Kerksick, Chad M

Creatine is one of the most studied and popular ergogenic aids for athletes and recreational weightlifters seeking to improve sport and exercise performance, augment exercise training adaptations, and mitigate recovery time. Studies consistently reveal that creatine supplementation exerts positive ergogenic effects on single and multiple bouts of short-duration, high-intensity exercise activities, in addition to potentiating exercise training adaptations. In this respect, supplementation consistently demonstrates the ability to enlarge the pool of intracellular creatine, leading to an amplification of the cell’s ability to resynthesize adenosine triphosphate. This intracellular expansion is associated with several performance outcomes, including increases in maximal strength (low-speed strength), maximal work output, power production (high-speed strength), sprint performance, and fat-free mass. Additionally, creatine supplementation may speed up recovery time between bouts of intense exercise by mitigating muscle damage and promoting the faster recovery of lost force-production potential. Conversely, contradictory findings exist in the literature regarding the potential ergogenic benefits of creatine during intermittent and continuous endurance-type exercise, as well as in those athletic tasks where an increase in body mass may hinder enhanced performance. The purpose of this review was to summarize the existing literature surrounding the efficacy of creatine supplementation on exercise and sports performance, along with recovery factors in healthy populations.

Energy needs of female team-sport athletes are poorly understood with no evidence highlighting differences present between scheduled activities. The purpose of this study was to examine the difference in energy expenditure between NCAA Division II female basketball (BBALL) and lacrosse (LAX) athletes during different scheduled team activities. Female BBALL (n = 13; 19.8 ± 1.3 yrs; 173.9 ± 13.6 cm; 74.6 ± 9.1kg; 27.1 ± 3.2%fat) and LAX (n = 20; 20.4 ± 1.8yrs; 168.4 ± 6.6cm; 68.8 ± 8.9kg; 27.9 ± 3.1%fat) athletes were outfitted with heart rate and activity monitors during four consecutive days on five different occasions (20 days total) across an entire academic year to assess differences in total daily activity energy expenditure (TDEE), activity energy expenditure (AEE), and physical activity level (PAL). Data were categorized by type of scheduled daily activities: Practice, Game, Conditioning, or Off. Independent of day type, TDEE, AEE, and PAL levels were greater (p < 0.05) in BBALL athletes. For each sport, TDEE, AEE, and PAL were significantly different (p < 0.05) between classified activity days. BBALL and LAX athletes experienced higher values on game days for TDEE, AEE, and PAL, with the lowest values experienced on off days. In conclusion, calculated levels of TDEE, AEE, and PAL in female collegiate BBALL and LAX athletes were determined to be different, irrespective of the scheduled activity.

Creatine is a popular ergogenic aid among athletic populations with consistent evidence indicating that creatine supplementation also continues to be commonly used among adolescent populations. In addition, the evidence base supporting the therapeutic benefits of creatine supplementation for a plethora of clinical applications in both adults and children continues to grow. Among pediatric populations, a strong rationale exists for creatine to afford therapeutic benefits pertaining to multiple neuromuscular and metabolic disorders, with preliminary evidence for other subsets of clinical populations as well. Despite the strong evidence supporting the efficacy and safety of creatine supplementation among adult populations, less is known as to whether similar physiological benefits extend to children and adolescent populations, and in particular those adolescent populations who are regularly participating in high-intensity exercise training. While limited in scope, studies involving creatine supplementation and exercise performance in adolescent athletes generally report improvements in several ergogenic outcomes with limited evidence of ergolytic properties and consistent reports indicating no adverse events associated with supplementation. The purpose of this article is to summarize the rationale, prevalence of use, performance benefits, clinical applications, and safety of creatine use in children and adolescents.

This case study examined changes in body composition, resting metabolic rate (RMR), aerobic capacity, and daily physical activity in a patient who had ulcerative colitis and underwent ileal pouch-anal anastomosis (IPAA) surgery. Body composition, RMR, and peak oxygen consumption (VO2peak) were assessed prior to surgery and four, eight, and 16 weeks after IPAA surgery. Daily physical activity data were extracted from a wrist-worn activity tracker preoperatively and 16 months postoperatively. At baseline, total body mass was 95.3 kg; body fat, 11.6%; lean body mass, 81.1 kg; RMR, 2416 kcal/d; and VO2peak, 42.7 mL/kg/min. All values decreased from baseline at four weeks postoperatively, body mass was 85.2 kg (−10.5%); body fat, 10.9% (−6.0%); lean body mass, 73.1 kg (−9.9%); RMR 2210 kcal/d (−8.5%) and VO2peak, 25.5 mL/kg/min (−40.3%). At 16 weeks postoperatively, most parameters were near their baseline levels (within 1–7%), exceptions were VO2peak, which was 20.4% below baseline, and RMR, which increased to nearly 20% above baseline. After the patient had IPAA surgery, his total and lean body masses, RMR, and aerobic capacity were markedly decreased. Daily physical activity decreased postoperatively and likely contributed to the decreased aerobic capacity, which may take longer to recover compared to body composition and RMR parameters.

