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Richard B. Kreider1*
Andrew R. Jagim2,3,4
Jose Antonio5
Douglas S. Kalman6
Chad M. Kerksick7
Jeffrey R. Stout8
Robert Wildman9Rick Collins10
Diego A. Bonilla11,12,13- 1Exercise and Sport Nutrition Laboratory, Human Clinical Research Facility, Texas A&M University, College Station, TX, United States
- 2Sports Medicine, Mayo Clinic Health System, La Crosse, WI, United States
- 3Exercise and Sport Science Department, University of Wisconsin—La Crosse, La Crosse, WI, United States
- 4Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA, United States
- 5Department of Health and Human Performance, Nova Southeastern University, Davie, FL, United States
- 6Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, United States
- 7Exercise and Performance Nutrition Laboratory, College of Science, Technology, and Health, Lindenwood University, St. Charles, MO, United States
- 8Physiology of Work and Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
- 9Department of Human Nutrition, Kansas State University, Manhattan, KS, United States
- 10Collins Gann McCloskey and Barry PLLC, Mineola, NY, United States
- 11Research Division, Dynamical Business and Science Society–DBSS International SAS, Bogotá, Colombia
- 12Hologenomiks Research Group, Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- 13Grupo de Investigación NUTRAL, Facultad Ciencias de la Nutrición y los Alimentos, Universidad CES, Medellín, Colombia
Introduction
As researchers investigating creatine supplementation, we have become increasingly concerned about reports that government agencies are attempting to restrict the sale of dietary supplements, including dietary supplements containing creatine, to children and adolescents. Creatine is a naturally occurring compound found in every cell in the human body that plays a critical role in cellular metabolism. The daily turnover of creatine is about 2–4 grams/day, depending on muscle mass and physical activity levels (1, 2). About half of the daily need for creatine is synthesized in the body from amino acids (arginine, glycine, methionine) and stored as free creatine or phosphocreatine in muscle, brain, heart, and other tissues (1). The remaining daily need to maintain normal cell and tissue levels of creatine primarily comes from consuming meat and fish. For example, one pound (16 oz.) of red meat and fish contains about 1–2 grams of creatine. In the cells, creatine changes into phosphocreatine, a compound vital in maintaining cellular energy availability, particularly during metabolically stressful conditions like intense exercise, periods of injury or illness, and some metabolic diseases with applications for diverse populations across a wide age range.
Creatine is essential to promote normal energy metabolism and healthy growth and maturation in children and adolescents (Figure 1). Low dietary creatine intake has been associated with slower growth, less muscle mass, and higher body fat in children and adolescents (3). Adolescents have been reported to consume lower than recommended amounts of creatine in the diet. Despite common misconceptions, creatine has a well-supported safety profile and has been repeatedly shown to be safe, even with long-term supplementation (4, 5). Additionally, there is no evidence that children and adolescents purchasing and taking creatine-containing supplements cause adverse health effects and/or increase the likelihood of eating disorders or use of performance-enhancing drugs. Conversely, individuals who take creatine are interested in improving health, exercise performance, gaining muscle mass, and improving their physique. While meat and fish are natural sources of creatine, they can be expensive and high in calories. A food-first approach is always recommended, meaning that dietary sources of creatine should be prioritized whenever possible. However, due to cost, accessibility, and other potential barriers, dietary supplementation of creatine monohydrate or supplements and foods fortified with creatine monohydrate are a cost-effective way to ensure that children and adolescents obtain enough creatine in their diet to promote healthy growth and maturation. Creatine supplementation has also been shown to be safe and have clinically meaningful benefits in pediatric disorders, including acute lymphoblastic leukemia, Duchenne muscular dystrophy, and disorders of creatine metabolism.
