And when we start getting the the brain

benefits up at this end,

>> Right.

>> what are those brain benefits that they

were recorded in the studies? Is it I'm

going to feel like I slept or is it

something more internal?

>> You likely won't feel anything.

>> Oh, okay.

>> However, when you get to task the next

day, so for example, you're up all

night, you take a high dose creatine,

then you have to go write the final or

the midterm or you can't remember. It's

those things when your memory and and

and doing puzzles or basic task.

Or what about a Stroop test?

>> What's a Stroop test?

>> So, I'm going to get you to do this. I

apologize in advance.

>> Uh-huh.

>> It's one of the most fatiguing things

that you can do and it was one of the

most robust studies to show the efficacy

behind creatine. So, all I simply want

you to do is you can see that there's

words and then corresponding letters,

but you'll notice that the color is

incorrect. So, up here you would see,

you know, you have red, blue, green,

blue, black, but the Stroop test is now

looking at the bottom part.

>> Okay.

>> So, I've tried it. I can only get the

line two without making a mistake.

>> Okay.

>> Okay, so I want you to do this

out loud, but as fast as possible.

>> And am I reading the words or the color?

>> You're reading the color.

>> Okay, so the first one's green, yeah?

>> Uh, yes.

>> Okay, fine.

You want to do it as fast as possible?

>> as possible. Okay, so let's see how you

do.

>> Gosh, this is confusing already. I hit

the second one and I got it wrong in my

head.

>> Depends how much creatine you took.

>> [laughter]

>> I don't think I had creatine today.

>> Okay.

>> Okay.

Green, red, yellow, green, blue, black,

orange, red,

blue,

green, blue, pink, black, gray, yellow,

red, blue, green,

>> [clears throat]

>> black.

>> There you go, see?

>> The study that they did, get this, they

had to do this for 90 straight minutes.

>> Oh, wow.

>> So, you can imagine how fatiguing that

is for someone studying for the MCAT for

medical school or, you know, midterms

being sleep deprived. And you're not

sleep deprived and you struggled, and

you got slower. Now you have to do this

for 90 minutes. And in this classic

study, they gave 20 g of creatine before

they did the test and then after, and it

really improved their ability with speed

and cognition there. So, it's just a

simple example to show, "Wow, our brain

is seeing one thing. We got to maintain

memory and cognition, and creatine can

help maintain some of those factors."

So, you won't feel anything, but

performance of activities like that come

into play.

>> Do you remember how much it improved

their performance on the Stroop test?

>> I would have to get the graph, but it

did prove statistically significant,

yeah.

>> What else is there for me to know about

the impact that creatine can have on the

brain? You know, I think as a

>> [clears throat]

>> as a podcaster who sometimes sits here

for many, many hours interviewing people

on a range of subjects, I'm always

trying to find if there's any way that I

can perform better mentally.

>> Yeah. So, it doesn't boost the brain. It

likely just brings those levels back up

to normal levels before stress, and it

might give you a little bit more. So,

there's been populations, Alzheimer's

disease, clinical depression, uh

concussion. When those populations are

evident, one of the biggest

factors is that they have reduced

creatine in their brain. So, maybe

supplementation can get through the

blood-brain barrier. The brain says, "I

need help." And that's why you see some

improvements there as well. So, I like

to think of the brain that creatine can

act as a safety net. Um and it certainly

won't cause any detrimental effects, but

it's always good to have that because

you never know when I give you a Stroop

test. Like, I'm going to find you

tomorrow, give you this, and say,

"You're going to be practicing all

night. Will you perform better?" But

that's just an example of something that

we go through on a daily basis. If

someone's working on Wall Street or

whichever it is, a really high-stress

demand, uh you know, stuck in traffic

for 2 hours, these all add up, and it's

a cascade of stressors that

unfortunately most people go through.

And now that we have a nutrient that is

being made in the brain, but during

times of stress, it likely needs a

little bit of help.

>> For the last couple of years, I've been

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>> What about inflammation in the body? So,

what is inflammation? And is there a

link between creatine supplementation

and inflammation?

>> There is. So, unfortunately, I'm 49. So,

at the age of 40, I have this systemic

inflammation that went up. And we all

know this because around the age of 30,

you know, you can work out and nothing

hurts and then all of a sudden you wake

up one day when you're in your 40s and

50s and things hurt. So, systemic

inflammation is happening all the time

and unfortunately, it accelerates aging.