Aerobic exercise and thermal stress instigate robust challenges to the immune system. Various attempts to modify or supplement the diet have been proposed to bolster the immune system responses. The purpose of this study was to identify the impact of yeast beta-glucan (Saccharomyces cerevisiae) supplementation on exercise-induced muscle damage and inflammation. Healthy, active men (29.6 ± 6.7 years, 178.1 ± 7.2 cm, 83.2 ± 11.2 kg, 49.6 ± 5.1 mL/kg/min, n = 16) and women (30.1 ± 8.9 years, 165.6 ± 4.1 cm, 66.7 ± 10.0 kg, 38.7 ± 5.8 mL/kg/min, n = 15) were randomly assigned in a double-blind and cross-over fashion to supplement for 13 days with either 250 mg/day of yeast beta-glucan (YBG) or a maltodextrin placebo (PLA). Participants arrived fasted and completed a bout of treadmill exercise at 55% peak aerobic capacity (VO2Peak) in a hot (37.2 ± 1.8 °C) and humid (45.2 ± 8.8%) environment. Prior to and 0, 2, and 72 h after completing exercise, changes in white blood cell counts, pro- and anti-inflammatory cytokines, markers of muscle damage, markers of muscle function, soreness, and profile of mood states (POMS) were assessed. In response to exercise and heat, both groups experienced significant increases in white blood cell counts, plasma creatine kinase and myoglobin, and soreness along with reductions in peak torque and total work with no between-group differences. Concentrations of serum pro-inflammatory cytokines in YBG were lower than PLA for macrophage inflammatory protein 1β (MIP-1β) (p = 0.044) and tended to be lower for interleukin 8 (IL-8) (p = 0.079), monocyte chemoattractment protein 1 (MCP-1) (p = 0.095), and tumor necrosis factor α (TNF-α) (p = 0.085). Paired samples t-tests using delta values between baseline and 72 h post-exercise revealed significant differences between groups for IL-8 (p = 0.044, 95% Confidence Interval (CI): (0.013, 0.938, d = −0.34), MCP-1 (p = 0.038, 95% CI: 0.087, 2.942, d = −0.33), and MIP-1β (p = 0.010, 95% CI: 0.13, 0.85, d = −0.33). POMS outcomes changed across time with anger scores in PLA exhibiting a sharper decline than YBG (p = 0.04). Vigor scores (p = 0.04) in YBG remained stable while scores in PLA were significantly reduced 72 h after exercise. In conclusion, a 13-day prophylactic period of supplementation with 250 mg of yeast-derived beta-glucans invoked favorable changes in cytokine markers of inflammation after completing a prolonged bout of heated treadmill exercise.

Little data is available regarding the energy and nutritional status of female collegiate team sport athletes. Twenty female NCAA Division II lacrosse athletes (mean ± SD: 20.4 ± 1.8 years; 68.8 ± 8.9 kg; 168.4 ± 6.6 cm; 27.9 ± 3% body fat) recorded dietary intake and wore a physical activity monitor over four consecutive days at five different time points (20 days total) during one academic year. Body composition, bone health, and resting metabolic rate were assessed in conjunction with wearing the monitor during off-season, pre-season, and season-play. Body fat percentage decreased slightly during the course of this study (p = 0.037). Total daily energy expenditure (TDEE) (p < 0.001) and activity energy expenditure (AEE) (p = 0.001) energy were found to change significantly over the course of the year, with pre-season training resulting in the highest energy expenditures (TDEE: 2789 ± 391 kcal/day; AEE: 1001 ± 267 kcal/day). Caloric (2124 ± 448 kcal/day), carbohydrate (3.6 ± 1.1 g/kg), and protein (1.2 ± 0.3 g/kg) intake did not change over the course of the year (p > 0.05). Athletes self-reported a moderate negative energy balance (366–719 kcal/day) and low energy availability (22.9–30.4 kcal/kg FFM) at each measurement period throughout the study. Reported caloric and macronutrient intake was low given the recorded energy expenditure and macronutrient intake recommendations for athletes. Athletic support staff should provide athletes with appropriate fueling strategies, particularly during pre-season training, to adequately meet energy demands.