Anti-Aging Expert: Creatine Is The Fat Loss Secret Doctors Don’t Tell You - Dr. Darren Candow

1. 0:00 – 2:26

   Intro

   1. DCDr. Darren Candow0:00

      A healthy brain likely doesn't need any creatine. But what if you're stressed? What about sleep deprivation, night shift workers, university students cramming for a midterm? Then all of a sudden, the healthy brain becomes a metabolically stressed brain. And most people fall into the stressed environment, and that's where creatine comes to the rescue. And we'll talk about how much, but the more stressed it is, the higher the dose seems to come into play.

   2. SBSteven Bartlett0:23

      And is there anyone that shouldn't take creatine?

   3. DCDr. Darren Candow0:25

      Well, I've published over 120 papers just on creatine alone.

   4. SBSteven Bartlett0:28

      Wow.

   5. DCDr. Darren Candow0:28

      And we've done at least 30 to 40 studies in our lab, and I can't find anybody that can't or shouldn't take creatine. So for example, at recommended dosages, creatine can not only have potential anti-cancer properties, but really speed up rehabilitation. And there's a lot of hope, especially around Alzheimer's.

   6. SBSteven Bartlett0:43

      And what about kids?

   7. DCDr. Darren Candow0:44

      The current body of evidence suggests they want to get at least one gram per day, because in children they want to have optimization for bone health as well as muscle development. And so I'm fascinated that this nutrient, discovered in 1832, like boring for the longest time, is having these profound benefits we never even thought would happen. And so your viewers today will be surprised about some of the things I'm going to talk about, including microdosing.

   8. SBSteven Bartlett1:05

      And we've got this thing here in front of us.

   9. DCDr. Darren Candow1:06

      Right.

   10. SBSteven Bartlett1:06

       This is The Dosing Dilemma.

   11. DCDr. Darren Candow1:08

       Right.

   12. SBSteven Bartlett1:08

       And I want to talk about how much I need to take for all these things. And I want to talk about nutrition, protein, weight training, et cetera.

   13. DCDr. Darren Candow1:13

       Mm-hmm.

   14. SBSteven Bartlett1:13

       But before that, you've got five myths in front of you. Can you reveal one by one what they are?

   15. DCDr. Darren Candow1:17

       So this is... Oh, I can't believe you did this one to me. Creatine causes hair loss. I was going bald before [laughs] I started taking creatine. Myth number two. Oh, so this is by far the biggest myth, and that is-

   16. SBSteven Bartlett1:32

       This is super interesting to me. My team give me this report to show me how many of you that watch this show subscribe, and some of you have told us, according to this, that you are unsubscribed from the channel randomly. So favor to ask all of you, please could you check right now if you've hit the subscribe button if you are a regular viewer of the show and you like what we do here. We're approaching quite a significant landmark on this show in terms of a subscriber number. So if there was one simple free thing that you could do to help us, my team, everyone here, to keep this show free, to keep it improving year over year and week over week, it is just to hit that subscribe button and to double-check if you've hit it. Only thing I'll ever ask of you. Do we have a deal? If you do it, I'll tell you what I'll do. I'll make sure every single week, every single month, we fight harder and harder and harder and harder to bring you the guests and conversations that you want to hear. I've stayed true to that promise since the very beginning of The Diary of a CEO, and I will not let you down. Please help us. Really appreciate it. Let's get on with the show. [instrumental music]

2. 2:26 – 4:14

   What is the mission that you're on?

   1. SBSteven Bartlett2:26

      Dr. Darren Candow, what is the mission that you're on in your life?

   2. DCDr. Darren Candow2:33

      I think right now it would be to promote health and make people live longer free of disease. It's fascinating how we've transcended our understanding of weight training, and now weight training is seeming to have these profound effects that cardiovascular exercise has, and it gives you a bit more. So really focusing now on the benefits of lifting things around the house and how exercise and then of course nutrition, we're going to talk about creatine. But also how other macronutrients, especially protein, come into play. And then when you combine those two, are we doing enough to optimize longevity? And we hope that we are. Yeah.

   3. SBSteven Bartlett3:06

      And so what are the reference points you're drawing on? H- how do you know the things you know? Are you doing your own research?

   4. DCDr. Darren Candow3:11

      Yeah. So I did my, uh, graduate school in Canada, a cell biology degree, and then I moved into my master's and PhD looking in kinesiology. So it's interesting that I fell into creatine supplementation research by accident. I was doing my master's on an amino acid called glutamine, and at the time, about 20, 30 years ago, glutamine was the biggest rage. Everybody was taking this non-essential amino acid and hoping that it would have body composition improvements. Uh, and I sort of determined it was worthless in young healthy individuals from a body composition, uh, standpoint. And at the same time, a good colleague of mine was doing creatine. And I started to notice these young biological males were getting bigger, stronger, faster. And then another study, bigger, stronger, faster. And then when you go to the research on creatine, it was very stimulating in a sense that we're now improving things that we know with aging go down. So then I turned my focus completely to healthy aging and trying to get, you know, grandparents and great-grandparents and your parents to live longer free of disease. But wait, let's start young. Start as early as you can and move forward.

3. 4:14 – 6:30

   Why has creatine exploded?

   1. DCDr. Darren Candow4:14

      Yeah.

   2. SBSteven Bartlett4:14

      And so you got really compelled by creatine. I want to talk about all these things.

   3. DCDr. Darren Candow4:16

      Yeah.

   4. SBSteven Bartlett4:16

      Um, nutrition, protein, weight training, et cetera.

   5. DCDr. Darren Candow4:19

      Mm-hmm.

   6. SBSteven Bartlett4:19

      But on this subject of creatine-

   7. DCDr. Darren Candow4:21

      Yes

   8. SBSteven Bartlett4:21

      ... what was it that compelled you so much to start? You, you did start doing your own research on creatine.

   9. DCDr. Darren Candow4:25

      I did, and I started to take creatine. So, you know, it was this natural metabolite that we're synthesizing in the liver and brain. If you take a little bit more, not a lot, just a little bit more than what we're probably taking in from the food, uh, sources such as red meat and seafood, can it have benefits? And sure enough, it's now the most researched supplement out there. It's overtaken protein and caffeine, uh, from an ergogenic perspective. And it's gone global, not just for males, but of course, uh, females a- and centenarians and elderly. So it's very fascinating, the explosion in this research part.

   10. SBSteven Bartlett4:57

       What is the sort of, um, h- not evolutionary backdrop-

   11. DCDr. Darren Candow5:00

       Mm-hmm

   12. SBSteven Bartlett5:00

       ... but I guess physiological backdrop of why humans need creatine-

   13. DCDr. Darren Candow5:03

       Yeah

   14. SBSteven Bartlett5:03

       ... but also why they might not be getting-

   15. DCDr. Darren Candow5:05

       Mm

   16. SBSteven Bartlett5:05

       ... optimal amounts?

   17. DCDr. Darren Candow5:06

       Yeah, that's a great question. So, uh, adenosine triphosphate, or ATP, is the energy currency of all our cells. And think of your muscle doing work or shoveling the driveway or, or walking. You're using your muscles, and you need to maintain that level of energy to, to maintain exercise. Well, creatine comes to the rescue to help maintain your energy currency. So if Batman, which gets all the press, is ATP, Robin is creatine. Creatine comes to the rescue, it's his best friend, to help maintain these levels. Now, when you exercise at a high intensity, you know, sprinting, weightlifting, those ATP stores do become jeopardized, and that's why creatine sort of sacrifices itself, uh, to come to the rescue. So that's why anaerobic sports. The World Cup just started. These individuals will be using a lot of creatine stores in their muscle. The question is, do they have enough? And if they had more, could they play better?

   18. SBSteven Bartlett5:58

       And so d- our body makes creatine naturally?

   19. DCDr. Darren Candow6:00

       That's correct. It's making about one to three grams a day, but only in two areas. So this will be quite shocking for people. We're only actually making it in the liver and the brain. We don't make it in skeletal muscle, but you store 95% in our muscle. So when it's being made in the liver or brain- The brain will keep it there, but in the liver it will get transported in the blood up to your, your skeletal muscle. The question is, well, what if we need more? And that's where dietary creatine from red meat or seafood or supplementation comes into play.

4. 6:30 – 8:14

   Are we deficient in creatine?

   1. SBSteven Bartlett6:30

      So are we deficient in creatine?

   2. DCDr. Darren Candow6:33

      There are small populations with, unfortunately, they were born with the inability to synthesize creatine. Uh, they would have a deficiency and they are required to take supplementation. The other unique population is vegans and vegetarians. So vegan and vegetarian diet is extremely healthy. The downfall though is they're not getting any dietary creatine, 'cause creatine is only found in animal-based flesh, so red meat, seafood, and poultry. They're naturally synthesizing about one to two, maybe even three grams a day through amino acids in their food. But vegans and vegetarians respond literally s- the best on the planet because now they're taking in a supplement to allow that in.

   3. SBSteven Bartlett7:11

      And is it thought that historically we would naturally have consumed more creatine?

   4. DCDr. Darren Candow7:14

      That's a good point. So back, you know, hunter and gatherer age, a lot of meat, they were consuming quite a bit through dietary products. Just say if you only wanted to get three grams of creatine through food, you'd have to eat quite a bit of meat to do that, and then it comes into the dilemma of, well, what if you don't eat meat or you just can't afford it, you know?

   5. SBSteven Bartlett7:30

      Hmm. Creatine has exploded over the recent-

   6. DCDr. Darren Candow7:33

      Mm-hmm

   7. SBSteven Bartlett7:33

      ... over the c- last couple of years. I, I, I saw a stat that said, uh, it, I think in women it had gone up to about 3% of women take the cr- creatine, and-

   8. DCDr. Darren Candow7:40

      Yeah

   9. SBSteven Bartlett7:40

      ... um, in men it's slightly higher.

   10. DCDr. Darren Candow7:42

       Mm-hmm.

   11. SBSteven Bartlett7:43

       It's still a little bit lower in terms of consumption in women-

   12. DCDr. Darren Candow7:45

       Mm-hmm

   13. SBSteven Bartlett7:46

       ... from the stats that I saw, and I think that in part is because there's still some prevailing myths about creatine.

   14. DCDr. Darren Candow7:51

       Mm-hmm. Yeah.

   15. SBSteven Bartlett7:51

       When I, when I speak to some of my friend, c- people know that I interview a lot of, um, health experts and scientists and PhDs on, that have done research on supplements.

   16. DCDr. Darren Candow7:59

       Right.

   17. SBSteven Bartlett7:59

       They ask me, the first question I get asked a lot is, "What are the supplements should I definitely take?"

   18. DCDr. Darren Candow8:02

       Yes.

   19. SBSteven Bartlett8:02

       And when I mention creatine, it's always met with a certain set of rebuttals-

   20. DCDr. Darren Candow8:06

       Mm-hmm

   21. SBSteven Bartlett8:06

       ... because there's some prevailing myths.

   22. DCDr. Darren Candow8:07

       Mm-hmm.

   23. SBSteven Bartlett8:08

       You've got some myths-

   24. DCDr. Darren Candow8:09

       Yes

   25. SBSteven Bartlett8:10

       ... about creatine on the cards in front of you. Can you reveal one by one what they are?

5. 8:14 – 10:32

   Does creatine damage your kidneys?

