Creatine from food can relieve chronic constipation and improve digestion

A new study shows that higher intakes of creatine from meat products may ease constipation, especially in men and young adults. It offers a potential dietary solution to a common digestive problem.

A study published in Frontiers in Nutrition reports that higher creatine intake from meat protein sources may help reduce the risk of chronic constipation.

Background

Chronic diarrhea and constipation are the most common forms of gastrointestinal disorders, significantly impairing quality of life. Several factors potentially contribute to these conditions, including diet, physical activity, age, gender, and underlying medical conditions such as irritable bowel syndrome, inflammatory bowel disease, and metabolic disorders.

Creatine is an endogenous organic compound found primarily in muscles. It is synthesized from three amino acids in the body and plays a key role in muscle energy metabolism. Creatine can also be obtained from food sources such as red meat and fish.

Emerging evidence suggests potential therapeutic efficacy of creatine in a variety of diseases, including neurodegenerative and cardiovascular diseases. Limited evidence also suggests that creatine supplementation may influence gastrointestinal motility and function, as well as gut microbiota composition.

Given the potential impact of creatine on gut health, the present study was designed to examine the association between dietary creatine intake and the risk of chronic diarrhea and constipation in US adults aged 20 years and older.

Study

The authors conducted a secondary analysis of data from 10,721 participants in the 2005–2010 National Health and Nutrition Examination Survey (NHANES), which is conducted by the National Center for Health Statistics (NCHS) to assess the health and nutrition status of children and adults in the United States.

Information on creatine intake from animal sources and incidence of chronic diarrhea and constipation was extracted from the NHANES database.

The association between creatine intake and the risk of chronic diarrhea and constipation was assessed using appropriate statistical methods. The possible influence of demographic factors (age, gender, physical activity) and comorbidities (diabetes and hypertension) on this association was also examined.

Key Results

The study found that creatine intake from animal products was associated with a significant reduction in the risk of chronic constipation. Specifically, a tenfold increase in absolute creatine intake was associated with a 19% reduction in the risk of constipation. However, no significant effect was found on chronic diarrhea.

Subgroup analyses showed that the observed benefits of creatine supplementation were greater in men, participants younger than 48 years, and those without hypertension, diabetes, or cardiovascular disease.

Significance of the study

The results of the study show that creatine consumption from animal products may reduce the risk of chronic constipation. However, creatine consumption does not significantly affect the risk of diarrhea.

The beneficial effects of creatine on chronic constipation were also shown to be greater in men, younger adults, smokers, people who drink alcohol, physically active individuals, and those without underlying medical conditions such as hypertension, diabetes, and cardiovascular disease. The authors note that these associations are significant in certain subgroups, but caution that the study is observational and does not establish cause and effect.

Some preclinical animal studies have shown that creatine may improve constipation by altering the composition of gut microbiota, intestinal barrier integrity, and fecal bile acid composition. Creatine may also improve intestinal metabolism and motility by increasing intestinal epithelial cell hydration.

The results suggest that dietary creatine may have a more pronounced protective effect against constipation in men than in women, which may be due to differences in hormonal and metabolic pathways. In particular, there is evidence that testosterone, a male sex hormone, influences the composition of the gut microbiota via the bile acid signaling pathway. In addition, testosterone promotes creatine absorption and strengthens the integrity of the gut barrier.

The study found no effect of creatine on constipation in people with comorbidities, including hypertension and diabetes. The lack of effect may be due to vascular dysfunction in hypertension, which affects intestinal blood flow and microbiota, and because people with diabetes often have gastrointestinal complications (eg, gastroparesis and constipation), which may limit creatine’s ability to improve bowel function.

The researchers conducted interaction tests and found that gender significantly modified the association between creatine intake and the risk of constipation. No such interactions were found for diarrhea. The results suggest that creatine from animal sources may be a potential dietary intervention for the management of chronic constipation.

The cross-sectional design of the study does not allow us to establish causality of the observed associations. Further experimental work is needed to investigate the biological mechanisms underlying the improvement in gut health under the influence of creatine in different subgroups.

The study used the NHANES database, which contains self-reported dietary data. This approach is often subject to recall errors and inaccuracies. Additionally, the database does not include information on the duration and dosage of creatine supplementation. Future studies should take these factors into account to better understand the effects of creatine on gut health.