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Sports Nutrition and Supplementation Muscle Building Strategies
By Jose Antonio, PhD, CSCS
The scientific investigation of various sports nutrition and supplement strategies has undergone a tremendous growth in the last decade. Individuals who are serious about maximizing their genetic potential naturally consider nutrition a primary tenant of their program. The purpose of this review is to provide practical, drug-free nutritional and supplement strategies for increasing lean body mass.
Nutrient Timing
When you consume nutrients has a profound effect on the adaptive response to exercise. For instance, one study determined whether consumption of an oral essential amino acid-carbohydrate supplement (EAC) before exercise results in a greater anabolic (muscle building) response than supplementation after resistance exercise. Six healthy human subjects participated in two trials in random order, PRE (EAC consumed immediately before exercise), and POST (EAC consumed immediately after exercise). These investigators discovered that the total net phenylalanine uptake across the leg was greater (P = 0.0002) during PRE (209 +/- 42 mg) than during POST (81 +/- 19). Phenylalanine disappearance rate, an indicator of muscle protein synthesis from blood amino acids, increased after EAC consumption in both trials. Therefore, net muscle protein synthesis is higher when an EAC solution is consumed immediately before resistance exercise versus after exercise. This may be due to the increase in muscle protein synthesis as a result of increased delivery of amino acids to the leg (9). However, inasmuch as this was an acute study, the important clinical endpoint is whether one can actually accrue more skeletal muscle mass as a result of utilizing a nutrient timing strategy.
Another study compared the effects of 14 weeks of resistance training combined with timed ingestion of isoenergetic (i.e. same total calories or energy) protein versus carbohydrate supplementation on muscle fiber hypertrophy and mechanical muscle performance. Supplementation was administered before and immediately after each training bout. On non-training days, subjects consumed their supplements in the morning. Muscle biopsy specimens were obtained from the vastus lateralis muscle and analyzed for muscle fiber cross-sectional area. After 14 weeks of resistance training, the protein group showed hypertrophy of type I (18% +/- 5%; P < .01) and type II (26% +/- 5%; P < .01) muscle fibers, whereas no change above baseline occurred in the carbohydrate group. Squat jump height increased only in the protein group, whereas countermovement jump height and peak torque during slow isokinetic muscle contraction increased similarly in both groups. In conclusion, the timed ingestion (pre- and post-exercise) of dietary protein is superior to an isoenergetic amount of carbohydrate.
From the standpoint of gaining skeletal muscle mass, it is evident that consuming carbohydrate is not necessary. However, one could propose that the addition of carbohydrate as well as insulinotropic protein (e.g. peptides, protein hydrolysates) may enhance the anabolic response. A recent investigation examined postprandial (after meal) plasma insulin and glucose responses after co-ingestion of an insulinotropic protein hydrolysate with and without additional free leucine with a single bolus of carbohydrate in male patients with long-standing Type 2 diabetes (n = 10) and healthy controls (n = 10). The investigators concluded that the co-ingestion of a protein hydrolysate with or without additional free leucine strongly augments the insulin response after ingestion of a single bolus of carbohydrate (6). Further work needs to determine if this can be applied to an athletic population.
Fast and Slow Proteins
Boirie et al.(2) found that a 30 gram feeding of casein protein versus whey protein had different effects on postprandial protein gain. Both whey and casein are proteins derived from milk. In essence, they showed that whey protein is absorbed very quickly producing peak levels of amino acids at approximately 60-90 minutes after ingestion and then returning to baseline levels at approximately three to four hours post-ingestion. Casein on the other hand produced a much slower and less dramatic rise in amino acid levels peaking at approximately 60-90 minutes but maintaining higher levels of amino acids (versus baseline) over the entire seven hour time frame.
