In this episode of the ATP Project, Matt interviews Dr. Richard B Kreider at the recent ISSN conference in Las Vegas. Dr. Kreider is well known for his accolades and extensive research in exercise and sports nutrition and a niche within that focus, specifically on the effects of Creatine in the body which is what Matt and Dr. Kreider break down in this episode in more detail.
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Matt: Well, welcome to the ATP project with your host, Matt. Today, over in Vegas with my good mate, Rich Kreider. Today we’re going to talk about, I don’t really know. We’ll make it up as we go, but we’re at the ISSN Conference in Vegas, 2019, and it has been absolutely amazing. Rich, for starters, we better explain what ISSN is.
Richard: Sure. Yeah. ISSN stands for the International Society of Sports Nutrition.
Richard: This is a group that started in 2003 or so. The founders are myself, Doug Kalman, Joey Antonio, Anthony Almada, and also Susan Kleiner. It started being at a conference. We were actually at the American Dietetic Association Conference in Chicago, all speaking, and we looked at each other’s like, “We’re the experts.” We always had to go to the American College of Sports Medicine Meetings and the American Dietetic Association to talk about sports nutrition, but it was always this small segment of the conference.
Richard: Sue Kleiner was across the table and says, “Why don’t we just…” we were out to dinner, “Why don’t we just start our own?” I had worked with the American Society of Exercise Physiology a few years before and helping form that with Tommy Boon, and that’s what we did. We contacted Human Kinetics, who became one of our sponsors. We officially formed it. Rick Collins is one of the attorneys that’s been with us forever. He’s done a lot of writing in muscle and fitness and things. He became our legal executor and we started forming all the content.
Richard: We’ve initially sponsored with Human Kinetics and the International Journal of Sports Nutrition and Exercise Metabolism, which I was one of the associate editors, so it became the official journal of the ISSN. A few years later we decided to do our own. We contacted Biomedical Central which is nature springer, really high quality. So they’d been our journal publisher for those, since 2007 or so.
Matt: Yeah. Right. Is it peer-reviewed and-
Richard: Absolutely. Yeah.
Matt: Who’s reviewing it? Is it-
Richard: I was the initial editor in chief and now Joey Antonio and Doug Kalman are co-editor in chief.
Richard: The articles come in and we review original research, but we wanted the International Society of Sports Nutrition to be a leader in the field, helping practitioners and scientists make informed decisions about the science of supplementation and performance enhancement through nutrition. We’ve done a lot of position stance on everything from the sports nutrition review, which was the launch of the journal, which has been that one article that has been downloaded almost 1.1 million times.
Matt: Yeah. Wow.
Richard: Then we have position stance on creatine and protein and meal timing and HMB, beta-alanine and a number of things. They have been really a foundation for the practitioner, the athlete, the coach and even the scientists of, what is the literature and how can you make informed decisions about what nutritionists are optimizing on?
Matt: What is sports nutrition when we talk in macros or we talk in micros or-
Richard: We talk in all of it.
Richard: It’s the combination of proper training, proper-based diet, and then how to manipulate the diet and strategically, to optimize training adaptations, optimize acute performance both from a physical as well as cognitive and then the overall health of an individual.
Matt: Now it’s pretty early in this conference, which so far I’ve seen, we’ve talked about gut health, we’ve talked about sleep, we’ve talked about different forms of exercise training and muscle hypertrophy and what actually is changing, so we can work out what to drive or we talk about responders and non-responders and that sort of stuff.
Matt: But it’s actually a lot more than what I thought it would be. I was just talking about branch chain amino acids or something like that.
Matt: One thing you mentioned before with position statements, such things as creatine have had, I don’t know an amazing amount of research, a lot of really cool data, but I heard it was a steroid. That with creatine it was crazy because I’ve never heard such criticism that a supplement as creatine, but if you actually have a look through these position statements and look through the data, it’s probably one of the most well-researched of all.
Richard: It is. It is. And we heard a great talk from Eric Ross yesterday, a look into the history and he talked about [inaudible 00:05:26] in the 1800s, who actually started doing creatine supplementation-
Matt: Yeah. And meat.
Richard: … and meat.
Matt: That’s right.
Richard: Yeah. Then in the early ’20s, there were a number of studies. Actually, the first ones I saw were in 1908, where they were giving animals creatine and they noticed they increased their body weight when they gave them creatine.
Richard: Then they started… They had a number of studies and identified the role of creatine and ATP and foster it creates in energy systems in the ’20s. But before that they had made these observations that if you gave creatine, the body stored it. If you gave creatine, you gained more weight. That was the beginning-
Matt: And it really holds it. It’s not just filling out or so, is it?
Matt: You can load up on creatine and that will hold that water, but it’ll take about… What Eric was saying is that you stop and about a month later, it’s actually depleting. It takes about a month to deplete.
Richard: Yeah. You can think of your creatine stores like a gas tank that on the normal, capacity is about two thirds, maybe three-quarters full.
Richard: So the body gets scripted from the diet, from meats and fishes, and different type of red meats primarily. When you consume 12 ounces of beef, for example, you’ll get about two grams of creatine. So it’s readily in a diet.
Richard: One of the things that Eric showed, some of the initial sport nutrition efforts for people, hundreds and thousands of years ago, legends of strength and feats in Greece, they all had high protein diets.
Matt: And how much protein of… There was a-
Richard: 20 pounds a day.
Matt: 20 pounds a day. Was that like 10 kilos of meat?
Richard: Well, when I was playing football, it was two steaks a day.
Matt: Yeah. Yeah.
Richard: And there was no creatine, we didn’t know much about that and that type of thing, and it was protein and lots of meat. I think the athlete knew, and so really we were all creatine loading-
Matt: Is that what got you looking for-
Richard: Yeah, football. Yeah.
Matt: … with that the steak and-
Richard: Yeah. It was like how do we optimize? I was always a little smaller than others, so I had to really train hard to keep muscle mass up to be able to [crosstalk 00:07:34] especially in American football, they’re so big. So that was my interest, strength conditioning. I wanted to be a strength coach, and then I started getting into nutritional aspects of performance.
