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The question for this post is from the father of a 16-year-old athlete who said: “My son plays two sports (baseball and football) and one of his coaches said that he should consider taking creatine to increase size, strength and athletic performance. 1) What is it? 2) Does it work? 3) Is it safe for kids? 4) Should young athletes use it? 5) Are there side-effects?”

PBSCCS submitted this question to several sports nutritionists and the following was prepared from their responses.

  • WHAT IS CREATINE? Creatine is an amino acid (building block for protein) that helps the body build muscle and other tissues. Athletes usually get it in three ways: 1) the body naturally makes it; 2) athletes who eat meat, can get it in their diet; and 3) it can be consumed as supplement. Regardless of its source, creatine is stored in the muscles and used to quickly rebuild ATP (adenosine triphosphate) in the muscles. ATP, not creatine, is the primary fuel for short-duration, high-intensity exercise of about 10-12 seconds or less like lifting weights, sprinting, jumping, swinging, throwing, etc. The quicker ATP can be rebuilt, the faster the athlete will recover and the longer he/she can perform short-bursts of high-intensity exercises. Physical improvements in size, strength, etc. are the result of training, not creatine. Creatine, by itself, doesn’t build muscle, increase speed or improve power. It helps athletes recover quicker during training so that they can train longer and harder. The longer and harder athletes train, the greater the potential for improvement. Creatine is not a primary fuel source for longer duration exercise, like jogging or cross-country running.

  • DOES IT WORK? Yes, research on adults and older teens indicate that, when used appropriately and with proper training, it can help improve muscle size, strength, power and performance in short-term, high-intensity activity. While this can sound appealing to coaches and athletes, it is not needed by young athletes. Young athletes, especially those that are going through puberty or have reached puberty, are at their peak for gaining muscle mass naturally. Therefore, they don’t need additional supplements to gain muscle and enhance performance. While creatine is a popular supplement, it’s plentiful in balanced diets and something the body makes on its own. More is not better. The body can store only so much. It takes 1-3 gm of creatine per day to maintain muscle stores of creatine and 3-5 gm to keep them super saturated. These amounts are achievable through diet. More is not better. Excess is excreted through urine.

Creatine is not necessary for most athletes because:

  • Young athletes gain muscle mass naturally and they don’t need supplements to achieve that.

  • Think food and sleep first. Two things that many young athletes don’t get enough of are food (calories) and sleep. Training is the stimulus for growth, food fuels the growth and growth occurs during sleep and recovery. Because many young athletes do not eat enough calories to support growth and don’t get enough sleep to allow time for optimal growth, most can improve their performance through enhanced nutrition and improved sleep without taking creatine or other supplements.

  • Meeting basic nutrition guidelines will help improve performance and health more than adding a supplement. Before considering to use a supplement, young athletes should: 1) eat three balanced meals daily; 2) consume pre- and post-workout snacks; 3) eat enough calories and quality foods to meet their energy and micronutrient needs; and 4) get 8-10 hours of sleep daily.

  • IS IT SAFE FOR KIDS? Creatine is a supplement, and supplements are not regulated by any US governing body. When independently tested, some supplements have shown significant differences in the amount in the product compared to what is listed on the label. In the US, the supplement manufacturer is solely responsible for ensuring the safety of these products. Concerns about a product’s safety aren’t usually raised until after several athletes start experiencing negative symptoms. Supplements can also be contaminated with illegal substances, which can create negative health outcomes and affect drug testing if required for competition.

  • While research has not indicated any safety issues for short- or long-term use by adults, there is limited research on adolescents. It’s important to note that the label on creatine products says – “Not to be used by anyone under the age of 18”. Creatine is not a magic bullet. The positive results reported with creatine use are the averages for all subjects in research studies. Creatine does not work for all subjects. Some don’t improve and some have performance decrements.

  • SHOULD YOUNG ATHLETES USE IT? The short answer is NO. Both the American Academy of Pediatrics and the American College of Sports Medicine say that teenagers should not use performance-enhancing supplements, including creatine. They agree that creatine is not necessary for most young athletes because:

  • Supplements aren’t shortcuts. The keys to improving athletic performance and building muscle are: 1) proper nutrrition; 2) proper training; and 3) adequate sleep and recovery. These three, not creatine, are the essential components to maximize athletic potential.

  • Taking nutritional supplements puts young athletes at a disadvantage because if they start taking them early, they will never know what their bodies can do without them. The keys to athletic succes are good genetics, proper training, adequate rest and recovery and a heallthy sports diet.

  • Before taking creatine, athletes should consult with a sports dietician or their primary care physician to make sure that creatine is appropriate. If it is found to be appropriate, parents should purchase only those that bear the NSF Certified for Sport Products seal. This seal ensures that the product has been tested by a trusted, independent, certification organization and meets strict standards for public health protection. In situations where an athlete is already taking creatine or other supplements, parents should schedule a visit with a registered sports dietitian to determine what nutritional adaptions the athlete can make to replace these products and improve performance and personal health.

ARE THERE SIDE-EFFECTS? Even though creatine may have benefits, it can cause side effects such as: nausea, dehydration, muscle cramping, stomach problems and headaches.

BOTTOM LINE: Adolescent athletes are still growing, developing, and maturing. The research on creatine is not bad so, the final decision to take it or not is a judgment call determined by parents, athletes and doctors. It’s best to let young athletes have fun and learn how to eat to support performance and physical development in their growing years. Creatine is not going to be the reason why any teen athlete will excel in sports. Elite performance is the result of genetics, hard work, perseverance, patience and effort.

Key Takeaways

  • Young athletes at their peak age of development do not need creatine

  • Training is the stimulus for growth

  • Nutrition provides the building blocks for tissue growth and repair

  • Tissue growth and recovery occur during rest and recovery

  • Creatine is not a magic bullet – it doesn’t work if you don’t work

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