Evidently, the differences in digestion and absorption translate into differences in protein metabolism. Whole body protein breakdown was inhibited 34% by casein ingestion but not by whey. Whey protein ingestion stimulated protein synthesis by 68% while casein stimulated protein synthesis to a lesser extent (+31%). However, when they looked at the 'net leucine balance' over the 7-hour time period after ingestion, casein ingestion resulted in a significantly higher net balance (i.e., post-feeding protein deposition was greater). On the other hand, a recent investigation showed no differences in the anabolic effects of whey or casein. Healthy volunteers were randomly assigned to one of three groups. Each group consumed one of three drinks: placebo (PL; n = 7), 20 g of casein (CS; n = 7), or whey proteins (WH; n = 9). Volunteers consumed the drink 1 h after the conclusion of a leg extension exercise bout. They discovered that the Ingestion of both CS and WH stimulated a significantly larger net phenylalanine uptake after resistance exercise, compared with the PL (PL -5 +/- 15 mg, CS 84 +/- 10 mg, WH 62 +/- 18 mg). Amino acid uptake relative to amount ingested was similar for both CS and WH (approximately 10-15%). Thus, the acute ingestion of both WH and CS after exercise resulted in similar increases in muscle protein net balance, resulting in net muscle protein synthesis despite different patterns of blood amino acid responses (9).
From the limited data, the authors of the research suggest that casein protein may provide more benefit than whey protein. What this means in a practical sense is that the results are not fully understood. However, one could speculate that if you were to consume a single protein source for gaining muscle mass, casein may be preferable over whey. It should be noted that there is no evidence that consuming a diet high in protein has any adverse renal effects (7,10).
Essential Amino Acids plus Carbohydrate
The ingestion of the essential amino acids (EAA) has been shown to produce a significant anabolic effect. For instance, thirty-two untrained young men performed 12 weeks of resistance training twice a week, consuming ~675 ml of either, a six percent carbohydrate (CHO) solution, six gram EAA mixture, combined CHO + EAA supplement, or placebo (PLA). Blood samples were obtained pre- and post-exercise (week 0, 4, 8, and 12), for determination of glucose, insulin, and cortisol. 3-Methylhistidine excretion and muscle fiber cross-sectional area (fCSA) were determined pre- and post-training. Post-exercise cortisol increased (p<0.05) during each training phase for PLA. No change was displayed by EAA; CHO and CHO + EAA demonstrated post-exercise decreases. All groups displayed reduced pre-exercise cortisol at week 12 compared to week zero. Post-exercise insulin concentrations showed no change for PLA. Increases were observed for the treatment groups, which remained greater for CHO and CHO + EAA than PLA. EAA and CHO ingestion attenuated 3-methylhistidine excretion 48 hours following the exercise bout. CHO + EAA resulted in a 26% decrease while PLA displayed a 52% increase. But most importantly, what happens to skeletal muscle fiber size?
Muscle fiber cross-sectional area (fCSA) increased across groups for type I, IIa, and IIb fibers, with CHO + EAA displaying the greatest gains in fCSA relative to PLA. These data indicate that CHO + EAA ingestion enhances muscle anabolism, following resistance training to a greater extent than either CHO or EAA consumed independently. Accordingly, the synergistic effect of CHO + EAA ingestion maximizes the anabolic response presumably by attenuating the post-exercise rise in protein degradation (1,13,16).
Creatine
There is robust evidence to show that regular creatine supplementation increases total muscle creatine (TCr) concentration by 20 — 40%, improves skeletal muscle mass, and enhances exercise performance (8,12,14,15). The increase in stored phosphagens allows for an enhanced ability to resynthesize phosphocreatine (PCr) thus promoting an ergogenic benefit for short-duration, high-intensity activities (e.g., weight lifting, sprinting, etc). Interestingly, creatine directly influences cellular physiology by increasing the expression of Type I, IIa, and IIx myosin heavy chain (MHC) as well as myogenin and MRF-4 mRNA, protein (10,11) and stimulating satellite cell proliferation (26, 27). On the practical side, it is not clear if there is an optimal method of enhancing intramuscular creatine uptake. For instance, it is known that the consumption of carbohydrates with creatine may facilitate creatine uptake into skeletal muscles. However, the enormous carbohydrate load used in previously published creatine loading studies may be an impractical method of improving intramuscular creatine concentrations (12).