Richard: Early in my career I worked with Mel Williams who was really many people think of as the father of sports nutrition. Great Book in the late ’70s, early ’80s on Ergogenic Aids and things. I worked with him the first few years of my career and we did a number of studies and creatine was one of the things we started looking at.
Richard: But creatine is one of the things that you need in your diet, it’s essential for the body. You get it from the diet and in which you don’t get in a diet, your body actually can synthesize in tissues like kidney and even in the brain.
Matt: Yeah. Yeah.
Richard: Your body’s-
Matt: I was going to ask you, of the plant-based diets, are they getting any creatine?
Richard: Well, not as much. That’s the concern. If you’re a vegetarian, we know that your muscle creatine stores are much less. The idea is, it’s almost like carbohydrate loading, add extra carbohydrate diet, you store more muscle glycogen, you perform longer. Whereas for sprint type exercises, creatine is the primary fuel for the high energy sprinting, the one-second, five-second, thirty-second sprint bouts. So by loading creatine and adding more creatine in a diet, you can actually fill that tank up, and then you have more energy for explosive activity and recovery.
Matt: I’d be thinking if I was an endurance athlete I wouldn’t need creatine then, but I know that’s… I’ve watched endurance although I’ve never competed, I’ve watched lots of endurance, but you’ll see the cyclist, they got a little amount of-
Richard: Sprints to [crosstalk 00:09:12].
Matt: … sprints, they got… So even in those endurance sports, you’ll hold-
Matt: … that creatine and you use that for the short power.
Richard: Yeah. When creatine came out in the U.S., actually the history was in England for the ’92 Olympics. Some of the sprinters, Christie, from Great Britain who won the hundred or so, they all were talking about, they were using creatine. I actually was in the Soviet Union and after the curtain fell and meeting in ’94 and they had a whole history of creatine use in their athletes for years and years and knowing exactly how much creatine was in the diet to be able to titrate now that they may have been doing other things as well. But certainly, creatine was known for athletes at least.
Richard: In the late ’80s, early ’90s, it became invoke because it became available as a supplement. Then Eric Holtman, who’s the person who was really instrumental in developing the muscle biopsy technique at Roger Harris in England, did some studies with Paul Greenhaff at University of Nottingham to show that if you gave creatine, it increased the muscle content, it increased blood concentrations, you stored more and you were able to do a little bit of more muscle work, knee extensions and things like that.
Richard: We did in 93 or four, I got contacted by Anthony Almada.
Matt: In Australia, we would know him as Virtago, the carbs.
Richard: Yes, yes.
Richard: It’s the same, Anthony. They had started a new company called Experimental and Applied Sciences, EAS, which became-
Matt: Yeah, that’s right. Yeah.
Richard: … a multimillion-dollar company and their first branded thing was creatine. We did some initial studies, the first studies in athletes were basically done in our lab at the University of Memphis. We found that if you added creatine to carbohydrate, you gave it to, in our case, American football player type, heavy resistance-trained athletes, they increase muscle mass by an extra one to two kilos compared to controls over a four-week period, worked as fast as 14 days, would start increasing muscle mass and take it for a month, you’re going to increase your strength, your power.
Richard: Then we added the protein powders and found huge benefits when you add it to carbohydrate and protein, kind of energy thing for protein powder.
Matt: Yeah, yeah. It needs those carbs to drive it in.
Richard: Well, it helps. We know that if you co-ingest creatine with carbohydrate, you can increase the muscle concentration, but it’s more than just energy. There’s so much more creatine involved we now know. Getting back to the point about endurance athletes, we used to think it was just for most of [crosstalk 00:11:55] which guys are slapping iron around the gym.
Richard: It’s not.
Richard: We now give creatine for endurance athletes for several reasons. One, if you take creatine or have your muscle high in creatine, and you are carbohydrate loading for a big marathon or a race or a triathlon, you store more carbohydrate in the muscle.
Richard: If glycogen loading is important for performance, which endurance athletes need, then it can help you. We now know that after endurance exercise, it helps reduce the amount of damage the muscle is associated with, so you can recover better.
Richard: Endurance athletes like cyclists and triathletes often lose a lot of weight during the season, five, 10 pounds, mostly muscle with along the fat, and they can help preserve that muscle mass, keep your power out for during the long season.
Matt: And even water. Does it maintain hydration status better?
Richard: Water as well because of the-
Matt: Yeah. Is that water used up already or is it the same water?
Richard: Yeah. One of the initial things we heard about creatine, it caused cramping and dehydration, which all the studies actually show completely the opposite.
Matt: Because it holds water, then how could that dehydrate you?
Richard: Yeah, so that’s the irony of it.
Richard: When you have creatine, it’s creatine monohydrate is the main form. So you tend to have a little bit of extra fluid in the cell that stimulates protein synthesis, which is great for muscle rebuilding, but also hydration. They’ve done studies where they’ve had creatine and it helps maintain a better temperature during exercise. It helps you maintain your fluid better balance. Your dehydrate is easily. If you add it with things like glycerol, which also causes hyperhydration, you get a greater effect.
Richard: So for endurance athletes, it can be a way to help them sustain high intensity exercise and no need to hydrate.
Matt: Yeah. Even for the everyday athlete and weekend warrior really, having all those benefits, you’re going to train harder, you’re going to feel better. So you’re going to put it in a little bit more effort and get better results for your [crosstalk 00:13:48] anyway.
Richard: Yeah. Some of the initial studies that were done with Bill Kramer and Jeff Olic showed that if you take it for 12 weeks, not only do you get more muscle mass and your lean mass from body composition tests go up, they were able to show that muscle fiber diameter goes up. So it’s actual hypertrophy, it’s not water. All of our studies never showed a water effect disproportionate to your body mass.
Richard: If you gain 10 pounds, 70% of muscle is water, so you’re going to have some water retention, but it’s not out of proportion. Those studies showed that people who were on creatine were able to maintain higher workloads during training, and so they’re able to tolerate training. They did more because they felt better and they ended up leading to the greater training data stations.
