In young rats given creatine in the diet at 2% of the diet for eight weeks, supplementation appears to increase bone mineral density (BMD) in the lumbar spine with a nonsignificant trend to increase BMD in the femur.[426] Despite the trend, the femur appeared to be 12.3% more resistant to snapping from mechanical stress associated with increased thickness.[426] Menopausal rats (ovarectomized) experience similar benefits, as supplementation of creatine (300mg/kg) for eight weeks during ovarectomy is able to increase phosphorus content of the bone and other biomarkers of bone health, although bone stress resistance was not tested.[427]
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]
Whey protein contains high levels of all the essential amino acids and branched-chain amino acids. It also has the highest content of the amino acid cysteine, which aids in the biosynthesis of glutathione. For bodybuilders, whey protein provides amino acids used to aid in muscle recovery.[27] Whey protein is derived from the process of making cheese from milk. There are three types of whey protein: whey concentrate, whey isolate, and whey hydrolysate. Whey concentrate is 29–89% protein by weight whereas whey isolate is 90%+ protein by weight. Whey hydrolysate is enzymatically predigested and therefore has the highest rate of digestion of all protein types.[27]
Gordon, P. H., Cheung, Y. K., Levin, B., Andrews, H., Doorish, C., Macarthur, R. B., Montes, J., Bednarz, K., Florence, J., Rowin, J., Boylan, K., Mozaffar, T., Tandan, R., Mitsumoto, H., Kelvin, E. A., Chapin, J., Bedlack, R., Rivner, M., McCluskey, L. F., Pestronk, A., Graves, M., Sorenson, E. J., Barohn, R. J., Belsh, J. M., Lou, J. S., Levine, T., Saperstein, D., Miller, R. G., and Scelsa, S. N. A novel, efficient, randomized selection trial comparing combinations of drug therapy for ALS. Amyotroph.Lateral.Scler. 2008;9(4):212-222. View abstract.
Different forms of creatine in combination with other sports supplements as well as varying doses and supplementation methodology should continue to be researched in an attempt to understand further application of creatine to increase sports and exercise performance of varying disciplines. It is important to remain impartial when evaluating the safety of creatine ingested as a natural supplement. The available evidence indicates that creatine consumption is safe. This perception of safety cannot be guaranteed especially that of the long term safety of creatine supplementation and the various forms of creatine which are administered to different populations (athletes, sedentary, patient, active, young or elderly) throughout the globe.

Bodybuilders often split their food intake for the day into 5 to 7 meals of roughly equal nutritional content and attempt to eat at regular intervals (e.g. every 2 to 3 hours). This method can serve two purposes: to limit overindulging in the cutting phase, and to physically allow for the consumption of large volumes of food during the bulking phase. Contrary to popular belief, eating more frequently does not increase basal metabolic rate when compared to the traditional 3 meals a day. While food does have a metabolic cost to digest, absorb, and store, called the thermic effect of food, it depends on the quantity and type of food, not how the food is spread across the meals of the day. Well-controlled studies using whole-body calorimetry and doubly labeled water have demonstrated that there is no metabolic advantage to eating more frequently.[38][39][40]