In an intriguing investigation from the University of Western Australia, scientists evaluated the efficacy of three different creatine (Cr) loading procedures and 2 different maintenance regimes on intramuscular Cr concentrations (11).
The three loading phases were as follows:
1. Cr (4 x 5 grams per day, for five days)
2. Cr + glucose solution (same Cr dosage; subjects consumed creatine followed by one gram glucose/kg body weight, dissolved in 500 ml water 30 minutes after the second and fourth daily doses).
3. Cr + exercise (cycling exercise performed one hour after ingesting the second Cr dose).
The two maintenance doses studied were as follows (with a control as well):
1. Two grams Cr daily for six weeks
2. Five grams Cr daily for six weeks
3. No creatine for six weeks
What did they find? TCr concentrations increased significantly more in the Cr + glucose group (+25%) compared to the Cr only (+16%) and the Cr + exercise (18%) groups. There were no significant differences between the Cr only and Cr + exercise groups. Also, PCr stores were significantly elevated in the Cr + glucose (+8%), the Cr + exercise (+9%), but not the Cr only group (+5%).
After the six week maintenance phase, the two grams per day and five grams per day Cr dosages produced similar intramuscular TCr concentrations; however, the no creatine resulted in a significant decrement in creatine stores. Interestingly, muscle TCr stores had not returned to baseline after six weeks of no creatine.
There are several interesting points about this study. First, it was surprising that exercise plus Cr did not improve intramuscular TCr over Cr alone. One could speculate that repeated sprint exercise (as used in this investigation) may have restricted gastrointestinal absorption and that perhaps exercise of a milder nature may have been more effective. Also, the improvement in TCr subsequent to carbohydrate plus creatine ingestion verifies this loading methodology. However, the dose used in this investigation is still rather high (~773 grams of sugar total over the five day period; that is over 3,000 extra calories). If maintenance of a low fat mass is critical, then the consumption of such high levels of high-glycemic sugars is not recommended. Another interesting observation is that a low daily dose of two grams of Cr is sufficient to maintain high intramuscular TCr stores. To date, creatine is clearly the single most effective dietary supplement for enhancing gains in anaerobic performance as well as increasing lean body mass and muscle fiber size.
In summary, one can reasonably conclude that if you are seeking a fairly rapid improvement in anaerobic performance and lean body mass, it would be sensible to do a loading phase with creatine. However, if time is not an issue, a dose of two to four grams daily should be sufficient to fully saturate skeletal muscle within a month. Furthermore, the use of high-glycemic sugars to potentiate the uptake of creatine has good support in the scientific literature; however, if the maintenance of low body fat levels is a paramount concern (example: bodybuilders, strength-power athletes in the lower weight classes), then one can still supplement with creatine (minus the sugar) and get significant elevations in total intramuscular creatine concentrations. Moreover, it should be noted that there is no evidence that regular creatine supplementation has any adverse effects (4,5)
Practical Applications
In essence, once you get through the 'clutter' of data, there are several practical strategies you can utilize to promote gains in lean body mass through nutrition.
1. Consume approximately a teaspoon of creatine daily.
2. Consume a combination of protein and carbohydrates (roughly 25 grams of protein with an equal amount of carbohydrates [less carbohydrates if you are a physique athlete]) 15 — 30 minutes pre-workout and immediately post-workout.
3. Consume a sports drink spiked with protein during a workout.
4. Consume essential amino acids as a stand alone supplement pre and post-workout (it can also be added to a protein shake).