Matt: The other sport I thought because I know we’re also looking at creatine now as something that might be good for the brain and concussion, and I do a little bit of work with some fighters and I thought it might be a really good opportunity for fighters, but then what about weight? I’m always conscious because one of our guys are pushing the possible because you can’t just deplete… Like if it was carbs and salt and sugars, like could deplete those in the water would go and the weight would go, but you can’t do that with creatine, can you? You’d had to [crosstalk 00:15:02]-
Richard: Well, you have to be smart. So you wouldn’t load before weighing or something like that. But if you had been taking creatine chronically and only are taking three to five grams per day for a maintenance dose thereafter, you should be able to manage the weight well. There are professional boxers, Chris Aguilar is one, that he’s a dietician and just came out with a great book. Hopefully, you’ll be able to talk to him, will you?
Richard: He uses creatine as well. Now they might taper off a little bit, but there’s no doubt that it improves performance, and as long as you don’t have swings in weight, it should be fine with the weight.
Matt: Yeah. With the UFC fighters and that sort of stuff, they get that 24 hours after the weight injury load. Is there any benefit in putting it in there then?
Richard: Yeah. Chris might give you some insights. One thing they do is they use creatine during training, they might taper off a little bit toward the fight, but then once it’s over they use it as a hyper iteration.
Matt: Yeah, yeah. I’ve heard that.
Richard: And build up to get the muscle loaded as well again. But the real interest with creatine, it’s much more than just a performance supplement. There’s so many medical uses now of creatine.
Richard: One of these is, there’s this study showing that if you have mainly the study is on animals because we have to do studies to actually cause concussion and brain injury, and so we do these on animals. The animals that are fed with creatine withstand brain trauma better, stroke better, heart failure better.
Matt: Yeah. Wow. Heart failure?
Richard: Yeah. Because when your heart lacks oxygen it has to go to the more non-oxidative energy systems and creatine provides that immediate source.
Matt: Yeah. Exactly.
Richard: So we’re now looking at creatine as a way to reduce concussions and also the severity of things like spinal cord injury.
Richard: In fact, our 2017 position stand on creatine’s news update, we basically concluded if you are a sport organization and do not allow athletes to take creatine, you are potentially putting yourself in liability just because of the potential reduction on spinal cord injury as well as brain trauma and concussion.
Matt: That’s fascinating because… Seriously still, is only a couple of years ago we had a potential person that wanted to invest into our company and he explained to me that he sat down with these PE teacher, their son’s PE teacher at the school, and they decided that creatine was a steroid and needs to be banned. So there’s a weird public perception of creatine, [crosstalk 00:17:37]-
Richard: Yeah. You were asking about, “Well, how did it happen?”
Richard: Well, up until the early ’90s or so-
Matt: Was there any bad news or was this just a-
Richard: Well, here’s the history. In ’94 we’d come out with papers to show that it’s working, right? After that the Dogman and nutritionist, just your normal diet, why it needs extra carbs. Don’t need more protein, don’t need any of these things because none of it works. That was the idea. So creatine was the first to really challenge with good scientific data to say, “If there is more than carbohydrate and there may be benefits to athletes more than just to maintain a high carbohydrate diet and glycogen loading.”
Richard: So when creatine came out, a lot of team started using it. I got a call from the University of Nebraska’s dietitian, Dave Ellis, right after we did our first study. He says, “Rick, is there something to this?” He said, “Well, here’s what our data shows and we’re getting ready to do a replication.”
Richard: They put them on creatine right away and won like three national championships right in a row, which is the top sport in college athletes. Then a lot of other teams started using creatine hearing the benefits, and of course, at the University of Memphis we were doing it. We actually upset the University of Tennessee with Peyton Manning and they’re like scratching, “How in the world were you able to do it? It’s creatine, right?” They put everybody on creatine the next year and then they won a national championship on Peyton Manning.
Matt: Wow, wow.
Richard: Yeah. It became very popular. The people who were against supplements were like, “Oh, we can’t let this go. There’s got to be something wrong with it. Right?” At first, it didn’t work, and then it’s like, “Well, maybe it works so well. It may not be safe.” Then all of a sudden, anybody that took creatine, the trainers and everybody were like, “Well, it had to be a process. Somebody cramped. It had to be the creatine, right?” Athletics, there’s a lot of that type of thing, if you have two or three hamstring folds, “What is the strength coach doing? Are they doing some unusual training techniques? It couldn’t be our coaching. It has to be the strength stuff or it has to be the diet.”
Richard: We did studies at University of Memphis on safety just to try to test the hypothesis of whether there were more injuries, more cramping, and these are the hallmarks in the literature now on the safety of creatine. We actually showed that if you took creatine, you had less cramping, you had less muscle injuries, you recovered faster after injury, and these were American football players, you tolerated heat stress better. We now know mechanistically that all of these things make a lot of sense.
Matt: Yeah, absolutely.
Richard: But it was because of all this misinformation. What happened was in ’94 or so, a wrestler supposedly was taking creatine and dehydrated and died. It was in U.S.A. today, “Wrestler’s death suspected to creatine use.” Why? They had a theory that if you took creatine, it would suck all the water out of the muscle, that’s completely opposite of what happens. This hit in front page and all of a sudden now if anybody had cramps, it had to be the creatine, if anybody had… So we actually wrote a paper in ’98 that talked about, “Are there any legitimacy to any of these anecdotal claims about creatine?”
Richard: It was claimed to cause baldness, it was claimed it was a steroid and it was like anything you can think of that you were throwing at creatine, and yet all of the studies showed none of that was happening. In fact, the opposite.
Matt: Yeah. Wow.
Richard: And now there’s all these health benefits. Things like even in third trimester pregnancy, the mother is actually needing more creatine in the diet. It actually starts pulling creatine from the mother to help with the formation of the child, and what ends up happening is that if you feed creatine to moms, they are able to provide better creatine as neuroprotective effects on the infant. If they give birth and there’s asphyxia, which is like blue baby, where the court [crosstalk 00:21:53], very dangerous can kill the child, they withstand that a whole lot better.
