What are BCAA (Branched-Chain Amino Acids) and creatine?

From the Guidelines

BCAAs (Branched-Chain Amino Acids) and creatine are supplements that can be beneficial for muscle protein synthesis and energy production, but their use should be prioritized based on individual needs and health status, as evidenced by a 2019 study on clinical nutrition in the intensive care unit 1.

Key Points

• BCAAs consist of three essential amino acids: leucine, isoleucine, and valine, which make up about one-third of muscle protein.
• BCAAs help with muscle protein synthesis, reduce muscle soreness, decrease exercise fatigue, and prevent muscle wasting.
• Creatine is a naturally occurring compound found primarily in muscle cells that helps produce energy during high-intensity exercise.
• Typical BCAA supplements contain a 2:1:1 ratio of leucine to isoleucine to valine, with common dosages ranging from 5-20 grams daily.
• Creatine supplementation enhances strength, increases lean muscle mass, and improves exercise performance, particularly during short bursts of intense activity.

Considerations

• A 2019 study on clinical nutrition in the intensive care unit found that high protein delivery may be beneficial in critically ill patients, but the optimal timing and amount of protein intake are unclear 1.
• Another study found that BCAA supplements may facilitate the provision of an adequate nitrogen intake in patients who are intolerant to meat protein, but the evidence for their use in hepatic encephalopathy is limited 1.
• Creatine supplementation may be beneficial for patients with Duchenne muscular dystrophy, but the evidence is not conclusive, and its use should be individualized 1.

Recommendations

• BCAA supplements should be considered for individuals who require high protein intake, such as athletes or critically ill patients, but their use should be guided by individual needs and health status.
• Creatine supplementation may be beneficial for individuals who engage in high-intensity exercise, but adequate hydration is important to minimize potential side effects.
• Further research is needed to determine the optimal timing and amount of protein intake, as well as the potential benefits and risks of BCAA and creatine supplementation in different populations.

From the Research

BCAA and Creatine Overview

• BCAA (Branched-Chain Amino Acids) are considered to favor post-exercise muscle recovery 2
• Creatine is a popular and widely used ergogenic dietary supplement among athletes, which has been shown to increase lean muscle mass and exercise capacity when used with short-duration, high-intensity exercise 3

BCAA Benefits

• Intake of BCAA favors post-exercise muscle recovery and may improve muscle function 2
• Optimal dosage regimen for post-exercise muscle recovery and/or muscle function after high-intensity resistance exercise is 2-10 g BCAA/day (leucine: isoleucine: valine at 2:1:1) 2
• BCAA can improve perceived muscle damage, fatigue, circumference of arm/leg, counter movement jump, maximum muscle strength and maximum voluntary contraction, and reduce creatine kinase and lactate dehydrogenase levels 2

Creatine Benefits

• Creatine supplementation can increase muscle total creatine, including both free and phosphocreatine 4, 5
• Creatine supplementation may enhance performance in high intensity, short-term exercise tasks that are dependent primarily on the ATP-CP energy system 4, 5
• Creatine supplementation can increase body mass, although the initial increase is most likely water associated with the osmotic effect of increased intramuscular total creatine 4, 5
• Chronic creatine supplementation in conjunction with physical training involving resistance exercise may increase muscle mass 4

Safety and Side Effects

• Creatine supplementation up to 8 weeks, with high doses, has not been associated with major health risks; with low doses, it was demonstrated that in 5 years period supplementation, there are no adverse effects 4
• The only side effect associated with creatine supplementation appears to be a small increase in body mass, which is due to either water retention or increased protein synthesis 5