Figure 1
Figure 1. Creatine is an important nutrient throughout the lifespan. Readers are encouraged to visit the Association for Creatine Deficiencies (ACD) for more information about Cerebral Creatine Deficiency Syndromes (CCDS)—available at https://creatineinfo.org/, as well as Creatine For Health to know more about the research-based information for educational purposes to promote awareness of the importance of creatine in health and disease—available at https://creatineforhealth.com/, and the Creatine REsearch And information System (CREAS), a DBSS project that implements bibliometrics, scientometrics, and other AI-assisted analyses to routinely inform, develop, improve and support research endeavors and clinical practice (available at: https://creas.pro/). Created with BioRender.com (DB).
Legislation restricting the sale of creatine-containing products to children and adolescents is not based on scientific evidence which strongly supports the importance of creatine in the diet and its safety as a supplement. Moreover, creatine supplementation is not associated with eating disorders (6), and any claim suggesting the contrary is not rooted in scientific evidence. These false claims and reckless speculation regarding the dangers of creatine supplementation may discourage the use of creatine by minors, parents of minors, and healthcare professionals from recommending creatine supplementation, a nutrient that offers a plethora of health and performance-related benefits for all populations. This may further reduce the availability of creatine in children's and adolescents' diets, impairing growth and maturation and negatively impacting the development of a healthy body composition. Lobbying groups and legislatures should base laws on the available science, not speculation, unfounded hypotheses, or politics. We provide the following scientific facts about creatine to help those proposing legislative efforts to limit the availability of creatine in children and adolescents make more informed legislation.
Creatine facts
1. Creatine is a naturally occurring compound that is a primary constituent of phosphocreatine stored in cells and is needed to provide cellular energy.
2. The daily need for creatine is about 2–4 grams/day, depending on muscle mass and physical activity levels. About half of the daily need for creatine is synthesized in the body from the amino acids arginine, glycine, and methionine. The remainder must be obtained from the diet and/or dietary supplements.
3. The best sources of creatine in the diet are meat and fish, which contain about 1–2 grams of creatine per pound. Since meat and fish are expensive (about $4.00 to $18.00 USD per pound) and contain large amounts of protein and fat (i.e., about 450 to 1,400 kcals/pound), dietary supplementation of creatine monohydrate (about $0.03–$0.05 USD per gram) is a more cost-effective way to ensure individuals obtain enough creatine in their diet to meet daily needs (1).
4. Creatine supplementation can also be an effective dietary strategy for vegans or vegetarians who often do not consume enough creatine in their diet (7).
5. Analysis of the National Health and Nutrition Examination Survey (NHANES) database revealed that 4,291 boys and girls aged 2–19 years (3) consumed an average of 1 gram/day of creatine in their diets, and higher dietary intake of creatine (>1.5 grams/day) was associated with greater height and weight compared to those consuming diets lower in creatine. Dietary creatine intake was also positively correlated with lean mass and bone mineral content while negatively correlating with fat mass and body fat percentage in 1,273 children and adolescents between the ages of 8 and 19 years (8). These findings indicate that the dietary availability of creatine in children and adolescents may positively affect growth, maturation, and body composition. Yet, in recent years, younger populations have been reported to have decreased dietary creatine intake (9), underscoring the need for children and adolescents to consume more creatine in their diets.
6. The adequate intake (AI) for creatine is 7 mg/day for infants aged 0–6 months who are exclusively breastfed and 8.4 mg/day for infants aged 7–12 months (10).
7. The NHANES database also revealed that lower dietary creatine intake (i.e., <0.95 grams/day) was associated with poorer cognitive function test performance among 1,340 adults >60 years compared to those consuming diets with <0.95 grams per day (11). Additionally, analysis of dietary creatine intake among 1,500 adults >65 years revealed that 70% of this cohort consumed less than recommended amounts of creatine in their diets (<0.95 grams per day), and low dietary creatine intake was associated with a greater risk of angina pectoris and liver conditions compared to those consuming >1.0 grams per day of dietary creatine (12). These findings highlight the need for older individuals to increase dietary intake of creatine.