Richard: Even as they’re-
Matt: Here we talk about dementias and strokes and that sort of stuff that-
Richard: Yeah, there’s evidence on all those things.
Richard: If you look at our ISSN position paper in ’17 it goes through all these medical uses of creatine. Brain function, cognitive function, aging, preventing muscle mass loss and aging, for pregnancy, for all these things that are being studied now. Initially, it was down to… Well, we had to say it didn’t work. Now, all the studies that’s come out-
Matt: So much is [crosstalk 00:22:26].
Richard: … it’s like, “This is really legitimate folks. This is a nutrient that’s very important.”
Matt: When do you take it? Should it be taken in pre-workout or post-workout, after it’s been depleted or-
Richard: Yeah. You generally want to load and you typically will take four or five doses a day of about one teaspoon, which is about five grams. If you have more muscle mass, you might a little more, if you have less muscle mass, a little less, but usually about 20 grams a day. And you do that for about five days. So that’s kind of the loading period.
Richard: Some say you don’t need to do that. You can take one teaspoon a day for a month, you’ll get there, but for performance you want to increase that muscle mass as much or that creatine availability so you get the training effect. So will still load. Then once you’ve loaded and saturate the stores, you can about one to two teaspoons depending on what muscle mass you have, can maintain that over time.
Richard: Our large American football players that were up to 120 kilos, they would take up to 10 grams a day, and the smaller folks would take a little bit less. That’s enough to maintain your level. If you stop taking creatine, it takes about four to six weeks to get back to base on a little. So you could take short breaks, but now there’s really no reason to stop taking it. In fact, the health benefits, we’re telling everybody that three grams a day is probably what you need for just general health.
Matt: Does it matter at all when you take it then? It could be better for the high carb meal or are you better off when you do training?
Richard: Yeah. We know that if you ingest with carbohydrate, it helps because the insulin helps with absorption. There’ve been studies beforehand or after, it really doesn’t get an acute effect of it. It’s more whether you had the gas tank full. But there are some studies where if you take it after with your carbohydrate and your protein, like whey protein, you get this milieu of nutrients that can enhance recovery. That’s why we recommend to athletes, once you’ve loaded, take with your carb and protein drink after a workout and then usually you’ll be able to maintain stores well.
Matt: And if we would be talking to the baby boomers and looking at the prevention of that, would it matter when they were to use it?
Richard: Well, we generally recommend three grams a day just for general health. Okay? With no loading just junk. But we’ve even done studies in untrained versus trained and people even aren’t even trained and get the benefit of creatine to some degree. And there’s certainly these other health benefits that we’re finding out that creatine is involved with all type of metabolic functions and brain function and basically creates in every cell and it’s an important mediator for energy metabolism. If there’s a limit in oxygen, limited ability in energy metabolism and disease caused that, creatine helps.
Matt: Creatine monohydrate is the one that’s been studied the most?
Matt: Is there anything exciting in regards to the different forms of creatine or do-
Richard: Well, 99% of the studies have been on creatine monohydrate. That’s where we base our recommendations on. We’ve actually done a lot of studies on whether you have a liquid form or semi-solid form or with carbohydrate and protein, without carbohydrate and protein, does it affect uptake in different forms?
Richard: You’ll see companies come out with effervescent creatine, does the fizzing help with the absorption? Or with bicarbonate and things to help buffer, the buffered form of creatine. We’ve looked at lots of types of different creatine, the bottom line is creatine monohydrate seems still be by far the best-
Matt: But then what’s the bioavailability?
Richard: It’s like 99.9%. That’s the issue, is, okay, you might get a little bit better stomach feeling if you take it with bicarbonate or whatever, but it doesn’t really affect muscle. Really, it’s the same.
Matt: It’s the same absorption.
Richard: You have to make sure the same amount of creatine is being delivered and some of the different forms actually have less percentage-wise. Creatine monohydrate is like 90% or so creatine, whereas effervescent or a buffered form might be 65. If you equate the same amount of creatine, it will probably do about the same amount.
Richard: So we’ve never found any advantage of the liquid versus the pills versus the chews, versus the-
Matt: What about RTD? What if it’s already pre-dissolved? Are they-
Richard: Well, our first studies were in a carbohydrate drink. This was the old Phosphagen HP that the EAS made. It was kind of a hallmark. Then we did a study with a Carpaccio protein, which was something called phosphate gain. And boy, that was the best stuff we’ve ever studied.
Matt: Oh really?
Richard: If we want to build muscle mass in athletes, we’d give them carbohydrate and protein, nothing magical about the type of carb protein, it was basically the old metrics type of thing with, and then we were giving up to eight grams per dose and using three grams a day.
Richard: Actually, in our initial studies we were doing up to 25 grams a day at creatine for 15 weeks straight in athletes and they were just getting massive. It was getting to a point where the position coach said, “Doc, you got to stop this because they’re getting too big. We’re having to move running back to the next position because they’re just putting too much muscle mass.”
Matt: You’re right. You’ve been working on a book. You’ve been pretty busy odd in your hotel room trying to finish off this book over [crosstalk 00:27:58].
Richard: Yes. Yes.
Matt: We’re going to actually bring you to Australia and take you around and show everyone this book because it’s pretty cool. So you want to tell us a little bit about that?
Richard: Yeah. We did a book in 2009 on Exercise Sport Nutrition. That was the basis for the position stance that we did. We’ve then updated it. So this is the Essentials of Exercise & Sports Nutrition: Science to Practice.
Matt: Yeah. Cool.
Richard: It talks about all the science in an easy to understand way, but then the bottom line is how do you implement it into a training program, what the training program should be, what the diet program, what particular nutrients you can actually optimize training adaptations, and promote recovery and enhancement of training and health?
Richard: This book is kind of essentials. It’s about 460 pages or so, and we’re really excited about it because it’s the latest information out there and people are very excited to see it come out.
