Anti-Aging Benefits of

CREATINENew Research Suggests Creatine Combats Muscle Loss,

Improves Brain Function, and May Modulate Inflammation

By Will Brink

C reatine is a nutrient with a long list of potential medical, exercise-enhancing, and anti-aging

applications. As discussed in the March 2003 issue o^ Life Extension, creatine may play a role in

preventing and treating diseases such as muscular dystrophy that affect the neuromuscular sys-

tem.' Creatine has potential therapeutic apphcations in aging populations and against disorders such as

wasting syndromes, muscle atrophy, fatigue, Parkinson's disease, and Huntington's disease, as well as mito-

chondrial disorders and brain pathologies. Another article in the September 2003 issue oi Life Extension

examined creatine's potential role in increasing growth hormone levels, reducing homocysteine levels, and

improving the symptoms of chronic fatigue syndrome.^

In this article, we will examine exciting new research on the use of creatine by older adults to fight age-

related muscle loss (sarcopenia), improve function in both healthy and damaged brains, and perhaps mod-

ulate inflammation. Crearine is proving ro be one of the most promising, well-researched, and safest

supplements ever discovered for an exceptionally wide range of uses. > > >

42

• * . j i ;^*-" C&.S?

What is creatine? In a nutshell,creatine helps the body generateenergy. Adenosine triphosphate(ATP), formed in the mitochon-dria, is often referred to as thebody's "universal energy molecule."When ATP loses a high-energyphosphate molecule to becomeadenosine diphosphate (ADP), itmust be converted back to ATPbefore it can be used again to pro-duce energy. Creatine, stored inthe body as creatine phosphate, candonate a phosphate group to ADP,thus recharging it to energy-pro-ducing ATP. By promoting fasterand more efficient recycling ofATP, creatine helps provide thefuel our bodies need to accomplishphysical and metabolic tasks.'

THE SCOURGE OE AGING:SARCOPENIA

In literally dozens of studies,creat ine has been shown toincrease strength and muscle massin young adults and to aid in reha-bilitative strength training."' Untilrecently, data concerning crea-tine's effects on older adults was

very limited. One of the greatestthreats faced by aging adults is thesteady loss of lean body mass(muscle) needed to maintain ahealthy, functional lifestyle. Themedical term for this loss of mus-cle tissue is sarcopenia, a conditionthat is only now getting the recog-nition it deserves by the medicaland scientific community.

Sarcopenia can be defined asthe age-related loss of musclemass, strength, and function. Fordecades, the medical communityhas focused on the loss of bonemass (osteoporosis) in agingadults, but has paid little attentionto the loss of muscle mass thatoccurs with aging. This loss ofmuscle mass can affect a person'sability to be functional, perhapseven more so than a loss of bonemass. As with most medical condi-tions, it is easier, less expensive,and more effective to prevent orslow the progression of this condi-tion than it is to treat it later inlife. Sarcopenia generally appearsin adults after the age of 40 andaccelerates after the age ofapproximately 75.

Although sarcopenia is mostlyseen in physically inactive adults, itis not uncommon in people whoremain physically active through-out their lives. Thus, while remain-ing physically active is essential toavoiding sarcopenia, physical inac-tivity is not the only contributingfactor to its development. Likeosteoporosis, sarcopenia is a multi-factorial process whose contribut-ing factors may include decreasedhormone levels (particularly ofgrowth hormone, insulin-likegrowth factor 1, and testosterone),lack of adequate protein and calo-ries in the diet, oxidative stress,inflammatory processes, and loss ofmotor nerve cells."'"

HOW CREATINE AFEECTSOLDER ADULTS

With aging and inactivity, musclewasting or atrophy most often occursin fast-twitch muscle fiber. Thesefibers, which are recruited duringhigh-intensity, low-endurance move-ments such as weight lifting andsprinting, are the most profoundlyaffected by creatine.

In a study examining creatine'seffect on isometric strength andbody composition, 28 healthy menand women over the age of 65received either five grams of crea-tine daily or a placebo.'̂ In this ran-dom, double-blind study, both thecreatine and placebo groups wereput on a resistance (weight) train-ing regimen. Fourteen weeks oftraining resulted in significantincreases in all measurements ofstrength, functional tasks, andmuscle fiber area in both groups.However, the creatine groupexperienced significantly greaterincreases in fat-free muscle mass,isometric knee extension strength,isometric dorsiflexion (ankle)strength, and intramuscular crea-tine levels. The researchers con-cluded, "the addition of creatine

44 LIFE EXTENSION April 2005

suppletnentation to the exercisestitnulus enhanced the increase intotal atid fat-free mass and gains inseveral indices of isometric musclestrength."^^

An abundatice of recent studieshas found creatine to have benefi-cial effects in older adults, espe-cially when combined with arcsistatice training protocol. Onestudy examined the effects of crea-tine supplementation on muscularperformance in older men over abrief time period." The studyauthors concluded, " . . . seven daysof creatine supplementation iseffective at increasing severalindices of muscle performance,including functional tests in oldermen without adverse side effects.Creatine supplementation may bea useful therapeutic strategy forolder adults to attenuate loss itimuscle strength and performanceof functional living tasks."