8. High-quality creatine monohydrate is Generally Recognized as Safe (GRAS) by the Food and Drug Administration (13) and is considered safe for human consumption in dietary supplements in the United States, Canada, Europe, Australia, South Korea, Japan, and China. Efforts are underway to fortify creatine in food and to position it as a conditionally essential nutrient.
9. Over 680 peer-reviewed clinical trials have been conducted on creatine supplementation (95% as creatine monohydrate) since the 1970s, involving over 12,800 study participants administered creatine supplements in dosages up to 30 grams per day for 14 years in populations ranging from infants to very elderly individuals in both healthy and clinical populations. No clinical adverse events were reported in any clinical trial study, and the minor side effects reported were infrequent and not significantly different from over 13,500 participants consuming placebos in these studies. This includes a comparison of studies conducted on children and adolescents (<18 years), young adults (19–45 years), middle-aged adults (46–65 years), and older adults (>65 years). Moreover, an analysis of over 28.4 million adverse event reports in the United States, Canada, Australia, and Europe, using SIDER 4.1 over the last 50 years, reveals that creatine has rarely been mentioned (about 0.0007%) despite billions of doses taken worldwide over the past 30 years. While adverse event reports do not imply causality, the lack of reports worldwide supports findings from clinical trials that creatine is safe for individuals of all ages.
10. Creatine monohydrate supplementation (e.g., 0.3 grams/kg/day for 5–7 days and 0.05 to 0.15 grams/kg/day thereafter) is the most effective nutritional strategy to increase and maintain tissue creatine content (1). Many studies indicate that creatine monohydrate supplementation increases gains in strength, high-intensity exercise performance, and muscle mass during resistance-exercise training (5, 14). It is considered the most effective nutritional strategy for individuals wanting to maintain and increase strength (5). Creatine supplementation has also been reported to reduce the risk of injury, including the severity of concussion and traumatic brain injury (2). Restricting the availability of creatine to children and adolescents may put them at risk for injury or compromise recovery following injury or disease management for neurocognitive disorders.
11. Emerging evidence indicates that creatine monohydrate supplementation possesses a number of health benefits during pregnancy and infancy (15), for children and adolescents (16), for women (17), for adults involved in exercise training (5), and for older populations (18). Additionally, there is evidence that creatine monohydrate supplementation enhances immunity (19) and can promote heart (20), vascular (21), and brain health (22). Therapeutic benefits have been reported in the management of diabetes (23), sarcopenia (24–27), osteoporosis (25, 28), patients with neuromuscular diseases (29), and rehabilitation (4, 24, 30–36). Furthermore, data shows that creatine slows the progression of some forms of cancer (37, 38) and may have therapeutic benefit in helping cancer patients maintain muscle mass (39) and prevent body fat accumulation during maintenance chemotherapy that includes corticosteroids (40). For this reason, it is recommended that all individuals consume 2–3 grams per day of creatine to promote general health (2, 5, 41).
12. Several studies, particularly in older populations, have shown that consuming diets higher in creatine (<0.95 grams/day) is associated with better cognition (6) and that creatine supplementation may improve cognitive function (42–45).
13. No evidence is available to demonstrate that consuming creatine monohydrate increases the prevalence of eating disorders or adversely affects individuals being treated for psychiatric conditions (6). Conversely, analysis of the NHANES database among 22,692 adults indicates that low dietary creatine intake is associated with a greater incidence of depression (45), which is often related to eating disorders and/or poor body image perceptions (46). Furthermore, creatine supplementation has been suggested as a potential nutritional adjunctive strategy to help manage depression and reduce suicidal ideations in individuals unresponsive to some psychiatric medications (47).
In summary, the robust body of evidence supports the safety and multifaceted benefits of creatine supplementation across all age groups. We urge lobbyists, policymakers, and health agencies to consult with leading creatine scientists, and to consider the full spectrum of scientific data before implementing restrictions that would have adverse public health and performance implications. This opinion letter was endorsed by leading creatine scholars (Table 1).
