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Powers Et Al. Creatine Supplementation Increases Total Body Water Without Altering Fluid Distribution
Powers Et Al. Creatine Supplementation Increases Total Body Water Without Altering Fluid Distribution
Michael E. Powers, PhD, ATC, CSCS, contributed to conception and design; acquisition and analysis and interpretation of the
data; and drafting, critical revision, and final approval of the article. Brent L. Arnold, PhD, ATC, contributed to conception and
design; analysis and interpretation of the data; and drafting, critical revision, and final approval of the article. Arthur L.
Weltman, PhD, and David H. Perrin, PhD, ATC, contributed to conception and design and drafting and final approval of the
article. Dilaawar Mistry, MD, ATC, and David M. Kahler, MD, contributed to acquisition of the data and drafting and final
approval of the article. William Kraemer, PhD, contributed to conception and design; analysis and interpretation of the data;
and drafting and final approval of the article. Jeff Volek, PhD, contributed to analysis and interpretation of the data and drafting
and final approval of the article.
Address correspondence to Michael E. Powers, PhD, ATC, CSCS, 144 FL Gym, PO Box 118205, Gainesville, FL 32611-8205.
Address e-mail to mpowers@hhp.ufl.edu.
Objective: To examine the effects of oral creatine (Cr) mono- (age 5 21.8 6 2.51 years, height 5 163.4 6 5.9 cm, body mass
hydrate supplementation on muscle Cr concentration, body 5 63.6 6 14.0 kg) involved in resistance training volunteered
mass, and total body water (TBW), extracellular water (ECW), to participate in this study.
and intracellular water (ICW) volumes. Measurements: Muscle Cr concentration was determined
Design and Setting: After an overnight fast, urinary Cr and from the vastus lateralis muscle using a percutaneous needle-
creatinine concentrations, muscle Cr concentration, body mass, biopsy technique. Total body water, ECW, and ICW volumes
TBW, ECW, and ICW were measured, and subjects were ran- were assessed using deuterium oxide and sodium bromide di-
domly assigned to either a Cr or a placebo (P) group. The Cr lution analyses.
Results: The Cr group experienced a significant increase in
group ingested 25 g/d of Cr for 7 days (loading phase) and 5
muscle Cr concentration, body mass, and TBW. The P group
g/d for the remaining 21 days (maintenance phase), whereas experienced a small but significant increase in TBW only.
the P group ingested a sucrose P using the same protocol. All Conclusions: The Cr supplementation protocol was effective
the measures were reassessed immediately after the loading for increasing muscle Cr concentrations, body mass, and TBW;
and maintenance phases. however, fluid distribution was not changed.
Subjects: Sixteen men (age 5 22.8 6 3.01 years, height 5 Key Words: ergogenic aids, hydration, fluid balance, body
179.8 6 7.1 cm, body mass 5 84.8 6 11.2 kg) and 16 women mass, body composition
C
reatine (Cr) supplementation continues to be extremely however, the only side effect directly associated with Cr sup-
popular as a potential ergogenic aid among athletes at plementation is weight gain.5–8,11,13,16–19 Some of these au-
all levels. Studies have shown that muscle Cr and phos- thors have reported increases in body mass after only a loading
phocreatine can be significantly elevated when a normal diet phase of supplementation (20–25 g/d for 5–7 days).8,11,13,16
is supplemented with Cr.1–4 The theory behind its use is sim- Thus, it is likely that the gains are due more to greater water
ilar to that of carbohydrate loading, because an increased mus- retention during supplementation than to lean-tissue accretion.