One especially noteworthy studyfound that crealine's positiveeffects on strength and lean tissuein older adults continued for atleast 12 weeks after they stoppedusing it.-" According to the studyauthors, "withdrawal from creatinehad no effect on the rate ofstrength, etidurancc, and loss of

lean tissue mass with 12 weeks ofreduced-volume training." Formost creatine users, however, opti-mal benefits occur with continuoususe of creatine, which is both safeand well tolerated.

THE SECRET TO AGING:CELLULAR ENERGY

What is one important differ-ence between an older and ayounger adult? The answer is cellu-lar energy: each cell's ability to pro-duce energy, detoxify harmfulcompounds, and defend itselfagainst free radical damage andother assaults. An increase inoxidative stress, coupled with acell's inability to produce essentialenergy molecules such as ATP, is ahallmark of aging and is present inmany disease states.''"^" While ayounger person's cells can effi-ciently meet these challenges, anolder person's cells are poorlyequipped to do so. Over time, dam-age accumulates in older cells, andcell death can occur. In youngerhealthy adults, healthy new cellsrapidly repair or replace older cells,but this process slows with age,

A decline in muscle mass withaging, or sarcopenia, may be relat-ed to a decline in mitochondrialfunction. Without optimal func-tioning of these energy generatorsthat arc found in every human cell,both the cell and the entire bodyexperience a decline in function.Research has established that olderadults tend to have lower tissue lev-els of creatine phosphate, ATP,and other essential high-energymolecules. Older adults are alsoless adept at replenishing theseessential molecules after exercise.

One study examined skeletalmuscle mitochondrial functionand lean body mass in healthy,exercising elderly adults.^' Thestudy measured mitochondrialfunction and recovery time in 45

older adults (with an average ageof 73) and 20 younger subjects(average age of 25) who werematched for body mass. The inves-tigators then had the two groupsexercise at different intensity lev-els. As other studies have found,the older adults had lower base-line creatine phosphate and ATPlevels than did their younger coun-terparts, and they were slower toreplenish tissue levels after exer-cise. As the researchers reported,"Our data suggest that mitoehon-drial function declines with age inhealthy, exercising elderly adultsand that the decline appears to beinfluenced by the level of physicalactivity," Thus, the older subjectsnot only had lower levels of essen-tial high-energy compounds tobegin with, but those levels werefurther diminished with moreintense exercise.

As studies in older adults show,creatine in supplemental form canameliorate some of the physiologi-cal decline that occurs with aging.Creatine may be one of the safest,most effective non-prescriptioncompounds currently available toimprove cellular energy.

April 2005 LIFE EXTENSION 45

CREAllNE'SANTI-INFLAMMATORY

EFFECTS

Creatine may also help to modu-late inflammation, at least afterexercise. One study examined crea-tine's effect on inflammation andmuscle soreness in experiencedrunners after a 30-kiIometer race.""-The researchers looked at inflam-matory and muscle sorenessmarkers—creatine kinase, lactatedehydrogenase, prostaglandin E2,and tumor necrosis factor-alpha—in runners before and after therace. One group of runners supple-mented for five days before therace with 20 grams of creatine and15 grams of maltodextrine daily,while the control group receivedonly the maltodextrine. Blood sam-ples were collected before the race,immediately afterwards, and 24hours after the race.

As one would expect, the controlgroup had large increases in allfour markers: a fourfold increase increatine kinase concentration, a43% increase in lactate dehydroge-nase, more than a sixfold increasein prostaglandin E2, and a dou-bling of tumor necrosis factor-

alpha. All these markers indicate ahigh level of cell injury and inflam-mation in these athletes. In thecreatine group, however, supple-mentation attenuated the exercise-induced changes observed forcreatine kinase by 19%, forprostaglandin E2 by 61%, and fortumor necrosis factor-alpha by34%, while entirely negating theincrease in lactate dehydrogenaseplasma concentration observed inthe control group. Participantssupplementing with creatinereported no side effects. Theresearchers concluded, "Theseresults indicate that creatine sup-plementation reduced cell damageand inflammation after an exhaus-tive, intense race."

These findings underscore animportant point. Regular exer-cise is an essential component ofwellness for people who want toimprove their health, minimizebody fat, and retain essential mus-cle mass. Exercise, however, alsohas potentially negative effects thatthe body must manage, includingincreased free radical production.Creatine thus may be beneficial inhelping to modulate the inflamma-tory stress generated by exercise.

