Muscle Up / Brain Up
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Muscle Up / Brain Up - Supplementation To Live For
I am focusing on two supplements today: Creatine and HMB
They will work when combined with our Foundations of Health, most importantly, while also incorporating aerobic and resistance training into your lifestyle.
Creatine:
Every few days a new study comes out about the muscle and brain benefits of creatine supplementation, primarily for those over 50 y/o, but truly, benefits can be found at any age. Women, especially those over 50 y/o seem to benefit most, whereby anecdotally I find in my practice that this demographic are least likely to find interest. This appears to be due to the mythology behind creatine only being for “bodybuilders”.
Yet, we are all building a body/brain every day, even if we are not aiming for a specific physique! As we age, even while staying physically fit, we lose muscle mass. The loss of lean body mass (LBM) with age correlates better with the loss of “health span”, meaning feeling well while living, than any other parameter. It then follows that maintaining and building LBM is the most important thing we can do to be well! And speaking on the brain being a “muscle”:
The first review to be aware of, “The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis” PMID: 39070254 . A bit of a bear to read, with some contradictory conclusions; let me give you my takeaway: All age groups appear to benefit, particularly in the domains of memory, attention time, and information processing speed. Groups over 60 benefits more when they are already showing signs of cognitive impairment. Women benefit most!
Taken directly from the article, with a little editing:
“The mechanisms underlying creatine’s enhancement of memory likely involve several biological pathways. Firstly, creatine increases the energy supply to brain cells, particularly in the form of phosphocreatine (PCr), which is crucial for maintaining cellular ATP levels in the energy-demanding brain. Secondly, creatine may enhance memory by improving neurotransmitter function, such as by increasing the synthesis of neurotransmitters like acetylcholine. Additionally, creatine may function as a neuromodulator, potentially affecting synaptic efficacy and plasticity, which are vital for learning and memory processes. Furthermore, creatine may exhibit neuroprotective properties by mitigating oxidative stress damage to brain cells. For instance, studies have shown that creatine is present in synaptic vesicles, released upon stimulation, and can be taken up by synaptosomes and synaptic vesicles, thereby enhancing neurotransmission. Moreover, research has indicated that creatine supplementation may significantly reduce processing speed time in women, suggesting potential sex-specific effects in improving cognitive function.”
Moving next to “Creatine Supplementation in Women's Health: A Lifespan Perspective” a 2021 review, PMCID: PMC7998865. I simply have to quote the abstract as I found it so humorous:
“Despite extensive research on creatine, evidence for use among females is understudied. Creatine characteristics vary between males and females, with females exhibiting 70-80% lower endogenous creatine stores compared to males. Understanding creatine metabolism pre- and post-menopause yields important implications for creatine supplementation for performance and health among females. Due to the hormone-related changes to creatine kinetics and phosphocreatine resynthesis, supplementation may be particularly important during menses, pregnancy, post-partum, during and post-menopause. Creatine supplementation among pre-menopausal females appears to be effective for improving strength and exercise performance. Post-menopausal females may also experience benefits in skeletal muscle size and function when consuming high doses of creatine (0.3 g·kg-1·d-1); and favorable effects on bone when combined with resistance training. Pre-clinical and clinical evidence indicates positive effects from creatine supplementation on mood and cognition, possibly by restoring brain energy levels and homeostasis. Creatine supplementation may be even more effective for females by supporting a pro-energetic environment in the brain. The purpose of this review was to highlight the use of creatine in females across the lifespan with particular emphasis on performance, body composition, mood, and dosing strategies.”
What I found funny was the whole ‘whether you’re having a period, not having a period, pregnant, just delivered, any phase of menopause…’ About covers it.
The particular aspect of current research for men or women as we get older is the dosage. Instead of the standard 5 grams (g) per day (still a good dosage), a better dosage may be 0.3 gram (g) per kilogram (kg) per day. Translating to American, a 150-pound man or woman might benefit from 20 grams (g) creatine per day especially as we get closer to 60 y/o.
I promise there are ample articles on creatine for LBM showing profound benefits, but more often mild benefits, either way, that would be benefits. There is some advantage to taking creatine immediately post exercise, but this is not necessary!
HMB:
HydroxyMethylButyrate is a metabolite of leucine (one of the three BCAAs - branched chain amino acids: leucine, isoleucine, and valine). It is known to inhibit protein breakdown, making it a perfect synergist with creatine!
This is a great little review for those that like the mechanism of action PMID: 31531146. Usual doses of 3g (grams) daily reduce muscle damage with exercise, accelerate recovery leading to improved lean body mass, with improved strength and aerobic capacity. To take full advantage of its effects, starting HMB 2 weeks prior to an increased intensity of workouts might provide the most benefits in terms of muscle protection.
In this trial combining HMB and creatine in endurance athletes PMCID: PMC7019716 showed a significant synergistic effect on aerobic capacity.
Although, not too surprisingly, most studies focus on athletes, the results of both HMB and creatine translate to a general population of people who need to increase muscle mass, and aerobic capacity as well as strength.
Walk at least 1.5 miles daily, you don’t have to do HIIT (High Intensity Interval Training). Spend at least 20-30 minutes twice weekly on resistance training, circuit training or other.
And especially if you are over 50, or are female, support your body with safe, healthy amino acid supplements that will decrease your soreness, and reinforce your successful workout program!
Your Journey to Health and Healing,
Gary E Foresman MD