5. Never decrease protein intake.
6. Drink plenty of water.
7. For your meals, consume primarily unprocessed carbohydrates, lean proteins, and health fats (e.g. fish fat, nuts, etc).
References
1. Bird SP, Tarpenning KM, Marino FE. (2006). Independent and combined effects of liquid carbohydrate/essential amino acid ingestion on hormonal and muscular adaptations following resistance training in untrained men. European Journal of Applied Physiology, Mar 24; [Epub ahead of print].
2. Boirie Y, Dangin M, Gachon P, Vasson MP, Maubois JL, Beaufrere B. (1997). Slow and fast dietary proteins differently modulate postprandial protein accretion. Proceedings of the National Academy of Sciences of the United States of America, 94(26):14930 — 14935.
3. Dangott B, Schultz E, Mozdziak PE. (2000). Dietary creatine monohydrate supplementation increases satellite cell mitotic activity during compensatory hypertrophy. International Journal of Sports Medicine, 21(1):13 — 16.
4. Greenwood M, Kreider RB, Melton C, Rasmussen C, Lancaster S, Cantler E, Milnor P, Almada A. (2003). Creatine supplementation during college football training does not increase the incidence of cramping or injury. Molecular and Cellular Biochemistry, 244(1-2):83 — 88.
5. Kreider RB, Melton C, Rasmussen CJ, Greenwood M, Lancaster S, Cantler EC, Milnor P, Almada A. (2003). Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Molecular and Cellular Biochemistry, 244(1-2):95 — 104.
6. Manders RJ, Koopman R, Sluijsmans WE, van den Berg R, Verbeek K, Saris WH, Wagenmakers AJ, van Loon LJ. (2006). Co-Ingestion of a Protein Hydrolysate with or without additional leucine effectively reduces postprandial blood glucose excursions in type 2 diabetic men. The Journal of Nutrition, 136:1294 — 1299.
7. Martin WF, Armstrong LE, Rodriguez NR. (2005). Dietary protein intake and renal function. Nutrition & Metabolism, Sept 20;2:25.
8. Olsen S, Aagaard P, Kadi F, Tufekovic G, Verney J, Olesen JL, Suetta C, Kjaer M. (2006). Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training. The Journal of Physiology, Apr 20; [Epub ahead of print].
9. Phillips SM, Parise G, Roy BD, Tipton KD, Wolfe RR, Tamopolsky MA. (2002). Resistance-training-induced adaptations in skeletal muscle protein turnover in the fed state. Canadian Journal of Physiology and Pharmacology, 80(11):1045 — 1053.
10. Poortmans JR, Dellalieux O. (2000). Do regular high protein diets have potential health risks on kidney function in athletes? International Journal of Sport Nutrition and Exercise Metabolism, 10(1):28 — 38.
11. Preen D, Dawson B, Goodman C, Beilby J, Ching S. (2003). Creatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle. International Journal of Sport Nutrition and Exercise Metabolism, 13(1):97 — 111.
12. Steenge GR, Simpson EJ, Greenhaff PL. (2000). Protein- and carbohydrate-induced augmentation of whole body creatine retention in humans. Journal of Applied Physiology, 89(3):1165 — 1171.
13. Tipton KD, Rasmussen BB, Miller SL, Wolf SE, Owens-Stovall SK, Petrini BE, Wolfe RR. (2001). Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. American Journal of Physiology. Endocrinology and Metabolism. 281(2):E197 — 206.
14. Willoughby DS, Rosene J. (2001). Effects of oral creatine and resistance training on myosin heavy chain expression. Medicine & Science in Sports & Exercise, 33(10):1674 — 1681.
15. Willoughby DS, Rosene JM. (2003). Effects of oral creatine and resistance training on myogenic regulatory factor expression. Medicine & Science in Sports & Exercise, 35(6):923 — 929.
