Athletes' supplement choices: creatine's 1992 breakthrough, common uses and testing risks
At the 1992 Olympics in Barcelona dozens of Great Britain athletes were taking a new product, creatine, which increased muscle mass and improved athletic performance while not falling foul of doping rules. That early adoption helped make creatine mainstream and it is now one of many supplements elite athletes use as they chase marginal gains.
Creatine has moved from suspicion to supermarket shelves and social feeds and is described in the article as the supplement of choice for millions and one of the most scientifically researched. From the minute an athlete wakes to the moment they go to bed they are thinking about optimising performance and recovery, and Prof Graeme Close says: "There are various reports in the literature of some studies that say maybe up to 90% of athletes take supplements. I often jokingly say that means 10% are lying." He adds: "The sports teams that I've worked in, I think that's probably closer to 100% of athletes will be taking some form of supplementation." While Close and other experts advocate meeting nutritional needs through food first, supplements fill gaps where food is impractical.
Creatine itself is naturally present in meat and fish and is produced in the kidneys, liver and pancreas; it provides a quick source of energy for muscles and is particularly relevant for short-duration, high-intensity activities such as sprinting. Close notes: "You would need the best part of a kilogram of raw chicken a day to get the amount of creatine you need," and the product's sporting breakthrough traces back to two scientists who had been researching it for two decades, their findings being shared with Steve Jennings of Maxim sports nutrition, which supplied products to the British Olympic team. Investigative reporter Doug Gillon reported a 'secret trial' and saw a box of Ergomax C150 effervescent creatine tablets, writing that if the scientists' claims — that creatine could improve explosive athletic performance by 1-3% — were true, then "sport may never be the same again." By the 1996 Olympics an estimated 80% of athletes were taking creatine and the Journal of the International Society of Sports Nutrition said the creatine breakthrough had "launched a new era in sports nutrition" and "sparked exploration into other supplements." Research since has suggested cognitive benefits as well as physical.
Close, who oversaw nutrition for last year's British and Irish Lions rugby union tour, ranks protein powders first among the supplements he sees athletes using, followed by creatine and vitamin D. The article states: "Protein powders maximise muscle repair and contribute to muscle growth, while creatine is a quick source of energy for muscles and important in short-duration, high-intensity activities like sprinting. Vitamin D, meanwhile, is essential for bone health and supports muscle function." Australian cyclist Nicole Frain says: "I'm a pretty big believer that they are called sport supplements. They are there to supplement the things you already do right. "I don't think supplements are the answer to fix my problems. "You need to be eating a balanced diet, training well, sleeping right, recovering well, hydrating – all of those things – before we add in all of the extras."
Carbohydrate gels and sports drinks also feature in elite practice; Close says they were key in the first sub-two hour marathon earlier this year by Kenyan long-distance runner Sabastian Sawe. He said: "As sport nutritionists we were all fascinated at what the fuelling programme was, and it was the sports drinks and gels that played a huge part of that fuelling." The article adds that calculations for breaking two hours involved ensuring more than 100 grams of supplemental carbohydrate per hour, and that reports from the recent sub-two-hour marathon said 110 grams of carbohydrate per hour was achieved.
Supplements carry anti-doping risks as well as potential benefits. Close explains Wada's approach: "For Wada to put anything on the list, it's got to hit two out of three criteria: dangerous to health, performance enhancing, and against the spirit of sport." UK Anti-Doping advises that "No guarantee can be given that any particular supplement is free from prohibited substances" and urges athletes to "be vigilant", warning that unintentional consumption can result in the same four-year ban as deliberate use. The article reports that batch-testing programmes such as Informed Sport exist to reduce risk and that Informed Sport says as many as one in 10 supplements is contaminated; a study by the Anti-Doping Knowledge Centre found product contamination was responsible for 8% of all anti-doping violations between 2005 and 2022. Wada cautions that quality assurance schemes can reduce but do not eliminate risk.
Athletes and support teams take precautions: Great Britain rower Heidi Long says: "I've recorded the batch number of every product that I've taken and its expiry date because if you take it after the expiry date the Informed Sport [certification] is no longer viable." Close has carried out site visits to factories to check manufacturing processes because, he says, "the risk of failing a drugs test is huge." The article says some studies have found creatine products with no creatine in them and that, in some cases, supplements may contain substances dangerous to health; Close states: "So it is really important that the message is that while they can play a small role, the safety considerations are the key factor." Alongside manufactured supplements, the piece notes return-to-basics alternatives such as turmeric, pickle juice and high-nitrate foods and highlights teff — an ancient Ethiopian grain now appearing on UK supermarket shelves — described in the article as having "a high mineral content and is rich in calcium, iron and vitamin C," being "naturally gluten-free and good for the gut," and unique as a "complete" protein providing all nine essential amino acids; the article says athletes from Haile Gebrselassie to Venus Williams have used teff. British boxer Fran Hennessy, introduced to teff by her nutritionist, says: "I've never looked back," and: "What I'm putting in my body is good fuel and energy and teff has so much. It energises you so much before a workout and it gives you the fibre you need." She adds: "Each meal I'm having there's a reason behind and everything that's in it there's a reason behind... I know what I'm putting in my body is fuelling me, recovering me, energising me." Long also notes the practical limits around supplements: "The supplement industry is really expensive," and "And we're definitely not made of money. So I think it's really picking and choosing when you want to put that investment in." She adds: "[But] on a daily basis if I can get the protein intake from my dinner and a glass of milk or yoghurt and breakfast then actually I was going to be eating that food anyway so it's not as expensive." On taste she says: "I would much rather enjoy a coffee in the morning with friends or while I'm working rather than have one of the gels," and: "Some of the gels ... you'll end up holding your nose when you take it. "I guess it's just like the enjoyment of what you're taking, you know, it's nicer to eat food than it is to take supplements."
Heidi Long says it is sensible to concentrate supplement use around competition: she believes "it's really picking and choosing" and that it makes sense to have more supplements around racing time "when the performance is super critical and very time dependent."