Table 1
Table 1. ISSN members, international creatine researchers, and scholars supporting this statement.
Author contributions
RK: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Software, Supervision, Validation, Writing – original draft, Writing – review & editing. AJ: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Software, Writing – original draft, Writing – review & editing. JA: Data curation, Formal analysis, Writing – review & editing. DK: Data curation, Formal analysis, Writing – review & editing. CK: Data curation, Formal analysis, Writing – review & editing. JS: Data curation, Formal analysis, Writing – review & editing. RW: Data curation, Formal analysis, Writing – review & editing. RC: Data curation, Formal analysis, Writing – review & editing. DB: Data curation, Formal analysis, Funding acquisition, Resources, Visualization, Writing – review & editing.
Funding
The author(s) declare that financial support was received for the research and/or publication of this article. The APC was funded by the DBSS Research Division.
Acknowledgments
We would like to express our sincere gratitude to the creatine scholars who have endorsed this opinion article (Table 1).
Conflict of interest
RK has conducted industry-sponsored research on creatine, received financial support for presenting at conferences about creatine, and has served as an expert witness throughout his career. Additionally, he serves as Chair of the Scientific Advisory Board for AlzChem (a company that makes creatine monohydrate), is a co-founder of the non-profit International Society of Sports Nutrition (ISSN), and a member of the scientific advisory boards for Oath Nutrition and Trace Minerals. AJ has consulted with and received external funding from companies selling certain dietary ingredients and has received remuneration from companies for delivering scientific conference presentations. AJ also writes for online and other media outlets on topics related to exercise and nutrition. In addition, AJ serves on the Scientific Advisory Board for AlzChem. JA is the CEO and co-founder of the International Society of Sports Nutrition (ISSN), an academic non-profit (501c3) sponsored by companies that manufacture, market, and sell dietary supplements. He is also a scientific advisor to brands including Bear Balanced®, Create®, Enhanced Games®, and Liquid Youth®. CK has consulted with and received external funding from companies that sell certain dietary ingredients and has received remuneration from companies for delivering scientific presentations at conferences and consulting services. CK also writes for online and other media outlets on topics related to exercise and nutrition. In addition, CK serves as a Scientific Advisor for NNB Nutrition, Oath Nutrition, and the Scientific Advisory Board for AlzChem. DK declares that over his career he has worked for Contract Research Organizations and others who have received research grants/contacts to execute studies for the pharmaceutical, foods, beverages, dietary supplement, and medical devices. DK co-directs a consultancy, Substantiation Sciences, consulting for the foods, beverages, dietary supplement consumer packaged goods, and other regulated industries. DK has also served as an Expert Witness for cases related to the pharmaceutical and dietary supplement industries. DK is a co-founder of the non-profit the International Society of Sports Nutrition. DK has been remunerated for presentations by companies within the pharmaceutical, foods/beverages and dietary supplement industries. DK serves as an unpaid member of the Scientific Advisory Committee for AlzChem. DB serves as the Scientific and Managing Director of KreaFood, an R&D&I project, and is a member of the “Creatine for Health” scientific advisory board for Alzchem Group AG. Additionally, he has served as a scientific consultant for dietary supplement brands in Europe and Colombia, researched nutritional supplements funded by academic institutions, and received honoraria for presenting on nutritional supplements at international conferences and private courses. RC has consulted with and represented companies that sell dietary supplements and serves in non-paying positions on the boards of supplement trade associations. Over the past 30 years, JS has received grants to investigate the efficacy and safety of dietary supplements, served as a paid consultant for the industry, and received honoraria for speaking at conferences and writing lay articles about sports nutrition ingredients and topics. RC is an equal partner of the law firm Collins Gann McCloskey and Barry PLLC.
