A study showed that 100mg/kg creatine monohydrate daily over four months supplemented by boys with DMD is able to enhance handgrip strength in the dominant hand only (less than 10% increase) and increase whole-body lean mass. While the trend toward whole body strength reduction seen in placebo was ablated and there was no interaction with corticosteroids,[560] this study failed to find an influence on activities of daily living or lung function.[560] Elsewhere in children not on corticosteroids with DMD, supplementation of 5g creatine for eight weeks was confirmed to increase muscular phosphocreatine content[554] and according to a manual muscle test (MMT) there was a significant improvement in muscular function relative to placebo, with more parents reporting benefit with creatine (53.8%) relative to placebo (14%).[554]
Due to the growing concerns of the high cost, health consequences, and illegal nature of some steroids, many organizations have formed in response and have deemed themselves "natural" bodybuilding competitions. In addition to the concerns noted, many promoters of bodybuilding have sought to shed the "freakish" perception that the general public has of bodybuilding and have successfully introduced a more mainstream audience to the sport of bodybuilding by including competitors whose physiques appear much more attainable and realistic.
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.”

If you're a beginner, just about any workout will be intense enough to increase protein synthesis. But if you've been lifting for a while, you'll build the most muscle quickest if you focus on the large muscle groups, like the chest, back, and legs. Add compound lifts like squats, deadlifts, pullups, bent-over rows, bench presses, dips, and military presses to your workout to work them the most efficiently.


If you’re the kind of person who shops for popular dietary supplements like protein or collagen powder, you’ve probably seen another popular bottle on the shelves: creatine. This supplement, which can be taken as a powder or liquid (and usually in some kind of healthy shake), is a staple in the bodybuilding community thanks to its ability to help you pack on muscle and work out longer and harder. (1) While creatine is generally considered safe — and is one of the most researched supplements out there (according to a review published in July 2012 in the Journal of the International Society of Sports Nutrition) — it is still a supplement, which means it’s not regulated by the Food and Drug Administration (FDA) and product claims don’t necessarily need to be substantiated (though the FDA can pull products that are found to be unsafe). (2,3)
Creatine may preserve dopamine synthesis in the striatum of mice (while protecting against dopaminergic depletion) when fed to mice at 2% of the diet for one week prior to MPTP toxicity[230]. This is possibly secondary to increasing tyrosine hydroxylase activity, the rate-limiting step of dopamine biosynthesis.[210][235] Two percent creatine was as protective as 0.005% rofecoxib (a COX2 inhibitor), but the two were additive in their protective effects (highly synergistic in regard to DOPAC by normalizing it, but not synergistic in preserving HVA).[230]
Creatine is most commonly found in the basic form of creatine monohydrate, which is the standard form and usually recommended due to the low price. It can also be micronized to improve water solubility, or the monohydrate can be temporarily removed to concentrate creatine in a small volume supplement. Neither alteration changes the properties of creatine.
^ Jump up to: a b c d e f g h Momaya A, Fawal M, Estes R (April 2015). "Performance-enhancing substances in sports: a review of the literature". Sports Med. 45 (4): 517–531. doi:10.1007/s40279-015-0308-9. PMID 25663250. Wilson et al. [91] demonstrated that when non-resistance trained males received HMB pre-exercise, the rise of lactate dehydrogenase (LDH) levels reduced, and HMB tended to decrease soreness. Knitter et al. [92] showed a decrease in LDH and creatine phosphokinase (CPK), a byproduct of muscle breakdown, by HMB after a prolonged run. ... The utility of HMB does seem to be affected by timing of intake prior to workouts and dosage [97].

Creatine transport has been shown to increase when muscle creatine stores are depleted. This was only noted to occur in muscle with particular fiber types (soleus and red gastrocnemius), while other fiber types, such as white grastrocnemius, did not show any clear trend.[146] This indicates that transport in relation to total creatine levels varies across different muscle fiber types.
Creatine supplementation appears to attenuate decreases in GLUT4 expression seen with immobility and may increase GLUT4 expression during exercise. While it seems capable of increasing GLUT4 during resting conditions, it has failed to reach significance, suggesting that creatine supplementation works best with some stimuli associated with exercise.
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.
This claim has not been demonstrated at this time, and a recent comparative study of buffered creatine against basic creatine monohydrate found no significant differences between the two in 36 resistance trained individuals, in regard to the effects or the accumulation of creatine in muscle tissue.[71] There also were no significant differences in the amount of adverse side-effects reported.

