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Creatine Use High Among High School Athletes

Study: Kids in 6th grade taking supplement

MONDAY, Aug. 6, 2001 (HealthDayNews) -- A new study says 5.6 percent of student athletes in grades 6 through 12 admit taking creatine, a natural supplement touted for its performance-enhancing powers but discouraged for use by adolescents.

New York researchers say use increases with grade levels, rising to 44 percent for high school seniors. For juniors and seniors combined, the rate of creatine use was nearly 30 percent, the same as college athletes.

The over-the-counter, unregulated substance, which gives muscles a boost during very short periods of intense activity, is thought to be relatively safe for adults, although it has been linked to kidney damage. But pediatricians say there isn't enough evidence to say it's safe for children.

"I think that people ought to be much more concerned about [creatine use among kids] than they are," says Dr. Thomas Martin, team physician for the Penn State University football squad and a member of the American Academy of Pediatrics' committee on sports medicine and fitness. "There's no proof of benefit in people under 18, and we don't know what the 30-year side effects are."

What's more, Martin says the substance often is mixed with potentially harmful supplements like steroids or ephedra. He discourages his own athletes from using creatine.

Creatine is the most popular over-the-counter exercise aid, racking up more than $400 million in sales a year.

Dr. Jordan D. Metzl of Cornell Medical College in New York City led the study, which appears in the August issue of the journal Pediatrics. Metzl and his colleagues surveyed 1,103 student athletes from four public and one private school in Westchester County, N.Y., about their creatine use.

Overall, 62 said they'd used the supplement, 85 percent of whom were boys. Nearly three-quarters of youngsters taking creatine said they did so to boost their athletic performance, and about six in 10 said they thought it would improve their physical appearance.

"Shockingly, we found creatine users in every grade," says Metzl, who is medical director of Sports Medicine Institute for Young Athletes at the Cornell's Hospital for Special Surgery.

Athletes in every sport reported using creatine, though gymnasts, wrestlers, and hockey, football and lacrosse players were most likely to say they took the compound.

"We have little kids, 11 and 12 years old, taking these supplements to improve their performance. That whole concept is very wrong," Metzl says.

About 45 percent of the children said they did not take creatine because they were afraid it would harm their health. Others shunned the supplement because they weren't sure it would work or because they couldn't afford to buy it.

Creatine briefly grabbed media attention three years ago when it was reported that baseball sluggers Mark McGwire and Sammy Sosa -- who at the time were in a neck-and-neck race to break the single-season home run record -- both used the diet aid in their workouts. Metzl says popular pro athletes may be setting a bad example for their young admirers. "Sammy Sosa got to be Sammy Sosa not because he used creatine, but because he worked hard and lifted weights," he says. "It's a potentially very harmful message that instead of working on your skills, you just take supplements."

While creatine might turn out to be harmless -- there's never been a study of the compound in adolescents -- Metzl says young athletes may graduate to other, less benign substances. For instance, he says androstendione, or "andro", which McGwire also admitted using, is a steroid precursor that might lead to serious growth abnormalities and other health problems in children. "It's a very slippery slope," Metzl says.

Dick Galiette, executive director of the National High School Athletic Coaches Association, says creatine use is "definitely on the radar screen" for association members, though its priority may vary in state systems and from school to school. The association works with the U.S. Drug Enforcement Agency to offer annual workshops to coaches on the compounds, such as steroids, that student athletes may use.

What To Do: For more on creatine, try the National Federation of State High School Associations. To read more about steroid use among children, visit the American Academy of Pediatrics.

SOURCES: Interviews with Jordan D. Metzl, M.D., medical director, Sports Medicine Institute for Young Athletes, Hospital for Special Surgery, Cornell Medical College, New York; Thomas Martin, M.D., team physician, Penn State University football, State College, Pa., and Dick Galiette, executive director, National High School Athletic Coaches Association; August 2001 Pediatrics
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