as you said, exercise is such an important thing. There aren't many panaceas out there, but exercise is going to be one of them. Hence, exercise is medicine. That big movement is so powerful.

 

Look, and I will tread softly when I go into this particular topic, but talking of correlations, I’ve spoken to Darren, yourself, Craig Sale, Eric Rawson and a number of others, even Roger Harris. I have noticed, there's been a certain degree of follicly challenged researchers involved in this. Since we danced around the idea that creatine, is it an anabolic steroid? Does it have an impact on your anabolic processes, like testosterone or whatever? That leads some people to be worried about whether or not creatine will actually cause hair loss, or contribute somehow to baldness. It is a genuine concern for some people, which is why I find it funny that some of the world's leading researchers in this topic happen to have not a lot of hair. Is this a myth? Is there some reality there? What was going on there?

 

[00:46:24] SF: Yeah. There's one study that was done in rugby players actually, where they showed that there is an increased conversion of testosterone to dihydrotestosterone, or DHT. DHT has been linked to male pattern baldness. That's basically where that myth started from was that there's this one study that showed in the creatine group there was a greater increase in EHT and DHT has been linked to male pattern baldness.

 

No study has actually looked at hair loss per se. There's actually a researcher, Grant Tinsley from the US that he's registered a clinical trial to actually examine the impact of creatine on hair loss. We'll have a truly evidence-based answer. The limitation with that study in rugby players was that the hormonal levels all stayed within normal ranges, so it's hard to really with confidence, basically, say that DHT levels truly changed with creatine, or was it just normal biological variation.

 

[00:47:35] LB: Yeah. I mean, the process of conducting research, the knowledge that comes from that process and the ways in which that information is translated and then transformed into words on paper. I mean, that's a complex process. We talk about it a lot on this podcast. Of course, there are a lot of issues with that process as we all know, but we won’t stay on that one. Look, there’s loads of pros to taking creatine and we’ll cover some more in a minute.

 

You've always got to look at the cost of benefit of things. You can, but should you is my catchphrase for this thing. What are the cost of benefits of taking it? By being aware of the strengths and limitations of these choices will enable you to make better informed decisions as a practitioner, or a user, or a researcher, or whatever. Another area of concern that some people have had with creatine is the perceived idea, whether or not it's reality you can help us understand, but this idea that it might lead to dehydration and muscle cramping. Why is there speculation on this and is there any actual facts to that?

 

[00:48:51] SF: Yeah. That was actually a really interesting area to research, because there's a lot of people out there saying that creatine does cause muscle cramps and dehydration. We've already talked about the impact of creatine bringing water into the muscle. That's the complete opposite of dehydration. What they thought was if that water got into the muscle, it's essentially stuck in the muscle and then you would have less extra cellular water. If you tried to exercise in the heat, or did some strenuous exercise, that perhaps would cause some sweating and dehydration, then that water that's stuck in the muscle wouldn't be able to come out and essentially help and it might actually be bad to exercise, either in a hot environment, or do strenuous exercise with creatine.

 

There's been some great research by Rick Kreider that's actually, they followed football players over an entire season and they looked at who got muscle cramps and heat illnesses and things of that nature. They actually showed the complete opposite, that creatine prevented muscle cramps, the opposite from a dehydration perspective.

 

[00:50:12] LB: Yeah, it's fascinating. There's an obsession with weight loss and weight gain, of course. I guess, from several perspectives, I can think of it's relevant, because number one, in your average, general population, the perspective, or the implications of gaining weight or losing weight can induce some severe anxiety and some behavioural repercussions of that can be quite severe for some people, including even leading to depression and ironically, then overeating, or downing a bottle of wine or something to compensate. When actually, they didn't understand that there's a difference between weight gain and fat gain.

