Creatine: Very Different For Young & Old People
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Whatโs the Deal with Creatine?
Creatine is best-known for its use as a sports supplement. It has a few other uses too, usually in the case of helping to treat (or recover from) specific medical conditions.
What actually is it?
Creatine is an organic compound formed from amino acids (mostly l-arginine and lysine, can be l-methionine, but thatโs not too important for our purposes here).
We can take it as a supplement, we can get it in our diet (unless weโre vegan, because plants donโt make it; vertebrates do), and we can synthesize it in our own bodies.
What does it do?
While creatine supplements mostly take the form of creatine monohydrate, in the body itโs mostly stored in our muscle tissue as phosphocreatine, and it helps cells produce adenosine triphosphate, (ATP).
ATP is how energy is kept ready to use by cells, and is cellsโ immediate go-to when they need to do something. For this reason, itโs highly instrumental in cell repair and rebuildingโwhich is why itโs used so much by athletes, especially bodybuilders or other athletes that have a vested interest in gaining muscle mass and enjoying faster recovery times.
See: Creatine use among young athletes
However! For reasons as yet not fully known, it doesnโt seem to have the same beneficial effect after a certain age:
What about the uses outside of sport?
Almost all studies outside of athletic performance have been on animals, despite it being suggested as potentially helpful for many things, including:
- Alzheimerโs disease
- Parkinsonโs disease
- Huntingtonโs disease
- ischemic stroke
- epilepsy
- brain or spinal cord injuries
- motor neuron disease
- memory and brain function in older adults
However, research thatโs been done on humans has been scant, if promising:
- A review of creatine supplementation in age-related diseases: more than a supplement for athletes
- Creatine supplementation and cognitive performance in elderly individuals
In short: creatine may reduce symptoms and slow the progression of some neurological diseases, although more research in humans is needed, and words such as โpromisingโ, โpotentialโ, etc are doing a lot of the heavy lifting in those papers we just cited.
Is it safe?
It seems so: Creatine supplementation and health variables: a retrospective study
Nor does it appear to create the sometimes-rumored kidney problems, cramps, or dehydration:
Where can I get it?
You can get it from pretty much any sports nutrition outlet, or you can order online. For example:
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N-Acetyl Cysteine For The Liver & More
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N-Acetyl Cysteine (NAC) is best-known for its liver support properties, but the benefits extend much further than that, and even include direct brain bonuses (as it does pass the blood-brain barrier):
More than just the liver
Inka Land, neuropsychologist, talks about her use of NAC over the course of the past year or so.
Most people take NAC to support liver health; for which it is considered safe and effective for reversing fatty liver disease, now also known as hepatic steatosis or steatotic liver disease.
For her, the most noticeable difference is that previously, she had 15โ20 migraines a month plus cluster/tension headaches, whereas after taking 1.2g of NAC daily for 1โ2 years, those migraines reduced to 1โ3 per month, sometimes none, and the attacks themselves became shorter, milder, and easier to manage.
How it works: NAC acts as a precursor for glutathione (a key antioxidant in the brain and the rest of the body), counteracts oxidative stress, lowers inflammation, and helps balance neurotransmitters like that drive nerve overactivity.
NAC is able to do this because it crosses the bloodโbrain barrier and promotes natural glutathione production inside cells, while oral glutathione is usually less bioavailable (except the liposomal form, which is more expensive).
While she didn’t get to enjoy these benefits herself, because she didn’t have the initial problems they relieve, she also cites studies showing benefits alleviating some repetitive OCD-like symptoms (e.g. hair-pulling, nail-biting, skin-picking) and addictions (e.g. nicotine, alcohol, gambling).
As for dosage, research shows doses over 1 g per day are most effective, but you might want to bear in mind that for some people (based on her personal experience) it may cause nausea if taken on an empty stomach, making it best taken about 30 minutes before food (why 30 minutes before? Because that’s how long it takes for a cellulose capsule to get where it’s going and dissolve).
For more on all of this, enjoy;
Click Here If The Embedded Video Doesnโt Load Automatically!
Want to learn more?
You might also like:
Take care!
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Fall Asleep In 2 Minutes (Doctor Explains)
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Beyond “sleep hygiene”, Dr. Siobhan Deshauer has insights to share:
Rest for your body and mind
First, do still do the basics. That means dimming/filtering lights for an hour before bed, lowering the room temperature a little, ensuring you have nice fresh sheets, not having alcohol or caffeine before bed, and getting out of bed if you’re not asleep within half an hour, to avoid associating being in bed with wakefulness.