Branched-chain amino acids (leucine, isoleucine, valine) play important roles in muscle building. Some researchers have found that following exercise, the branched-chain amino acids, especially leucine, increase the rate of protein synthesis and decrease the rate of protein catabolism (Blomstrand, 2006). The billion dollar supplement industry has been quick to respond; leucine supplements are widely available in health food stores, with a cost upwards of $50 per container. However, because the research findings are inconsistent and little is known about the safety of these products, the American Dietetic Association (soon to be renamed the Academy of Nutrition and Dietetics) advises against individual amino acid supplementation and protein supplementation overall (Rodriquez, 2009). It may be that food sources of these proteins and amino acids provide the same effect for a small fraction of the cost.
Gualano, B., de, Salles Painelli, V, Roschel, H., Lugaresi, R., Dorea, E., Artioli, G. G., Lima, F. R., da Silva, M. E., Cunha, M. R., Seguro, A. C., Shimizu, M. H., Otaduy, M. C., Sapienza, M. T., da Costa, Leite C., Bonfa, E., and Lancha Junior, A. H. Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Eur.J.Appl.Physiol 2011;111:749-756. View abstract.
Several review studies assessing the safety of creatine supplementation tend to make note of increases in formaldehyde and possible carcinogenic results.[451][452] Specifically, creatine is metabolized into an intermediate called methylamine, which can be converted to formaldehyde by the SSAO enzyme.[453] An increase in urinary formaldehyde has been noted in youth given 21g of creatine for one week, during which both methylamine (820% increase) and formaldehyde (350%) were increased, relative to control.[454] However, a more prolonged study using 300mg/kg (loading dose of around 20g) in adults for ten weeks failed to replicate these effects.[455]
A big clue is digestion. He does occasional cleanses. (“There’s no planes that week,” he said. “And no judgment at home.”) The slightest change in a muscle, just a stripe in a striation, is noticed. And while Heath does most workouts alone, he has a trainer, Hany Rambod, who is based in California. They see each other about once a month. In between, Heath sends photos and receives workout and dietary advice in return.
Bodybuilders spend years and years of their lives focused on perfecting the human body through proper training and nutrition. You, on the other hand, might not have an interest in the sport of bodybuilding, but do want to know the secrets to six-pack abs, a wide back, and rounded shoulders. And what better place to score the tricks of the trade than from 3-time Mr. Olympia Phil Heath. 
Creatine is old school and definitely hit a pop culture zenith, but that doesn’t make it out-dated or irrelevant today. Creatine supplementation gets results. For starters, one study from Medicine and Science in Sports and Exercise confirms that creatine supplementation can enhance physical performance, claiming that it “exhibits small but significant physiological and performance changes.”
Include cardio training. Good cardiovascular health improves blood flow, a requirement for muscle growth. Doing cardio also improves your cardiovascular fitness, which allows you to use your muscle gains for various sports and activities. The standard recommendation is 150 minutes of moderate cardio each week, or 75 minutes of vigorous cardio, or an equivalent combination of the two. A good place to start would be doing 30-60 minutes of cardiovascular activity every other day or 3 times a week. Examples of cardio include running, biking, swimming, and any sport that involves constant movement.
In regard to bioenergetics, phosphorylated cyclocreatine appears to have less affinity for the creatine kinase enzyme than phosphorylated creatine in terms of donating the high energy phosphate group (about 160-fold less affinity) despite the process of receiving phosphorylation being similar.[104][105] When fed to chickens, phosphorylated cyclocreatine can accumulate up to 60mM in skeletal muscle,[106] which suggests a sequestering of phosphate groups before equilibrium is reached.[105] Cyclocreatine still has the capacity to donate phosphate, however, as beta-adrenergic stimulated skeletal muscle (which depletes ATP and glycogen) exhibits an attenuation of glycogen depletion (indicative of preservation of ATP) with phosphocreatine.[102]
Women who train hard and reach low body fat levels, say under 10 percent, may be at risk of losing their periods as a result of hormonal disruption to estrogen production. Exercise-induced estrogen declines can result in bone loss in a way similar to that which occurs at the menopause. Loss of periods from athletic training is not uncommon but does require that you see a doctor, or better still, a sports physician and sports nutritionist to assess what is required to address the problem. Calcium supplements may be a part of the solution if bone health is likely to be affected. 
Don’t get us wrong—cardio is important for keeping your body fat down and keeping your heart health in check. (Bonus points if you run or bike, since outdoor exercise is linked to better energy and improved mental health.) But when it comes to building muscle, hitting the treadmill won't help you much. “Every component of exercise, minus cardio, can help with muscle hypertrophy,” which is the scientific term for muscle building, says Michelle Lovitt, an exercise physiologist and trainer in Los Angeles. “Cardio tends to burn calories and puts your body in a deficit, which is great for leaning out, but not building mass.”

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. 
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