 

If someone's going to gain weight, I know you've already mentioned this, but if they're gaining weight and they're going to correlate that with I’ve increased my fat mass, is that even possible? Because that is something that I know practitioners working in the trenches with clients, particularly in the general population, but I’ve definitely had athletes, you'd like to think they're more aware, but the minute they see those numbers go up on the scales, it's like, “Holy shit. I’ve gained weight and you're the nutritionist and you gave me bad advice. Of course, it's not my fault as the client. It's all yours.” So that we're armed with the right knowledge and response to that, is creatine going to be a suspect in that situation?

 

[00:51:41] SF: It will cause you to gain weight, that's typically about 1 to 3 kilograms. It's due to an increase in muscle mass. It will not increase fat mass. There's actually some really interesting research in rats that shows that if you actually block the creatine transporter at adipose sites, it reduces whole body energy expenditure. They're actually suggesting that if you take creatine, or supplement with creatine, you can increase energy expenditure. Based off energy balance, if you can increase energy output or energy expenditure, that will actually help with losing fat mass.

 

We read some of that research and we're pretty interested in it. We actually did a systematic review in older adults and we looked at all the individuals that took creatine and performed resistance training, versus those that just performed resistance training. We already had all the data for the lean body mass to show that they can increase muscle mass. We're like, “Well, let's just extract all the fat mass data.” When we did that, those that took creatine, their percent body fat significantly were reduced and they lost about a 0.5 kilograms more fat mass when they took creatine, compared to when they took a placebo.

 

Creatine not only helps you gain lean body mass, but it potentially helps you lose fat mass. Not a massive amount, but at least it's heading in the right direction. That's usually when I talk to individuals that are on the fence and worried about weight gain. I ask them, do you want to increase lean body mass and lose fat mass? They're usually like, “Yes, I do.” Then creatine's the supplement for you.

 

[00:53:36] LB: Yeah. That's a perfect segue in this conversation. You had mentioned older individuals that you did some of your studies in. I guess, that's a really interesting area on the conversations that I have with researchers about protein needs in older individuals, sarcopenia, older athletes, that sort of thing. It's very interesting to see how their needs change.

 

Is this something that is also the case for creatine? I’m thinking about my own father. For example, the implications of maybe not eating as much. Even if in a masters level athlete who might be eating enough, is there a reason for them to also be factoring in creatine?

 

[00:54:23] SF: Yeah, absolutely. There's huge amount of research in that particular area to show that creatine is effective at increasing muscle mass. Phil Chilibeck and Darren Candow, they recently – or in 2017, I’d say that's recently, completed a meta-analysis with over 700 participants that were in the meta-analysis. They showed that those that took creatine and performed resistance training, they actually gained 1.37 more kilograms of muscle mass, compared to if you just performed resistance training. It's very effective. Then we've also shown that it also improves sit to stand as well, which is a surrogate marker of falls risk. Potentially, if you took creatine, you could reduce your risk of falling.

 

[00:55:13] LB: That could be a game-changer for the older population, which makes it – I mean, we're now exploding the concept that it is only for resistance and power type activities. Since you're teasing us with the benefits that creatine can have with older individuals, I mean, why else might I want to consider, or would a listener, or a member of listener’s family want to consider taking creatine? What are some of the other areas you think are relevant in this conversation?

 

[00:55:45] SF: Yeah. A lot of people take creatine to enhance muscle mass and strength. People thought it was just for bodybuilders. We know now it's really effective for a variety of populations from perhaps, even younger, although there's a limited evidence to show real effectiveness in younger individuals. There's not nearly as much data in children, or adolescents as there is in an adult population. There is potentially some benefit to younger children, or adolescents.

 

[00:56:21] LB: It's safe for them, isn't it? It's safe for the young athletes.

 

[00:56:26] SF: Yeah. I’m slightly hesitant to say that it's truly safe, because there's actually been no study to – that's with a primary focus to look at safety in children or adolescents. There's definitely been studies done in children and adolescents and they haven't shown any harm of it. With the limited evidence that we have, it does seem to be safe for children, or adolescents.