   1. DCDr. Darren Candow8:14

      So this is definitely the number one myth, creatine damages your kidneys. So when you take in creatine to the body, it gets stored as creatine, but when you metabolize it, sort of, sort of thinking leaking from the muscle, it gets leaked out as creatinine. And most people watching is like, "Oh, that was on my blood requisition form, and right below creatinine was something called eGFR." So glomerular filtration rate is an estimation of your kidney health. So the problem is when individuals on creatine supplementation, they go to their doctor for their annual blood work, their creatinine might be a little bit elevated, and that's only from the breakdown of the m- uh, the compound. And then unfortunately their, uh, filtration rate is lower, so then their doctor gets really surprised and they're like, "Stop taking creatine because it's hurting your kidneys." What typically happens is they go back, uh, are stopping creatine, and then they check their kidneys again and it's fine. So I would say 99 out of 100 times, uh, that it's a false positive. So this is by far the biggest, uh, myth, and there's been randomized control trials for several years showing that creatine causes no detrimental effects to the kidneys.

   2. SBSteven Bartlett9:16

      I had exactly that twice on my blood tests.

   3. DCDr. Darren Candow9:18

      Yeah. Yes. And if you're also, creatinine could be elevated if you're on a high meat diet, a little bit dehydrated. So, uh, those that are exercising, uh, it's very, very elevated. So always tell your doctor you're on creatine supplementation because your creatinine could be a little bit higher.

   4. SBSteven Bartlett9:31

      Okay.

   5. DCDr. Darren Candow9:31

      Yep. Myth number two, creatine makes you retain water. So this is really important, and I think this is one of the main reasons females were really hesitant to take creatine. If you take too much too soon, it can lead to an increase in water retention. So you've probably heard of the creatine loading phase. This is where supplement companies want you to take about 20 or 30 grams a day for about five or seven days. That has been shown to increase water retention acutely. So maybe it'll reside there for about three to five days, but after that, when you go on a maintenance phase of about three to five grams a day, uh, that water retention goes away. So in the initial stages, if done improperly or too much, it can cause a little bit of water retention. The good news for everybody watching is after about the first week, that water's inside our muscle, so now we're volumizing the size of our muscle sort of like a balloon here. It's full of water. Now, after a while, the water's now going into our muscle, it's a lot bigger compared to a deflated balloon or muscle that didn't have any water.

6. 10:32 – 11:50

   If I have creatine in my muscle, am I more likely to gain muscle?

   1. DCDr. Darren Candow10:32

      So creatine is osmotic. Water likes to follow creatine, so by taking it into the muscle, it gets a lot bigger, and that's good because a swollen muscle stimulates protein synthesis to get bigger and stronger.

   2. SBSteven Bartlett10:44

      Oh, really?

   3. DCDr. Darren Candow10:45

      Yes.

   4. SBSteven Bartlett10:45

      A swollen muscle stimulates protein synthesis?

   5. DCDr. Darren Candow10:47

      Synthesis, yeah. So when you have water coming in, that's a really good thing, and creatine does that and that's one of the main mechanisms why it works.

   6. SBSteven Bartlett10:54

      So what does that mean? Does that mean that if I have creatine in my muscle, I'm more likely to gain muscle?

   7. DCDr. Darren Candow10:58

      That is potentially the, the factor because when you're having, or trapping water, it turns on all these signaling pathways that are involved in protein synthesis. A- and one of the biggest robust evidence is that creatine increases lean tissue mass and regional muscle thickness with weight training over time.

   8. SBSteven Bartlett11:13

      Oh, wow. Okay.

   9. DCDr. Darren Candow11:13

      Yeah.

   10. SBSteven Bartlett11:14

       Yeah, 'cause a lot of people are concerned that they're gonna put on lots of weight and be bloated-

   11. DCDr. Darren Candow11:17

       Yep

   12. SBSteven Bartlett11:17

       ... with creatine.

   13. DCDr. Darren Candow11:18

       The interesting there is if you take smaller, more microdosing, there's hardly any effect. And this might come surprising, but if you did a six-week study, pre and post after creatine, you only increase mass by .86 kilograms.

   14. SBSteven Bartlett11:30

       Oh, wow.

   15. DCDr. Darren Candow11:31

       And the majority of that is lean mass. So at the end of the day, you know, a pound and a half is not a lot.

   16. SBSteven Bartlett11:37

       Lean mass?

   17. DCDr. Darren Candow11:37

       Lean mass, yeah.

   18. SBSteven Bartlett11:38

       Which is?

   19. DCDr. Darren Candow11:39

       We think of lean mass, most people think of it as muscle, but lean mass in our body, that includes water, connective tissue, organs, as well as skeletal muscle, and about 50% of our lean mass is muscle.

   20. SBSteven Bartlett11:49

       Okay.

7. 11:50 – 12:31

   Should women take creatine?

   1. DCDr. Darren Candow11:50

      Yeah.

   2. SBSteven Bartlett11:50

      Great.

   3. DCDr. Darren Candow11:50

      Okay, myth number three, creatine is only for men. Uh, this is 100% false. When you go through the totality of all the evidence, uh, females res- uh, respond extremely robustly to creatine supplementation. They get profound benefits in strength, endurance, and performance. They lose a little bit of body fat. So there's another idea that people thought water retention was causing an increase in, in fat mass. We've done some meta-analysis now showing that creatine reduces fat mass. Uh, females get an increase in lean mass as well. Uh, and I'm happy this one came up because from our lab with bone health, females do respond very favorably with creatine and bone, and we can talk about that as well.

8. 12:31 – 13:36

   Will creatine cause hair loss?

   1. DCDr. Darren Candow12:32

      Myth number four. Oh, I can't believe you did this one to me.

   2. SBSteven Bartlett12:35

      [laughs]

   3. DCDr. Darren Candow12:35

      Creatine causes hair loss. So obviously, looking at me, and, uh, I, I'm a prof- prolific, uh, creatine researcher and taking creatine religiously for, like, the last two and a half decades, people would look at me and say, "Well, obviously, looking at him, creatine caused this." And I was going bald before [laughs] I started taking creatine. This myth came from a study in rugby players decades ago, uh, where creatine, about 20 to 25 grams a day for seven days, increased a hormone called DHT. It's a precursor for testosterone, which unfortunately has been linked to hair follicle loss and thinning. Uh, but the ironic thing is, when creatine was given to these young males, the hormone went up, but it was still within the biological range, and no measure of hair follicle thinning or loss, uh, was done. The cool thing is, just a few years ago, they decided to put this, uh, uh, theory to the test, and five grams in young males for about six to eight weeks of training caused no, uh, detrimental effect, uh, from hair thinning, follicle loss. So my appearance was probably based on something else, so there's no evidence

9. 13:36 – 16:28

   Creatine causes muscle cramps?

   1. DCDr. Darren Candow13:36

      to that as well.

   2. SBSteven Bartlett13:37

      [laughs]

   3. DCDr. Darren Candow13:37

      Myth number five, creatine causes muscle cramps. No, I think this is so overplayed. When creatine ta- is taken into the body and water will follow it, now you're super hydrating the muscle. So one of the main issues with muscle cramps is it could be, you know, uh, uh, dehydration in the muscle. Some people have heard of sodium potassium. That's why Gatorade was invented. But if anything, sodium decreases muscle cramps, and it super hydrates. So in the hotter environments, June, July, August, creatine is gonna be one of your best friends.

   4. SBSteven Bartlett14:06

      So there's the five myths. We talked there about weight training.

   5. DCDr. Darren Candow14:09

      Mm-hmm.

   6. SBSteven Bartlett14:09

      What is this very curious graph? It seems to show that creatine helped gain muscle mass through a training regime.

   7. DCDr. Darren Candow14:20

      Oh, yes. So this is actually showing now that, uh, when you take creatine supplementation, you're actually getting an improvement in training volume. So when you go in the weight room, you look at the load you're lifting by the reps, by the sets, so it actually goes up. Um, and then when you don't, obviously it would go down over time as well. So the cool thing here is that one of the main reasons you get an enhancement in performance is that creatine seems to enhance training capacity. So a lot of people say, "I've taken creatine, now I got an increase in the number of reps or, uh, sets that I can perform," and that probably leads to a stimulation over time.

   8. SBSteven Bartlett14:53

      So this is a eight-week study?

   9. DCDr. Darren Candow14:55

      That is an eight-week study. Very short term as well. So you can see that the number of weeks came, uh, down when they weren't taking creatine, and then when they started to take it, it went up as well. And this leads to another important point, so, and it's often not talked about. When you take creatine for at least a month, people say, "Well, how long does it stay in my muscles if I go on vacation? What if I can't take creatine?" And in skeletal muscle, it takes about a month for those elevated levels to come back down. In the brain, we don't have a lot of evidence, but it's speculated it takes about anywhere between five, uh, weeks to about three months for those elevations to come back down.

   10. SBSteven Bartlett15:30

       And this, uh, essentially means that if I take creatine, I will be able to train harder.

   11. DCDr. Darren Candow15:35

       Harder or longer or more frequent. So one of the things with creatine, it allows the muscle to recover quicker, so you might be able to get back to, to the, uh, you know, if an athlete's training twice a day. Um, so either one of those seems to be one of the most plausible mechanisms.

   12. SBSteven Bartlett15:48

       And why is there a big dip in the middle of this graph?

   13. DCDr. Darren Candow15:50

       So that is actually showing where the individuals would train, and then, without creatine, and then take it over time as well.

   14. SBSteven Bartlett15:56

       Oh, okay.

   15. DCDr. Darren Candow15:56

       Yeah.

   16. SBSteven Bartlett15:56

       So then s- then stop.

   17. DCDr. Darren Candow15:57

       It's a detraining and then taking it again. Correct.

   18. SBSteven Bartlett16:00

       Okay, so they start taking it.

   19. DCDr. Darren Candow16:02

       Uh, taking it at the, at week four, and then that's where the elevations go up.

   20. SBSteven Bartlett16:06

       Oh.

   21. DCDr. Darren Candow16:06

       Yeah. So it goes to show that when you have creatine, everything is elevated. If you stop taking it, it takes about four weeks to come back down, but you'll notice that it was at the same level as the placebo. And then when they take it again, they get a rebound effect. So I think this has application for people who have injured themselves, and they now need to go back and start training. If you take creatine, it can accelerate the rehabilitation program.

10. 16:28 – 18:08

    How effective is creatine in gaining muscle mass?

    1. SBSteven Bartlett16:28

       Hmm. And it, does it ha- I guess because it makes your training volume increase-

    2. DCDr. Darren Candow16:32

       Correct

    3. SBSteven Bartlett16:33

       ... it makes your muscle mass gain increase?

    4. DCDr. Darren Candow16:35

       It can ga- uh, gain increase in muscle mass. It's not great. That's probably gonna be a bit surprising to a lot of people. A lot of people take creatine for huge increases in muscle. You get an increase in lean mass by about 1.2 kilograms, but as I, I said previously, remember, only half of that is skeletal muscle. So creatine, yes, can with weight training improve muscle mass, but it has more robust evidence for muscle performance.

    5. SBSteven Bartlett16:57

       Is there anything else we need to know about creatine's link to muscle mass?

    6. DCDr. Darren Candow17:01

       I think one of the big things is that it decreases something called protein breakdown, so that might allow the muscle to maintain its integrity or recover quicker. Uh, but overall, when you combine creatine with a standard weight training program, you should expect a greater increase than weight training alone. Absolutely. And that is, that's across all ages, which is really important.