Matt: Because it quite amazes, something that will still quite back from the year 2000 talking about what there is to be known about sport, and there’s a lot of stuff that’s happened since then.
Richard: A lot of stuff.
Matt: But including testing techniques, the ability for science to have-
Matt: … gotten much better, and even the old data redone should be coming out [crosstalk 00:29:13].
Richard: I think what we’re starting is re-examining things that didn’t work, which we put on the shelf because now with all the new metabolic capacity in genomics and metabolomics and things that can be done to really understand the mechanisms, we’re finding out that, maybe we just assumed it didn’t work, but there were some potential.
Richard: I think that’s enhanced, but if you look at exercise and nutrition literature, every year there’s just thousands and thousands of papers that are coming out showing that the role of exercise and nutrition intertwined are involved to optimize health and wellbeing and performance. So basing comments on something from the 2000s is like the stone ages in sports nutrition.
Matt: Yeah, exactly.
Matt: Eric’s talk yesterday mentioned the value in pro-science as well as sometimes the guys know when something’s working for them and you can get a scientific paper to prove that it doesn’t necessarily work, but sometimes it’s worth investigating with all the new techniques.
Richard: Well, there are different levels of what you would do for supplementation. The general health, mostly the diet and proper timing in nutrients are a problem. But if you’re an elite athlete you don’t always wait for the point of five effects, which is 95 times out of 100 and is not going to happen by chance.
Richard: They may be willing to go with a point to effect. If it works 80% of the time and I’m already at the elite world-class level, it may be worth trying as long as it’s safe and it doesn’t cause a problem, and get me positive-
Matt: Statistical significance for an athlete is a little bit different too-
Richard: Yeah, because-
Matt: … because of the population.
Richard: … even in our studies when you compare the elite to world-class to what we’ve studied as available sample sizes at universities or whatever, they’re not the same type of individual, they’re not the same type of athlete, and they’re certainly not at the elite level, world-class level unless you have the opportunity to work with some of those. But even then, you can’t do a study with 50 world-class runners because they are not world-class if there’s 50 of them. Right?
Matt: Yeah, exactly. Yeah.
Richard: Unless you go to Kenya and all the runners would be world-class if they’re are allowed to be in the same race, and that type of thing.
Richard: So there are these challenges. Even with science, you have to ask, “What was the population? What was the exercise consideration? What was the performance measure? Is it applicable to what’s happening in the field and in the real world for athletes?” In our book, we actually talk about how to evaluate the literature and know and ask these basic questions so that you can interpret the literature as you hear it and know whether “Does this make sense or not?”
Matt: Because like a matter analysis or something like that, that might try to find consistent data that can be compared, maybe eliminating a lot of the really valuable stuff that an athlete could really benefit from.
Richard: Yeah. I have some issues with that. There’s now a big push to, “Let’s do this matter analysis.” Then matter analysis combines a bunch of studies that have similar characteristics and try to get a strong conclusion based on lots of more people that were valued, and theoretically, that makes sense. But the problem is, unless every study is done exactly the same way, in the same population or the same conditions, it’s really hard to be able to determine.
Richard: Our approach is let’s explain what the literature is comprehensively, and then after looking at it, let’s come up with some conclusions based on what appears to make sense scientifically as well as the research results, and let people make an informed decision about what the data says so that if they want to try it.
Matt: Yeah. And what’s important to them.
Richard: Yeah. What an elite athlete may want to try may not be something that a bodybuilder may want to try.
Matt: Yeah, yeah, yeah.
Richard: A bodybuilder may be more experimental then the elite athlete is worried about drug tests and things like that. The person just starting a program wants some basic guidelines. They don’t need to necessarily try a lot of things. Let’s get them started on the basics. Actually, the book goes from beginner to the elite athlete. It gives you the-
Matt: Yeah. And you’re going to be given dosing and timing and all that stuff and everything and then referencing it so they will know where to go-
Matt: … [crosstalk 00:33:22] the full papers.
Matt: We know how dangerous abstracts can be. So the paper that you mentioned, all those side effects associated with creatine probably got quoted as, “The source of all the…”-
Richard: I was telling you that the other day is that we’re afraid we started that because there were so many things in the paper that I was asked to do a review for the sports science internet thing and I thought I should at least address, “Is there any legitimacy to any of these?” Paul Greenhaff was a reviewer of this. It’s like, “Do we really want to mention this?” Because if we do, people are going to think there’s actual science in it, but there wasn’t.
Richard: I’m afraid that we bring in the literature then all of a sudden is, “Well, it’s been reported and there are no suggestions.” It’s like, “No, the point was there wasn’t any literature to show it, and these things aren’t valid, and the other research is-
Matt: That’s so important because there’s a weird trend through social media. It used to be, I think it’s eight seconds or 10-second attention span or something like that. Well, it’s down to about two seconds because that’s how long it takes. You’ve got to have a statement with a reference, so people think it’s got a reference. It might have statements. They could easily be saying, “This study acknowledged these things and referenced it here,” and that’s enough to keep it going.
Richard: Yeah. And you have to look at the details because if you just go by headlines, headlines can be very misleading, and in social media, it’s all about clickbait.
Matt: Yeah. Exactly.
Richard: So they want something provocative. “Creatine causes baldness.” [inaudible 00:34:52] was like, “Somebody mentioned this and really there are no studies showing it.” But the headline sticks with people in their mind, and so that’s a problem with nutrition and the social media in general.
Richard: So you have to be able to look at the science, you have to read the paper and listen to people that actually are publishing and reviewing the literature. That’s why we did the ISSN. We started it to help people understand what science is, and make informed decisions.
Matt: Anyone can join the ISSN?
Richard: Yes, we have a Facebook page. It’s wide open for, there’s over 35,000 who follow that. Then we have the webpage is, sportsnutritionsociety.com, and you can go on there. You can join and follow, and get access to all the great presentations-
Matt: Yeah. Like all the slides that are available from this show and everything.
