. 2021 Jan 20;24(4):632–640. doi: 10.1017/S1368980020005121

Table 1.

Effect and applications of the CM according to the European regulation and scientific evidence established by the reference institutions

	Sports involved	Dose	Ergogenic effects
European regulation
EFSA and European Commission⁽⁷⁾	Improves physical performance in sport events with explosive activities especially of a repeated nature.	Daily intake of 3 g of creatine.	Improvement in exercise performance in sport events that require explosive, high-energy output activities especially of a repeated nature.
EFSA and European Commission⁽⁷⁾	Improvement in muscle strength and muscle function in adults over the age of 55 years who are engaged in regular resistance training. Beneficial effects are related with resistance exercise. Resistance training which allows an increase in the workload overtime should be performed at least three times per week for several weeks, at an intensity of at least 65–75 % of one repetition maximum.	In order to obtain the claimed effect, 3 g of creatine should be consumed daily.	Creatine intake improves muscle training capacity in higher intensities, which allows a higher muscle strength development.
Scientific evidence
AND⁽¹⁶⁾	Improves performance of repeated bouts of high-intensity exercise with short recovery periods. - Direct effect on competition performance. - Enhanced capacity for training.	No data.	Increases creatine and phosphocreatine concentrations. May also have other effects such as enhancement of glycogen storage and direct effect on muscle protein synthesis.
IOC⁽³⁾	Can acutely enhance the performance of sports involving repeated high-intensity exercise (e.g. team sports), as well as the chronic outcomes of training programmes based on these characteristics (e.g. resistance or interval training), leading to greater gains in lean mass and muscular strength and power.	Loading phase: ~20 g/d (divided into four equal daily doses), for 5–7 d. Maintenance phase: 3–5 g/d (single dose) for the duration of the supplementation.	Supplementation increases muscle creatine stores, augmenting the rate of phosphocreatine re-synthesis, thereby enhancing short-term, high-intensity exercise capacity and the ability to perform repeated bouts of high-intensity effort.
ISSN⁽⁹⁾	Ergogenic aid for power/strength athletes to help them optimise training adaptations or athletes who need to sprint intermittently and recover during competition (e.g. American football, soccer, basketball, tennis, etc.).	Loading phase: ~0·3 g/kg/d of creatine monohydrate for 5–7 d. Maintenance phase: 3–5 g/d to maintain elevated stores. Cyclic dose: 3 g/d for 28 d to increase muscle creatine stores. 6 g/d for 12 weeks to enhance muscle volume and strength.	It increases the amount of muscle phosphocreatine, lean muscle mass, muscle strength, performance in sprints (aerobic capacity), power, training capacity and muscle diameter.
Effects of Creatine Supplementation on Athletic Performance in Soccer Players: A Systematic Review and Meta-Analysis⁽²⁰⁾	Beneficial in anaerobic sports such as football.	Loading phase: 20–30 g/d, divided into 3–4 shots a day, for 6–7 d. Maintenance phase: 5 g/d for 9 weeks. Continued reduced dose: 3 mg/kg/d for 14 d.	It produces positive effects in physical performance tests related to anaerobic metabolism, especially with anaerobic power.

EFSA: European Food Safety Authority; AND: Academy of Nutrition and Dietetics; IOC: International Olympic Committee; ISSN: International Society of Sports Nutrition.