    7. SBSteven Bartlett17:21

       Okay. And, uh, the studies you've done in your-

    8. DCDr. Darren Candow17:23

       Mm-hmm

    9. SBSteven Bartlett17:23

       ... own lab, what are those? How wide varying are those?

    10. DCDr. Darren Candow17:26

        Yeah.

    11. SBSteven Bartlett17:26

        And how many have you done?

    12. DCDr. Darren Candow17:27

        We've... Oh, God, we've done at least 30 to 40 studies, um, in our lab. I've published over 120 papers just on creatine alone.

    13. SBSteven Bartlett17:34

        Wow.

    14. DCDr. Darren Candow17:34

        And the interesting thing is that from young individuals to middle-aged to older adults, we see a very common, uh, theme that, combined with weight training, uh, creatine, about five grams or more, uh, we use typically a little bit more, seems to have, uh, beneficial effects on muscle mass, uh, muscle strength, as well as performance. Absolutely.

    15. SBSteven Bartlett17:53

        Can you show me what five grams-

    16. DCDr. Darren Candow17:54

        Yeah

    17. SBSteven Bartlett17:55

        ... looks like?

    18. DCDr. Darren Candow17:55

        Absolutely. So this would be a standard five gram dose.

    19. SBSteven Bartlett17:59

        Which is one scoop really.

    20. DCDr. Darren Candow18:01

        One scoop. Now, keep in mind that can be found in, in meat or seafood, but you're gonna require a lot. Yeah.

    21. SBSteven Bartlett18:07

        Okay.

11. 18:08 – 19:06

    Is the "loading phase" unnecessary?

    1. SBSteven Bartlett18:08

       So five grams is one scoop.

    2. DCDr. Darren Candow18:09

       One scoop.

    3. SBSteven Bartlett18:10

       And you're saying we don't necessarily need to do this loading phase that bodybuilders would tend to do.

    4. DCDr. Darren Candow18:15

       Correct. So the loading phase is the most rapid way to saturate y- your muscles. Now, that's very beneficial, but that would be four scoops. So four scoops is a loading phase per day and is very effective, but the issue is can it cause some adverse GI tract irritation, things like that? That's where anecdotally people have report that. But a lot of people, from a muscle perspective, will start with just five grams a day, and that's very beneficial.

    5. SBSteven Bartlett18:37

       And at five grams a day, what benefits am I getting?

    6. DCDr. Darren Candow18:39

       Five... Oh, across from a skeletal muscle perspective, you get a whole plethora. So you definitely get an increase in lean tissue mass or muscle size, uh, and then, again, muscle performance, uh, muscle strength, power, and endurance. And the other one that never gets a lot of press but should is functional ability. Uh, an older adult to sit to stand. Uh, this has applications getting off the toilet, out of the bed, out of a car. So as we get older, we're losing muscle strength and performance as well as functionality, and creatine and weight training seems to come to the rescue there.

12. 19:06 – 19:41

    Is there anyone that shouldn't take creatine?

    1. SBSteven Bartlett19:06

       And is there anyone that shouldn't take creatine?

    2. DCDr. Darren Candow19:08

       You know, I can't find anybody that can't or shouldn't. The safety profile is exceptional. If they have preexisting medical conditions, they definitely need to speak to their, their doctor. Uh, besides that, I'm not seeing any reason a healthy individual can't take or shouldn't take creatine.

    3. SBSteven Bartlett19:23

       And pregnant women?

    4. DCDr. Darren Candow19:24

       So that's an interesting... W- A colleague of mine, Dr. Stacy Alary out of Australia, is now finally looking at human, uh, trials with pregnancy, uh, going into breast milk, into, uh, the fetus. So, uh, it's still in its infancy. The jury's still out, but as it currently stands, it seems to be relatively safe a- and well-tolerated.

13. 19:41 – 21:31

    Whats the best type of creatine to take?

    1. SBSteven Bartlett19:41

       Okay. So not all creatine is made the same.

    2. DCDr. Darren Candow19:44

       Right. Correct.

    3. SBSteven Bartlett19:45

       There's lots of different types of creatine.

    4. DCDr. Darren Candow19:46

       Yeah.

    5. SBSteven Bartlett19:46

       People... Some people take creatine gummies.

    6. DCDr. Darren Candow19:47

       Yep.

    7. SBSteven Bartlett19:48

       Um, I mean, I have some different types of creatine here.

    8. DCDr. Darren Candow19:50

       Yeah.

    9. SBSteven Bartlett19:50

       Creatine monohydrate.

    10. DCDr. Darren Candow19:52

        Right.

    11. SBSteven Bartlett19:52

        Creatine hydrochloride.

    12. DCDr. Darren Candow19:54

        Okay. [laughs]

    13. SBSteven Bartlett19:55

        I, I remember looking when I was in a, a shelf a couple of months ago-

    14. DCDr. Darren Candow19:57

        Yeah

    15. SBSteven Bartlett19:57

        ... and seeing, like, five or six different types-

    16. DCDr. Darren Candow20:01

        Mm-hmm

    17. SBSteven Bartlett20:01

        ... of creatine.

    18. DCDr. Darren Candow20:01

        Yep.

    19. SBSteven Bartlett20:01

        Um, what is the, the optimal type of creatine to take-

    20. DCDr. Darren Candow20:03

        Yeah

    21. SBSteven Bartlett20:04

        ... and why?

    22. DCDr. Darren Candow20:04

        So by far, creatine monohydrate, and that goes against all the new marketing forms. So creatine monohydrate is simply creatine linked to one wal- water molecule. When you take it into the body, the water molecule dissolves. It's identical to, uh, what's being produced in the liver a- and the brain. All the evidence that you ever hear about the safety and efficacy of creatine is based on the old, boring, from 1832 creatine monohydrate. There's new marketed forms of creatine, such as hydrochloride, which does have evidence behind it. There's many other forms, but the only downfall with all these marketed forms is it's never been shown to be safer or more effective than creatine monohydrate. The other big thing for your viewers is make sure it has Creapure or some form of creatine monohydrate on, uh, the label and then, and that it's also third-party tested.

    23. SBSteven Bartlett20:52

        Creapure.

    24. DCDr. Darren Candow20:52

        Creapure is from Germany. It has the highest, um, standard o- of qualification and, and, um, uh, scrutiny and then NSF certified or another third-party certified. So those are the three things that I personally would look for, monohydrate, Creapure is the type, and then NSF c- certified or third-party certification.

    25. SBSteven Bartlett21:09

        Which is that little logo at the bottom.

    26. DCDr. Darren Candow21:10

        That little logo here at the bottom, that's right. It's that-

    27. SBSteven Bartlett21:11

        And what does that mean?

    28. DCDr. Darren Candow21:12

        So NSF is the National Sanitation Foundation. It's a third-party organization that will independently take the, the supplement and then third-party test it, and then you get a certificate of analysis to make it so there, there's no, uh, uh, contaminants like lead or arsenic or things like that. So that's something for the consumers watching to definitely be aware of when you go to, uh, the store.

    29. SBSteven Bartlett21:30

        And we've got

14. 21:31 – 22:43

    The Dosing Dilemma - How much to take for each benefit?

    1. SBSteven Bartlett21:31

       this, uh, thing here in front of us.

    2. DCDr. Darren Candow21:32

       Right.

    3. SBSteven Bartlett21:32

       This is The Dosing Dilemma.

    4. DCDr. Darren Candow21:33

       Right.

    5. SBSteven Bartlett21:34

       Um, we talked about muscle there.

    6. DCDr. Darren Candow21:36

       Mm-hmm.

    7. SBSteven Bartlett21:36

       Have we checked muscle off, or is there anything else to cover?

    8. DCDr. Darren Candow21:38

       No. So how many scoops do you think is optimal for skeletal muscle?

    9. SBSteven Bartlett21:43

       Oh, uh, skeletal muscle.

    10. DCDr. Darren Candow21:46

        Yeah, your bicep, your tricep. You know, Arnold Schwarzenegger.

    11. SBSteven Bartlett21:50

        Five gra- five grams.

    12. DCDr. Darren Candow21:51

        Five grams.

    13. SBSteven Bartlett21:51

        I don't know.

    14. DCDr. Darren Candow21:51

        So that's only gonna be one little scoop.

    15. SBSteven Bartlett21:53

        Okay.

    16. DCDr. Darren Candow21:54

        Okay? That's probably very viable, and you're correct. Across the lifespan, five grams has been shown to be effective, but here's a little bit of caveat. If you're over the age of 50, maybe you want to have a little bit more because as we get older, the creatine in our lower legs is more jeopardized, and therefore you might need a bit more.

    17. SBSteven Bartlett22:14

        Okay.

    18. DCDr. Darren Candow22:14

        Okay?

    19. SBSteven Bartlett22:15

        So that's-

    20. DCDr. Darren Candow22:15

        But this is without the loading phase, so this is if you just want to take a little bit per day.

    21. SBSteven Bartlett22:19

        And do you have to take it consistently?

    22. DCDr. Darren Candow22:21

        Good question. So ideally, yes. There is evidence that you can just take it on the training days, but we haven't talked about the brain yet. And the reason why I think you should take it every day is it likes to go to other tissues on a daily basis.

    23. SBSteven Bartlett22:33

        So that's about seven grams? How much is that?

    24. DCDr. Darren Candow22:34

        That's about seven or eight grams, and that seems to be a very safe and viable, uh, dose to be shown to be effective for improving muscle mass-

    25. SBSteven Bartlett22:42

        Okay

    26. DCDr. Darren Candow22:42

        ... and performance.

15. 22:43 – 24:49

    Does creatine cause dizziness?

    1. SBSteven Bartlett22:43

       I, I do have, um, an issue sometimes when I take a little bit more creatine, which is-

    2. DCDr. Darren Candow22:47

       Yes

    3. SBSteven Bartlett22:47

       ... I feel, I wouldn't say lightheaded-

    4. DCDr. Darren Candow22:50

       Mm-hmm. Yep

    5. SBSteven Bartlett22:50

       ... but I get a little bit dizzy almost.

    6. DCDr. Darren Candow22:52

       Yes, 100%. Yep.

    7. SBSteven Bartlett22:52

       What is that?

    8. DCDr. Darren Candow22:53

       So there is a mechanism. So creatine is the biggest methyl scavenger in, in the body, and without boring your viewers, but methyl groups are used for everything. They're also used to synthesize something called adrenaline and are neurotransmitters, you know, the things that we get excited about. So when you take in too much creatine, typically on an empty stomach or in a dehydrated state, that will spare methyl groups in the body to be used because you're taking so much in.

    9. SBSteven Bartlett23:14

       Hmm.

    10. DCDr. Darren Candow23:15

        And then it says, "Where can I go?" So since creatine is now being taken in through a supplement, these methyl groups are available in your body to go elsewhere to do work, and they like to synthesize adrenaline, and that's why you feel more, uh, um, energetic, so to speak.

    11. SBSteven Bartlett23:27

        When you say synthesize adrenaline, what does that mean?

    12. DCDr. Darren Candow23:29

        Yeah, that means you're creating more of the hormone called epinephrine and that, you know, you hear about fight or flight or you're nervous or whichever it is. It gives you a little bit more of that, so that's why sometimes you feel a little bit jittery or things like that.