In the last week leading up to a contest, bodybuilders usually decrease their consumption of water, sodium, and carbohydrates, the former two to alter how water is retained by the body and the latter to reduce glycogen in the muscle. The day before the show, water is removed from the diet, and diuretics may be introduced, while carbohydrate loading is undertaken to increase the size of the muscles through replenishment of their glycogen. The goal is to maximize leanness and increase the visibility of veins, or "vascularity". The muscular definition and vascularity are further enhanced immediately before appearing on stage by darkening the skin through tanning products and applying oils to the skin to increase shine. Some competitors will eat sugar-rich foods to increase the visibility of their veins. A final step, called "pumping", consists in performing exercises with light weights or other kinds of low resistance (for instance two athletes can "pump" each other by holding a towel and pulling in turn), just before the contest, to fill the muscles with blood and further increase their size and density.


Three amino acids (glycine, arginine and methionine) and three enzymes (L-arginine:glycine amidinotransferase, guanidinoacetate methyltransferase and methionine adenosyltransferase) are required for creatine synthesis. The impact creatine synthesis has on glycine metabolism in adults is low, however the demand is more appreciable on the metabolism of arginine and methionine [11].
A muscle imbalance—when one muscle is stronger than its opposing muscle—can limit your ability to exercise effectively, and could lead to injury down the line. “It’s important to recognize whether you’re really working the muscles you think you are and recognize if you’ve developed an imbalance that alters your movement pattern,” says Eric Ingram, physical therapist at Louisiana Physical Therapy Centers of Pineville. One common imbalance in women is stronger quads and weaker, tighter hamstrings, thanks to prolonged sitting, high heels, and improper training. If you suspect you have a muscle imbalance, make an appointment with a physical therapist, who will prescribe exercises to even you out.
Creatine supplementation at 300mg/kg for one week (loading with no maintenance) in youth subject to six repeated 35m sprints (10s rest, known as the Running-based Anaerobic Sprint Test or RAST) noted that the increased average and peak power output seen in creatine was not met with a reduction in fatigue, although there was an attenuation in inflammation from exercise (TNFα and CRP).[299]

Creatine supplementation (11.4g) with glycerol (1g/kg; per se effective[394][395]) and glucose (75g) in endurance runners in the heat appears to attenuate the increase in internal temperature associated with an increase in total body water of 0.71+/-0.42L, while performance (VO2 max and running economy) were unaffected over 30 minutes.[3] Creatine is effective without glycerol (20g daily with 140g of glucose polymer over a week),[346] again without an improvement in physical performance.


Progression – Throughout the course of your lifting career you should consistently strive for progress both mentally and physically. Initially, you may find that you’re incessantly focused on nutrition and training but as you progress in both maturity and muscular development, you should be focused on improving the balance between lifting and your life. It’s never about having an all or nothing mindset, balance must be incorporated in all aspects but this takes times to develop and occurs with progression over time.
Supplementation of a loading phase of creatine has been noted to augment the increase in RBC levels of superoxide dismutase (SOD) from exercise, when measured immediately after, by 8.1%, but control groups increased to match within an hour.[299] Glutathione (normally decreases with exercise) and catalase (increases) were both unaffected,[299] and elsewhere in vitro red blood cells incubated with 3mM of creatine (within the supplemental range) is able to improve filterability (a measure of cell rheology, or fluid structure of the cell[300]) when RBC creatine was increased by 12.3% to reach 554µM.[301] This was thought to be due to reduced oxidative stress (assessed via MDA) in the red blood cells, which in the presence of 1-5mM creatine was progressively reduced by 20-41%.[301]
While this nonessential amino acid may not deliver earth-shattering PRs or extreme muscle growth, it does play an important role in repair and recovery. Glutamine works by removing excess ammonia, which can accumulate during intense exercise, helping to regulate your body's acid-base balance. Individuals who are engaged in heavy resistance training, two-a-day training splits, or are in a calorie deficit may benefit from the extra support of glutamine supplementation.

