Overview – Creatine loading can acutely enhance the performance of sports involving repeated high-intensity exercise (eg, team sports)
– As well as the chronic outcomes of training programs based on these characteristics (eg, resistance or interval training)
– This leads to greater gains in lean mass and muscular strength and power
Mechanism – Supplementation increases muscle creatine stores, augmenting the rate of PCr resynthesis, thereby enhancing short-term, high-intensity exercise capacity and the ability to perform repeated bouts of high-intensity effort.
Protocol of use – Loading phase: ~20 g/day (divided into four equal daily doses), for 5–7 days
– Maintenance phase: 3–5 g/day (single dose) for the duration of the supplementation period
Note: taken with a mixed protein/CHO source (~50 g of protein and CHO) may enhance muscle creatine uptake via insulin stimulation
Performance Impact – Enhanced maximum isometric strength
– Acute performance of single and repeated bouts of high-intensity exercise (<150 s duration)

– Most pronounced effects evident during tasks <30 sec
– Chronic training adaptations include lean mass gains and improvements to muscular strength and power
– Less common: enhanced endurance resulting from increased/improved protein synthesis, glycogen storage and thermoregulation
– Potential anti-inflammatory and antioxidant effects are noted
Further considerations and potential side effects – No negative health effects are noted with long-term use (up to 4 years) when appropriate loading protocols are followed
– A potential 1–2 kg BM increase after creatine loading (primarily as a result of water retention)
– This may be detrimental for endurance performance or in events where the BM must be moved against gravity (eg, high jump, pole vault) or where athletes must achieve a specific BM target

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