Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans
Abstract
This study investigated the effect of carbohydrate (CHO) ingestion on skeletal muscle creatine (Cr) accumulation during Cr supplementation in humans. Muscle biopsy, urine, and plasma samples were obtained from 24 males before and after ingesting 5 g Cr in solution (group A) or 5 g Cr followed, 30 min later, by 93 g simple CHO in solution (group B) four times each day for 5 days. Supplementation resulted in an increase in muscle phosphocreatine (PCr), Cr, and total creatine (TCr; sum of PCr and Cr) concentration in groups A and B, but the increase in TCr in group B was 60% greater than in group A (P < 0.01). There was also a corresponding decrease in urinary Cr excretion in group B (P < 0.001). Creatine supplementation had no effect on serum insulin concentration, but Cr and CHO ingestion dramatically elevated insulin concentration (P < 0.001). These findings demonstrate that CHO ingestion substantially augments muscle Cr accumulation during Cr feeding in humans, which appears to be insulin mediated.
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Ingesting creatine with carbohydrate or carbohydrate and protein have been reported to more consistently promote greater creatine retention.
“Ingesting creatine with carbohydrate or carbohydrate and protein have been reported to more consistently promote greater creatine retention”
From International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine (2017) · cites this paper as [8]
Dietary supplementation of creatine serves to increase muscle creatine and PCr by 20-40%.
“Therefore, dietary supplementation of creatine serves to increase muscle creatine and PCr by 20–40%”
From International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine (2017) · cites this paper as [8]
Creatine's ability to promote glycogen loading and storage of carbohydrate may translate into improved endurance exercise performance.
“Less research is available involving creatine supplementation and endurance exercise, but creatine’s ability to promote glycogen loading [463] and storage of carbohydrate [464–466], key fuels during endurance exercise, may translate into improved endurance exercise performance.”
From ISSN exercise & sports nutrition review update: research & recommendations (2018) · cites this paper as [463]
Once muscle creatine stores are fully saturated, creatine stores can generally be maintained by ingesting 3-5 g/day, although some studies indicate that larger athletes may need to ingest as much as 5-10 g/day.
“Once muscle creatine stores are fully saturated, creatine stores can generally be maintained by ingesting 3–5 g/day, although some studies indicate that larger athletes may need to ingest as much as 5–10 g/day”
From International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine (2017) · cites this paper as [8]
CrM supplementation (e.g., 5 g/day for 5-7 days or 3-5 g/day for 30 days) increases blood, muscle, and tissue levels of creatine and PCr by 20-40%.
“Over the last 30 years, several studies have shown that CrM supplementation (e.g., 5 g/day for 5–7 days or 3–5 g/day for 30 days) increases blood, muscle, and tissue levels of creatine and PCr by 20–40% [11,12,19,20].”
From Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review (2022) · cites this paper as [20]
Co-ingesting CrM with carbohydrates and carbohydrate and protein promotes more consistent and greater creatine retention.
“Co-ingesting CrM with carbohydrates [20,21,22] and carbohydrate and protein [23] promotes more consistent and greater creatine retention.”
From Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review (2022) · cites this paper as [20]
For a dietary source of creatine to be bioavailable, creatine must be absorbed as creatine into the blood and transported to tissues, transported into tissue via tissue-specific creatine transporter genes, and increase tissue and cellular creatine and PCr content by a physiologically meaningful amount (e.g., 20-40% in muscle and 10-20% in brain).
“For a dietary source of creatine to be bioavailable, creatine must be: (1) absorbed as creatine into the blood and transported to tissues [2,25]; (2) transported into tissue via tissue-specific creatine transporter genes (e.g., CRT1 or SLC6A8 in muscle) [6,7]; and (3) increase tissue and cellular creatine and PCr content by a physiologically meaningful amount to influence metabolic activity (e.g.,”
From Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review (2022) · cites this paper as [20]
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Self-citation
- Authors
- Green, A. L., Hultman, E., Macdonald, I. A., Sewell, D. A., & Greenhaff, P. L.
- Affiliations
- Queen's Medical Centre (GB)
- Venue
- American Journal of Physiology-Endocrinology and Metabolism
- Publisher
- American Physiological Society
- Published
- 1996-11-01
- Volume
- 271
- Issue
- 5
- Pages
- E821-E826
- ISSN
- 0193-1849 (ISSN-L)
- 1522-1555
- OpenAlex
- W2173720144
- Cited by
- 294
- References
- 3
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 12 · 2023: 8 · 2022: 7 · 2021: 12 · 2020: 4 · 2019: 3 · 2018: 9 · 2017: 8 · 2016: 10 · 2015: 12 · 2014: 12 · 2013: 8 · 2012: 6
- FWCI
- 3.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Physiology › Biochemical effects in animals
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Keywords
- creatine supplementation, carbohydrate intake, phosphocreatine, total creatine, insulin, muscle creatine
- MeSH terms
- Adenosine Diphosphate, Adenosine Triphosphate, Administration, Oral, Adult, Analysis of Variance, Creatine, Dietary Carbohydrates, Food, Fortified, Humans, Male, Phosphocreatine, Reference Values, Muscle, Skeletal
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