Part II. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?

Creatine monohydrate supplementation (CrM) is a safe and effective intervention for improving certain aspects of sport, exercise performance, and health across the lifespan. Despite its evidence-based pedigree, several questions and misconceptions about CrM remain. To initially address some of these concerns, our group published a narrative review in 2021 discussing the scientific evidence as to whether CrM leads to water retention and fat accumulation, is a steroid, causes hair loss, dehydration or muscle cramping, adversely affects renal and liver function, and if CrM is safe and/or effective for children, adolescents, biological females, and older adults.

Prevalence of electrocardiographic markers associated with myocardial fibrosis in masters athletes: a cohort study.

Objectives: Myocardial fibrosis (MF) is associated with an increased predisposition to adverse cardiac events. The accumulation of high-volume and high-intensity exercise over an extended duration potentially increases the risk of MF. Specific electrocardiographic markers have been correlated with the presence of MF.

Dietary Quality and Nutrient Intakes of Elite Paracyclists.

Nutrient requirements for para-athletes will be influenced by a variety of factors secondary to their impairment and, therefore, recommendations for para-athletes cannot be drawn directly from that of able-bodied athletes. Information on the dietary intakes of para-athletes is lacking and therefore needs to be examined. This study assessed the nutrient intakes and diet quality of 31 paracyclists via food frequency questionnaires.

The effect of tart cherry juice compared to a sports drink on cycling exercise performance, substrate metabolism, and recovery.

Tart cherries have low glycemic index, antioxidant and anti-inflammatory properties, and therefore may benefit performance and recovery from exercise. We determined the effects of consuming tart cherry juice versus a high-glycemic index sports drink on cycling performance, substrate oxidation, and recovery of low-frequency fatigue. Using a randomized, counter-balanced cross-over design, with one-month washout, 12 recreational cyclists (8 males and 4 females; 35±16y; VO2peak 38.

Nutrition Knowledge and Dietary Adequacy in Powerlifters.

Leonhardt, TPM, Chilibeck, PD, Ko, J, and Zello, GA. Nutrition knowledge and dietary adequacy in powerlifters. J Strength Cond Res 38(11): 1924-1932, 2024-Athletes competing in weight categories (e.

Musculoskeletal perturbations of deep space radiation: Assessment using a Gateway MRI.

Human space exploration expansion from Low-Earth Orbit to deep space is accelerating the need to monitor and address the known health concerns related to deep space radiation. The human musculoskeletal system is vulnerable to these risks (alongside microgravity) and its health reflects the well-being of other body systems. Multiparametric magnetic resonance imaging (MRI) is an important approach for assessing temporal physiological changes in the musculoskeletal system.

A Comparison of Subjective Estimations and Objective Velocities at Quantifying Proximity to Failure for the Bench Press in Resistance-Trained Men and Women.

Hickmott, LM, Butcher, SJ, and Chilibeck, PD. A comparison of subjective estimations and objective velocities at quantifying proximity to failure for the bench press in resistance-trained men and women. J Strength Cond Res 38(7): 1206-1212, 2024-The purpose of this study was to compare the accuracy of quantifying repetitions in reserve (RIR) in the bench press among 18 men and 18 women between 2 conditions: (a) subjective estimations and (b) objective velocities.

Dietary Intake of Athletes at the World Masters Athletics Championships as Assessed by Single 24 h Recall.

Proper dietary intake is important for masters athletes because of the physiological changes that occur with aging and the unique nutritional needs when competing at high levels. We evaluated the dietary intake of masters athletes competing at the World Masters Athletics Championships (outdoor games, Tampere, Finland, 2022, and indoor games, Torun, Poland, 2023). A total of 43 athletes (16 females and 27 males, mean age 59.

A park-based group mobility program for older adults with difficulty walking outdoors: a quantitative process evaluation of the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial.

Background: Process evaluations of randomized controlled trials (RCTs) of community exercise programs are important to help explain the results of a trial and provide evidence of the feasibility for community implementation. The objectives of this process evaluation for a multi-centre RCT of outdoor walking interventions for older adults with difficulty walking outdoors, were to determine: 1) implementation fidelity (the extent to which elements of the intervention were delivered as specified in the original protocol) and 2) participant engagement (the receipt of intervention components by the participants) in the Getting Older Adults Outdoors (GO-OUT) trial.

Methods: GO-OUT participants attended an active 1-day workshop designed to foster safe, outdoor walking skills.

Effects of hemp supplementation during resistance training in trained young adults.

Purpose: Hemp contains protein with high concentrations of the branched-chain amino acids leucine, isoleucine, and valine and oils that have anti-inflammatory properties. Our purpose was to investigate the effects of hemp supplementation during resistance training in trained young adults.

Methods: Males (n = 22, 29 ± 8y) and females (n = 12, 30 ± 9y) were randomized (double-blind) to receive 60 g/d of hemp (containing 40 g protein and 9 g oil) or 60 g/d of soy (matched for protein and calories) during eight weeks of resistance training (~  4x/week).

Finding the Optimal Resistance Training Intensity for Your Bones: Protocol for a Randomized Controlled Trial.

Objective: The purpose of this trial is to evaluate the effect of twice-weekly, moderate-to-high intensity progressive resistance training (PRT) for 1 year on lumbar spine bone mineral density (BMD) in individuals with low BMD, compared to attention control. Secondary analyses will examine if resistance training improves other health outcomes; if high intensity is more effective than moderate intensity resistance training for all outcomes; the cost of intervention versus benefit; the willingness to pay; and harms.