cle Cr content would conceivably enhance the capacity of the It is conceivable that increased muscle Cr concentrations are
phosphagen energy system, providing greater resistance to fa- associated with changes in the intracellular osmotic pressure,
tigue and improving performance. Anecdotal reports of ergo- resulting in movement of water into the cell, water retention,
genic value have been supported by scientifically controlled and weight gain. When water loss through sweating occurs
studies investigating its effects on strength,5–8 power,8–11 from exercise, increased environmental temperatures, or a
speed,12 and fatigue.4,13,14 However, not all the findings sup- combination of both, this intracellular fluid shift may be det-
port ergogenic claims.3,15,16 rimental. For example, the water bound inside the cell may
Numerous anecdotal reports have associated muscle cramp- not be available to the extracellular compartment for thermal
ing, spasm, strains, gastrointestinal distress, kidney dysfunc- regulation. Therefore, cramping and other heat-related prob-
tion, and heat illness with Cr supplementation. At this time, lems may result from a fluid shift occurring during supple-
Creatine
Urinary creatine (mg/dL) 14.09 6 35.62 454.09 6 290.74*† 331.26 6 272.34*†
Muscle creatine (mg/kg dm‡) 123.18 6 11.78 146.99 6 25.63*† 143.58 6 18.84*†
Body mass (kg) 75.54 6 17.67* 76.29 6 18.04* 76.86 6 18.07*†
Total body water (L) 41.98 6 11.78 43.35 6 12.19*† 44.02 6 12.37*†
Intracellular water (L) 24.44 6 7.40 25.39 6 8.03 25.57 6 8.66
Placebo
Urinary creatine (mg/dL) 8.12 6 7.52 14.22 6 48.83 6.15 6 5.98
Muscle creatine (mg/kg dm) 127.99 6 13.20 124.28 6 13.65 126.50 6 19.02
Body mass (kg) 72.94 6 15.72 73.61 6 15.92 73.28 6 16.05
Total body water (L) 41.34 6 8.93 42.21 6 9.08† 42.23 6 9.11†
Intracellular water (L) 24.00 6 5.59 24.08 6 6.19 23.70 6 7.16
*Significantly greater than placebo group (P , .05).
†Significantly greater than presupplementation (P , .05).
‡dm indicates dry mass.
0.75% daily.21 Total body water was calculated as the deute- were observed in either group for blood or urine creatinine
rium-dilution space divided by 1.04, which corrects for ex- concentrations. However, the time-by-group (F2,56 5 25.56,
change of the deuterium with nonaqueous hydrogen of body P 5 .000) and time-by-sex (F2,56 5 4.04, P 5 .023) interac-
solids.21,22 We also assessed TBW using a Xitron 4200 multi- tions for urinary Cr concentration were significant. The Cr
frequency bioelectrical impedance analyzer (Xitron Technol- group had significantly greater urinary Cr concentrations on
ogies Inc, San Diego, CA). This was performed as a backup days 7 and 28 as compared with presupplementation, whereas
measure in case we were unable to perform the dilution anal- no changes were observed in the P group (Table). Further-
ysis on the plasma samples. more, women experienced greater urinary Cr concentrations
Intracellular Water and Extracellular Water Volumes. than did men on days 7 and 28.
The ECW compartment was determined using a sodium bro-
mide dilution method.25–27 We administered each subject an
oral dose of sodium bromide (approximately 60 mg/kg of body Muscle Creatine Concentration
mass) simultaneously with the deuterium oxide solution. The Assays for Cr could not be completed for 4 subjects (2 each
same blood samples taken for the deuterium analysis were also in the Cr and P groups); thus, these subjects were not included
used for the sodium bromide analysis, with the bromide con- in the Cr analysis. The time-by-group interaction was signifi-
centration in the serum ultrafiltrate determined by high-per- cant (F2,48 5 4.75, P 5 .013): the Cr group had a greater Cr
formance liquid chromatography (Metabolic Solutions, Inc). concentration on days 7 and 28 as compared with presupple-
Because of the extreme sensitivity of this method, small quan- mentation (see Table). No changes were observed in the P
tities of bromide can be administered for the analysis, allowing group. No differences were observed when the men and wom-
for sufficient washout between measurement days.26 The cor- en within the Cr group were compared before or after supple-
rected bromide space was calculated and used to determine the mentation.
ECW volume.25–27 The intracellular water (ICW) volume was
calculated by subtracting the ECW volume from the TBW
volume. Body Mass
A significant time-by-group interaction (F2,56 5 3.30, P 5
Statistical Analysis .044) was observed for body mass, as the Cr group experi-
enced a significant increase from presupplementation to day
We used the Statistical Package for the Social Sciences soft- 28 (see Table). The Cr group’s body mass on day 7 was 0.75
ware (version 10.0, SPSS Inc, Chicago, IL) to perform the kg greater than at presupplementation; however, this change
statistical analysis of the raw data. All dependent measures was not significant. The Tukey post hoc test revealed that an
were analyzed using a 1-within (time), 2-between (group and increase of 0.88 kg was necessary for statistical significance.
sex) mixed design with repeated-measures analyses of vari- The P group did not experience any significant changes in
ance and Tukey Honestly Significant Difference post hoc tests body mass. As expected, men had greater body mass than
to test differences between means. For all statistical tests, the women, but there were no significant sex interactions.
alpha level was set at .05.