 

Then creatine could be a benefit for endurance athletes as well. Again, increasing glycogen into the muscle is a benefit for endurance athletes. That's well-known that carbohydrates can enhance endurance performance and glycogen is an important substrate for enhancing endurance performance. Louise Burke, for example, did a study in elite cyclists looking at a 120 kilometre time trials. They loaded with either carbohydrates, or carbohydrates and creatine. They showed that their performance at the end of the race was better when they took creatine, which was pretty cool. It could be a benefit for endurance athletes as well.

 

[00:57:38] LB: Also, because I have a particular interest in nutrition for endurance, or ultra-endurance athletes. Also, where athletes are engaged in high volumes of training, but particularly in a competition event, like a multi-day event, or you think cyclists out there for days on end like in Tour de France, or whatever, their caloric intake, or particularly their protein intake might not be something that they're heading on a day-to-day basis in that short period of time, but the creatine can play a useful role in ameliorating the loss of muscle – muscle loss, or muscle damage. Is that true as well?

 

[00:58:20] SF: Absolutely. Yeah. That's potentially some other benefits to it that it can enhance recovery. Yeah, reduce the amount of inflammation or muscle damage. There's one particular study where they looked at muscle damage following a marathon. Those that took creatine had less muscle damage, so there's some pretty cool evidence for that. Actually, I did my PhD at the University of Alberta. In one of the labs beside me, Ted Potman did some research looking at creatine in rats that were doing chronic low-frequency stimulation. Essentially, what they did was they would zap these rats and cause a muscle contraction and they did that for a 12-hour period. 12 hours a day they were doing this low-frequency stimulation. To me, that's extreme endurance training.

 

If you can endurance train 12 hours a day, that'd be nuts. That's essentially what they're making these rats do. They took muscle biopsies, so they took the muscle out of the rats and they showed that with the chronic low-frequency stimulation, their aerobic capacity improved, which makes sense. You do endurance training, you're going to improve. Those that took creatine, they preserved their fast-twitch properties.

 

To me as an endurance athlete, that's pretty cool that if I’m doing endurance training, perhaps I can improve my aerobic potential, but I’m also going to maintain, if I took creatine, maintain my fast-twitch properties as well, which would be important for bursts of activity in a race, or sprinting at the end and winning the race. That could be of benefit.

 

[01:00:09] LB: Absolutely. Well, that's an important point you make is that when you look at endurance events, particularly multi-day endurance events, you see a lot of these athletes keeping up with each other. It's only when you get things like hill climbs, sprint, sprint finishes, that's what separates the men from the boys, so to speak, isn't it? That's going to be your ability to unleash the fast twitch action, isn't it? Often, historically avoided by endurance athletes.

 

When it comes to periodising your training with your athlete, clearly, they should not be ignoring the potential role for creatine. Would you say that would be in season, out of season depending on what they're trying to achieve with their training, perhaps?

 

[01:00:58] SF: Yeah, absolutely. There's lots of context, I guess, associated with creatine. There's actually some evidence that if you took creatine and you gain water weight because of that, or you gain weight, that could actually be of detriment to running performance. You need to take a lot of things into consideration. If you're doing a 100-kilometre race and you weigh an extra 3 kilograms, is that actually going to help your performance at the end of the day, or not? There's lots of things to take into consideration with creatine and what race you're doing, how many hills there are, how do you personally respond to creatine, things like that.

 

[01:01:44] LB: That's why I like to drum home the need to understand what tools are in your toolbox, the strengths, the limitations, think about the bigger picture and hence, why I like to say, you can in this case, take creatine, but should you? Probably yes. Just think about it. If you can't answer the question, then you don't understand the situation sufficiently. Therefore, go back and read the studies and listen to podcasts like this and then go back and re-ask the question and see if you can actually answer it this time.

 

Particularly with the potential to gain weight, that's a really fascinating conversation when you hear experts like Lewis James, for example, at Loughborough University here in the UK, where they talk about we need to think about how obsessive we get with our hydration strategies, because all that extra fluid that we're drinking may increase the weight which has implications for performance, also increases risk of injury. Also, you might need to stop and have a pee somewhere. What's the situation there? Just think. Just think.