CREATINE IMPROVESBRAIN FUNCTION

Perhaps the most compellingcase for creatine supplementationis its ability to modulate brainfunction and metabolism. Previousarticles in Life Extension haveexamined some of creatine's appli-cations in promoting muscle, brain,and heart health.'^ Ongoingresearch indicates that creatine isan important nutrient for brainfunction and metabolism in bothhealthy people and those who suf-fer from brain damage or brain-related disease. Traumatic braininjuries affect thousands each year.Adding to this tragedy is that muchof the damage is caused not by theimmediate injury to the brain, butby cell death caused by ischemia(lack of blood flow and oxygen totissues), free radical damage, andoxidative stress.

A cell's ability to function isdirectly related to its mitochondri-al health and ATP status. Evensmall changes in ATP supply canhave profound effects on the tis-sues' ability to function properly.Heart tissue, brain neurons, andother highly active tissues are verysensitive to diminished ATP levels.Creatine appears to be among themost effective nutritional supple-ments for maintaining or raisingATP levels.

Recent research indicates thatcreatine affords the human ner-vous system significant protectionagainst ischemic and oxidativeinsults.̂ '"'''A study published in theAnnals of Neurology examinedcreatine's effects on brain tissuedamage following simulated trau-matic brain injury in animals."Administration of creatine amelio-rated the extent of cortical damageby as much as 36% in mice and50% in rats. The researchers notedthat this protection may be tied tocreatine-induced maintenance of

46 LIFE EXTENSION April 2005

mitochondrial bioenergetics. Theyconcluded that creatine ". . . mayprovide clues to the mechanismsresponsible for neuronal loss aftertraumatic brain injury and may finduse as a neuroprotective agentagainst acute and delayed neurode-generative processes." This studysuggests that creatine therapyshould be initiated as soon as possi-ble after traumatic brain injury.People who have already beenusing creatine regularly may beafforded considerable protectionagainst additional brain damagefollowing such an injury.

Research also indicates thatcreatine improves brain functionin healthy adults. A recent dou-ble-blind, placebo-controlledcrossover study examined how sixweeks of ereatine supplementa-tion affected cognitive function inadult vegetarians.'" Subjects weregiven five grams of creatine daily.Following creatine supplementa-tion, the study participants demon-

strated improved scores on testsassessing intelligence and workingmemory. Creatine's effects may bedue to its ability to increase the cel-lular energy available to the brain.Although creatine supplementa-tion may have a less dramatic effecton non-vegetarians who obtainsome creatine from dietary sourcessuch as meat, it is likely that crea-tine benefits brain function in meateaters and vegetarians. Supple-mental creatine thus appears toimprove function and performancein healthy and injured brains alike.

CONCLUSION

Through its role in promoting anabundant pool of cellular energy,creatine helps support the healthyfunctioning of muscle, brain, andother body tissues. A substantialbody of research demonstrates thatcreatine is a safe and effective toolfor managing a wide range ofpathologies, and may be a powerful

COMBINING NUTRIENTS TO COMBAT SARCOPENIA

Creatine helps to build muscle mass, but may work even better when combinedwith other nutrients. Whey protein is well known for its ability to augment athletictraining, boost immunity, and increase levels of the body's primary Intracellular antiox-idant, glutathione."^" Many athletes and health-conscious people have made wheyprotein a regular part of their diet in order to reap its vast array of benefits. Glutamine,the body's most abundant amino add, is essential in supporting muscle mass, immu-nity, gut health, and more.'"" Together, creatine, whey protein, and giutamine offerpowerful anabolic support for building musde.

Life Extension has combined this dynamic trio of nutrients in its Creatine Whey Glu-tamine Powder formula. Unlike other formulas that contain minimal amounts of nutri-ents, two scoops of Creatine Whey Glutamine Powder provide 30 grams of CFM^^whey isolate, 6 grams of glutamine, and 4 grams of German micronized creatine. Thisformula is indicated not only for those fighting the muscle loss of sarcopenia, but forall adults who seek to optimize their body composition and protect against age-relat-ed disease.

A healthy meal substitution recipe that tastes great and contains an impressivearray of health benefits is one to three scoops of Creatine Whey Glutamine Powder,one cup of filtered water, one-half cup of juice, and one-half cup of frozen strawber-ries or other fruit blended to taste. For a true meal replacement beverage, add onetablespoon of an oil rich in omega-3 fatty adds, such as flaxseed oil or Udo's ChoiceOil Blend, and one to three scoops of Life Extension Mix^^ powder. This creates a trulyhealthy meal containing virtually every nutrient needed for optima! health and diseaseprevention.

anti-aging nutrient. Healthy adultsmay benefit from supplementingwith two to three grams of creatinedaily, while those seeking toaddress specific health concernssuch as muscle loss or brain injurymay benefit from five to ten gramsof creatine daily. •

Additional information on howcreatine and other supplements may

benefit athletes is available atwww. Muscle BuildingNutdtion. com.

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