Your Meat Consumption is Probably Not the Reason You're a Creatine Non-Responder: 5% Faster 50m-Sprint Time in 6 Days W/ 20g/day of Creatine for Vegetarians & Omnivores

It's hard to be a non-responder andno way to change it.

In some people the ingestion of creatine appears to be ineffective. Aside from minor diarrhea, when they increase the dosage to the 20g+ range per day in a desperate effort to reap the benefits of one of the, if not the only tried and proven natural ergogenic with significant (real world!) effects, these creatine non-responders don't get any results from either creatine monohydrate or any of the fancier, but mostly inferior "advanced creatines" you can buy at you local, national and international supplement vendor.

One of the commonest and eventually most reasonable explanation for "non-responding", I've heard is the hypothesis that non-responders have a high enough creatine intake from meat that would reduce any additional benefit from supplemental creatine to unmeasurable levels.

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And in fact, with beef and co being your best dietary creatine sources, it seems legit that meat-eaters would benefit less from supplemental creatine than vegetarians whose plant-based diets are more or less devoid of creatine.

By now you should yet be used to the fact that there are billions of things in the realm of nutrition, health and fitness that make perfect sense and still don't exist... and yes, the aforementioned hypothesis that omnivores won't benefit from creatine is one of them.

Figure 1: Higher increase in the previously low creatinine levels, but identical increase in 50m spring performance in vegetarians ans omnivores in response to 6 days on 20g of creatine (Seyedjalali. 2014)

If you take a look at the data in Figure 1, data from a recent study from the Chandrashekar Agashe  College  of  Physical Education in India, you will see that the omnivores had higher blood creatine (=used creatine) levels, but an identical increases in 50m sprinting performance.

The study at hand does therefore the findings of this study support the usefulness of short-term creatine supplementation at 20 grams  per  day  for  6  days, but it does not support the hypothesis that the corresponding increases in 4x 50 m dash run performance would be more pronounced in the vegetarian subjects, whose baseline creatine intake borders zero.

Are you like one of three subjects in Greenhaff's 1994 study?

Bottom line: If you belong to the small group of creatine non-responders you will obviously have to wait until someone identifies another hopefully non-genetic determinant of your non-existing response to the provision of creatine monohydrate or any other form of creatine. Until then, a highly efficient creatine recycling / endogenous production and / or the inability to use exogenous creatine remain the most likely and eventually the only realistic explanation for a phenomenon of which only the second one, i.e. the inability to use supplemental creatine as a means to increase muscular the creatine stores has scientific backup from one of the early studies on creatine (Greenhaff. 1994)

Reference:

• Greenhaff, P. L., et al. "Effect of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis." American Journal of Physiology-Endocrinology and Metabolism 29.5 (1994): E725.
• Nimkar, Nayana, and Ph D. Physical Education. "Comparative Effect of Creatine Supplementation Blood Lactate and Intermittent Running Performance on Vegetarian and Non-Vegetarian Active Males." Heg©< e Òeew {veeieefjkeÀeb® ³ee jkeÌleoeye Je ceOegcesneJej efveJe [keÀ ÒeeCee³eece Je Deemeveeb® ee nesCeeN³ee HeefjCeeceeb® es DeO³e³eve-mebefoHejepe Me. Deewlee [s: 30.

Carnitine Deficiency of Vegetarians Can Be Compensated W/ 2g of L-Carnitine Tartrate Per Day - Unfortunately, Without Measurable Metabolic or Performance Benefits

Vegetarian athletes do lack carnitine in their diets and muscle, but whether this has significant effects on their performance appears to be questionable based on the results of the study at hand.

In a recent study, researchers from the University Hospital Basel investigated whether the previously observed low carnitine levels of vegetarians could be compensated for by longterm oral treatment with 2g of l-carnitine to replenish the body carnitine pool. Furthermore, the scientists wanted to know whether this would have significant effects on (a) fuel metabolism and (b) physical performance of vegetarians and omnivores.

Novakova et al. hypothesized that "treatment with carnitine would increase plasma and possibly also skeletal muscle carnitine concentrations in vegetarians and would thereby improve skeletal muscle energy metabolism and physical performance" (Novakova. 2015).