 

That's the problem we have with good science involves a high degree of reductionism. That doesn't mean we want to keep the reductionism in our thinking processes and how we're actually going to apply this stuff into the real world. The real world does not operate on reductionism, believe me. You've really helped us on that one.

 

In the same way that creatine tends to be something that people associate with muscles and strength and power, we also tend to associate it with men. Well, is it only men? What about women? What are the implications for women who historically have shied away, even from taking their protein intake seriously, because of fear of increase in muscle mass, other than potentially female bodybuilders, where they might be trying to do that? Why should women consider creatine or not? Is there anything you wanted to add into that conversation as it relates to females and creatine?

 

[01:03:48] SF: Yeah. There hasn't been a lot of studies that have truly compared males to females with regards to responsiveness to creatine supplementation. There's definitely a lot of evidence to show that creatine can be effective in a female population, including post-menopausal women. Darren Candow has done quite a few studies with Phil Chilibeck in that regard, to show that it can enhance muscle mass, strength, but also bone health in that particular population.

 

Yeah, there's a lot of evidence to show that it definitely can be effective. I think more science needs to look at sex-based differences and the implications of that. On the whole right now, I would suggest that it is effective for females. Again, hopefully with some of that evidence that it can increase muscle mass, but also help you lose fat mass. Maybe creatine will become more important from a female perspective. Then also, there's some evidence that for example, if you take creatine when you're pregnant, there's some potential benefits to the baby. Things like that are also emerging areas of research to show that creatine is not only for males or for bodybuilders, but it's also for females as well.

 

[01:05:05] LB: Yeah. It is fascinating. In the same way, I was left with that feeling from my conversations with Professor Rawson, Professor Candow, Professor Sale, likewise with you, it's amazing that we can keep talking about creatine and still make these conversations last as long as they do. We've pretty much run out of time here. There was just a couple of things I wanted to delve into with you since this is some areas that you are involved with in your own research currently.

 

The one question I didn't ask you which I’d love to quickly chat about is what about when we take creatine? You've talked about dosing. You've talked about that acute loading phase and so on, but what about before training, after training, between sets? I’ve seen people do these things. What are your thoughts on that and what have you seen in the research thus far?

 

[01:05:59] SF: Yeah. There's been three published studies looking at the effects of creatine before training versus after training. All three show a very slight advantage to after training. We actually put those three studies together into a meta-analysis. When you put those three studies together, it actually shows that creatine after was superior and creatine before. There's only three studies. It's pretty small and it's hard to have strong evidence from those studies, because there's a lot of variability between those studies.

 

I got criticised a lot for including them into a meta-analysis. People were like, “What? You can't do that,” because it included younger individuals and older individuals and different dosing strategies and things like that. A problem with those studies or a limitation, I should say, for those studies is that the use of a between subject design. For example, you would train for a certain period of time, let's say 10 weeks with creatine before training. I would train for 10 weeks with creatine and I would get creatine after training and we'd see how big and strong our muscles got.

 

The after group got a little bit bigger and stronger. Is that just because we have different genetics, different sleep patterns, different protein intake, all those things that can affect muscle adaptations. We're just finished within subject design. What I did was I made my participants, they trained one side of their body one day and they got either creatine before training or after training. Then they strength train their other side of their body the next day and got the opposite. If they got creatine before training on their right side, they got creatine after training on their left side. We looked at muscle mass changes and strength changes between the right and left sides. When we did that, there's absolutely no difference between before or after training.

 

Right now, I suggest that it actually doesn't matter if you consume it before training, or after training. We've also just published a study in collaboration with Dr. Darren Candow and the student was Scottie Mills, who ran the study. We looked at creatine during training. That is also a very effective strategy. Essentially, after each set, you just take a sip and that also work to enhance muscle mass and strength gains over a training period. The answer to timing, I would suggest to take it close to your training, but it doesn't matter if you take it before training, during training, or after training.