    13. SBSteven Bartlett23:41

        Hmm. Yeah, sometimes I, I can feel a little bit sick as well-

    14. DCDr. Darren Candow23:43

        Yeah

    15. SBSteven Bartlett23:43

        ... if I do too much.

    16. DCDr. Darren Candow23:44

        Yeah, and so that's where it's sort of the new area of interest for me is this microdosing based on that. So we're starting to see some evidence now that if you take smaller amounts all throughout the day, it does not have any adverse effects. If anything, it seems to be a li- little bit more tolerable. Um, so you could take a few grams in the morning, a few grams in the evening, or whichever. I think one of the best, uh, ways to take it that never gets any press is I put five grams in my water bottle during my workout.

    17. SBSteven Bartlett24:11

        Mm-hmm.

    18. DCDr. Darren Candow24:11

        And so now I'm consuming a little bit of creatine as I do my weightlifting or cardio, and then I'll consume a little bit in the morning as well. So I take about 10 grams a day at minimum on, on a daily basis. Other people will take more or less, but that's just how I get it in, yeah

    19. SBSteven Bartlett24:25

        I find that if I do take a little bit in the morning and then a little bit later-

    20. DCDr. Darren Candow24:28

        Yeah

    21. SBSteven Bartlett24:28

        ... it's much better.

    22. DCDr. Darren Candow24:30

        100%. Yeah.

    23. SBSteven Bartlett24:30

        And I don't get any weird feelings.

    24. DCDr. Darren Candow24:32

        That's correct. And, uh, it seems to be more consistent and appreciated for individuals, because if you do or are susceptible to any, uh, fluctuations in weight gain, water retention, or GI tract irritation, those seem to, to definitely go away. And we've... God, we've assessed over 1,000 individuals in my lab, and that seems to be a very viable

16. 24:49 – 25:38

    Taste test

    1. DCDr. Darren Candow24:49

       approach. Not a lot of taste to it, is there? [laughs]

    2. SBSteven Bartlett24:53

       It's not the best-tasting thing in the world, is it?

    3. DCDr. Darren Candow24:54

       No. It's very bland, very boring. Um, but there's other companies trying to make it more flavorful, things like that. The cool thing is with, uh, creatine, you can put it in anything. You can put it in yogurt, uh, uh, a juice, whichever it is. You can now put it in coffee. There's a little bit of controversy over the dose of caffeine. I think anywhere lower than 350 milligrams is fine, and that's gonna be most standard, uh, coffees or teas as well. So whichever allows you to become consistent is, is a great way to do it, yeah.

    4. SBSteven Bartlett25:21

       There should be a button just down below here, and if it says Subscribe, you're already subscribed. If it says Subscriber, that means you're not yet. And if you're not subscribed, please could you do us a favor and hit that button? It helps the show more than you know, and according to the algorithm, you're someone that watches our show, but you haven't yet hit that button. Thank you so much.

17. 25:38 – 34:20

    The best dosage for bone health

    1. SBSteven Bartlett25:39

       Okay, so bone. Tell me what I need to know about bone and creatine.

    2. DCDr. Darren Candow25:41

       Okay, so now we talked about muscle. How many do you think for the skeleton here?

    3. SBSteven Bartlett25:45

       Um, uh, the same.

    4. DCDr. Darren Candow25:46

       Okay.

    5. SBSteven Bartlett25:47

       Seven.

    6. DCDr. Darren Candow25:47

       Unfortunately, the lowest dose ever that's been shown to have bone benefits is eight grams all the way up to 12. So now we're in a dosing dilemma already. We just started. We have a little bit disconnect between muscle and bone. Three to five grams seems to be really good for muscle. A little bit more is fine. But bone needs to be a little bit more, and that's primarily based on some of our work from our lab, where we've shown that about 8 to 12 grams a day with exercise, and that's crucial. If you do not exercise, there's never been a study ever, uh, shown to have bone benefits. But if you do perform weightlifting, one of the very cool things in post-menopausal females is that creatine seemed to reduce the rate of bone mineral density loss around the hip region. So it didn't increase bone density, but it decreased bone density loss, and it also seemed to maintain or improve the structure of the bone a little bit more. So that has profound beneficial effects, especially as we get older. If those individuals on creatine were to fall, maybe they might not fracture their hip. And as we both know, if you fracture your hip, you're gonna be placed in long-term care, or you're gonna be inactive for at least six months. So creatine has some bone benefits. They're not great. They don't improve bone density, so they're not gonna be an osteoporotic cure. But there is something there, especially if you're prone to, uh, osteoporosis or osteopenia.

    7. SBSteven Bartlett27:03

       And what's the mechanism there that's just stop- stopping bone loss?

    8. DCDr. Darren Candow27:06

       Yeah, it's very interesting. So if you understand a 24-hour cycle, that creatine sort of stimulates these bone-building cells to become more energized. Think of Super Mario, the original Nintendo, when he got the mushroom and he became energized. Creatine does that as well. And then on the flip side, creatine seems to decrease, uh, the osteoclast or bone breakdown cells. So by a synergistic, uh, uh, mechanism, it seems to cause this turnover to go a little bit better, causing the bone to maintain its structure. It's very similar to a bisphosphonate that someone would be taking to maintain their bone health.

    9. SBSteven Bartlett27:38

       A bisphosphonate?

    10. DCDr. Darren Candow27:39

        Yeah, it's a drug that a lot of individuals will take if they're, uh, prone to bone loss. Uh, obviously creatine's not a drug, but it has some of those similar properties.

    11. SBSteven Bartlett27:47

        So we've got muscle.

    12. DCDr. Darren Candow27:47

        Yeah.

    13. SBSteven Bartlett27:47

        I need to take about seven or eight grams to get those benefits.

    14. DCDr. Darren Candow27:50

        Yeah.

    15. SBSteven Bartlett27:50

        With bone, it's a little bit more.

    16. DCDr. Darren Candow27:51

        A little bit more.

    17. SBSteven Bartlett27:52

        You don't mean additionally?

    18. DCDr. Darren Candow27:54

        No, in, in total. So now this is where we get into the daily dosing dilemma. We've gone from three to five grams or a little bit more for muscle. Bone is maybe eight to 10 or a little bit more. So what do you think on the brain, the hottest topic?

    19. SBSteven Bartlett28:06

        10?

    20. DCDr. Darren Candow28:06

        10, okay. So that would be, you know, two scoops.

    21. SBSteven Bartlett28:10

        I'm just assuming this increases.

    22. DCDr. Darren Candow28:11

        Yeah. So the interesting thing here is that the brain will naturally make its own creatine, very similar to the liver. So since the brain is actually making its own creatine, it may not require as much or any on a daily basis. So here's the brain, obviously, and in different regions, creatine is being synthesized and being used all throughout. So this organ is about two kilograms but uses 20% of our daily energy at rest. So just think about that. 20% of the amount of energy we're consuming from food or using is being used by the brain. But what if you're stressed? Sleep deprivation. Your dog got you up in the middle of the night to pee, and you couldn't fall back to sleep. Uh, university students cramming for a midterm. Um, now all the countries look at the World Cup, they're gonna be up stress, you know, different time zones. Then all of a sudden, the healthy brain becomes a metabolically stressed brain. So your guess about 10 grams on average is fine, because the brain on a non-stress day is naturally making, uh, uh, enough and it's healthy. But now we get into a more difficult. What about those metabolic stressors? So again, all the neurons in the brain are being used. So what about sleep deprivation?

    23. SBSteven Bartlett29:22

        10 grams?

    24. DCDr. Darren Candow29:22

        For sleep-deprived?

    25. SBSteven Bartlett29:24

        You tell me.

    26. DCDr. Darren Candow29:24

        When was the last time you slept 10 straight hours?

    27. SBSteven Bartlett29:28

        [laughs] It's been a while.

    28. DCDr. Darren Candow29:31

        It's been a while.

    29. SBSteven Bartlett29:31

        Yeah.

    30. DCDr. Darren Candow29:31

        For even you to pause there, you know, that's, that's alarming, 'cause you're thinking, "When was the last time I got a really good night's sleep?"
18. 34:20 – 36:51

    What are the brain benefits of creatine?

    1. SBSteven Bartlett34:20

       And when we start getting the, the brain benefits up at this end-

    2. DCDr. Darren Candow34:22

       Right

    3. SBSteven Bartlett34:23

       ... what are those brain benefits-

    4. DCDr. Darren Candow34:24

       Mm-hmm

    5. SBSteven Bartlett34:25

       ... that, that were recorded in the studies? Is it I'm gonna feel like I slept?

    6. DCDr. Darren Candow34:28

       Yeah.

    7. SBSteven Bartlett34:28

       Or is it something more internal?

    8. DCDr. Darren Candow34:30

       You likely won't feel anything.

    9. SBSteven Bartlett34:32

       Ah, okay.

    10. DCDr. Darren Candow34:32

        However, when you get to tasks 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 b- basic tasks. Or what about a Stroop test?

    11. SBSteven Bartlett34:49

        What's a Stroop test?

    12. DCDr. Darren Candow34:50

        So I'm gonna get you to do this. I apologize in advance.

    13. SBSteven Bartlett34:53

        Uh-huh.

    14. DCDr. Darren Candow34:54

        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, uh, 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.

    15. SBSteven Bartlett35:17

        Okay.

    16. DCDr. Darren Candow35:18

        So I've tried it. I can only get to line two without making a mistake.

    17. SBSteven Bartlett35:22

        Okay.

    18. DCDr. Darren Candow35:22

        Okay? So I want you to do this out loud but as fast as possible.

    19. SBSteven Bartlett35:28

        And am I reading the words or the color?

    20. DCDr. Darren Candow35:30

        You're reading the color.

    21. SBSteven Bartlett35:31

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

    22. DCDr. Darren Candow35:33

        Uh, yes.

    23. SBSteven Bartlett35:34

        Okay, fine. You want me to do it as fast as possible?

    24. DCDr. Darren Candow35:36

        As fast as possible.

    25. SBSteven Bartlett35:37

        Okay.

    26. DCDr. Darren Candow35:38

        So let's see how you do.

    27. SBSteven Bartlett35:39

        Gosh, this is confusing already. I hit the second one, and I got it wrong in my head. Um-

    28. DCDr. Darren Candow35:41

        Depends how much creatine you took. [laughs]

    29. SBSteven Bartlett35:43

        Oh, yeah. [laughs] I don't think I've had creatine today.

    30. DCDr. Darren Candow35:44

        Okay.
19. 36:51 – 38:06

    Anything else to know about creatine's impact on the brain?

    1. SBSteven Bartlett36:51

       What else is there for me to know about the impact that creatine can have on the brain?

    2. DCDr. Darren Candow36:55

       Yeah.

    3. SBSteven Bartlett36:55

       You know, I think-

    4. DCDr. Darren Candow36:56

       Mm-hmm

    5. SBSteven Bartlett36:56

       ... as a, as a podcaster who sometimes sits here for-

    6. DCDr. Darren Candow36:58

       Yep

    7. SBSteven Bartlett36:58

       ... many, many hours interviewing people-

    8. DCDr. Darren Candow37:00

       Yeah

    9. SBSteven Bartlett37:00

       ... on a range of subjects.

    10. DCDr. Darren Candow37:01

        Mm-hmm.

