Objective. Creatine is a nutritional supplement that is purported to be a s
afe ergogenic aid in adults. Although as many as 28% of collegiate athletes
admit taking creatine, there is little information about creatine use or p
otential health risk in children and adolescents. Although the use of creat
ine is not recommended in people less than 18 years of age, numerous anecdo
tal reports indicate widespread use in young athletes. The purpose of this
study was to determine the frequency, risk factors, and demographics of cre
atine use among middle and high school student athletes.
Methods. Before their annual sports preparticipation physical examinations,
middle and high school athletes aged 10 to 18 in Westchester County, a sub
urb north of New York City, were surveyed in a confidential manner. Informa
tion was collected regarding school grade, gender, specific sport participa
tion, and creatine use.
Results. Overall, 62 of 1103 participants (5.6%) admitted taking creatine.
Creatine use was reported in every grade, from 6 to 12. Forty-four percent
of grade 12 athletes surveyed reported using creatine. Creatine use was sig
nificantly more common (P <.001) among boys (53/604, 8.8%) than girls (9/49
2, 1.8%). Although creatine was taken by participants in every sport, use w
as significantly more common among football players, wrestlers, hockey play
ers, gymnasts, and lacrosse players (P <.001 for all). The most common reas
ons cited for taking creatine were enhanced performance (74.2% of users) an
d improved appearance (61.3%), and the most common reason cited for not tak
ing creatine was safety (45.7% of nonusers).
Conclusions. Despite current recommendations against use in adolescents les
s than 18 years old, creatine is being used by middle and high school athle
tes at all grade levels. The prevalence in grades 11 and 12 approaches leve
ls reported among collegiate athletes. Until the safety of creatine can be
established in adolescents, the use of this product should be discouraged.