enhance high intensity exercise performance (for recent reviews of the effects of creatine, see
references 3-5).
Improvements are primarily seen in short duration, high-intensity activity such as sprint
performance as well as weight lifting (3). However, creatine has not consistently been shown to
improve longer events, which rely on other energy systems. The improvements range from the
ability to maintain a higher performance level prior to fatigue, the ability to perform more
repetitions with a given weight, and some studies suggest that creatine supplementation may
increase maximal strength (1 repetition maximum). Additionally, creatine typically causes a
large initial weight gain of 5 or more pounds, although the majority of this weight is water.
Whether long-term creatine supplementation causes significantly greater gains in lean body
mass is still under research.
Creatine is typically loaded first to saturate muscular stores. Although the optimal dosage
can vary, most studies suggest consuming 20 grams of creatine in divided doses (typically 5
grams four times a day) for 5 days to saturate muscular stores. An alternate method is to take
small (3 grams) daily doses of creatine, which results in similar loading over a period of a month.
Some individuals find that high doses of creatine cause stomach upset, and lower doses may
make loading possible while avoiding this problem.
Although maintenance doses have been suggested, there is some debate as to whether or
not this is truly necessary. As long as red meat is an integral part of the diet, as it will most likely
be on any form of ketogenic diet, muscular CP stores will stay elevated for long periods of time.
One concern regarding creatine and the ketogenic diet is that research suggests that
creatine is absorbed most efficiently if it is taken with a high glycemic index carbohydrate (6,7).
Thus the low-carbohydrate nature of the ketogenic diet raises the question of whether creatine
supplementation is useful. What should be remembered is that the early creatine studies used
coffee or tea, without carbohydrates, and creatine uptake was still fairly high. Simply more
creatine is absorbed if it is taken with a carbohydrate.
There are several strategies to get around this problem. The first is to load creatine before
starting a ketogenic diet, so that it can be taken with a high glycemic carbohydrate. Once
loaded, the high intake of meat on a ketogenic diet should maintain muscular stores. Additionally,
creatine uptake is higher following exercise so that a maintenance dose could be taken
immediately after training. Finally, many individuals have had success taking high dose of
creatine (10-20 grams) during the carb-load of the CKD. As well, creatine could be taken around
workouts on a TKD.
Creatine has no known effects on ketosis, nor would it be expected to affect the
establishment or maintenance of ketosis.
Other mass gaining supplements
Weight trainers and bodybuilders are bombarded daily with advertisements for new
supplements purported to increase strength and mass. As a general rule, there is little human
data to suggest that these substances offer a significant advantage in terms of strength or mass
gains.