Creatine Supplementation in Children and Adolescents

Abstract

Creatine is a popular ergogenic aid among athletic populations with consistent evidence indicating that creatine supplementation also continues to be commonly used among adolescent populations. In addition, the evidence base supporting the therapeutic benefits of creatine supplementation for a plethora of clinical applications in both adults and children continues to grow. Among pediatric populations, a strong rationale exists for creatine to afford therapeutic benefits pertaining to multiple neuromuscular and metabolic disorders, with preliminary evidence for other subsets of clinical populations as well. Despite the strong evidence supporting the efficacy and safety of creatine supplementation among adult populations, less is known as to whether similar physiological benefits extend to children and adolescent populations, and in particular those adolescent populations who are regularly participating in high-intensity exercise training. While limited in scope, studies involving creatine supplementation and exercise performance in adolescent athletes generally report improvements in several ergogenic outcomes with limited evidence of ergolytic properties and consistent reports indicating no adverse events associated with supplementation. The purpose of this article is to summarize the rationale, prevalence of use, performance benefits, clinical applications, and safety of creatine use in children and adolescents.

Youth Athlete Development and Nutrition

“…The judicious use of specific dietary supplements and nutritional ergogenic aids may improve sporting performance in adults [ 84 ]. However, most (but not all [ 85 ]) products are yet to have their effectiveness and long-term safety rigorously explored in younger populations, often due to the ethical principle of beneficence (i.e. cost vs. benefit).…”

“…Apart from issues related to safety, the use of legal supplements in developing athletes over-emphasizes their ability to manipulate performance (i.e., typically 2–5% improvement [ 84 ]). Prioritising prudent training and whole food-based nutrition practices in adolescent athletes has been emphasized, even when safe supplements are being considered [ 85 ].…”

Exercise, Nutrition, and Supplements in the Muscle Carnitine Palmitoyl-Transferase II Deficiency: New Theoretical Bases for Potential Applications

“…Furthermore, creatine supplementation might influence post-exercise muscle recovery by enhancing muscle satellite cell proliferation ( Vierck et al, 2003 ; Olsen et al, 2006 ). Creatine monohydrate (CM) is currently considered a safe and effective supplement to support resistance activities in the healthy, and several therapeutic benefits in diseased populations (ranging from the young to the elderly) have been reported ( Smith et al, 2014 ; Candow et al, 2019 ; Stares and Bains, 2020 ; Jagim and Kerksick, 2021 ; Kreider and Stout, 2021 ). Considering its strong background, a periodical use of CM can be speculated in CPTII deficiency patients with different aims (e.g., at the beginning of a training program, to support muscle bioenergetics or to reduce fatigue when muscle recovery/adaptation needs to be boosted).…”

A Convergent Functional Genomics Analysis to Identify Biological Regulators Mediating Effects of Creatine Supplementation

“…The CK/PCr system can be enhanced through supplementation with creatine monohydrate (CrM), which is the most studied, safe, and effective nutritional supplement to optimize physical performance [ 5 , 6 , 7 , 8 ], with potential benefits in health and disease [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. It seems that the elevation of intracellular PCr concentration causes a greater capacity for phosphagens to contribute to energy metabolism, while working to reduce the accumulation of Pi and H + and improving Ca 2+ handling as important mediators of fatigability in young and older adults [ 20 , 21 , 22 , 23 ].…”