Evidence for creatine and brain health remains uncertain

Transcript

Transcribed by machine (Whisper) from the episode’s audio, so a word may be off here and there.

1. 46:22

   So for creatine, there's very clear evidence that it can increase your benefits from strength training, build more lean mass, on the order of 10% to 20%. Separately, what people often pitch it for is cognitive benefits. And so there, the evidence is much less clear. is not particularly compelling as of yet. It could turn out in the future. Right now, what we have are small-scale heterogeneous studies that aren't often controlled.

2. 46:45

   There was one last year that people bang on about on podcasts and social media. It was a group of 20 patients with Alzheimer's giving creatine, and no placebo group, by the way. So uncontrolled. And their outcome of interest was performance on this cognitive test over time. And so they saw some improvements on some of the outcomes or processing speed on those test measures as they took the test time and time again.

3. 47:09

   But one thing about taking tests time and time again, sometimes you get better at that test. So, you know, the authors of that paper are saying- They took the same test. I'm not sure if it was the exact same test instrument or the same type of category. But the authors are saying, you know, maybe this is an effective practice, which is well-known, sort of in the cognitive testing space. So the authors are framing it as, it's feasible to give it to people with Alzheimer's.

4. 47:30

   You increase the creatine stores in the brain. We're going to have to do bigger, better studies to show whether or not there is a benefit in amelioration of symptoms or people who don't have dementia yet in terms of reducing risk of getting dementia. That's what the authors are hedging. And then on social media, you'll see, take creatine, it's going to solve Alzheimer's disease. It's not going to be an issue.

5. 47:49

   So there's this huge disconnect where the data are legitimately very uncertain as it relates to cognitive outcomes from these small studies, but people pitch it as it's going to solve all your trouble. And the main risk with that for me is knowing there is this long list of risk factors we do know influence your risk of dementia. What happens if people start thinking all they have to do is take a scoop or two scoops or three scoops of cream If that in any way reduces the effort you're putting towards the risk of stuff we know matters, then that's going to be an indirect harm of taking creatine and thinking it's, even if it's not causing direct toxicity, you know, I consider that to be...

6. 48:24

   The absence of other actions. Right. Which I see as the main sort of category harm of supplements in general. NAD as an anti-aging. Now, I think it's nicotinamide, something like that,