Creatine consumption and liver disease manifestations in individuals aged 12 years and over

Abstract

Despite the overwhelming safety evidence concerning creatine intake in various settings, there is still incomplete information whether dietary creatine affects liver health at the population level. The main aim of this cross‐sectional population‐based study was to evaluate the association between creatine intake through regular diet and liver disease manifestations, including liver fibrosis and hepatic steatosis, among individuals aged 12 years and over, using open‐source data from the 2017–2018 U.S. National Health and Nutrition Examination Survey (NHANES). A total of 9254 male and female participants of all ages were included in the 2017–2018 NHANES round. We extracted data from the total sample population for participants who provided dietary data for individual foods via dietary interviews and examination data from liver ultrasound transient elastography. The final study sample consisted of 5957 participants (mean age 44.7 ± 21.0 years; 50.1% women), and the mean dietary creatine intake across the study population was 0.88 ± 0.71 g/day. Liver fibrosis and cirrhosis were diagnosed in 1703 (28.7%) and 288 (4.8%) participants, respectively; hepatic steatosis was identified in 2595 (43.7%) individuals. Binary logistic regression with multivariable model adjusted for age, gender, family income to poverty ratio, body mass index, total energy intake, and alcohol consumption showed that consuming more creatine (≥2 g/day) did not significantly increase the risk of liver fibrosis (OR = 0.92, 95% CI 0.70–1.21, p = .57), cirrhosis (OR = 0.94, 95% CI 0.53–1.65, p = .82), or hepatic steatosis (OR = 0.77, 95% CI 0.59–1.02, p = .07), as compared to participants who ingested <1 g of creatine daily. Dietary exposure to creatine through a regular diet is not associated with an increase in disease manifestations in individuals 12 years and over; further research is warranted to address the effects of excessive creatine intake (≥5 g/day) through a regular diet on liver health at the population level.

Creatine homeostasis and the kidney: comparison between kidney transplant recipients and healthy controls

“…The daily intake of meat, fish and dairy was used to calculate the daily creatine intake. Individual values for total grams of creatine consumed per day were computed using the average amount of creatine (0.20 g/kg for dairy-based foods and 3.88 g/kg for meat and fish) across all creatine-containing food sources, as described in (Bakian et al 2020 ; Korovljev et al 2021 ; Todorovic et al 2022 ).…”

“…In omnivores, this supply is a combination of dietary creatine intake and endogenous creatine synthesis. Dietary sources of creatine are primarily animal-based foods (meat, poultry, fish, and seafood) and dairy products (Bakian et al 2020 ; Korovljev et al 2021 ; Todorovic et al 2022 ). Endogenous creatine synthesis consists of two steps.…”