    11. SBSteven Bartlett37:01

        I'm always trying to find if there's any way that I can perform better mentally.

    12. DCDr. Darren Candow37:04

        Yeah, 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, uh, there's been populations, Alzheimer's disease, clinical depression, uh, concussion. When those populations are evident, one of the biggest, uh, uh, 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 gonna find you tomorrow and give you this and say, "You're gonna 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, really high-stress demand, uh, you know, stuck in, uh, traffic for two hours, these all add up, and it's a cascade of stressors that, unfortunately, most people go through. And now th- we have a nutrient that is being made in the brain, but during times of stress, it likely needs a little bit of help.

20. 38:06 – 40:13

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    1. DCDr. Darren Candow38:06

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    2. SBSteven Bartlett38:07

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21. 40:13 – 41:28

    Does creatine help with inflammation?

    1. SBSteven Bartlett40:13

       What about inflammation-

    2. DCDr. Darren Candow40:14

       Yes

    3. SBSteven Bartlett40:14

       ... in the body?

    4. DCDr. Darren Candow40:15

       Yeah.

    5. SBSteven Bartlett40:15

       So what is inflammation, and is there a link between creatine supplementation-

    6. DCDr. Darren Candow40:18

       Yeah

    7. SBSteven Bartlett40:18

       ... and inflammation?

    8. DCDr. Darren Candow40:19

       There is. So, uh, unfortunately, uh, 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 we're, you know, you can work out and d- nothing hurts, and all of a sudden you wake up one day when you're in your 40s and 50s and things hurt. And 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 not like acetaminophen or ibuprofen, which directly, as a drug effect, uh, 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 grams a day for five 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.

    9. SBSteven Bartlett41:27

       Interesting.

22. 41:28 – 42:45

    Using creatine for Alzheimer's

    1. DCDr. Darren Candow41:28

       Yeah.

    2. SBSteven Bartlett41:29

       And what about people that have neurodegenerative disorders?

    3. DCDr. Darren Candow41:32

       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 a- and Aaron Smith showing that 20 grams a day for eight weeks did increase brain creatine levels in Alzheimer's patients, and it seemed to improve measures o- 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 neural protection e- effect as well. There's evidence in cell cultures a- and in rodents that there's some lines there, but in humans we're still in i- 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.

    4. SBSteven Bartlett42:10

       There was an eight-week trial in Alzheimer's patients that also showed modest muscle gains-

    5. DCDr. Darren Candow42:13

       Yes

    6. SBSteven Bartlett42:13

       ... and a 1.9 kilogram increase in hand grip strength-

    7. DCDr. Darren Candow42:16

       Yeah

    8. SBSteven Bartlett42:16

       ... which is a key predicator of survival in dementia patients.

    9. DCDr. Darren Candow42:20

       Correct

    10. SBSteven Bartlett42:21

        Um, which was a landmark study of 20 Alzheimer's patients found that taking 20 grams of creatine daily for eight weeks increased brain creatine levels by 11% and significantly improved the cognitive test scores they showed.

    11. DCDr. Darren Candow42:31

        Mm-hmm.

    12. SBSteven Bartlett42:32

        That's the Journal of Psychiatry-

    13. DCDr. Darren Candow42:33

        Yes

    14. SBSteven Bartlett42:33

        ... and Brain Science.

    15. DCDr. Darren Candow42:34

        And that one's really exciting, and I think more future, uh, studies will come out. The limitation with those is that there was no placebo to compare to, but again, that's just showing that, yes, creatine can be used as an effective

23. 42:45 – 44:39

    Does creatine have an impact on our mental health?

    1. DCDr. Darren Candow42:45

       adjunct, yeah.

    2. SBSteven Bartlett42:46

       And because there is impact on our brain-

    3. DCDr. Darren Candow42:48

       Right

    4. SBSteven Bartlett42:48

       ... is there impact on our mental health-

    5. DCDr. Darren Candow42:50

       Oh

    6. SBSteven Bartlett42:50

       ... with creatine?

    7. DCDr. Darren Candow42:51

       Excellent point. So the best lines of evidence here come from clinical depression and anxiety. Uh, 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 behavior 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, uh, bioenergetics, it improves, uh, neural, uh, transmission or neuromodulation. Uh, but it also in animals has been shown to improve a protein called BDNF. Uh, 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, uh, as a treatment in the toolbox for a lot of these clinical, uh, issues. PTSD also comes to my mind.

    8. SBSteven Bartlett43:43

       There was a study in Gatorade Sports Science Institute-

    9. DCDr. Darren Candow43:45

       Yes

    10. SBSteven Bartlett43:45

        ... pub- which PubMed published that said, uh, a study of over 200,000 adults found that those who consumed the least amount of creatine-

    11. DCDr. Darren Candow43:52

        Mm-hmm

    12. SBSteven Bartlett43:53

        ... in their daily diet-

    13. DCDr. Darren Candow43:54

        Right

    14. SBSteven Bartlett43:54

        ... had the highest rates of depressive symptoms.

    15. DCDr. Darren Candow43:56

        Yes, that's correct. And the common denominators, those with clinical depression or 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 r- disruption at the brain, a bioenergetic level, and creatine levels are decreasing.

    16. SBSteven Bartlett44:14

        And there was another in, in PubMed that said in a clinical trial of women with major depression, adding five grams of creatine-

    17. DCDr. Darren Candow44:19

        Mm

    18. SBSteven Bartlett44:19

        ... to their daily antidepressant-

    19. DCDr. Darren Candow44:20

        Yes

    20. SBSteven Bartlett44:21

        ... doubled their remission rate over eight weeks.

    21. DCDr. Darren Candow44:23

        That's correct, yes. And that, uh, group is from, uh, Perry Ca- 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

24. 44:39 – 45:03

    What are foods I can eat that would supply creatine?

    1. DCDr. Darren Candow44:39

       come out.

    2. SBSteven Bartlett44:39

       If I don't want to be supplementing with creatine-

    3. DCDr. Darren Candow44:42

       Mm-hmm

    4. SBSteven Bartlett44:42

       ... is there, what are the foods that I can eat that are high in creatine naturally?

    5. DCDr. Darren Candow44:45

       They're primarily, uh, animal-based, so seafood and red meat. Um, you know, herring is gonna 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,

25. 45:03 – 47:43

    Study that showed creatine improved young athletes' sleep

    1. DCDr. Darren Candow45:03

       yeah.

    2. SBSteven Bartlett45:03

       There's some other studies that I, that I love that I've, I think I've heard you talk about before.

    3. DCDr. Darren Candow45:06

       Mm-hmm.

    4. SBSteven Bartlett45:06

       One of them was, um, young athletes who took five grams of creatine daily slept an average of one hour longer-

    5. DCDr. Darren Candow45:11

       Yes

    6. SBSteven Bartlett45:11

       ... on training days.

    7. DCDr. Darren Candow45:12

       Yeah. We did that study a few years ago in, in, 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 a 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, uh, it 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 ar- 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, I think everybody on the planet would raise their hand and say, "Hey, I need more sleep."

    8. SBSteven Bartlett45:59

       Is there anything else we haven't covered as it relates to creatine?

    9. DCDr. Darren Candow46:02

       You know, the expected gains versus the hype gains. I think there's evidence there that creatine can have a, a, an effect. I, I think it's getting over-hyped, especially around the brain, for what it can do. It's one tool in the toolbox, and I think it's, it's one of those things that I'd like to show or, you know, talk about for sure, yeah.

    10. SBSteven Bartlett46:19

        Well, what do you mean by that?

    11. DCDr. Darren Candow46:21

        So if you think of a 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. A- 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?

    12. SBSteven Bartlett46:42

        Um, as in like a-

    13. DCDr. Darren Candow46:44

        Is it-

    14. SBSteven Bartlett46:45

        So-

    15. DCDr. Darren Candow46:45

        ... weight training? Is it cardio? Is it creatine? Is it protein, or is it sleep?

    16. SBSteven Bartlett46:49

        Sleep.

    17. DCDr. Darren Candow46:50

        Okay. So I say weight training is gonna be the hammer.

    18. SBSteven Bartlett46:54

        Okay.

    19. DCDr. Darren Candow46:54

        Okay? Now, what about the screwdriver? Always need a screwdriver.

    20. SBSteven Bartlett47:00

        Cr- creatine?

    21. DCDr. Darren Candow47:02

        No, I think aerobic training or sleep comes way before creatine.

    22. SBSteven Bartlett47:06

        Okay.

    23. DCDr. Darren Candow47:07

        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.

26. 47:43 – 48:12

    The importance of weight training

    1. SBSteven Bartlett47:43

       So you said weight training was the hammer.

    2. DCDr. Darren Candow47:45

       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. Uh, weight training, if done effectively, can actually improve mitochondrial health. You can ac- improve VO2 max if done correctly, uh, 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

27. 48:12 – 50:58

    What are the misconceptions about weight training?

    1. DCDr. Darren Candow48:12

       effective.

    2. SBSteven Bartlett48:12

       So weight training.

    3. DCDr. Darren Candow48:14

       Yes.

    4. SBSteven Bartlett48:14

       What are the, the sort of misconceptions about-

    5. DCDr. Darren Candow48:15

       Mm

    6. SBSteven Bartlett48:16

       ... r- weight training, and why are you so-

    7. DCDr. Darren Candow48:18

       Yeah

    8. SBSteven Bartlett48:18

       ... positive about it?

    9. DCDr. Darren Candow48:19

       Yeah, I think one of the biggest myths is that you always need to lift heavy to put on muscle mass, a- and world-renowned 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 as, 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.

    10. SBSteven Bartlett48:57

        And why are you putting it above cardiovascular work?

    11. DCDr. Darren Candow49:00

        Yeah, I think the benefits there is that cardiovascular exercise will make you live longer a- a- a- and, uh, and healthier, but the downfall with cardiovascular exercise, it doesn't stimulate strength or the muscle skeletal 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 muscle skeletal 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.

    12. SBSteven Bartlett49:30

        And if I just do weight training-

    13. DCDr. Darren Candow49:31

        Yep

    14. SBSteven Bartlett49:31

        ... what am I missing from not doing cardio training?

    15. DCDr. Darren Candow49:34

        Yeah, if you do weight training improperly, where you're lifting heavy, heavy weight with low repetitions all the time, you're likely gonna jeopardize capillary density or mitochondrial health. These are things that sort of move blood flow to and from, uh, your muscles. You could decrease VO2 max or a fitness parameter for, uh, 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 because the majority of the population doesn't do anything.

    16. SBSteven Bartlett50:01

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

    17. DCDr. Darren Candow50:03

        Yeah. 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. Uh, I- 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 gonna do 70," or, "I'm gonna do 30. I'm gonna hold the couch down and watch Netflix." So we've given 150, and we say, you know, if you can do 21 minutes or t- 22 minutes a day for seven days a week, that's gonna 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 two 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.

28. 50:58 – 52:46

    Why is exercise more important as we get older?

    1. DCDr. Darren Candow50:58

       That's the key.

    2. SBSteven Bartlett50:59

       Why especially as we get older?

    3. DCDr. Darren Candow51:00

       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.

    4. SBSteven Bartlett51:17

       When you're 20 or 40 years old.

    5. DCDr. Darren Candow51:19

       When you're 20 and 40 years old or all the way from 20 to 40, you can see, great. That's probably the area that you're gonna have the most muscle.