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As you already know from the headline of this article, the latter was not the case and that despite the fact that the data in Figure 1 indicates that the daily provision of 2x1g l-carnitine tartrate after breakfast and dinner, respectively, for twelve weeks lead to a significant increase of the muscular carnitine levels of the 16 vegetarian, 18-40 year-old subjects of the study at hand.

Figure 1: Study design (left) and total skeletal muscle carnitine levels according to biopsy (right | Novakova. 2015)

In the 8 omnivore subjects that served as a control, the non-choline supported (choline maximizes carnitine retention | learn more) provision of a total 2g of l-carnitine tartrate did not show a consistent effect on the total carnitine muscle content (Figure 1).

Hold on, wasn't carnitine the stuff that's responsible for the artherogenic effects of meat? If you believe in the headlines in all the major news outlets after the publication of the 2013 study by Koeth et al., the answer would be: "Yes! It does.". If you take a look at the existing scientific evidence it is yet a bit strange that this hold only for processed, best fried, yet not for other types of meat (learn more). One of the latest meta-analyses of in vivo studies indicates by the way that "L-carnitine is associated with a 27% reduction in all-cause mortality, a 65% reduction in VAs [ventricular arrhythmias], and a 40% reduction in anginal symptoms in patients experiencing an acute myocardial infarction." Furthermore, the authors from the Mayo Clinic demand that "study with large randomized controlled trials of this inexpensive and safe therapy in the modern era is warranted" (DiNicolantonio. 2013). And if you look at the epidemiological evidence, it will strike you as odd that eating unprocessed red meat regularly is not associated with a significant increase of heart disease, although it is the type of meat that is highest in carnitine (Micha. 2010).

This observation in the omnivore control group is quite disappointing - specifically in view of the fact that 90% of the people who buy carnitine supplements probably eat meat.

Figure 2: None of the metabolically or performance relevant parameters changed sign. (Novakova. 2015).

In that, it's probably a small comfort that the increase in muscle carnitine levels didn't pay off in terms of increased physical performance, anyway. A brief glimpse at the data in Figure 2 goes to show you: Neither of the tested metabolic and performance variables changes significantly from baseline to post-supplementation. If anything there as a minimal glycogen sparing effect which didn't reach statistical significance either (not shown in Figure 2). Most importantly, however, the VO2max and the RER of which you would hope that a supplement that's supposed to increase fatty acid oxidation would increase and lower them, respectively, didn't budge.

The more choline the better the carnitine retention. The question is however: If the levels already increased and there still was no effect - would adding choline actually make a difference?

Bottom line: The good news is that vegetarians can easily compensate their lack of dietary carnitine by supplementing with 2g of l-carnitine tartrate per day. The bad news is that this is without consequences on any of the relevant metabolic and/or performance markers.

In view of the fact that the l-carnitine was consumed immediately after breakfast and dinner, i.e. in a period where insulin was high and could help shuttle the carnitine into the muscle, it's questionable whether the addition of choline, of which you as a SuppVersity reader know that it increases the muscular carnitine retention, would have yielded significantly different results. It may have helped to elevate the carnitine levels in the muscle of the omnivore control subjects, but it's unlikely that it would have changed the non-existent effects the increase in muscular carnitine pools in the vegetarians had on their metabolism and physical performance | Comment on Facebook!

References:

• DiNicolantonio, James J., et al. "L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis." Mayo Clinic Proceedings. Vol. 88. No. 6. Elsevier, 2013.
• Koeth, Robert A., et al. "Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis." Nature medicine 19.5 (2013): 576-585.
• Micha, Renata, Sarah K. Wallace, and Dariush Mozaffarian. "Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus a systematic review and meta-analysis." Circulation 121.21 (2010): 2271-2283.
• Novakova, Katerina, et al. "Effect of l-carnitine supplementation on the body carnitine pool, skeletal muscle energy metabolism and physical performance in male vegetarians." European Journal of Nutrition (2015): 1-11.
• Wang, Zeneng, et al. "Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease." Nature 472.7341 (2011): 57-63.