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Supervise creatine use in teens

Fitness Q&A

Tuesday, March 11, 2003

By Joe Luxbacher

Q: My 16-year-old son plays football and baseball. He has been taking a protein drink containing creatine to build muscle mass. How do you feel about athletes using creatine-enhanced drinks? Does it really work and if so, how? I was also told that creatine could damage his kidneys if he doesn't drink enough water.

Joe Luxbacher

A. Unlike many performance-enhancing supplements on the market, creatine has been researched fairly extensively and studies do suggest that creatine supplementation in conjunction with high-intensity weight training and proper nutrition can produce significant increases in strength and muscle mass.

Creatine is produced in the liver and kidneys. You also get a small amount of creatine from the foods you eat. Most of the body's creatine is stored in the muscle cells as creatine phosphate. Creatine phosphate functions as a miniature energy supply for the muscles and is particularly important for activities that require short bursts of intense effort, such as weight training.

The compound also restocks cellular reserves of adenosine triphosphate, the fuel that provides the impetus for muscular contractions. Creatine is not a drug and can be purchased over the counter in pill and powder form. Supplements usually come in a powdered form called creatine monohydrate.

How supplementation works

By loading additional creatine into the muscles, a person can train longer and harder, and the muscles are able to recover more quickly from strenuous workouts. Unlike anabolic steroids, creatine does not build muscle directly. Strength gains occur because the person is able to work out more often, more intensely and for greater duration.

Known side effects of creatine supplementation, at least in some individuals, are water weight gain and cramping. Athletes using creatine should drink more water than usual during the loading phase. More important, creatine needs carbohydrate to facilitate entry into the muscle cell, so consuming creatine in juice or a carbohydrate-rich sport drink is generally more effective than mixing creatine with water.

I do have reservations about unsupervised use of creatine among high school athletes, specifically regarding dosage. Competitive athletes, in their zeal to become bigger and stronger, may incorrectly assume that if some creatine is good, more must surely be better. That is not necessarily the case. The body has a ceiling on how much creatine it can store in the muscles, so taking large doses may be counterproductive and possibly even hazardous to one's health.

According to some reports, large doses taken on a regular basis may lead to liver and kidney damage. Long term longitudinal studies are needed to verify or refute these claims.

Q: What is more critical to weight loss -- diet or exercise? My goal is to lose 10 pounds and I want to do it the correct way. Personally I prefer to diet. I've never been very athletic, plus I've read that jogging a mile only burns 100 calories, and I'm not sure I feel the effort is worth the return.

A: Choosing one to the exclusion of the other will only make the journey more difficult, if not impossible. To lose weight and keep it off usually requires long-term adjustments in diet and activity habits.

Please note that I am not advocating a highly restrictive low calorie "diet." Studies conclusively demonstrate that such diets don't work over the long haul. I am also not suggesting that you must conform to a structured exercise plan. What I do recommend is a balanced, low-fat eating plan coupled with a physically active lifestyle. Physical activity may take the form of formal workouts such as jogging, stair climbing and weight training, or more recreational activities involving walking, hiking, canoeing, tennis, golfing (walking the course) and gardening.

Whatever you decide to do, to lose a pound of fat you must burn 3,500 calories above and beyond what you consume. You can do that by eating less, exercising more, or preferably both.

On the surface it would appear that you are correct in your assessment that it takes an inordinate amount of exercise -- like running 35 miles -- to lose one pound of fat. The important point to consider is that the calorie burning effects of exercise are cumulative. Burning an extra 200 calories daily through physical activity won't alter your body weight very much over several days, but it can add up to a 20-pound weight loss over a year. In the process you will also be toning your muscles, reshaping your body, strengthening bones, reducing stress and possibly even improving your blood profile.

Suffice to say, I strongly believe that exercise should be an integral component of any long-term weight loss plan.

Joe Luxbacher, University of Pittsburgh men's soccer coach, writes a monthly Q&A on fitness. You can e-mail questions to him at jlux@pitt.edu or mail them to Your Health, Post-Gazette, 34 Blvd. of the Allies, Pittsburgh, PA. 15222

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