Next, the extra tips:
- Progressive relaxation: tense and relax each muscle group from toes to head
- Box breathing: inhale, hold, exhale, and hold for 4 seconds each; helps calm the nervous system (itโs called โbox breathingโ because of the 4:4:4:4 setup)
- Diaphragmatic breathing: focus on belly breathing, with longer exhalation to activate the parasympathetic nervous system (note that this can, and even ideally should, be done at the same time as the previous)
- Cognitive shuffling: think of words starting with each letter of a chosen word while visualizing them (this is like โcounting sheepโ, but does the job betterโthe job in question being preventing your brain from moving to anything more strenuous or stressful)
For more on all of these plus some extra side-along advice, enjoy:
Click Here If The Embedded Video Doesnโt Load Automatically!
Want to learn more?
You might also like to read:
Non-Sleep Deep Rest: A Neurobiologistโs Take โ a way to get many of the benefits of sleep, while awake
Take care!
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The Kitchen Doctor
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Dr. Rupy Aujla: The Kitchen Doctor
This is Dr. Rupy Aujla, and heโs a medical doctor. He didnโt set out to become a โhealth influencerโ.
But then, a significant heart condition changed his life. Having a stronger motivation to learn more about nutritional medicine, he did a deep dive into the scientific literature, because thatโs what you do when your life is on the line, especially if youโre a doctor!
Using what he learned, he was able to reverse his condition using a food and lifestyle approach. Now, he devotes himself to sharing what he learnedโand what he continues to learn as he goes along.
One important thing he learned because of what happened to him, was that he hadnโt been paying enough attention to what his body was trying to tell him.
He wants us to know about interoceptionโwhich isnโt a Chris Nolan movie. Rather, interoception is the sense of what is going on inside oneโs own body.
The counterpart of this is exteroception: our ability to perceive the outside world by means of our various senses.
Interoception is still using the senses, but is sensing internal body sensations. Effectively, the brain interprets and integrates what happens in our organs.
When interoception goes wrong, researchers found, it can lead to a greater likelihood of mental health problems. Having an anxiety disorder, depression, mood disorder, or an eating disorder often comes with difficulties in sensing what is going on inside the body.
Improving our awareness of body cues
Those same researchers suggested therapies and strategies aimed at improving awareness of mind-body connections. For example, mindfulness-based stress reduction, yoga, meditation and movement-based treatments. They could improve awareness of body cues by attending to sensations of breathing, cognitions and other body states.
But where Dr. Aujla puts his focus is โthe heart of the homeโ, the kitchen.
The pleasure of food
โEating is not simply ingesting a mixture of nutrients. Otherwise, we would all be eating astronaut food. But food is not only a tool for health. Itโs also an important pleasure in life, allowing us to connect to others, the present moment and nature.โ
Dr. Rupy Aujla
Dr. Aujla wants to help shift any idea of a separation between health and pleasure, because he believes in food as a positive route to well-being, joy and health. For him, it starts with self-awareness and acceptance of the sensory pleasures of eating and nourishing our bodies, instead of focusing externally on avoiding perceived temptations.
Most importantly:
We can use the pleasure of food as an ally to healthy eating.
Instead of spending our time and energy fighting the urge to eat unhealthy things that may present a โquick fixโ to some cravings but arenโt what our body actually wants, needs, Dr. Aujla advises us to pay just a little more attention, to make sure the bodyโs real needs are met.
His top tips for such are:
- Create an enjoyable relaxing eating environment
To help cultivate positive emotions around food and signal to the nervous system a shift to food-processing time. Try setting the table with nothing else on it beyond whatโs relevant to the dinner, putting away distractions, using your favorite plates, tablecloth, etc.
- Take 3 deep abdominal breaths before eating
To help you relax and ground yourself in the present moment, which in turn is to prepare your digestive system to receive and digest food.
- Pay attention to the way you sit
Take some time to sit comfortably with your feet grounded on the floor, not slouching, to give your stomach space to digest the food.
- Appreciate what it took to bring this food to your plate
Who was involved in the growing process and production, the weather and soil it took to grow the food, and where in the world it came from.
- Enjoy the sensations
When youโre cooking, serving, and eating your food, be attentive to color, texture, aroma and even sound. Taste the individual ingredients and seasonings along the way, when safe and convenient to do so.
- Journal
If you like journaling, you can try adding a mindful eating section to that. Ask questions such as: โhow did I feel before, during, and after the meal?โ
In closingโฆ
Remember that this is a process, not only on an individual level but as a society too.
Oftentimes itโs hard to eat healthilyโฆ We can be given to wonder even โwhat is healthy, after all?โ, and we can be limited by what is available, what is affordable, and what we have time to prepare.
But if we make a conscious commitment to make the best choices we reasonably can as we go along, then small changes can soon add up.
Interested in what kind of recipes Dr. Aujla goes for?