Richard: Yeah. We try to just present what we know, but then also before thinking, “What are we all working on? What are we thinking? Where are we going to go?” And the traditional scientific conference is very conservative and thought, “Well, we better not say what really is because then somebody might think if we’re wrong down the line, while you guys say, “Well, we want to test the Dogman.” It’s really thinking about, “Where are we going and what potential is out there to get people thinking and do the research?”
Richard: That’s the fun part of coming to this conference. Then if you follow the Facebook page, we’re always talking about studies and top people will chime in when they’re asked to when they can, and it’s just a great environment for learning.
Matt: Yeah. That’s excellent.
Richard: We were at our board meeting last night and they said there were over 2 million downloads of our papers each year.
Matt: Wow, that’s really impressive.
Matt: That’s a big platform to work from and it’s really important that you’re actually getting the chance to speak the truth in amongst all the other stuff.
Richard: And what’s been fun since is that we got out there with the first position stance and a lot of things like that. Now the other organizations are following suit and they’re looking a lot like our position stance and making similar conclusions. So now you have a body of different professionals size coming up with similar findings.
Richard: The people in the public can have confidence that, “This is what you should do to improve training and performance,” and whether it was something that really does work or doesn’t work or how to ask the right questions.
Matt: Yeah. What about trends? Like moving forward, I noticed in these talk, there’s a lot more talk about whole foods, even the caffeine and then comparing anhydrous caffeine to coffee and stuff and showing all the benefits of the polyphenols and we’re talking a lot more back and gut health and sleeping and removing all these handbrakes rather than pushing. What do you reckon are the future trend?
Richard: I think those are some of the areas. I think the next… In 1993, I did a paper and it was what was the future of sports nutrition, and I said it was amino acids. But here we are, right?
Richard: Now, amino acids are all over the place. And I remember back in the day, the first paper we did on branch chain amino acids, reviewers said, “There is no way that any of this can actually work, and there’s no way are you even doing a study on it.” It’s like, now we know because we’re doing the studies.
Richard: Back then it was amino acids, amino acids are still huge, but now we’re moving into brain, neuroprotection, cognitive function, how can we enhance availability in nutrients and deliver them to brains so that we can enhance memory and function as you age as well as acute focus so that you could perform better? If you’re an athlete, winning and losing occurs at the end of the game when you’re tired, fatigued physically and mentally. So if you can optimize that as well as all the other nutritional and training adaptations, that might help.
Richard: The role of gut and training. We now know exercise affects gut permeability and all these things. Can you provide premium probiotics to try to enhance nutrient delivery to further enhance the physiological effect? I think that’s wide open. We’re starting to do some of those types of studies, and we’re always going to be looking for things that can maximize the efficiency of energy metabolism and/or factors that affect health.
Richard: What you’re going to see in the future is the application of sport nutrition to health. A classic example is a creatine with the health benefits and HMB with health benefits in elderly and other folks. It may not be the greatest thing for athletes, but I’ll tell you what, in Sarcopenia, individuals are aging and you’re in the hospital, it helps recovery and maintain muscle mass and some other things.
Richard: So you’re going to see the application, sports nutrition, and clinical medicine and nutrition, and I think it’s just beginning. We’re going to see a lot more things that we thought the pro-science or maybe why are these people taking these things? We may find some of them actually is a reason and they feel it and they want to do it. So not everything is like that, but there certainly are a few things.
Matt: I think the first time I saw you speak you mentioned beetroots and Schisandra berries and all that stuff. And that’s when I thought, “Oh, here’s my man talking about our stuff.” There’s a lot of more of data coming out about the role with herbs and then the microbiome and the polished biotic compounds and everything as well-
Richard: Yes. Yeah, absolutely. I think that’s another also trend to mention. We’re going to see fruits and vegetable bioactives in their natural form being more used with nutritional supplementation because of all the other co-factors and things are coming with the act of nutrients that we don’t yet even know how they’re interacting, but if you give a natural form, it seems to work better. I think that’s also a burgeoning area.
Matt: The science has evolved a bit more. Now we’re hopefully moving a little bit away from that medical model where it’s all about bioavailability and systemic delivery of the actual compound because now we’re seeing a lot of microbiome altering compounds and changing them and absorbing them lighter or something where they missed the area under the curve and assume they’re not bioavailable in some form.
Richard: Well, one of the things that we talked about in our book is that when you ask questions, the bottom line is, does it really affect the outcome?
Richard: If I’m taking a supplement to increase muscle mass and strength and recovery after 12 weeks of taking it, do I have evidence that you actually get stronger, bigger, faster or whatever or had a better health outcome? There’s a lot of stuff that acutely might do some things, but we don’t know if it over time actually works. So doing the studies to look at the overall effect, is it really causing the outcome? If it does, then do the actual science look the mechanisms and things to further understand why it’s doing that. It’s where we need to go rather than just focus on, “Well, it works if you take this particular compound when your blood levels go up and it affects this biomarker and knocks out mice or whatever was being studied.” Yes. But does it really bottom-line effect?
Richard: I’ll give you an example. We did some studies on Melatonin when I was at Baylor with Darren Willoughby and Walmart Grad students. Acutely, it caused some hormonal adaptations. So, of course, it’s going to promote this great adaptation. Bottom line is after eight or 12 weeks, didn’t increase muscle mass.
Matt: Yeah. Right.
Richard: So you have to look at those outcomes. Does it improve health, does it improve performance? And then understanding the mechanism.
Matt: Even the talk… Oh, I forgot the gentleman’s name, but even our talk earlier, where we were talking about the hormonal adaptations to strength training and they showed some changes to androgens, but then they showed the reduction in the androgen receptor activity. It’s a [inaudible 00:42:34], so this goes up, that goes down, throughout the middle.
Richard: Yeah. You balance out. There’s also, we did a really cool study with weight loss and genetics. “Can you do genetic screening and identify fat-related genes and predict whether you do better on a high carb or high protein type diet or type of thing?” First two, three months, man, we’re seeing some really, really great results, look like you can pretty much predict. But then after that, it narrowed down to, after six months it really didn’t matter. So there may be some of these things that work acutely, but then the body reacts and responds and it gets back to equilibrium, and then the bottom line is, does it make an impact overall?