16. Wolfe RR. (2001). Effects of amino acid intake on anabolic processes. Canadian Journal of Applied Physiology, 26 Suppl:S220 — 227
By Jose Antonio, PhD, CSCS
The scientific investigation of various sports nutrition and supplement strategies has undergone a tremendous growth in the last decade. Individuals who are serious about maximizing their genetic potential naturally consider nutrition a primary tenant of their program. The purpose of this review is to provide practical, drug-free nutritional and supplement strategies for increasing lean body mass.
Nutrient Timing
When you consume nutrients has a profound effect on the adaptive response to exercise. For instance, one study determined whether consumption of an oral essential amino acid-carbohydrate supplement (EAC) before exercise results in a greater anabolic (muscle building) response than supplementation after resistance exercise. Six healthy human subjects participated in two trials in random order, PRE (EAC consumed immediately before exercise), and POST (EAC consumed immediately after exercise). These investigators discovered that the total net phenylalanine uptake across the leg was greater (P = 0.0002) during PRE (209 +/- 42 mg) than during POST (81 +/- 19). Phenylalanine disappearance rate, an indicator of muscle protein synthesis from blood amino acids, increased after EAC consumption in both trials. Therefore, net muscle protein synthesis is higher when an EAC solution is consumed immediately before resistance exercise versus after exercise. This may be due to the increase in muscle protein synthesis as a result of increased delivery of amino acids to the leg (9). However, inasmuch as this was an acute study, the important clinical endpoint is whether one can actually accrue more skeletal muscle mass as a result of utilizing a nutrient timing strategy.
Another study compared the effects of 14 weeks of resistance training combined with timed ingestion of isoenergetic (i.e. same total calories or energy) protein versus carbohydrate supplementation on muscle fiber hypertrophy and mechanical muscle performance. Supplementation was administered before and immediately after each training bout. On non-training days, subjects consumed their supplements in the morning. Muscle biopsy specimens were obtained from the vastus lateralis muscle and analyzed for muscle fiber cross-sectional area. After 14 weeks of resistance training, the protein group showed hypertrophy of type I (18% +/- 5%; P < .01) and type II (26% +/- 5%; P < .01) muscle fibers, whereas no change above baseline occurred in the carbohydrate group. Squat jump height increased only in the protein group, whereas countermovement jump height and peak torque during slow isokinetic muscle contraction increased similarly in both groups. In conclusion, the timed ingestion (pre- and post-exercise) of dietary protein is superior to an isoenergetic amount of carbohydrate.
From the standpoint of gaining skeletal muscle mass, it is evident that consuming carbohydrate is not necessary. However, one could propose that the addition of carbohydrate as well as insulinotropic protein (e.g. peptides, protein hydrolysates) may enhance the anabolic response. A recent investigation examined postprandial (after meal) plasma insulin and glucose responses after co-ingestion of an insulinotropic protein hydrolysate with and without additional free leucine with a single bolus of carbohydrate in male patients with long-standing Type 2 diabetes (n = 10) and healthy controls (n = 10). The investigators concluded that the co-ingestion of a protein hydrolysate with or without additional free leucine strongly augments the insulin response after ingestion of a single bolus of carbohydrate (6). Further work needs to determine if this can be applied to an athletic population.
Fast and Slow Proteins
Boirie et al.(2) found that a 30 gram feeding of casein protein versus whey protein had different effects on postprandial protein gain. Both whey and casein are proteins derived from milk. In essence, they showed that whey protein is absorbed very quickly producing peak levels of amino acids at approximately 60-90 minutes after ingestion and then returning to baseline levels at approximately three to four hours post-ingestion. Casein on the other hand produced a much slower and less dramatic rise in amino acid levels peaking at approximately 60-90 minutes but maintaining higher levels of amino acids (versus baseline) over the entire seven hour time frame.