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How Your Exercise Today Gives A Brain Boost Tomorrow
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Regular 10almonds readers may remember we not long back wrote about a study that showed how daily activity levels, in aggregate, make a difference to brain health over the course of 1โ2 weeks (in fact, it was a 9-day study):
Daily Activity Levels & The Measurable Difference They Make To Brain Health
Today, we’re going to talk about a new (published today, at time of writing) study that shows the associations between daily exercise levels (amongst other things) and how well people performed in cognitive tests the next day.
By this we mean: they recorded exercise vs sedentary behavior vs sleep on a daily basis (using wearable tech to track it), and tested them daily with cognitive tests, and looked at how the previous day’s activities (or lack thereof) impacted the next day’s test results.
Notably, the sample was of older adults (aged 50โ83). The sample size wasn’t huge but was statistically significant (n=76) and the researchers are of course calling for more studies to be done with more people.
What they found
To put their findings into few words:
- Consistent light exercise boosts general cognitive performance not just for hours (which was already known) but through the next day.
- More moderate or vigorous activity than usual in particular led to better working memory and episodic memory the next day.
- More sleep (especially slow-wave deep sleep) improved episodic memory and psychomotor speed.
- Sedentary behavior was associated with poorer working memory.
Let’s define some terms:
- general cognitive performance = average of scores across the different tests
- working memory = very short term memory, such as remembering what you came into this room for, or (as an example of a test format) being able to take down a multi-digit number in one go without it being broken down (and then, testing with longer lengths of number until failure)
- episodic memory = memory of events in a narrative context, where and when they happened, etc
- psychomotor speed = the speed of connection between perception and reaction in quick-response tests
These are, of course, all useful things to have, which means the general advice here is to:
- move more, generally
- exercise more, specifically
- sit less, whenever reasonably possible
- sleep well
You can read the study itself here:
Want to know the best kind of exercise for brain health?
Check out our article about neuroscientist Dr. Suzuki, and what she has to say about it:
The Exercise That Protects Your Brain
Enjoy!
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What Diabetes Does To Your Heart
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We’ll get straight to it: researchers (Dr. Jasmine Khor et al.) have found that type 2 diabetes physically remodels the human heart by disrupting energy production, weakening muscle structure, and increasing fibrous tissue (that is also bad), which, together, push the heart towards failure.
So, how does it do that and how can we avoid that unfortunate outcome?
At the heart of things
Type 2 diabetes reshaping the heart fits neatly into the bigger picture of metabolic syndrome, which absolutely bears mentioning because people tend to talk a lot about the parts, without talking about how it all comes together.
Metabolic syndrome is the name given to a cluster of energy-handling (thus: metabolic) problemsโhigh blood sugar, insulin resistance, abdominal fat, abnormal lipids, and high blood pressureโwhich all strain the same biological systems. And yes, the effect compounds, with each part making the others worse, unless reversed.
In metabolic syndrome, cells across the body become less responsive to insulin, and the heart is no exception: it struggles to switch fuels efficiently, overworks its mitochondria, and gradually stiffens as fibrous tissue builds up. Over time, this energy mismatch and low-grade inflammation quietly remodel the heart muscle, making it less flexible and less efficient at pumping blood.
With that in mind, metabolic syndrome is not just a collection of risk factors on a checklist, but rather also a slow-motion metabolic stress test for the heartโone that can, if neglected, tip the heart from adaptation (i.e. dealing with problems better) into failure (i.e. literally, heart failure).
The aforementioned researchers at the University of Sydney analyzed donated human heart tissue from transplant recipients and compared it with tissue from (formerly)* healthy donors, allowing direct observation in humans rather than merely non-human animal models.
*Formerly healthy because, of course, the donors are dead. But what this means is that they died in otherwise good health, as can happen if accident or incident should befall.
What they found is that diabetes alters how heart cells generate energy by reducing insulin sensitivity in glucose transporters, increasing stress on mitochondria, and worsening the metabolic profile seen in advanced heart failure.
As part of this, diabetes also reduces key proteins involved in contraction and calcium regulation while promoting fibrosis, making the heart muscle stiffer and thus less efficient at pumping blood. These direct, tissue-level changes help explain why people with type 2 diabetes face a much higher risk of heart failure, beyond the shared risk factors alone.
You can read the paper in full, here: Left ventricular myocardial molecular profile of human diabetic ischaemic cardiomyopathy
What to do about it?
Here are some very good starting points:
- What Matters Most For Your Heart? โ perhaps not coincidentally, this is also what matters most for avoiding/reversing type 2 diabetes
- The Two Worst Things For Cardiac Aging
- Three Tweaks To Cut Diabetes Risk By 1/3
Want to learn more?