Matt: Yeah, exactly. Oh, that’s fascinating. Lots of stuff’s got to be in your book. You’re going to come to Australia, we’re going to take you around to see all of our mates, and maybe give you a couple of days off because you sound like you work pretty bloody out. We’ve got the book coming out. So when’s the book out?
Richard: I just sent the last proofs today. I understand a couple of weeks. We have a website called essentialsofsportnutrition.com. So be looking for that. As soon as it hits, we’ll announce it on our Facebook with our lab Facebook as well as the ISSN’s.
Richard: We’ve got versions in Spanish in preparation. Colleagues from Columbia have been helping with that. Mara Marquez is actually here and Diego Bonilla, Professor Bonilla, and Professor Jorge Petro. They’ve got the Spanish version about ready to get hit. Then we have colleagues now asking from other countries to try to do the same thing.
Matt: Oh, brilliant.
Richard: We’re really excited about how this might have even more production.
Matt: I can tell you that I’ll interpret for Australian and basically remove all the information out of it.
Richard: Well, it’s interesting. Sometimes different countries they get so focused on the legality and all this. You need to have these outside voices. We look at the literature and here’s what the review of the literature and here’s what the actual data shows and when you look at the literature, you should always base your review and your guidelines or what the study said.
Matt: We’ve tried to do RTOs or the ITB sign. So we are a registered training organization for the education points and everything for personal trainers and that sort of thing in Australia and we’re not allowed to actually talk to them about, I’m not even sure if they want to talk about macros, but definitely not allowed to talk about supplementation and that sort of stuff.
Matt: These sorts of things you’re not going to learn in Australia as part of your typical training. You’re going to have to go and find it for yourself and you’ve got to go and learn this stuff and have these books on hand and use this as a bit of a reference guide. I can get back to it because it’s going to have the most up-to-date information and all the references that you need to back yourself.
Richard: Comments… There’s something I’ve been quoted before that says, “Comments and regulation about nutrition, exercise, and dietary supplement must follow the available science.” But you realize the available science maybe five to 10 years behind.
Matt: Yeah. Yeah.
Richard: The perfect example is we finally did NIH studies on creatine after 15 years of its throwing all these benefits, they started saying, “Maybe it can work in Parkinson’s, maybe in other types of neurological diseases and some spirit of yes and some maybe not,” but it took 15 years before the United States said, “It’s worth us funding a study, international study to actually look at this.”
Matt: Yeah. But then everything you’ve learned about creatine delivery to skeletal muscle, you can’t relate that, we’ve got a blood-brain barrier in away.
Richard: That’s right.
Matt: So it’s all going to start again to a certain degree, isn’t it?
Richard: Yeah. But we’re trying to get the… With creatine and the levels of the brain, we’re trying to find out is creatine the best source of where maybe one of the precursor’s creatine. What we chatted about is cedar acetic acid, which is a quantity and acetic acid, which is a precursor to creatine that seems to go into the brain better. Some studies out of Poland by [ASIC 0:00:00:46:24] and colleagues show that you get a much better brain change in creatine if you use GAA versus just creatine. Both will work but creatine you have to be very large doses of overtime to get there.
Richard: So we may find other nutrients, but the physiology is, increased creatine content it helps brain function, memory, all these types of benefits. The world’s wide open to get into the brain.
Matt: Yeah, yeah. That’s exciting times. So we’ve got to definitely work more on that. Well, is there anything else you wanted to talk about, Rich? Anything important to tell the people?
Richard: No, just base your decisions about doctor substance nutrition exercise on the available sites, look at ISSN and other great organizations to give you a clue about what would work. If you do that you’re going to stay in the right [crosstalk 00:47:13].
Matt: Yeah, and you’re in the most up-to-date information and then they keep referencing the same old papers. Yeah.
Richard: Yeah, because the field is changing so often.
Richard: Even from the time we did our Sport Nutrition reviews, we tried to do one every five or six years or so, the amount of data coming out on topics, it’s just amazing. In fact, the last class I taught this spring, I used my old book, but I then gave the students access to the new one I was working on. And the question was, how much has changed over the last eight or 10 years? Some things that look promising haven’t been picked up, they’re still promising, need to be studied. Some things that are just been a plethora of information come out on, and we now thought we knew that we now have much more clarity on whether something does [crosstalk 00:47:59].
Matt: Have you changed your position on anything in particular? Was there something in the last book that you said doesn’t work or-
Richard: Great question.
Matt: … does and then this time, it just doesn’t?
Richard: Oh, great question. I probably… We have in the book, in the ISSN position stance also there’s this, it rates the categories as something that seems to work, there’s good evidence behind, some things that I have good theoretical knowledge and maybe a little bit of data supporting and things that don’t seem to work.
Richard: There are some things that we thought might have been helpful that probably aren’t, and there are a few category changes. But there are a few other shifts. If you compare the categorization, there’s a few things that went from not enough data that now maybe, there are a few things that went from maybe to now we know that there’s just not any evidence to it. Yeah, there’s been some subtle shifting and we’re always looking at the literature to try to make the best recommendation for people.
Matt: Yeah. That’s excellent.
Matt: Things keep changing. It’s an exciting industry to be in. It’s good fun-
Richard: It is, yes.
Matt: … as it relates to absolutely everyone and not just… all the way from the elite athletes. But what we learn from elite athletes is amazing that we can use in the everyday athlete, but also protecting the elderly and the more vital people.
Matt: So it’s probably because athletes are harder to kill cheaper than [crosstalk 00:49:13].
Richard: Well, they’re testing the bounds of physiological limits, right? We can try things and they might give us a clue what the limits are or might give us a clue what the de-limitations are if you have the disease. So that’s what you’re seeing. You’re seeing the creatine, the post-exercise or post protein being given to hospital patients and you’re giving different types of nutrients to special conditions to try to help them manage the disease a little bit better. Won’t cure the disease, but help manage it a little bit better.
