In a pilot study on youth with cystic fibrosis, supplementation of creatine at 12g for a week and 6g for eleven weeks afterward was associated with a time-dependent increase in maximal isometric strength reaching 14.3%, which was maintained after 12-24 weeks of supplement cessation (18.2% higher than baseline).[485] This study noted that more patients reported an increase in wellbeing (9 subjects, 50%) rather than a decrease (3, 17%) or nothing (6, 33%) and that there was no influence on chest or lung symptoms.[485]
Daily, Heath usually eats five to six pounds of protein-rich meats — filet mignon, chicken, turkey, salmon and tilapia, mostly. He consumes up to 75 grams of carbohydrates in the form of grits or oatmeal, white or brown rice, and various types of potatoes, including sweet potatoes. Mornings might bring 16 ounces of scrambled egg whites. He tries to drink two gallons of water a day. His off-season weight usually reaches 275 pounds or more, still chiseled.

Eat 0.4–0.5 grams of fat per pound of your body weight. Fat is essential for hormone optimization, brain function, and joint health. Now, if you’re following a ketogenic diet (or modified keto diet), or you just feel better with more fat in your diet, you can certainly add more fat and lower your protein and carb intake to accommodate it. The 0.4–0.5 grams per pound recommendation just represents a starting point and a minimum so that you don’t eat too little fat, either out of fear that it will make you fat or damage your heart (both untrue). For more about ketogenic diets, see Onnit’s guide HERE.


Many athletes follow a "loading" protocol of around 25 grams a day for five days, but this isn't essential. But as Ciaran Fairman notes in the article "Do I Need to Load With Creatine," you can also get the same benefits with around 5 grams a day, potentially with none of the mild side effects of the loading protocol, which include stomach pain and water weight gain. The catch is that you have to take it consistently. Don't skip it!
Creatine ethyl ester increases muscle levels of creatine to a lesser degree than creatine monohydrate.[72] It may also result in higher serum creatinine levels[73] due to creatine ethyl ester being converted into creatinine via non-enzymatic means in an environment similar to the digestive tract.[74][75] At equal doses to creatine monohydrate, ethyl ester has failed to increase water weight after 28 days of administration (indicative of muscle deposition rates of creatine, which are seemingly absent with ethyl ester).[76] 

In otherwise healthy adults subject to leg immobilization for two weeks while taking 20g creatine daily during immobilization and then 5g daily during eight weeks of rehabilitation, it was noted that the creatine group failed to reduce atrophy during the immobilization (10% reduction in cross sectional area and 22-25% reduction in force output) despite preventing a decrease in phosphocreatine, yet experienced a significantly enhanced rate of regrowth and power recovery.[358] A similarly structured and dosed study has also noted greater expression of skeletal muscle, GLUT4 expression, and a 12% increase in muscle phosphocreatine content.[330]

It raised the question about performance-enhancing drugs. Their murky role in bodybuilding has long shrouded the sport. A 2013 documentary on Heath and Mr. Olympia called “Generation Iron” (a sort of bookend piece to 1977’s “Pumping Iron,” which launched Schwarzenegger and others to fame) called the topic “taboo.” It then insinuated that, of course, bodybuilders competing in top-level contests like Mr. Olympia use steroids.
Kerksick, C. M., Wilborn, C. D., Campbell, W. I., Harvey, T. M., Marcello, B. M., Roberts, M. D., Parker, A. G., Byars, A. G., Greenwood, L. D., Almada, A. L., Kreider, R. B., and Greenwood, M. The effects of creatine monohydrate supplementation with and without D-pinitol on resistance training adaptations. J.Strength.Cond.Res. 2009;23(9):2673-2682. View abstract.
Heath has 1.8 million Instagram followers, 300,000 Twitter followers, a global fan base and a growing portfolio of muscle magazine covers. He competes in just one competition a year, Mr. Olympia, for which he won the $400,000 first prize this year. He spends the rest of the year staying in shape and flying hundreds of thousands of miles for appearances, conferences and meetings. He has five sponsors, led by Ultimate Nutrition, a supplement company. All told, he earns more than $1 million a year, his agent said.
One pilot study using 150mg/kg creatine monohydrate for a five day loading phase followed by maintenance (60mg/kg) for the remainder of the five weeks noted that supplementation was associated with fewer muscle symptoms and complaints alongside improved muscular function,[572] yet a later trial trying to replicate the obsevations using 150mg/kg daily for five weeks noted the opposite, that creatine supplementation exacerbated symptoms.[573] 
Increasing creatine levels in skeletal muscle to 687% of baseline (0.5mM creatine, thought to be equivalent to 5g creatine[135]) doesn’t seem to per se increase glucose uptake, but increases glucose oxidation (140% of baseline)[341] which is due to a two-fold increase in the activity of α1 and α2 subunits of AMPK, a potency comparable to 1mM of the reference drug AICAR.[341] Glucose uptake associated with AMPK has indeed been noted in diabetic people who are undergoing physical exercise[342] and in contracting skeletal muscle cells,[153][330] but according to rat[343][344][345] and in vitro studies of cells not being contracted,[341] this is not a per se effect of non-exercising tissue but an augmentation of exercise-induced glucose uptake.
Moving through repetitions too quickly, going too fast; there is nothing gained by lifting weights fast. Some of the perks of lifting weight in a slow and controlled manner, include more total muscle tension and force produced, more muscle-fiber activation both slow and fast twitch fibers, and less tissue trauma. Remember, a joint is only as strong as the muscles that cross it; if you haven't lifted in a long time, or ever, be careful what you ask of your joints.
K. Aleisha Fetters, M.S., C.S.C.S., is a Chicago-based personal and online trainer. She has a graduate degree in health and science reporting from the Medill School of Journalism at Northwestern University and regularly contributes to Men's Health, Women's Health, USNews.com, TIME, and SHAPE. When she's not lifting something heavy, she's usually guzzling coffee and writing about the health benefits of doing so.
Many trainees like to cycle between the two methods in order to prevent the body from adapting (maintaining a progressive overload), possibly emphasizing whichever method more suits their goals; typically, a bodybuilder will aim at sarcoplasmic hypertrophy most of the time but may change to a myofibrillar hypertrophy kind of training temporarily in order to move past a plateau. However, no real evidence has been provided to show that trainees ever reach this plateau, and rather was more of a hype created from "muscular confusion".[clarification needed][citation needed]
Collectively the above investigations indicate that creatine supplementation can be an effective strategy to maintain total creatine pool during a rehabilitation period after injury as well as to attenuate muscle damage induced by a prolonged endurance training session. In addition, it seems that creatine can act as an effective antioxidant agent after more intense resistance training sessions.
×