 

[01:08:39] LB: Yeah. If we reduce that to the most basic view of it, I guess, the most important feature is taking it, period. That's the most important thing, because everything else is it has varying levels of importance, or relevance, but ultimately, the huge percentage of that's going to be just taking it on a daily basis, or the variations that you discussed at the beginning.

 

[01:09:05] LB: Absolutely. When we first got those results to show that there was no difference between before and after, at first we're like, “Oh, man. That sucks.” As researchers, you're always looking for that [inaudible] than 0.05. When I thought about it for a couple minutes, I was basically like, this is probably a good thing, because now people can take creatine whenever they want and get the benefits from it. It's actually from a practical standpoint. It's a pretty cool study, I think.

 

[01:09:37] LB: Yeah, absolutely. Speaking of practical, I wanted to end on a science to practice type perspective. I know that you published, recently a review on some practical strategies for creatine usage in MMA athletes, which is always interesting with athletes, the nature of how they fight, how they compete, how they prepare, make weight and so on. We'll put links to all of this in the show notes. Everyone listening, you've got to come to our website, which I’ll refer to at the end of this podcast to read all these things. Scott, tell us about the practical aspects in the context of MMA athletes.

 

[01:10:18] SF: First, I should mention that Tony Ricci was the lead author on that particular paper. Myself was on there and then Dr. Darren Candow. Tony Ricci is involved with elite MMA athletes and has a renowned practical experience working with them. Me and Darren are just the creatine nerds on the paper.

 

[01:10:42] LB: Creatine nerds.

 

[01:10:44] SF: Yeah. It was a really cool paper to get together and to write, because there's a great interest to me to look at what are the practical strategies to implement creatine into fighters, because things that you need to take into consideration is weight gain, for example. Looking at creatine, it could be effective not only to enhance muscle and performance for fighters, but it could also be effective to enhance their cognition and perhaps, could also be protective for their brain as well.

 

Eric Rawson has been involved looking at creatine for brain health and there's some evidence, at least in rats that shows that if you take creatine and performs, or cause some traumatic brain injury, that it could be effective in rats. Then in humans, there's been some studies where they've done creatine with hypoxia. They've shown that if you take creatine that you get a low amount of oxygen, that your cognitive function doesn't go down nearly as much as you would predict with just a low amount of oxygen.

 

There seems to be some protective effects for the brain and we tried to translate that into a practical paper for people to essentially read, and what type of creatine, when to take it, how much to take it, what about during weight cuts, things like that. That was a pretty cool paper.

 

[01:12:16] LB: Yeah. Well, I highly recommend it. I think your dog's recommending it too. Listen, look, clearly, we could talk for much longer about this, but there has to be a limit to how much we can get into. I’d like to thank you on behalf of myself and the listeners for your time today, Scott. 

 

It’s been fascinating to talk to you and share your knowledge and experience on creatine, which absolutely adds to the discussions I’ve had with Professor Candow and Professor Rawson, Professor Craig Sale and so on. I’ve got a nice little collection of discussions. No doubt, I’ll enjoy talking to you in the future. If people want to follow you and what you're doing, I will put links and so on into the show notes, but just tell us now if you're on Twitter, or Instagram, or Research Gate. What are the areas that you tend to be most active with when it comes to sharing stuff publicly?

 

[01:13:12] SF: Mostly on Instagram. @Scott_Forbes_PhD. Yeah, I respond to a lot of people on Instagram, so that's usually my main form of either giving out my current research, or talking about my current research and posting that, or answering questions.

 

[01:13:30] LB: Yeah. Well, that's awesome. I’ll be sure to link to all of that and have them read your work and the other things that we've talked about. As I said, all the links will be in the show notes, which you can find via our website at www.theiopn.com and just look for our podcast and everything will be sign-posted from there.

 

Once again, thank you, Scott, for your time. It's been awesome. I’ve really enjoyed it. I of course, am Laurent Bannock, and I look forward to bringing another episode of We Do Science back to you all very soon. Take care, everyone.

 

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