The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
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The author(s) declare that no Gen AI was used in the creation of this manuscript.
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References
1. Kreider RB, Jager R, Purpura M. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. (2022) 14:1035. doi: 10.3390/nu14051035
2. Kreider RB, Stout JR. Creatine in health and disease. Nutrients. (2021) 13:447. doi: 10.3390/nu13020447
3. Korovljev D, Stajer V, Ostojic SM. Relationship between dietary creatine and growth indicators in children and adolescents aged 2-19 years: a cross-sectional study. Nutrients. (2021) 13:1027. doi: 10.3390/nu13031027
4. Balestrino M, Adriano E. Beyond sports: efficacy and safety of creatine supplementation in pathological or paraphysiological conditions of brain and muscle. Med Res Rev. (2019) 39:2427–59. doi: 10.1002/med.21590
5. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. (2017) 14:18. doi: 10.1186/s12970-017-0173-z
6. Hewlings SJ. Eating disorders and dietary supplements: a review of the science. Nutrients. (2023) 15:2076. doi: 10.3390/nu15092076
7. Balestrino M, Lensman M, Parodi M, Perasso L, Rebaudo R, Melani R, et al. Role of creatine and phosphocreatine in neuronal protection from anoxic and ischemic damage. Amino Acids. (2002) 23:221–9. doi: 10.1007/s00726-001-0133-3
8. Korovljev D, Todorovic N, Stajer V, Ostojic SM. Food creatine and DXA-derived body composition in boys and girls aged 8 to 19 years. Nutr Metab Insights. (2021) 14:11786388211059368. doi: 10.1177/11786388211059368
9. Korovljev D, Todorovic N, Stajer V, Ostojic SM. Temporal trends in dietary creatine intake from 1999 to 2018: an ecological study with 89,161 participants. J Int Soc Sports Nutr. (2021) 18:53. doi: 10.1186/s12970-021-00453-1
10. Ostojic SM. Establishing reference intakes for creatine in infants aged 0 to 12 months. Nutr Rev. (2024) 13:nuae124. doi: 10.1093/nutrit/nuae124
11. Ostojic SM, Korovljev D, Stajer V. Dietary creatine and cognitive function in U.S. adults aged 60 years and over. Aging Clin Exp Res. (2021) 33:3269–74. doi: 10.1007/s40520-021-01857-4
12. Ostojic SM, Korovljev D, Stajer V. Dietary intake of creatine and risk of medical conditions in U.S. older men and women: data from the 2017-2018 National Health and Nutrition Examination Survey. Food Sci Nutr. (2021) 9:5746–54. doi: 10.1002/fsn3.2543
13. GRN No. 931 Creatine Monohydrate. U.S. Department of Health and Human Services: U.S. Food and Drug Administration (2020).