We're more sore more often and it can

lead to a lot of arthritis or or joint

pain and things like that. Creatine does

have anti-inflammatory effects, but a

big distinction. Creatine is [snorts]

not like acetaminophen or ibuprofen

which directly as a drug effect blocks

that, but it has been shown to decrease

markers of inflammation specifically

during long duration exercise. So, this

is an important distinction. Weight

training is too acute.

But when you do Ironman, triathlon,

things like that, those individuals who

took creatine 20 g a day for 5 days

beforehand, they had reductions in

inflammation markers. So, that might

allow that individual to recover

quicker, not get ill, and then perform

more optimally. From a weight training

perspective, we see that it decreases

markers of muscle damage. So, it has

these anti-inflammatory and

anti-catabolic effects as well.

>> Interesting.

>> Yeah.

>> And what about people that have

neurodegenerative disorders?

>> Yes, so Alzheimer's is is the area we're

really starting to focus on and a couple

single arm studies came out last year by

Matt Taylor and Aaron Smith showing that

20 g a day for 8 weeks did increase

brain creatine levels in Alzheimer's

patients and it seemed to improve

measures of memory and cognition there

as well. So, again, using the same

mechanisms. It decreases inflammation,

it maintains brain bioenergetics, and it

might actually have a neuroprotection

effect as well. There's evidence in cell

cultures and in rodents that there's

some lines there, but in humans we're

still in a in the infancy. But if it can

have any benefit to any neurological

disease, it's huge and there's a lot of

hope, especially around Alzheimer's.

>> There was an 8-week trial on Alzheimer's

patients that also showed modest muscle

gains and a 1.9 kg increase in hand grip

strength.

Which is a key predictor of survival in

dementia patients. And which was a

landmark study of 20 Alzheimer's

patients found that taking 20 g of

creatine daily for 8 weeks increased

brain creatine levels by 11% and

significantly improved the cognitive

test scores they showed as the Journal

of Psychiatry and Brain Science.

>> And that one's really exciting and I

think more future studies will come out.

The limitation with those is that there

was no placebo to compare to, but again,

it's just showing that yes, creatine can

be used as an effective adjunct, yeah.

>> And because there is impact on our

brain, is there impact on our mental

health with creatine?

>> Excellent point. So, the best lines of

evidence here come from clinical

depression and anxiety. The group out of

Utah in the United States have clearly

shown that creatine in addition to other

therapies. So, this is important.

Creatine by itself has never been shown

to be a standalone, but with SSRIs or

cognitive behavioral therapy or

methamphetamine use in populations under

medical supervision, the addition of

creatine seemed to improve symptoms and

it's likely going back to all the ones

we've already talked about where it

improves bioenergetics, it improves

neuro transmission or neuromodulation,

but it also in animals has been shown to

improve a protein called BDNF. So, this

protein is involved in brain plasticity.

So, there's a whole bunch of emerging

evidence and hope that creatine one day

will be used as a treatment in the

toolbox for a lot of these clinical

issues. PTSD also comes to my mind.

>> There was a study in Gatorade Sports

Science Institute which PubMed published

that said it a study of over 200,000

adults found that those who consumed the

least amount of creatine in their daily

diet had the highest rates of depressive

symptoms.

>> Yes, that's correct. And the common

denominators those with clinical

depression and anxiety, when you measure

their baseline creatine stores very

similar to concussion or Alzheimer's,

they're reduced. So, therefore,

obviously, this

condition or series of conditions is

causing a disruption at the brain

bioenergetic level and creatine levels

are decreasing.

>> There's another impairment that said in

a clinical trial of women with major

depression adding 5 g of creatine to

their daily antidepressant

>> Yes.

>> doubled their remission rate over 8

weeks.

>> That's correct, yes. And that uh group

is from uh Perica Renshaw's group out of

Utah. Uh they do great work. Our hope,

and I'm collaborating uh with some

colleagues now to look at creatine as a

standalone treatment versus placebo,

could it have some beneficial effects

there? So, that's very exciting to come

out.

>> If I don't want to be supplementing with

creatine, is there what are the foods

that I can eat that are high in creatine

naturally?

>> They're primarily uh animal-based, so

seafood and red meat. Um you know,

herring is going to have one of the

highest concentrations, uh salmon,

uh as well as beef. Uh very small

amounts in milk and dairy, so you'd have

to drink all the the milk in the Jersey

cow to get a sufficient amount. So, uh

it definitely comes down to animal-based

flesh, yeah.

>> There's some other studies that I that I

love that I I think I've had you talk

about before. One of them was um young

athletes who took 5 g of creatine daily

slept an average of 1 hour longer

>> Yes.

