Creatine Monohydrate Use in Adolescents for Athletic Performance Enhancement Amber Helou Saint Peter’s University ABSN Helou 2 Creatine Monohydrate for Adolescent Athletic Performance Enhancement Knowledge and recommendations regarding a variety of topics have now become easily accessible to those who have access to the internet, including adolescents. A topic that has been discussed extensively in recent years is the use of athletic enhancement supplements by teens, many of whom have discovered these supplements via online recommendations for muscle building. Now Foods states that their creatine monohydrate powder will provide quick bursts of power, strength, and optimal performance, making it a staple in any athlete’s diet. This powder is solely made of creatine monohydrate with a recommended serving size of 5 grams (see nutritional label below). One of the largest claims Now Foods states is that of not only maintaining muscle mass but promoting the development of lean muscle mass during intense exercise1. Jenna Braddock, a registered dietitian and certified specialist in sports dietetics, claims that creatine is not only safe for adolescents, but can benefit them by protecting the brain from concussions and enhancing recovery2. Braddock goes on to state, “Studies further suggest that teen athletes can benefit from creatine supplementation as it improves recovery, cognition, and fatigue”2. In this article, Braddock lists her research references which seem to be some of the few that can be found studying the use of creatine in adolescents. Several different companies that produce creatine powder for supplementation purposes state on the label that it is to not be used by anyone below the age of 18, but rather than this being a warning backed by research, it is simply a legal precaution that is now evidence-based. To evaluate the validity of these claims of safety and athletic enhancement, several journals have been reviewed for discussion. In a journal published by the National Library of Medicine in 2021 titled “Creatine Supplementation in Children and Adolescents”3, it is stated that there is a dire need for more research and double-blind clinical trials to accurately understand the safety of creatine use amongst this age group as well as whether or not it will enhance muscle building. While acknowledging the lack of evidence, this journal claims that there are seemingly no adverse effects of creatine use as indicated by the current research made available to us The author states, Helou 3 “Additionally, the recent popularity of marketing through social media platforms and online markets for supplement companies has likely altered how adolescents perceive and obtain information surrounding dietary supplements in addition to how they purchase them Further, there continues to be a need for more education regarding safe and effective dietary supplement strategies among adolescents, rather than strict policies avoiding or advocating against their use”3. As per the author of this journal, clinical trials show no significant changes in organ function in adolescents who have used creatine monohydrate. So long as the proper research is done prior to purchasing the product, they are claiming that the hypothesis of this supplement being safe for this specific age group is supported by additional claims of creatine improving the athletic ability of those who consistently use it. The authors of “Safety of Creatine Supplementation in Active Adolescents and Youth: A Brief Review”, which was published by the National Library of Medicine in 2018, claim that evidence continues to emphasize that this supplement is well tolerated by healthy adolescents. The author states that no studies have been performed to directly examine the safety of creatine in this age group4. The authors of this journal reviewed said studies to determine if there were any clinical side effects noted in the trials. The evidence backing the author’s claim that creatine is safe is backed by the statement “... none of these studies observed any gastrointestinal discomfort or changes in hemodynamic, urine, or any blood markers of clinical health and safety following the supplementation periods”4. The authors have not compiled research from a trial specifically aiming to determine if there are any side effects of creatine use in adolescents but instead have analyzed pre-existing trials that focus on the ability of this supplement to enhance muscle mass. While the prior two journals have claimed that creatine use is beneficial for the improvement of athletic ability with no safety concerns, the following articles goes against this. In an article titled “Is the Warning that Creatine’s Not for Teens Getting Through?” published by National Public Radio in 2017, Patti Neighmond begins by emphasizing that supplements are not as intensely evaluated as drugs are by the Food and Drug Administration (FDA) regarding safety. In this article, Neighmond evaluates a survey done by the Children’s Medical Center of New York in which a 20-year-old undergraduate posed as a 15-year-old athlete while calling different stores for recommendations for muscle enhancement supplements. Over 2/3 of the stores recommended creatine to the supposed minor regardless of the warning against use by those under 18 years of age on every label5. One of the largest concerns causing researchers to warn teens against the use of creatine is the purity of the supplement. Due to the lack of strict regulation of dietary supplements, the quality of these supplements is not controlled meaning that there is a possibility of contamination with other harmful substances. Rather, this article recommends a good diet and strength training program as a more effective and safe way for adolescent athletes to build muscle. The consensus amongst researchers is that there is a need for high-quality, controlled studies on the use of creatine monohydrate in the adolescent population. It is important to acknowledge the lack of studies and the influence of social media marketing when evaluating the efficacy of this supplement in regard to the enhancement of muscle mass. For this reason, parents and teens should speak extensively to their primary care physician about adverse effects and how this supplement can affect their health. Helou 4 References 1. NOW Sports Creatine Monohydrate Powder Mass Building* / Energy Production*. Nowfoods.com. https://www.nowfoods.com/products/sports-nutrition/creatinemonohydrate-powder. Accessed April 29, 2022. 2. Braddock J. Benefits of Creatine for Teen Athletes. Off-Season Athlete. https://offseasonathlete.com/benefits-of-creatine-for-teen-athletes/. Published June 22, 2021. Accessed April 29, 2022. 3. Jagim AR, Kerksick CM. Creatine supplementation in children and adolescents. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922146/. Nutrients. 2021;13(2):664. doi:10.3390/nu13020664 4. Jagim AR, Stecker RA, Harty PS, Erickson JL, Kerksick CM. Safety of creatine supplementation in active adolescents and youth: A brief review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279854/. Frontiers in Nutrition. 2018;5. doi:10.3389/fnut.2018.00115 5. Neighmond P. Is the warning that creatine's not for teens getting through? National Public Radio. https://www.npr.org/sections/health-shots/2017/01/02/507478762/is-the-warningthat-creatines-not-for-teens-gettingthrough#:~:text=The%20American%20Academy%20of%20Pediatrics,recommended%20 for%20anyone%20under%2018. Published January 2, 2017. Accessed April 29, 2022.