14. Wax B, Kerksick CM, Jagim AR, Mayo JJ, Lyons BC, Kreider RB. Creatine for exercise and sports performance, with recovery considerations for healthy populations. Nutrients. (2021) 13:1915. doi: 10.3390/nu13061915
15. Muccini AM, Tran NT, de Guingand DL, Philip M, Della Gatta PA, Galinsky R, et al. Creatine metabolism in female reproduction, pregnancy and newborn health. Nutrients. (2021) 13:490. doi: 10.3390/nu13020490
16. Jagim AR, Kerksick CM. Creatine supplementation in children and adolescents. Nutrients. (2021) 13:664. doi: 10.3390/nu13020664
17. Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine supplementation in women's health: a lifespan perspective. Nutrients. (2021) 13:877. doi: 10.3390/nu13030877
18. Candow DG, Forbes SC, Kirk B, Duque G. Current evidence and possible future applications of creatine supplementation for older adults. Nutrients. (2021) 13:745. doi: 10.3390/nu13030745
19. Bredahl EC, Eckerson JM, Tracy SM, McDonald TL, Drescher KM. The role of creatine in the development and activation of immune responses. Nutrients. (2021) 13:751. doi: 10.3390/nu13030751
20. Balestrino M. Role of creatine in the heart: health and disease. Nutrients. (2021) 13:1215. doi: 10.3390/nu13041215
21. Clarke H, Hickner RC, Ormsbee MJ. The potential role of creatine in vascular health. Nutrients. (2021) 13:857. doi: 10.3390/nu13030857
22. Roschel H, Gualano B, Ostojic SM, Rawson ES. Creatine supplementation and brain health. Nutrients. (2021) 13:586. doi: 10.3390/nu13020586
23. Solis MY, Artioli GG, Gualano B. Potential of creatine in glucose management and diabetes. Nutrients. (2021) 13:570. doi: 10.3390/nu13020570
24. Dolan E, Artioli GG, Pereira RMR, Gualano B. Muscular atrophy and sarcopenia in the elderly: is there a role for creatine supplementation? Biomolecules. (2019) 9:642. doi: 10.3390/biom9110642
25. Candow DG, Forbes SC, Chilibeck PD, Cornish SM, Antonio J, Kreider RB. Effectiveness of creatine supplementation on aging muscle and bone: focus on falls prevention and inflammation. J Clin Med. (2019) 8:488. doi: 10.3390/jcm8040488
26. Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med. (2017) 8:213–26. doi: 10.2147/OAJSM.S123529
27. Riesberg LA, Weed SA, McDonald TL, Eckerson JM, Drescher KM. Beyond muscles: the untapped potential of creatine. Int Immunopharmacol. (2016) 37:31–42. doi: 10.1016/j.intimp.2015.12.034
28. Stares A, Bains M. The additive effects of creatine supplementation and exercise training in an aging population: a systematic review of randomized controlled trials. J Geriatr Phys Ther. (2020) 43:99–112. doi: 10.1519/JPT.0000000000000222
29. Tarnopolsky MA. Clinical use of creatine in neuromuscular and neurometabolic disorders. Subcell Biochem. (2007) 46:183–204. doi: 10.1007/978-1-4020-6486-9_10
30. Dover S, Stephens S, Schneiderman JE, Pullenayegum E, Wells GD, Levy DM, et al. The effect of creatine supplementation on muscle function in childhood myositis: a randomized, double-blind, placebo-controlled feasibility study. J Rheumatol. (2020) 48:434–41. doi: 10.3899/jrheum.191375
31. Balestrino M, Sarocchi M, Adriano E, Spallarossa P. Potential of creatine or phosphocreatine supplementation in cerebrovascular disease and in ischemic heart disease. Amino Acids. (2016) 48:1955–67. doi: 10.1007/s00726-016-2173-8
32. Neves Jr M, Gualano B, Roschel H, Fuller R, Benatti FB, Pinto AL, et al. Beneficial effect of creatine supplementation in knee osteoarthritis. Med Sci Sports Exerc. (2011) 43:1538–43. doi: 10.1249/MSS.0b013e3182118592
33. Cornelissen VA, Defoor JG, Stevens A, Schepers D, Hespel P, Decramer M, et al. Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial. Clin Rehabil. (2010) 24:988–99. doi: 10.1177/0269215510367995