    6. SBSteven Bartlett51:25

       Yeah.

    7. DCDr. Darren Candow51:26

       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, it's about 1% per year after the age of 40.

    8. SBSteven Bartlett51:42

       Even if you're training?

    9. DCDr. Darren Candow51:43

       So if you're training, you're maintaining that. So this is the average sedentary inactive population. You lose strength at about one point... or one to three percent even faster. Now, if we were to maintain resistance training, that muscle mass would plateau. So I can't stress this enough. Although we focused on creatine, if you were to choose one thing to do today, it's exercise, and the only form of exercise that really maintains muscle is weight bearing or, um, resistance training. And if that's the case, you're gonna 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.

    10. SBSteven Bartlett52:19

        Can you not just, uh, I don't know, 60 years old-

    11. DCDr. Darren Candow52:21

        Yeah

    12. SBSteven Bartlett52:21

        ... start training then?

    13. DCDr. Darren Candow52:22

        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 gonna be nutrition. They go hand-in-hand all throughout lifespan.

    14. SBSteven Bartlett52:45

        And on-

    15. DCDr. Darren Candow52:45

        You've got

29. 52:46 – 53:55

    Combining protein and creatine

    1. DCDr. Darren Candow52:46

       to have both.

    2. SBSteven Bartlett52:46

       And on the subject of protein, you're saying that com- when combined with creatine-

    3. DCDr. Darren Candow52:49

       Right

    4. SBSteven Bartlett52:50

       ... it's a m- force multiplier.

    5. DCDr. Darren Candow52:52

       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, uh, a high quality protein with creatine, they, they've been shown to increase lean tissue mass and muscle performance a little bit more than each alone, yeah.

    6. SBSteven Bartlett53:04

       Does the average person get enough protein through their diet?

    7. DCDr. Darren Candow53:06

       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 grams per kilogram. So, you know, if you're 70 kilograms, that's gonna be on average about 84 to about 115 grams of protein. I think we're so conscious now of the health benefits of protein, uh, 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 in 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 a- and, uh, 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.

30. 53:55 – 54:56

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31. 54:56 – 56:00

    How creatine helps menopausal and post-menopausal women

    1. SBSteven Bartlett54:57

       Menopause.

    2. DCDr. Darren Candow54:58

       Yes.

    3. SBSteven Bartlett54:58

       We talked a little bit briefly about menopause, bringing both together the subjects of muscle, but also-

    4. DCDr. Darren Candow55:04

       Mm-hmm

    5. SBSteven Bartlett55:04

       ... of creatine.

    6. DCDr. Darren Candow55:05

       Yes.

    7. SBSteven Bartlett55:05

       How, how does those two things impact w- a woman's journey through menopause?

    8. DCDr. Darren Candow55:09

       Yeah. So we know from animal cells that estrogen is highly involved in creatine metabolism. Estrogen seems to be implicated in the enzymes that are needed to make creatine, and then estrogen also has, uh, uh, a huge impact on, uh, uh, not only brain bioenergetics but muscle metabolism as well. So as the, the female goes from a pre-menopausal stage to perimenopausal stage to the post-menopausal transition, if estrogen is decreasing, uh, and then independent of their diet, we think creatine has bone effects and muscle effects, and of course, we've talked about the cognitive effects there. So from a whole skeleton perspective, I think everybody should be, but of course the perimenopausal, post-menopausal transition, uh, is good. And then that brings up a question about what about really young pre-menopausal females, you know, optimal health? What if we built up their tissues more? Maybe that would offset the rate of this decline over time as well. So that's what

32. 56:00 – 57:09

    Is creatine safe for kids and people in general?

    1. DCDr. Darren Candow56:00

       we're hoping to get to.

    2. SBSteven Bartlett56:01

       Is creatine safe for kids?

    3. DCDr. Darren Candow56:02

       So it's interesting you bring that up, and the current body of evidence suggests yes, at recommended dosages. Uh, good researchers, uh, in, in the United States have put out multiple reviews, uh, looking at creatine in, uh, adolescent children and teenagers. Improves balance, agility, body composition. If anything, they want to get at least one gram per day, because in children they want to have an optimization for bone health as well as muscle development. Um, but again, if a- any parents are watching, obviously talk to their medical practitioner. Uh, but all the current reviews, um, currently sus- suggests that it's safe.

    4. SBSteven Bartlett56:33

       And we're talking about... We're not talking about babies here. We're talking about-

    5. DCDr. Darren Candow56:35

       Yeah, we're talking about adolescents all the way into teenage years. When it comes to baby or infancy, um, out of Australia, Stacy Aldery is starting to do that work there as well, but we don't have a lot of data in humans yet. But that is an area to, to pay attention to for sure. Yeah.

    6. SBSteven Bartlett56:48

       What is the most important thing we haven't talked about that we should've talked about, doctor?

    7. DCDr. Darren Candow56:51

       Yeah, I think one of the big things is the safety profile of creatine. Uh, there's been, uh, you know, hundreds of randomized control trials now on creatine. The safety profile is, is exceptional. Uh, last year they put out a, a study looking at over 25,000 cases i- in creatine. Even over 10 grams a day for many years has been s- very, very

33. 57:09 – 58:15

    What's the best time to take creatine?

    1. DCDr. Darren Candow57:09

       safe and effective. Uh, one area that comes up is, what about the timing? Does it matter when I take it? And, and the cool thing is we just got a paper accepted two days ago putting the nail in the coffin on this, and at the end of the day, you can take creatine at any time of the day. You can take it in the morning with breakfast. You can take it right before workout. I take some during. You can take it after, go to bed. It doesn't matter when you take it as well.

    2. SBSteven Bartlett57:32

       So you can take it right before sleep-

    3. DCDr. Darren Candow57:34

       You can

    4. SBSteven Bartlett57:34

       ... and it won't impact your sleep?

    5. DCDr. Darren Candow57:35

       No. Uh, currently we haven't exactly assessed the effect on sleep, but, uh, another study looked at it in the evening, and it had no detrimental effect there as well.

    6. SBSteven Bartlett57:44

       And what else? What else is the, are the questions that you get messaged with or asked most often, doctor?

    7. DCDr. Darren Candow57:48

       Yeah. Can I spread out creatine all throughout the day? So for example, we have, like, if we were to take creatine in a gummy form or a candy, you can actually have, you know, one or two of these every hour all throughout the day. You can have it, uh, uh, periodically. So you don't have to take creatine all at once. You can take it in smaller amounts all throughout the day. And if anything, there's been a study, uh, a few years ago showing that one gram every 30 minutes, up to 20 gram dose, uh, seemed to retain more in the body, and that was b- beneficial

34. 58:15 – 1:00:44

    What do you think of creatine gummies?

    1. DCDr. Darren Candow58:15

       as well.

    2. SBSteven Bartlett58:15

       What do you think of these gummies?

    3. DCDr. Darren Candow58:17

       You know, there's only been a few companies that have actually shown some validity and reliability. Um, as long as they're third-party tested, they're very, very effective. Do you want to try one?

    4. SBSteven Bartlett58:24

       Are they, are they third-party tested?

    5. DCDr. Darren Candow58:26

       They're third-par- The green ones, yep, and the bottom ones, third-party tested, yep.

    6. SBSteven Bartlett58:30

       Well, but, you know, the stuff that makes it a gummy-

    7. DCDr. Darren Candow58:32

       Right

    8. SBSteven Bartlett58:32

       ... is that stuff, is that stuff good for you?

    9. DCDr. Darren Candow58:34

       So the issue there is does the manufacturing trying to keep the, uh, creatine together, uh, influence it? It can, and there's only been a few, uh, uh, companies out there. The one you're eating is by Create from the United States. They, they have had, uh, multiple trials. They're the first, uh, company to actually look at, uh, a randomized control trial to show improvements in volleyball players with the gummies. Children love them. Older adults, this has become an area of interest where, uh, chewing ability or taste sensation has gone down. Uh, they seem to be very, uh, convenient and effective. Uh, you can have these at your desk, whichever. You don't need the white powder to mix. So they're... The companies are coming up with more viable ways to get creatine in there, but to your point, you always want to make sure the company's third-party tested, it uses a high-quality creatine, and it actually has a source of creatine in there as well.

    10. SBSteven Bartlett59:17

        'Cause I, I remember watching a YouTube video by a guy called James Smith, who's been on the show before.

    11. DCDr. Darren Candow59:21

        Yep.

    12. SBSteven Bartlett59:21

        And he did some testing on-

    13. DCDr. Darren Candow59:22

        Yes

    14. SBSteven Bartlett59:23

        ... the off-the-shelf creatine-

    15. DCDr. Darren Candow59:24

        Yep

    16. SBSteven Bartlett59:24

        ... um, and found that a lot of them didn't c- contain any creatine.

    17. DCDr. Darren Candow59:27

        90%, and there was only a few. And the one that you did, uh, consume, it did. Yep. 1.5.

    18. SBSteven Bartlett59:31

        Uh, isn't that crazy that you can go buy s- creatine and it has no creatine in it?

    19. DCDr. Darren Candow59:34

        Yeah, so that's why I think for the consumers watching, you gotta do a little bit of homework a- and look at those three things. Make sure third party tested, it has a logo clearly on the packaging. If it doesn't, I would strongly advise you not to consume it.

    20. SBSteven Bartlett59:46

        Of all the, of all the studies that you've encountered-

    21. DCDr. Darren Candow59:49

        Yeah

    22. SBSteven Bartlett59:49

        ... on all the subjects we've talked about, muscle-

    23. DCDr. Darren Candow59:51

        Right

    24. SBSteven Bartlett59:51

        ... protein, creatine, are there studies that were pivotal in how you think about these subjects?

    25. DCDr. Darren Candow59:55

        Yeah, there was. So the, the landmark study came out in 1992, uh, and it clearly showed that five grams elevated creatine in the blood, but if you took multiple five gram dosages, it maintained that throughout the day. So this is where the dose of five grams seems to be very, very viable. And the other one showed that, hey, I don't want to take five. What if I only want to take three grams? So three grams seems to be the lowest, most effective dose, and you just need to take that for one month and you'll saturate your muscles. So again, you have options to take a, as little an amount or a high amount a- as, as you want over time. But I think one of the biggest studies is that we did was a two-year trial in post-menopausal women where we gave .14 grams of creatine, and it really seemed to improve or have an effect on bone preservation as well as muscle performance. So these are the, the studies that seem to come to my mind. We've done quite a few, uh, but they seem to be the landmark

35. 1:00:44 – 1:02:52

    What supplements do you take other than creatine?

    1. DCDr. Darren Candow1:00:44

       ones, yeah.

    2. SBSteven Bartlett1:00:44

       And what are the supplements that you take outside of creatine?

    3. DCDr. Darren Candow1:00:47

       Yes, for sure. So on a daily basis, it's a probiotic, uh, with food in the morning and evening, and that's something I just recently learned. I was taking it on an empty stomach, but probiotic. I take, uh, two forms of magnesium, uh, one before bed and then one in the day, 3:00 and 8:00 for, uh, uh, cognition and function. I take, uh, 2,000 international units of vitamin D. Um, I always take protein on a sufficient basis as well, and then I take about four grams of omega-3 fatty acids, and I always take one of the omega-3 fatty acids post-exercise, 'cause that seems to be the best time to take it.