Matt: I’m really loving this whole trend or the whole foodstuff. Even you mentioned earlier that you predicted amino acids to be the trend and now I’m starting to see a lot more talking about the different peptides or the less processed forms of the wheys and the bolus proteins having more of a significant effect. Is that something you’ve noticed in the literature?
Richard: Yeah. Actually, we look at individual amino acids, but then it’s all these polypeptides that seem to have also triggering mechanisms as well. I think that we’re going to find certain forms of the amino acids, certain fragments and things that may be found in whole foods to a greater degree might be the keys to unlock certain pathways.
Richard: Yeah, I think it’s wide open. I think protein still-
Matt: You book’s going to be only published data. There’s not going to be the unpublished confidential data that’s being held back from… For example, there’s a lot of data on Collagen that hasn’t yet been published.
Richard: Yeah, yeah.
Matt: You wouldn’t have had any of that in the book at all, would you?
Richard: No, we might tell us what we might be working on a little bit to get some clues, but there’s a whole bunch of data that’s sitting there waiting for patents and stuff. Actually, when I do the literature review, it’s not just what’s in pub med and those things, I actually look at the patents to try to figure out-
Matt: That’s good. When you do a literature review. This is really interesting because Australia would be like pub med typically, would just be in pub med and if it’s not in the pub made, it doesn’t exist.
Matt: So you’re saying there’s a lot more data in-
Richard: Yeah. I think if you’re trying to be on the novel front edge, you need to not only look at what’s been published in the traditional peer-review literature, but you look at patents because people were trying new things, and usually every patent has a little bit of pilot data and that’s to substantiate the validity of the patent, and that gives you clues about what might work.
Richard: We’ve actually used some of that. Then Anthony Almada is a great person that he would have access to abstracts that are being presented all over the world with different… And so sometimes those novel abstracts might give you an idea that “Hey, maybe there’s something to this.”
Richard: I think a good scientist is looking at the novelty, what’s coming out and what potentially we’ve been very fortunate over the years to do a lot of the beginning research on lots of nutrients from creatine, some of the initial HNB and athletes to CLA in humans. You’d look at, “Well, how could we have been on the right track with so many of these?” It’s because we were looking at what was coming out, and if something didn’t pan out, we did a lot of studies that don’t work, but on the other hand, there’ve been a few that hit pretty good. The reason is that we were like the first to the market or to do the studies.
Matt: Yeah. That’s important to be part of something like ISSN to keep your finger on the pulse and then have that network of people that are sharing information well before it gets into the public domain.
Richard: The other thing we do is we look at what’s coming out in the basic animal research because that also gives you clues about what potentially might work in a human. Animals are different human and they always relate, but we did this first CLA study, conjugated linoleic acid study in humans for training and body composition and bone health.
Richard: Well, the initial stuff out of the University of Wisconsin and had patents and had a number of nice papers in animals showing all types of benefits of CLA. It had to be done in humans. Well, we were the first ones to do that with some of our colleagues that worked with Anthony and others at EAS at the time.
Richard: So HNB in animals and our State folks did some studies with it and we were the first one to actually try to do it in trained individuals. It seems to work better in untrained than trained, but you have to be looking at those initial studies to give you clues about what might work in a trained clinician.
Matt: Yeah. Is that good news or bad news or just news? It’s just a matter of gathering data and even a bad result in the study might highlight a bad testing technique that we still need to publish and share-
Matt: … [crosstalk 00:53:42] proved science.
Richard: Yeah, absolutely.
Matt: That’s the stuff that people often quote and share and say, “This is why I [crosstalk 00:53:47].”
Richard: Yeah. You have to be careful when you see a study that shows no effect, don’t just necessarily completely dismiss it because if they’re not using the right techniques and the methodology and the application, you might miss a lot of stuff. There are some things we didn’t think did as much, amino acid’s perfect, or there’s no need to have any amino acids. We now know that we have better methods of doing tracer studies that, “Hey, there are some roles of this.”
Richard: I think you have to look at the initial studies as the beginning and then what you want to look for is a para enough study showing an effect to make a conclusion. But if you’re not looking at that basic research, you’re not looking at the patterns-
Matt: Yeah. Or piecing it all together. It takes in lots and lots of bits of data to create a conclusion, which is why your books are important. Yeah, because if you look at muscle hypertrophy, they might say, “Oh, this showed no effect on muscle diameter.” But then you might have satellite cells, [crosstalk 00:54:38]-
Matt: … there’s mother data that other studies are showing it has an effect on. So you’re also, “This is how it’s working.” Yeah.
Richard: One of the things we’ve enjoyed over the years is working with some of the research and development officers for some of the companies, who are more venture capitalistic in mind in that, “Let’s try this, let’s do studies,” and a lot of things don’t pan out. But on the other hand, if you have something that shows some of the vegan, they do another study and another people start replicating and you start seeing, you’re going to build, you have something to build off of. But that’s the nature of science. No one study means it all, it’s a matter of doing lots of studies over time.
Matt: Yeah, yeah. That’s amazing. That’s going to be fun. Well, we better wrap it up now and then we’ll do a hit more of these, I reckon. It’s going to bug the hell out of here. That was a good commentary. You’re one of the experts in the industry, but it’s the history and the overview. You put everything in perspective for us and I think the listeners are really appreciative.
Richard: Well, we’ve come a long way from the day when I was training that all you had is eight protein, and you eat a lot of steaks.
Matt: Yeah, yeah. That’s good.
Richard: That was about-
Matt: You still like steak and eggs. That’s all.
Richard: Yeah, I do.
Matt: Well, thanks, Rich. Someone will sign this off when one of the adults come in. How are the people in these shows? I normally have an adult in here doing the interview, but… Yeah.
Richard: Very good.
Matt: Any last words?
Richard: No. Good day.
Matt: Yeah, good day and good work. Yeah. All right.
Speaker 1: Thanks for listening. And remember to question everything.
Speaker 2: Well, except what we say.