34. Al-Ghimlas F, Todd DC. Creatine supplementation for patients with COPD receiving pulmonary rehabilitation: a systematic review and meta-analysis. Respirology. (2010) 15:785–95. doi: 10.1111/j.1440-1843.2010.01770.x
35. Hespel P, Derave W. Ergogenic effects of creatine in sports and rehabilitation. Subcell Biochem. (2007) 46:245–59. doi: 10.1007/978-1-4020-6486-9_12
36. Hespel P, Op't Eijnde B, Van Leemputte M, Urso B, Greenhaff PL, Labarque V, et al. Oral creatine supplementation facilitates the rehabilitation of disuse atrophy and alters the expression of muscle myogenic factors in humans. J Physiol. (2001) 536:625–33. doi: 10.1111/j.1469-7793.2001.0625c.xd
37. Di Biase S, Ma X, Wang X, Yu J, Wang YC, Smith DJ, et al. Creatine uptake regulates CD8 T cell antitumor immunity. J Exp Med. (2019) 216:2869–82. doi: 10.1084/jem.20182044
38. Campos-Ferraz PL, Gualano B, das Neves W, Andrade IT, Hangai I, Pereira RT, et al. Exploratory studies of the potential anti-cancer effects of creatine. Amino Acids. (2016) 48:1993–2001. doi: 10.1007/s00726-016-2180-9
39. Fairman CM, Kendall KL, Hart NH, Taaffe DR, Galvao DA, Newton RU. The potential therapeutic effects of creatine supplementation on body composition and muscle function in cancer. Crit Rev Oncol Hematol. (2019) 133:46–57. doi: 10.1016/j.critrevonc.2018.11.003
40. Bourgeois JM, Nagel K, Pearce E, Wright M, Barr RD, Tarnopolsky MA. Creatine monohydrate attenuates body fat accumulation in children with acute lymphoblastic leukemia during maintenance chemotherapy. Pediatr Blood Cancer. (2008) 51:183–7. doi: 10.1002/pbc.21571
41. Jager R, Purpura M, Shao A, Inoue T, Kreider RB. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids. (2011) 40:1369–83. doi: 10.1007/s00726-011-0874-6
42. VAN Cutsem J, Roelands B, Pluym B, Tassignon B, Verschueren JO, DE Pauw K, et al. Can creatine combat the mental fatigue-associated decrease in visuomotor skills? Med Sci Sports Exerc. (2020) 52:120–30. doi: 10.1249/MSS.0000000000002122
43. Dolan E, Gualano B, Rawson ES. Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. Eur J Sport Sci. (2019) 19:1–14. doi: 10.1080/17461391.2018.1500644
44. Avgerinos KI, Spyrou N, Bougioukas KI, Kapogiannis D. Effects of creatine supplementation on cognitive function of healthy individuals: a systematic review of randomized controlled trials. Exp Gerontol. (2018) 108:166–73. doi: 10.1016/j.exger.2018.04.013
45. Toniolo RA, Fernandes FBF, Silva M, Dias RDS, Lafer B. Cognitive effects of creatine monohydrate adjunctive therapy in patients with bipolar depression: Results from a randomized, double-blind, placebo-controlled trial. J Affect Disord. (2017) 224:69–75. doi: 10.1016/j.jad.2016.11.029
46. Nagoshi JL, Nagoshi C, Akter F, Pillai VK. Experienced versus perpetrated intimate partner violence and psychological maladjustment: the role of adaptive and avoidant coping. Int J Environ Res Public Health. (2024) 22:36. doi: 10.3390/ijerph22010036
Keywords: dietary supplements, creatine monohydrate, adolescent nutritional physiological phenomena, frail older adults, transition to adult care, public policy, nutritional epidemiology
Citation: Kreider RB, Jagim AR, Antonio J, Kalman DS, Kerksick CM, Stout JR, Wildman R, Collins R and Bonilla DA (2025) Creatine supplementation is safe, beneficial throughout the lifespan, and should not be restricted. Front. Nutr. 12:1578564. doi: 10.3389/fnut.2025.1578564
Received: 17 February 2025; Accepted: 20 March 2025;
Published: 04 April 2025.
Edited by:
Terence Moriarty, University of Northern Iowa, United StatesReviewed by:
Giannis Arnaoutis, Harokopio University, GreeceCopyright © 2025 Kreider, Jagim, Antonio, Kalman, Kerksick, Stout, Wildman, Collins and Bonilla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Richard B. Kreider, cmJrcmVpZGVyQHRhbXUuZWR1