>> on training days.

>> Yeah, we did that study a few years ago

in uh uh young biological females who

were healthy, and on the days that they

trained and took creatine,

this is interesting because they

actually slept an hour longer uh

compared to the placebo. So, this is a

very interesting fact. So, creatine, you

know, we now know it has brain

bioenergetics, and there's two

arguments. If it's making the brain

recover, wouldn't you need less sleep,

right? Now, in this study, it showed

that improved, so maybe these

individuals trained at a higher capacity

and allowed the brain to have more

homeostasis to come back. So, this is an

a study that needs to be replicated in

males as well to see can creatine

improve sleep quantity, and if it is, I

think that's a game changer. I think

everybody on the planet would raise

their hand and say, "Hey, I need more

sleep."

>> Is there anything else we haven't

covered as it relates to creatine?

>> You know, the expected gains versus the

hype gains. I think there's evidence

there that creatine can have a

an effect. I I think it's getting

overhyped, especially around the brain

for what it can do. It's one tool in the

toolbox and I think it's one of those

things that I'd like to show or, you

know, talk about for sure, yeah.

>> Well, what do you mean by that?

>> So, if you think of the toolbox when it

comes to a plan, whenever you need to go

fix things, you simply say, "Where's my

toolbox?" You can't do anything without

a plan. And the way I like to preface

this is the most popular tool in

anybody's toolbox is the hammer. Now,

from a lifestyle perspective, what do

you think the hammer represents? What

would you decide that the hammer

represents?

>> Um as in like a

>> Is it weight training? Is it cardio? Is

it creatine? Is it protein? Is it sleep?

>> Sleep.

>> Okay. So, I say weight training is going

to be the hammer.

>> Okay.

>> Okay.

Now, what about the screwdriver? Always

need a screwdriver.

>> Creatine.

>> No, I think aerobic training or sleep

comes way before creatine.

>> Okay.

>> But most people say, "Hey, I can fix a

lot of things with that." Now, remember,

we have a nice big toolbox.

I like to think of creatine as the

multifactorial wrench or screwdriver.

Because creatine has profound benefits

for muscle, a little bit for bone, of

course brain and other areas of the

body. So, you can hit something with

this.

You can open it up and fix something

with this. It's heavy. You can also pull

out the measuring tape. Your argument,

sleep. This could be protein, whichever

it is. So, when you put all these things

in your toolbox, you're now having a

greater comprehensive plan to improve

health.

>> So, you said weight training was the

hammer.

>> Hammer. I like to consider if you were

to choose one modality of exercise,

weight training is a little bit superior

to cardio. You get pretty much all the

same benefits of cardiovascular

exercise, and then you get more with

obviously an increase in lean tissue

mass and performance. Weight training if

done effectively can actually improve

mitochondrial health. You can actually

improve VO2 max if done correctly,

and you don't need a lot of it. So, I

think we've switched from just doing

cardio to now incorporating weight

training to be effective.

>> So, weight training.

>> Yes.

>> What are the sort of misconceptions

about

weight training, and why are you so

positive about it?

>> Yeah, I think one of the biggest myths

is that you always need to lift heavy to

put on muscle mass.

And world-renowned [clears throat]

researchers in this area have clearly

shown now that lighter weights if

performed to a lot of effort almost to

fatigue, if done correctly, you can get

the same increases in muscle mass as

then compared to lifting heavy weights.

However, if your goal is just to get

stronger, lifting heavy is always there.

So, I think this is a cool thing for

people. Some days if you have a little

bit of soreness or you don't have a lot

of energy, you can lift lighter weights

but just to fatigue. Whereas other days

you come in Monday, you've had your

coffee, whichever it is, you're ready to

go, you can lift heavy. So, I think

there's not one concrete way. There's a

little bit of variety here as well.

>> And why are you putting it above

cardiovascular work?

>> Yeah, I think the benefits there is that

cardiovascular exercise will make you

live longer and and

and healthier. But the downfall with

cardiovascular exercise, it doesn't

stimulate strength or the

musculoskeletal system as much as we

we'd hope. So, improving muscle mass and

that is very difficult to do with

cardio. Maybe sprint interval training

will do that, but the cool thing with

weight training is you get

cardiovascular benefits, but you also

get those profound musculoskeletal

benefits. So, if I was to tell anybody

if there's one form of exercise to do,

it's weight training, but you've got to

do cardio as well. So, do both.