For a much deeper dive, you might like this excellent book we reviewed a while back:
Why We Get Sick โ by Dr. Benjamin Bikman โ the title doesn’t really give it away, but we promise this book is very much specifically about this very topic, the science of how insulin resistance (not even the blood sugar imbalances that may result, but the insulin resistance itself already) leads to an increase in most other health risks (especially of the cardiometabolic variety), and why it’s a bigger problem sooner than people think from blood sugar tests alone, and what to do about it
Take care!
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People on Ozempic may have fewer heart attacks, strokes and addictions โ but more nausea, vomiting and stomachย pain
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Ozempic and Wegovy are increasingly available in Australia and worldwide to treat type 2 diabetes and obesity.
The dramatic effects of these drugs, known as GLP-1s, on weight loss have sparked huge public interest in this new treatment option.
However, the risks and benefits are still being actively studied.
In a new study in Nature Medicine, researchers from the United States reviewed health data from about 2.4 million people who have type 2 diabetes, including around 216,000 people who used a GLP-1 drug, between 2017 and 2023.
The researchers compared a range of health outcomes when GLP-1s were added to a personโs treatment plan, versus managing their diabetes in other ways, often using glucose-lowering medications.
Overall, they found people who used GLP-1s were less likely to experience 42 health conditions or adverse health events โ but more likely to face 19 others.
myskin/Shutterstock What conditions were less common?
Cardiometabolic conditions
GLP-1 use was associated with fewer serious cardiovascular and coagulation disorders. This includes deep vein thrombosis, pulmonary embolism, stroke, cardiac arrest, heart failure and myocardial infarction.
Neurological and psychiatric conditions
GLP-1 use was associated with fewer reported substance use disorders or addictions, psychotic disorders and seizures.
Infectious conditions
GLP-1 use was associated with fewer bacterial infections and pneumonia.
What conditions were more common?
Gastrointestinal conditions
Consistent with prior studies, GLP-1 use was associated with gastrointestinal conditions such as nausea, vomiting, gastritis, diverticulitis and abdominal pain.
Other adverse effects
Increased risks were seen for conditions such as low blood pressure, syncope (fainting) and arthritis.
People who took Ozempic were more likely to experience stomach upsets than those who used other type 2 diabetes treatments. Douglas Cliff/Shutterstock How robust is this study?
The study used a large and reputable dataset from the US Department of Veterans Affairs. Itโs an observational study, meaning the researchers tracked health outcomes over time without changing anyoneโs treatment plan.
A strength of the study is it captures data from more than 2.4 million people across more than six years. This is much longer than what is typically feasible in an intervention study.
Observational studies like this are also thought to be more reflective of the โreal worldโ, because participants arenโt asked to follow instructions to change their behaviour in unnatural or forced ways, as they are in intervention studies.
However, this study cannot say for sure that GLP-1 use was the cause of the change in risk of different health outcomes. Such conclusions can only be confidently made from tightly controlled intervention studies, where researchers actively change or control the treatment or behaviour.
The authors note the data used in this study comes from predominantly older, white men so the findings may not apply to other groups.
Also, the large number of participants means that even very small effects can be detected, but they might not actually make a real difference in overall population health.
Observational studies track outcomes over time, but canโt say what caused the changes. Jacob Lund/Shutterstock Other possible reasons for these links
Beyond the effect of GLP-1 in the body, other factors may explain some of the findings in this study. For example, itโs possible that:
- people who used GLP-1 could be more informed about treatment options and more motivated to manage their own health
- people who used GLP-1 may have received it because their health-care team were motivated to offer the latest treatment options, which could lead to better care in other areas that impact the risk of various health outcomes
- people who used GLP-1 may have been able to do so because they lived in metropolitan centres and could afford the medication, as well as other health-promoting services and products, such as gyms, mental health care, or healthy food delivery services.
Did the authors have any conflicts of interest?
Two of the studyโs authors declared they were โuncompensated consultantsโ for Pfizer, a global pharmaceutical company known for developing a wide range of medicines and vaccines. While Pfizer does not currently make readily available GLP-1s such as Ozempic or Wegovy, they are attempting to develop their own GLP-1s, so may benefit from greater demand for these drugs.
This research was funded by the US Department of Veterans Affairs, a government agency that provides a wide range of services to military veterans.
No other competing interests were reported.
Diabetes vs weight-loss treatments
Overall, this study shows people with type 2 diabetes using GLP-1 medication generally have more positive health outcomes than negative health outcomes.
However, the study didnโt include people without type 2 diabetes. More research is needed to understand the effects of these medications in people without diabetes who are using them for other reasons, including weight loss.
While the findings highlight the therapeutic benefits of GLP-1 medications, they also raise important questions about how to manage the potential risks for those who choose to use this medication.
The findings of this study can help many people, including:
- policymakers looking at ways to make GLP-1 medications more widely available for people with various health conditions
- health professionals who have regular discussions with patients considering GLP-1 use
- individuals considering whether a GLP-1 medication is right for them.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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