Methods: For this study, 324 men or postmenopausal women aged ≥50 years with a femoral neck, total hip, or lumbar spine BMD T-score of ≤-1, or a Fracture Risk Assessment Tool probability of ≥20% for major osteoporotic fracture or ≥ 3% for hip fracture are being recruited to participate in a randomized controlled trial with 1:1:1 randomization.

A Brief Narrative Review of the Underlying Mechanisms Whereby Omega-3 Fatty Acids May Influence Skeletal Muscle: From Cell Culture to Human Interventions.

Skeletal muscle is essential for human locomotion as well as maintaining metabolic homeostasis. Age-related reduction in skeletal muscle mass, strength, and function (i.e.

Low phytic acid pea supplementation as an approach to combating iron deficiency in female runners: A randomized control trial.

Iron deficiency (ID) is the most prevalent micronutrient deficiency in the world and the leading cause of anemia globally. Female athletes are at a disproportionate risk for ID due to blood loss through menstruation and decreased iron absorption secondary to exercise. Field peas are a rich source of iron but, similar to iron from other plant-based sources, the iron has limited bioavailability due to high levels of phytic acid, an inherent compound that binds to cations, creating a salt (phytate), which limits absorption during digestion.

A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health.

Purpose: Our purpose was to examine the effects of 2 yr of creatine monohydrate supplementation and exercise on bone health in postmenopausal women.

Methods: Two hundred and thirty-seven postmenopausal women (mean age, 59 yr) were randomized to receive creatine (0.14 g·kg -1 ·d -1 ) or placebo during a resistance training (3 d·wk -1 ) and walking (6 d·wk -1 ) program for 2 yr.

Prevention of COVID-19 during youth ice hockey.

Ice hockey players are susceptible to COVID-19 because of close contact and poor arena ventilation. Preventive strategies include reducing arena crowding, practice strategies that reduce clustering of players, at-home rapid tests, symptom screening, and face mask or vaccine recommendations for spectators, coaches, and players. Face masks have little effect on physiological responses or performance and reduce COVID-19 transmission, but shifts should be shortened later in periods to reduce perceived exertion and players should be encouraged to assume a classic "hockey stance" when puck handling to improve peripheral vision.

Effects of Creatine Supplementation and Progressive Resistance Training in Stroke Survivors.

The purpose was to investigate the effects of progressive resistance training (PRT) and creatine supplementation in stroke survivors. Participants were randomized to one of two groups: creatine ( = 5; 51 ± 16y) or placebo ( = 3; 73 ± 8y) during 10 weeks of supervised PRT. Prior to and following PRT and supplementation, assessments were made for body composition (lean tissue and fat mass), muscle thickness, muscle strength (1-repetition maximum), functional exercise capacity (6-minute walk test, Berg Balance Scale; BBS), cognition (Montreal Cognitive Assessment; MoCA), and symptoms of anxiety (Generalized Anxiety Disorder Assessment-7; GAD-7) and depression (Center for Epidemiological Studies Depression Scale; CES-D).

Creatine supplementation for older adults: Focus on sarcopenia, osteoporosis, frailty and Cachexia.

Sarcopenia refers to the age-related reduction in strength, muscle mass and functionality which increases the risk for falls, injuries and fractures. Sarcopenia is associated with other age-related conditions such as osteoporosis, frailty and cachexia. Identifying treatments to overcome sarcopenia and associated conditions is important from a global health perspective.

Effects of Omega-3 Supplementation Alone and Combined with Resistance Exercise on Skeletal Muscle in Older Adults: A Systematic Review and Meta-Analysis.

Sarcopenia negatively affects skeletal muscle mass and function in older adults. Omega-3 (ω-3) fatty acid supplementation, with or without resistance exercise training (RET), is suggested to play a role as a therapeutic component to prevent or treat the negative effects of sarcopenia. A systematic review and meta-analysis were conducted on the impact of ω-3 fatty acid supplementation with or without RET on measures of muscle mass and function in older adults (≥55 y).

Benefits of a plant-based diet and considerations for the athlete.

Individuals may opt to follow a plant-based diet for a variety of reasons, such as religious practices, health benefits or concerns for animal or environmental welfare. Such diets offer a broad spectrum of health benefits including aiding in the prevention and management of chronic diseases. In addition to health benefits, a plant-based diet may provide performance-enhancing effects for various types of exercise due to high carbohydrate levels and the high concentration of antioxidants and phytochemicals found in a plant-based diet.

The effects of Pilates on health-related outcomes in individuals with increased risk of fracture: a systematic review.

This systematic review examined the effect of Pilates on health-related outcomes in individuals with increased fracture risk to inform the 2021 Clinical Practice Guidelines for Management of Osteoporosis and Fracture Prevention in Canada. Seven electronic databases were searched to December 2020. Studies of Pilates in men and postmenopausal women aged ≥50 years with low bone mineral density (BMD), history of fragility fracture, or moderate-high risk of fragility fracture were included.

The Effect of Load and Volume Autoregulation on Muscular Strength and Hypertrophy: A Systematic Review and Meta-Analysis.

Background: Autoregulation has emerged as a potentially beneficial resistance training paradigm to individualize and optimize programming; however, compared to standardized prescription, the effects of autoregulated load and volume prescription on muscular strength and hypertrophy adaptations are unclear. Our objective was to compare the effect of autoregulated load prescription (repetitions in reserve-based rating of perceived exertion and velocity-based training) to standardized load prescription (percentage-based training) on chronic one-repetition maximum (1RM) strength and cross-sectional area (CSA) hypertrophy adaptations in resistance-trained individuals. We also aimed to investigate the effect of volume autoregulation with velocity loss thresholds ≤ 25% compared to > 25% on 1RM strength and CSA hypertrophy.