McArdle’s disease is a myopathy associated with impaired glucose release from glycogen and impairments in muscle function at times when glucose would be the primary energy substrate. Creatine is thought to be therapeutic, but has shown differing effects in the two trials so far (both benefit and worsening of symptoms) for currently unknown reasons.


It is suggested [16,37] that another mechanism for the effect of creatine could be enhanced muscle glycogen accumulation and GLUT4 expression, when creatine supplementation is combined with a glycogen depleting exercise. Whereas it has been observed [38] that creatine supplementation alone does not enhance muscle glycogen storage. Hickner et al [15] observed positive effects of creatine supplementation for enhancing initial and maintaining a higher level of muscle glycogen during 2 hours of cycling. In general, it is accepted that glycogen depleting exercises, such as high intensity or long duration exercise should combine high carbohydrate diets with creatine supplementation to achieve heightened muscle glycogen stores [39].
In addition to the basic principles of strength training, a further consideration added by weight training is the equipment used. Types of equipment include barbells, dumbbells, pulleys and stacks in the form of weight machines, and the body's own weight in the case of chin-ups and push-ups. Different types of weights will give different types of resistance, and often the same absolute weight can have different relative weights depending on the type of equipment used. For example, lifting 10 kilograms using a dumbbell sometimes requires more force than moving 10 kilograms on a weight stack if certain pulley arrangements are used. In other cases, the weight stack may require more force than the equivalent dumbbell weight due to additional torque or resistance in the machine. Additionally, although they may display the same weight stack, different machines may be heavier or lighter depending on the number of pulleys and their arrangements.
How long and how often? Two or three weekly 20- to 30-minute, weight-training sessions are sufficient to start reaping noticeable benefits within four to 12 weeks, such as improved energy and muscle tone. Within six months, most people increase their strength 40 percent or more. Give your body at least one recovery day between sessions (although some people may need more, especially in the beginning).
Parameters of lung function (main cause of death in ALS is declining respiratory function) have not benefited after creatine supplementation, and when quality of life is measured, there is no benefit either. Despite one study failing to find any significant differences in mortality risk, two other studies have suggested that creatine may reduce the risk. The results were nonsignificant, but due to all treatments being well tolerated it is thought that creatine may still play a role as an adjuvant.
In weight training, as with most forms of exercise, there is a tendency for the breathing pattern to deepen. This helps to meet increased oxygen requirements. Holding the breath or breathing shallowly is avoided because it may lead to a lack of oxygen, passing out, or an excessive build up of blood pressure. Generally, the recommended breathing technique is to inhale when lowering the weight (the eccentric portion) and exhale when lifting the weight (the concentric portion). However, the reverse, inhaling when lifting and exhaling when lowering, may also be recommended. Some researchers state that there is little difference between the two techniques in terms of their influence on heart rate and blood pressure.[8] It may also be recommended that a weight lifter simply breathes in a manner which feels appropriate.

One case study exists of a man with focal segmental glomerulosclerosis who experienced an accelerated rate of GFR decline during supplementation (5g thrice daily for loading, then a 2g maintenance for seven weeks) which was partially reversed upon supplement cessation. This was deemed strong circumstantial evidence, and the brand of supplement was not named.[616] Elsewhere, interstitial nephritis associated with creatine supplementation has been reported in a man, although symptoms arose four weeks after supplementation started with no evidence to support correlation.[617] Some studies involving athletes and various dietary supplements have attempted to draw a correlation with creatine and cases of rhabdomyolysis.[618][619][620][621] Finally, one study in a diabetic person ingesting both metformin and creatine resulting in metabolic acidosis has attempted to place causation on creatine, but it did not establish causation or circumstantial evidence.[622]
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