>> And if I just do weight training, what

am I missing from not doing cardio

training?

>> Yeah, if you do weight training

improperly where you're lifting heavy

heavy weight with low repetitions all

the time, you're likely going to

jeopardize capillary density or

mitochondrial health. These are things

that sort of move blood flow to and from

your muscles. You could decrease VO2 max

or a fitness parameter for metabolic

health fitness. So, at the end of the

day, everybody should be doing both.

But, if you only have time to do weight

training or cardio, you still benefit

cuz the majority of the population

doesn't do any.

>> And how how much how often do you think?

>> It's amazing that it's a small amount.

So, let's just do cardio. Most countries

will say 150 minutes of physical

activity at a moderate level over a

week.

I'm okay with that. I'd like it to be

higher. I'd also like the intensity to

be a bit higher. So, when you tell an

average individual 150 minutes a week,

most people say, "Well, I'm going to do

70." Or, "I'm going to do 30." "I'm

going to hold the couch down and watch

Netflix." So, we're given 150 and we

say, you know, if you can do 21 minutes

or 22 minutes a day for 7 days a week,

that's going to be a brisk walk or

whichever. We'd like to be at a higher

intensity if possible.

Now, when it comes to weight training,

this might be surprising, but 2 days a

week or more is all you basically need.

And you can do a whole body routine. So,

you don't need to go in there and just

do chest and biceps Monday and then legs

Tuesday. You can, but if you say I want

to do whole body of training Monday,

Wednesday, Friday, that is great as

well. So, a little bit of volume or

frequency goes a long way, especially as

we get older. That's the key.

>> Why especially as we get older?

>> Well, based on this graph here, it's

clearly showing a detrimental effect.

So, if you can see here, you know, you

have muscle mass on the the x-axis or

the y-axis, and then you're having all

the catastrophic effects as we get

older. So, unfortunately, you know, 20

and 30 looks great.

>> When you're 20 and 40 years old.

>> When you're 20 and 40 years old or all

the way from 22 40, you can see great.

That's probably the area that you're

going to have the most muscle.

>> Yeah.

>> But, look what happens 40, age 60, 80,

and if you live to be 100.

It's catastrophic. You're losing muscle

mass at an accelerated rate. On average

is about 1% per year after the age of

40.

>> Even if you're training?

>> So, if you're training, you're

maintaining that. So, this is the

average sedentary inactive population.

You lose strength at about 1. or 1 to 3%

even faster. Now,

if we were to maintain resistance

training, that muscle mass would

plateau.

So, I can't stress this enough. Although

we focus on creatine, if you were to

choose one thing to do today is

exercise. And the only form of exercise

that really maintains muscle is

weight-bearing or resistance training.

And if that's the case, you're going to

have way more muscle later on in life.

So, you can pick up the grandkids. You

can walk those stairs. You can do more

functionality things later on in life.

>> Can you not just do I don't know, 60

years old start training then?

>> You can absolutely and you get profound

benefits. You can be 80 or 100 and you

still get benefits. It's never too late

to start.

But one of the things we've already

talked about is if you do weight

training and add in a little bit of

creatine,

it gets a bit higher. If you added in

protein, it gets even higher. So, again,

nutrition, you know, if exercise is

king, the queen is going to be

nutrition. They go hand in hand all

throughout lifespan. You got to have

both.

>> And on the subject of protein, you're

saying that can when combined with

creatine, it's a

force multiplier.

>> It's it's a force multiplier when it

comes to performance and lean tissue

mass. So, there's been a few studies

when you combine a high-quality protein

with creatine, they have been shown to

increase lean tissue mass and muscle

performance a little bit more than each

alone, yeah.

>> Does the average person get protein

through their diet?

>> You know, I think nowadays we do and and

I think this is overhyped as well. I

think if you're getting about 1.2 to 1.6

g per kilogram. So, you know, if you're

70 kg, that's going to be on average

about 84 to about 115 g of protein. I

think we're so conscious now of the

health benefits of protein that most

people are. I think if you're training

really intensely five, six days a week

and you take a gram per pound, that's

probably the max. But a lot of times

when you take an excess protein, it

doesn't go to your body area that you're

probably hoping. It doesn't all go to

your muscle. It's used for other things

like hormones and blood cells, things

like that. But I think nowadays most

people are likely getting enough

protein. The question is, are they

getting enough high-quality protein? So

vegans and vegetarians can definitely

get enough protein. They might just need

to eat a little bit more to get all

those essential amino acids, which we

need.

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