    4. SBSteven Bartlett1:01:17

       So omega-3, magnesium-

    5. DCDr. Darren Candow1:01:18

       Yep

    6. SBSteven Bartlett1:01:19

       ... vitamin D.

    7. DCDr. Darren Candow1:01:19

       Vitamin D, probiotics. Of course, creatine and, uh, protein I take powder and/or through, uh, dietary food. Every now and then, I don't eat a lot of red meat, so I'll take iron, um, but, um, not on a consistent basis.

    8. SBSteven Bartlett1:01:31

       And you know-

    9. DCDr. Darren Candow1:01:31

       And I'm hoping the new one is, this is an area of controversy, NAD. This is the, you know, it's a precursor for a main enzyme that's highly involved in metabolism. There's been evidence to suggest it goes down with aging, so my eye is closely on that, uh, to see if that's gonna be something to come up into play. And a multivitamin. You know, started with Flintstone vitamins as a kid, and I take a multivitamin a day as a safety net.

    10. SBSteven Bartlett1:01:55

        I noticed that when I looked at your video, in the interview you did with Dr. Rhonda Patrick-

    11. DCDr. Darren Candow1:01:59

        Mm-hmm

    12. SBSteven Bartlett1:01:59

        ... a lot of the comments were from people in their 60s, 70s-

    13. DCDr. Darren Candow1:02:02

        Yes

    14. SBSteven Bartlett1:02:02

        ... and 80s.

    15. DCDr. Darren Candow1:02:03

        Yep.

    16. SBSteven Bartlett1:02:03

        And I wondered why that was. If you just, I was just looking at the top three or four comments-

    17. DCDr. Darren Candow1:02:08

        Right

    18. SBSteven Bartlett1:02:08

        ... and it's a 71-year-old.

    19. DCDr. Darren Candow1:02:09

        Mm-hmm.

    20. SBSteven Bartlett1:02:09

        It's an 82-year-old.

    21. DCDr. Darren Candow1:02:10

        Yep.

    22. SBSteven Bartlett1:02:10

        It's a 53-year-old who's, um, contending with Alzheimer's.

    23. DCDr. Darren Candow1:02:13

        Right.

    24. SBSteven Bartlett1:02:14

        Why is that?

    25. DCDr. Darren Candow1:02:16

        Yeah, I think it's the awareness and education now, and social media's really helped with this, getting our evidence-based research out to the public, and the awareness that creatine is just not for young males to get bigger, stronger, faster. If anything, when you go to an aging body and they're predisposed to age-related muscle loss, strength loss, functionality, bone loss, and atrophy in the brain, creatine has been shown to have effects there as well. So I think a lot of older individual populations are becoming more aware of the effects of creatine. And of course, as we produce more research, it gets out to the public more often. So it's, I'm really excited and encouraged that creatine has sort of taken on a life of its own in the last decade.

36. 1:02:52 – 1:04:18

    Are there any direct weight benefits to creatine?

    1. SBSteven Bartlett1:02:52

       And are there direct weight benefits if I'm trying to cut fat by taking creatine?

    2. DCDr. Darren Candow1:02:57

       Yeah.

    3. SBSteven Bartlett1:02:57

       Or is it indirect?

    4. DCDr. Darren Candow1:02:58

       It's indirect. So it seems that if you increase lean mass, it might stimulate energy expenditure or, uh, turnover. And then in animal models, it sh- has been shown to have some beneficial effects from a cellular perspective on fat. But at the end of the day, if you are seeing a reduction in fat, it's likely that you're improving your metabolic, uh, health with lean tissue mass.

    5. SBSteven Bartlett1:03:15

       Do you think much about how to get these habits to stick? Because I imagine there's lots of people that are-

    6. DCDr. Darren Candow1:03:19

       Yeah

    7. SBSteven Bartlett1:03:19

       ... aware by now-

    8. DCDr. Darren Candow1:03:19

       Yeah

    9. SBSteven Bartlett1:03:19

       ... that creatine is a-

    10. DCDr. Darren Candow1:03:20

        Mm-hmm

    11. SBSteven Bartlett1:03:20

        ... a useful thing to take.

    12. DCDr. Darren Candow1:03:22

        Yep.

    13. SBSteven Bartlett1:03:22

        But for whatever reason, they still don't-

    14. DCDr. Darren Candow1:03:24

        Yeah

    15. SBSteven Bartlett1:03:24

        ... take it.

    16. DCDr. Darren Candow1:03:25

        Exactly, and I think that's one of the biggest reasons people don't. So we gotta come up with ways to maintain consistency, and I think whatever vehicle you wanna choose to maintain that in the, in the run of a day i- is the best. So if it's putting it in your coffee in the morning 'cause you won't forget it, great. If it's putting a little bit in Greek yogurt, if it's using the gummies, whichever it is, as long as it's a viable source of creatine that makes it very practical and consistent for you, uh, that's the best way.

    17. SBSteven Bartlett1:03:48

        Yeah, I found that, um, having it en route to where I'm going-

    18. DCDr. Darren Candow1:03:51

        Yes

    19. SBSteven Bartlett1:03:52

        ... being really, really important.

    20. DCDr. Darren Candow1:03:53

        Yep.

    21. SBSteven Bartlett1:03:53

        So when I come to my office in the morning, it's all on my desk.

    22. DCDr. Darren Candow1:03:55

        Yes.

    23. SBSteven Bartlett1:03:56

        Um, so I have the supplements just on my desk.

    24. DCDr. Darren Candow1:03:57

        Correct.

    25. SBSteven Bartlett1:03:57

        And actually, even before I walked into the studio today, in the green room that I have, it's on the green room.

    26. DCDr. Darren Candow1:04:02

        Right.

    27. SBSteven Bartlett1:04:02

        When I'm at home, it is where the coffee machine is.

    28. DCDr. Darren Candow1:04:05

        Correct, yeah.

    29. SBSteven Bartlett1:04:06

        And that has radically helped me.

    30. DCDr. Darren Candow1:04:07

        Yeah.
37. 1:04:18 – 1:06:42

    What differences will I notice when taking creatine?

    1. DCDr. Darren Candow1:04:18

       forgot about it."

    2. SBSteven Bartlett1:04:18

       I think the other thing is, with some things like creatine, it's hard to really notice the difference sometimes.

    3. DCDr. Darren Candow1:04:24

       Ah, excellent point, yeah. This is not like caffeine, you know, with an immediate effect. So unlike, uh, caffeine, creatine takes a while to notice the effects, and they come indirect. You don't n- n- immediately notice a massive increase in energy or alertness. It's like after a week of weight training or even two, you're like, "Wow, I did more repetitions. I could do more weight. Uh, I recover quickly" is one that we hear, uh, quite often. You'll never notice with, with your bone, but we have s- uh, heard anecdotally with cognition, especially sleep deprivation, people do notice the effects. And I'm a N of one, but I notice jet lag goes down quite a bit, uh, when I take a high dose of creatine.

    4. SBSteven Bartlett1:04:58

       And, you know, when you start taking it, if you start taking it today-

    5. DCDr. Darren Candow1:05:01

       Yes

    6. SBSteven Bartlett1:05:01

       ... if I start taking, say, three to five grams of creatine today, am I gonna notice the differences today?

    7. DCDr. Darren Candow1:05:06

       No. It'll pr- with three to five grams, you'll probably notice it in a few weeks, if not to a month, from a muscle perspective. From a brain perspective, that low, you're likely not gonna notice any effect because the brain is probably making enough. But if you're really metabolically stressed, then you might notice some memory or cognitive, uh, benefits after a few days. But at such a low dose, you need to be a little bit patient. But again, three grams could saturate your skeletal muscle in 30 days, so it's not that long of a wait.

    8. SBSteven Bartlett1:05:32

       And on the cognitive side-

    9. DCDr. Darren Candow1:05:33

       Yes

    10. SBSteven Bartlett1:05:33

        ... the cognitive benefits that were observed when doing these Stroop tests-

    11. DCDr. Darren Candow1:05:36

        Mm-hmm

    12. SBSteven Bartlett1:05:37

        ... had they been taking it previously, or was it just administered on that particular day when the test happened?

    13. DCDr. Darren Candow1:05:41

        Yeah, so that one was in a week in advance with the loading phase.

    14. SBSteven Bartlett1:05:44

        Oh.

    15. DCDr. Darren Candow1:05:44

        So they really saturated the body to try to get the effects.

    16. SBSteven Bartlett1:05:47

        Okay, so they were taking it for some time.

    17. DCDr. Darren Candow1:05:48

        Yeah, yeah. But on the sleep deprivation study from Germany, they just gave it one bolus mega dose for 21 hours of sleep deprivation, and those individuals did perform better from a, a number of tests like this the next day. So if you're like, "Wow, I got something coming up Friday. Unfortunately, I'm not gonna get any sleep, at best one or two hours," then a high dose might come into play, and then you can go back to your more consistent routine. I think what happened or is happening is a lot of individuals who are s- now thinking, "I need to take 20 or 30 grams on a daily basis" based on those studies, and I'm like, wait a minute. Are you getting enough sleep the next day? Because at that dose, we don't know if the neuron will swell with water, and if that's the case, is that potentially causing any detrimental effects in the long term? So again, I would not s- uh, uh, recommend taking a mega dose for consistently over time. Could that downregulate your natural synthesis? Uh, these are all questions that we need to look at, yeah.

38. 1:06:42 – 1:08:31

    Whats your health routine?

    1. SBSteven Bartlett1:06:42

       So outside of the realm of creatine-

    2. DCDr. Darren Candow1:06:43

       Mm-hmm

    3. SBSteven Bartlett1:06:43

       ... outside of the realm of muscle-

    4. DCDr. Darren Candow1:06:44

       Yeah

    5. SBSteven Bartlett1:06:44

       ... outside of the realm of, I guess, nutrition generally, what are you doing to keep yourself healthy?

    6. DCDr. Darren Candow1:06:49

       Yeah.

    7. SBSteven Bartlett1:06:49

       What is, what is your routine?

    8. DCDr. Darren Candow1:06:50

       Yeah, so I'm religious with exercise. So I try to exercise at least three to four days a week with weight training, uh, and add in at least 20 to 30 minutes of either moderate intensity cardio or, um, like a spin class. I per- personally like to do alternating days.

    9. SBSteven Bartlett1:07:04

       Okay.

    10. DCDr. Darren Candow1:07:05

        So I'll do weight training, like maybe Monday, Wednesday, Friday, and then cardio Tuesday, Thursday. Uh, and then on the weekends, hiking, things like that. Um, pretty religious with nutrients as well. Try to eat a really balanced diet. And my, God, my failure is getting enough sleep, so I've had to cut caffeine out quite a bit by past noon to allow me. I'm probably a slower metabolizer, um, with caffeine. So, uh, I try to really optimize evidence-based research, take it into my daily life and try to promote it that way, yeah.

    11. SBSteven Bartlett1:07:32

        And is there anything you're particularly excited about in the work and research that you're doing?