Evidently, the differences in digestion and absorption translate into differences in protein metabolism. Whole body protein breakdown was inhibited 34% by casein ingestion but not by whey. Whey protein ingestion stimulated protein synthesis by 68% while casein stimulated protein synthesis to a lesser extent (+31%). However, when they looked at the 'net leucine balance' over the 7-hour time period after ingestion, casein ingestion resulted in a significantly higher net balance (i.e., post-feeding protein deposition was greater). On the other hand, a recent investigation showed no differences in the anabolic effects of whey or casein. Healthy volunteers were randomly assigned to one of three groups. Each group consumed one of three drinks: placebo (PL; n = 7), 20 g of casein (CS; n = 7), or whey proteins (WH; n = 9). Volunteers consumed the drink 1 h after the conclusion of a leg extension exercise bout. They discovered that the Ingestion of both CS and WH stimulated a significantly larger net phenylalanine uptake after resistance exercise, compared with the PL (PL -5 +/- 15 mg, CS 84 +/- 10 mg, WH 62 +/- 18 mg). Amino acid uptake relative to amount ingested was similar for both CS and WH (approximately 10-15%). Thus, the acute ingestion of both WH and CS after exercise resulted in similar increases in muscle protein net balance, resulting in net muscle protein synthesis despite different patterns of blood amino acid responses (9).
From the limited data, the authors of the research suggest that casein protein may provide more benefit than whey protein. What this means in a practical sense is that the results are not fully understood. However, one could speculate that if you were to consume a single protein source for gaining muscle mass, casein may be preferable over whey. It should be noted that there is no evidence that consuming a diet high in protein has any adverse renal effects (7,10).
Essential Amino Acids plus Carbohydrate
The ingestion of the essential amino acids (EAA) has been shown to produce a significant anabolic effect. For instance, thirty-two untrained young men performed 12 weeks of resistance training twice a week, consuming ~675 ml of either, a six percent carbohydrate (CHO) solution, six gram EAA mixture, combined CHO + EAA supplement, or placebo (PLA). Blood samples were obtained pre- and post-exercise (week 0, 4, 8, and 12), for determination of glucose, insulin, and cortisol. 3-Methylhistidine excretion and muscle fiber cross-sectional area (fCSA) were determined pre- and post-training. Post-exercise cortisol increased (p<0.05) during each training phase for PLA. No change was displayed by EAA; CHO and CHO + EAA demonstrated post-exercise decreases. All groups displayed reduced pre-exercise cortisol at week 12 compared to week zero. Post-exercise insulin concentrations showed no change for PLA. Increases were observed for the treatment groups, which remained greater for CHO and CHO + EAA than PLA. EAA and CHO ingestion attenuated 3-methylhistidine excretion 48 hours following the exercise bout. CHO + EAA resulted in a 26% decrease while PLA displayed a 52% increase. But most importantly, what happens to skeletal muscle fiber size?
Muscle fiber cross-sectional area (fCSA) increased across groups for type I, IIa, and IIb fibers, with CHO + EAA displaying the greatest gains in fCSA relative to PLA. These data indicate that CHO + EAA ingestion enhances muscle anabolism, following resistance training to a greater extent than either CHO or EAA consumed independently. Accordingly, the synergistic effect of CHO + EAA ingestion maximizes the anabolic response presumably by attenuating the post-exercise rise in protein degradation (1,13,16).
Creatine
There is robust evidence to show that regular creatine supplementation increases total muscle creatine (TCr) concentration by 20 — 40%, improves skeletal muscle mass, and enhances exercise performance (8,12,14,15). The increase in stored phosphagens allows for an enhanced ability to resynthesize phosphocreatine (PCr) thus promoting an ergogenic benefit for short-duration, high-intensity activities (e.g., weight lifting, sprinting, etc). Interestingly, creatine directly influences cellular physiology by increasing the expression of Type I, IIa, and IIx myosin heavy chain (MHC) as well as myogenin and MRF-4 mRNA, protein (10,11) and stimulating satellite cell proliferation (26, 27). On the practical side, it is not clear if there is an optimal method of enhancing intramuscular creatine uptake. For instance, it is known that the consumption of carbohydrates with creatine may facilitate creatine uptake into skeletal muscles. However, the enormous carbohydrate load used in previously published creatine loading studies may be an impractical method of improving intramuscular creatine concentrations (12).
