Creatine and phosphocreatine: a review of their use in exercise and sport.
OBJECTIVE
Creatine and phosphocreatine (PCr) are important compounds in the normal energy metabolism of muscle. Recently, it has been shown that dietary creatine (5 to 20 g/day) can increase muscle creatine and PCr, with enhancement in anaerobic exercise performance after two weeks of administration caused by an increase in anaerobic capacity.


METHODS
MEDLINE was searched from 1983 to 1996 using key word "creatine" along with "humans," "muscle," "exercise," and "transport." Also, APStracts, the American Physiology Society search engine for abstracts, was searched from 1994 to 1996.


RESULTS
Creatine is transported into the muscle cell by a specific transporter, resulting in increased intracellular creatine and PCr. The PCr is capable of acting as an energy buffer, protecting the adenosine triphosphate (ATP) concentration. Maintaining muscle nucleotides therefore enhances exercise performance and recovery. There have been reports that PCr protects the cells from ischemic damage and decreases the loss of nucleotides by stabilizing cell membranes. Indeed, intravenous PCr (2-4 g/day) has been administered to cyclists, resulting in a faster recovery time between training sessions.


CONCLUSIONS
It is becoming evident that oral creatine supplementation may yield certain benefits to enhance the athlete's performance during maximal anaerobic exercise and interval training.
Joseph F. Clark is Lecturer at St. Anne's College, Oxford.
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