    12. DCDr. Darren Candow1:07:35

        I'm super fascinated with the movement from the neck up. I think we know a lot about the neck down with creatine and exercise or other nutrients. I'm fascinated with the ability, what about concussion? You know, can an, uh, uh, the UFC fighter take creatine before they get hit? Could that decrease CTE or concussion or brain trauma later on in life? I think of boxing, Muhammad Ali, uh, things like that. So there's evidence in, in, in rodents that if you take creatine before head trauma, it really speeds up concussion recovery. So I'm fascinated with that as well, like almost a prophylactic. Anybody involved in head trauma, I think you should definitely look at creatine as something to be taking just in case you get hit, and then of course, everything with Alzheimer's or o- o- other areas of depression. So I'm fascinated that this nutrient, which was, you know, 1832 it was discovered, boring for the longest time because we thought we knew everything, and now it's taken a life of its own and it's having these profound benefits we never even thought would happen, yeah.

39. 1:08:31 – 1:10:45

    Do different people need to dose differently?

    1. SBSteven Bartlett1:08:31

       A lot of people consider you to be the sort of leading expert on this subject for many reasons. Do you think there'll be a time where you, you stop researching creatine and you move on to something else?

    2. DCDr. Darren Candow1:08:39

       You know, that's interesting. I would've said yes about five years ago, but now, no. There's too much to do. Even with skeletal muscle, if you were to say, "What's the best dose, Darren, to take?" I'd say, "I have no clue." Every creatine researcher said, "I don't know." We still don't know the best dose that every person can take that will check off all the boxes, especially in the brain. We're just giving an estimate that I take 10, maybe you take 12, someone might take 15. But at the end of the day, we still don't know the best supplementation protocol, the best dose, uh, so there's so many areas. So for the next 20 years, I bet y'all still be focusing on creatine with other things as well, yeah.

    3. SBSteven Bartlett1:09:15

       And on that dosage, is that different for different people?

    4. DCDr. Darren Candow1:09:19

       Excellent question. So the thought was that the larger you are-

    5. SBSteven Bartlett1:09:23

       Yeah

    6. DCDr. Darren Candow1:09:23

       ... you have more storing capacity in your muscle for creatine. So it makes sense. If you're 50 kilograms and 150 kilograms, you're gonna have a greater storing capacity, so the dose on a relative basis is likely higher there as well. The more stressed the person is, it's likely they're gonna require more because their natural machinery in the brain can't keep up. So it is very individualistic. I think we give, uh, general recommendations to make it easy. But again, some people can take it very scientifically and base it on body weight, and you can't go wrong with both of them.

    7. SBSteven Bartlett1:09:52

       I bet there's a lot of people that are this far into the conversation-

    8. DCDr. Darren Candow1:09:54

       Mm-hmm

    9. SBSteven Bartlett1:09:54

       ... and their, their central question is, right, I've got loved ones-

    10. DCDr. Darren Candow1:09:57

        Mm-hmm

    11. SBSteven Bartlett1:09:58

        ... that I really, really want to start, um, considering-

    12. DCDr. Darren Candow1:10:01

        Right

    13. SBSteven Bartlett1:10:01

        ... creatine supplementation for whatever reason.

    14. DCDr. Darren Candow1:10:03

        Yep.

    15. SBSteven Bartlett1:10:03

        It could be cognitive benefits, muscular benefits, whatever.

    16. DCDr. Darren Candow1:10:05

        Right.

    17. SBSteven Bartlett1:10:05

        All the things we've talked about. They might end up sending this conversation to their loved ones.

    18. DCDr. Darren Candow1:10:10

        Right. Yep.

    19. SBSteven Bartlett1:10:10

        Something that I do sometimes when I, when I have episodes that are particularly moving for me. If their loved ones are now listening-

    20. DCDr. Darren Candow1:10:15

        Yep. Yep

    21. SBSteven Bartlett1:10:16

        ... and you had to make a case to their loved ones-

    22. DCDr. Darren Candow1:10:18

        Yeah

    23. SBSteven Bartlett1:10:18

        ... about why they should take creatine-

    24. DCDr. Darren Candow1:10:21

        Yep

    25. SBSteven Bartlett1:10:21

        ... what would you say?

    26. DCDr. Darren Candow1:10:23

        I would say creatine is one tool in that health promotion, um, toolbox that might help you live longer and better and allow you to maintain activities later on in life which you wouldn't have been able to do. A- and unfortunately, that leads to accelerated aging and a poor way to go. It's like, it's like saying, "I'm gonna save everything for retirement." My question is, why? You might not make it to retirement. So that's one

40. 1:10:45 – 1:12:04

    How do you define ageing?

    1. DCDr. Darren Candow1:10:45

       of the things, yeah.

    2. SBSteven Bartlett1:10:45

       Ageing.

    3. DCDr. Darren Candow1:10:46

       Yes.

    4. SBSteven Bartlett1:10:47

       What is ageing in your definition of the word?

    5. DCDr. Darren Candow1:10:49

       It's catastrophic. Unfortunately, I'm going through it. You know, I've noticed ever- ever since I hit the fourth decade, things hurt a lot more and muscle mass to retain it is a little bit harder. Um, so unfortunately, think of the body's ability to withstand stress is not as high, and things start to break down quite fast. So we all know, you know, things hurt more. We've lost muscle mass. I can't run as fast. So biological aging is kind of the de- deterioration of the human body. We need to, with this conversation and others, come up with ways to stop the deterioration and, if anything, come up with ways to maintain that ability to live longer free of disease, yeah.

    6. SBSteven Bartlett1:11:27

       We have a closing tradition on this podcast-

    7. DCDr. Darren Candow1:11:29

       Okay

    8. SBSteven Bartlett1:11:29

       ... where the last guest leaves a question for the next, not knowing who they're leaving it for.

    9. DCDr. Darren Candow1:11:32

       Okay.

    10. SBSteven Bartlett1:11:32

        This one's quite a tricky question.

    11. DCDr. Darren Candow1:11:33

        Okay.

    12. SBSteven Bartlett1:11:34

        What is reality? What do you think all of this is, all this stuff that we can see and all we experience? What, what do you think it is? Do you think it's a simulation? Do you think it's...

    13. DCDr. Darren Candow1:11:43

        This is all real for sure, because I think we can feel it. It's not a, a big brother or anything that's a, a game show. We all go through different emotions and things like that, so I think you can feel it, yeah.

    14. SBSteven Bartlett1:11:53

        Are you religious?

    15. DCDr. Darren Candow1:11:54

        Yes, Catholic. Roman Catholic.

    16. SBSteven Bartlett1:11:55

        You're a Catholic.

    17. DCDr. Darren Candow1:11:55

        Yeah. Yeah.

    18. SBSteven Bartlett1:11:55

        Okay. And you're a family man. You've got-

    19. DCDr. Darren Candow1:11:57

        Mm-hmm

    20. SBSteven Bartlett1:11:57

        ... got some...

    21. DCDr. Darren Candow1:11:59

        Uh, a French bulldog and a cat, as we talked about, and wife at home, yeah, and, uh, really close to my family and stuff like that, yeah.

41. 1:12:04 – 1:13:05

    What is your goal?

    1. SBSteven Bartlett1:12:04

       And what is your goal? If we get to the end of your career and this was your last day and you had been successful-

    2. DCDr. Darren Candow1:12:07

       Oh, yeah

    3. SBSteven Bartlett1:12:08

       ... what-

    4. DCDr. Darren Candow1:12:08

       I think it would be a lasting impression on my students that, wow, he changed my life in some way. And if I can make one person live longer, free of disease and happier, I'm all for it. You know, y- when you start to see the human body as people get older, you're like, "Oh, that person used to be young and vibrant." And then when you hear other people that can't do a- activities they live in or they can't travel or they're afraid to, I'm like, you need to embrace today. I, I love that quote from, uh, Morgan Freeman in Shawshank, "Get busy living or get busy dying." 'Cause honestly, we have the ability with lifestyle choices to improve optimization, and I wanna see people live to be 120, 130, still active, still going. And I think we're on the cusp with technology, and I think awareness around nutrition, exercise, sleep, uh, laughter. Oh, geez, if I, uh, could ask anybody to do one more thing, it'd be just laugh more often. For me to be just a small piece of the, the puzzle promoting it, I think it's, if anything, it's, it's just beyond

42. 1:13:05 – 1:15:31

    Fear of death

    1. DCDr. Darren Candow1:13:05

       my belief, yeah.

    2. SBSteven Bartlett1:13:06

       Why did this pull you in? I, I, I ask that in part because it tends to be the case that the things that draw us in-

    3. DCDr. Darren Candow1:13:12

       Mm-hmm

    4. SBSteven Bartlett1:13:12

       ... or pull on our, make us curious, there tends to always be a bit of a personal reason.

    5. DCDr. Darren Candow1:13:16

       Right. Yeah.

    6. SBSteven Bartlett1:13:17

       Um-

    7. DCDr. Darren Candow1:13:17

       It was, it was more that, uh, you know, am I scared of death? 100%. Yeah.

    8. SBSteven Bartlett1:13:21

       Really?

    9. DCDr. Darren Candow1:13:21

       I can't, I can't think of it. Yeah.

    10. SBSteven Bartlett1:13:22

        Why?

    11. DCDr. Darren Candow1:13:23

        Yeah. I just think it's weird for me. I get to a point, uh, maybe being religious, and then you think about it, and then I, my brain stops. I can't think about it.

    12. SBSteven Bartlett1:13:31

        Really?

    13. DCDr. Darren Candow1:13:31

        Yeah. And it's, it becomes, it's almost like I want to live forever, and if I can think of ways to make me live and partially get there, obviously it, it's not reality, but yeah, I'm, uh, scared to death of dying, yeah. Yeah.

    14. SBSteven Bartlett1:13:41

        Have you always been?

    15. DCDr. Darren Candow1:13:42

        Yep. 100%. Scared of death of heights, and I can't even talk about the, the death experience, yeah. 'Cause I think it, it sort of brings into perspective things that i- you just don't know.

    16. SBSteven Bartlett1:13:53

        Did you ever lose anybody?

    17. DCDr. Darren Candow1:13:54

        Uh, just, uh, uh, friends and things like that, but nothing, um, specific like parents or anything like that yet. But it's always been there. I don't know if it's the Roman Catholic in me or not, but it's like, whoa, I don't want that at all, yeah.

    18. SBSteven Bartlett1:14:05

        You can't even talk about it.

    19. DCDr. Darren Candow1:14:06

        Can't even talk about it, no. No. Yeah.

    20. SBSteven Bartlett1:14:08

        Really?

    21. DCDr. Darren Candow1:14:09

        Yeah. It's kind of like I can talk about it in a sense I understand and it's realistic, but it's, it's more, um, that for some reason I don't even want to think about it, 'cause I have so much passion for life that I don't even want to think about, oh, shit, this could happen, yeah. Yeah.

    22. SBSteven Bartlett1:14:23

        And you believe you go somewhere after death?

    23. DCDr. Darren Candow1:14:25

        Oh, for sure. Heaven. Yeah, yeah, yeah.

    24. SBSteven Bartlett1:14:26

        Okay.

    25. DCDr. Darren Candow1:14:26

        Yeah, yeah.

    26. SBSteven Bartlett1:14:27

        But if you do believe you're going to heaven, that sounds like a good place, no?

    27. DCDr. Darren Candow1:14:29

        A g- great place, yeah. I just want to spend more time here. [laughs] There's still a lot of things to do, yeah, for sure.

    28. SBSteven Bartlett1:14:34

        Makes sense.

    29. DCDr. Darren Candow1:14:35

        Yeah.

    30. SBSteven Bartlett1:14:36

        Well, thank you. Thank you for doing the work that you do.

Episode duration: 1:15:32