In an intriguing investigation from the University of Western Australia, scientists evaluated the efficacy of three different creatine (Cr) loading procedures and 2 different maintenance regimes on intramuscular Cr concentrations (11).
The three loading phases were as follows:
1. Cr (4 x 5 grams per day, for five days)
2. Cr + glucose solution (same Cr dosage; subjects consumed creatine followed by one gram glucose/kg body weight, dissolved in 500 ml water 30 minutes after the second and fourth daily doses).
3. Cr + exercise (cycling exercise performed one hour after ingesting the second Cr dose).
The two maintenance doses studied were as follows (with a control as well):
1. Two grams Cr daily for six weeks
2. Five grams Cr daily for six weeks
3. No creatine for six weeks
What did they find? TCr concentrations increased significantly more in the Cr + glucose group (+25%) compared to the Cr only (+16%) and the Cr + exercise (18%) groups. There were no significant differences between the Cr only and Cr + exercise groups. Also, PCr stores were significantly elevated in the Cr + glucose (+8%), the Cr + exercise (+9%), but not the Cr only group (+5%).
After the six week maintenance phase, the two grams per day and five grams per day Cr dosages produced similar intramuscular TCr concentrations; however, the no creatine resulted in a significant decrement in creatine stores. Interestingly, muscle TCr stores had not returned to baseline after six weeks of no creatine.
There are several interesting points about this study. First, it was surprising that exercise plus Cr did not improve intramuscular TCr over Cr alone. One could speculate that repeated sprint exercise (as used in this investigation) may have restricted gastrointestinal absorption and that perhaps exercise of a milder nature may have been more effective. Also, the improvement in TCr subsequent to carbohydrate plus creatine ingestion verifies this loading methodology. However, the dose used in this investigation is still rather high (~773 grams of sugar total over the five day period; that is over 3,000 extra calories). If maintenance of a low fat mass is critical, then the consumption of such high levels of high-glycemic sugars is not recommended. Another interesting observation is that a low daily dose of two grams of Cr is sufficient to maintain high intramuscular TCr stores. To date, creatine is clearly the single most effective dietary supplement for enhancing gains in anaerobic performance as well as increasing lean body mass and muscle fiber size.
In summary, one can reasonably conclude that if you are seeking a fairly rapid improvement in anaerobic performance and lean body mass, it would be sensible to do a loading phase with creatine. However, if time is not an issue, a dose of two to four grams daily should be sufficient to fully saturate skeletal muscle within a month. Furthermore, the use of high-glycemic sugars to potentiate the uptake of creatine has good support in the scientific literature; however, if the maintenance of low body fat levels is a paramount concern (example: bodybuilders, strength-power athletes in the lower weight classes), then one can still supplement with creatine (minus the sugar) and get significant elevations in total intramuscular creatine concentrations. Moreover, it should be noted that there is no evidence that regular creatine supplementation has any adverse effects (4,5)
Practical Applications
In essence, once you get through the 'clutter' of data, there are several practical strategies you can utilize to promote gains in lean body mass through nutrition.
1. Consume approximately a teaspoon of creatine daily.
2. Consume a combination of protein and carbohydrates (roughly 25 grams of protein with an equal amount of carbohydrates [less carbohydrates if you are a physique athlete]) 15 — 30 minutes pre-workout and immediately post-workout.
3. Consume a sports drink spiked with protein during a workout.
4. Consume essential amino acids as a stand alone supplement pre and post-workout (it can also be added to a protein shake).
5. Never decrease protein intake.
6. Drink plenty of water.
7. For your meals, consume primarily unprocessed carbohydrates, lean proteins, and health fats (e.g. fish fat, nuts, etc).
References
1. Bird SP, Tarpenning KM, Marino FE. (2006). Independent and combined effects of liquid carbohydrate/essential amino acid ingestion on hormonal and muscular adaptations following resistance training in untrained men. European Journal of Applied Physiology, Mar 24; [Epub ahead of print].
2. Boirie Y, Dangin M, Gachon P, Vasson MP, Maubois JL, Beaufrere B. (1997). Slow and fast dietary proteins differently modulate postprandial protein accretion. Proceedings of the National Academy of Sciences of the United States of America, 94(26):14930 — 14935.
3. Dangott B, Schultz E, Mozdziak PE. (2000). Dietary creatine monohydrate supplementation increases satellite cell mitotic activity during compensatory hypertrophy. International Journal of Sports Medicine, 21(1):13 — 16.
4. Greenwood M, Kreider RB, Melton C, Rasmussen C, Lancaster S, Cantler E, Milnor P, Almada A. (2003). Creatine supplementation during college football training does not increase the incidence of cramping or injury. Molecular and Cellular Biochemistry, 244(1-2):83 — 88.
5. Kreider RB, Melton C, Rasmussen CJ, Greenwood M, Lancaster S, Cantler EC, Milnor P, Almada A. (2003). Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Molecular and Cellular Biochemistry, 244(1-2):95 — 104.
6. Manders RJ, Koopman R, Sluijsmans WE, van den Berg R, Verbeek K, Saris WH, Wagenmakers AJ, van Loon LJ. (2006). Co-Ingestion of a Protein Hydrolysate with or without additional leucine effectively reduces postprandial blood glucose excursions in type 2 diabetic men. The Journal of Nutrition, 136:1294 — 1299.
7. Martin WF, Armstrong LE, Rodriguez NR. (2005). Dietary protein intake and renal function. Nutrition & Metabolism, Sept 20;2:25.
8. Olsen S, Aagaard P, Kadi F, Tufekovic G, Verney J, Olesen JL, Suetta C, Kjaer M. (2006). Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training. The Journal of Physiology, Apr 20; [Epub ahead of print].
9. Phillips SM, Parise G, Roy BD, Tipton KD, Wolfe RR, Tamopolsky MA. (2002). Resistance-training-induced adaptations in skeletal muscle protein turnover in the fed state. Canadian Journal of Physiology and Pharmacology, 80(11):1045 — 1053.
10. Poortmans JR, Dellalieux O. (2000). Do regular high protein diets have potential health risks on kidney function in athletes? International Journal of Sport Nutrition and Exercise Metabolism, 10(1):28 — 38.
11. Preen D, Dawson B, Goodman C, Beilby J, Ching S. (2003). Creatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle. International Journal of Sport Nutrition and Exercise Metabolism, 13(1):97 — 111.
12. Steenge GR, Simpson EJ, Greenhaff PL. (2000). Protein- and carbohydrate-induced augmentation of whole body creatine retention in humans. Journal of Applied Physiology, 89(3):1165 — 1171.
13. Tipton KD, Rasmussen BB, Miller SL, Wolf SE, Owens-Stovall SK, Petrini BE, Wolfe RR. (2001). Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. American Journal of Physiology. Endocrinology and Metabolism. 281(2):E197 — 206.
14. Willoughby DS, Rosene J. (2001). Effects of oral creatine and resistance training on myosin heavy chain expression. Medicine & Science in Sports & Exercise, 33(10):1674 — 1681.
15. Willoughby DS, Rosene JM. (2003). Effects of oral creatine and resistance training on myogenic regulatory factor expression. Medicine & Science in Sports & Exercise, 35(6):923 — 929.
16. Wolfe RR. (2001). Effects of amino acid intake on anabolic processes. Canadian Journal of Applied Physiology, 26 Suppl:S220 — 227
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