Scientific Opinion on the substantiation of health claims related to creatine  
and increased attention (ID 1524) and improvement of memory (ID 1528)  
pursuant to Article 13(1) of Regulation (EC) No 1924/2006[sup]1[/sup]  
EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA)2, 3  
European Food Safety Authority (EFSA), Parma, Italy  
Słowa kluczowe:
Creatine
 
attention
 
health claims
 
memory
 
	
	1. Charakterystyka żywności / składnika
	
        
		The food constituent that is the subject of the health claims is creatine.  
Creatine is a nitrogenous organic acid which is used in the muscles and the brain to synthesise  phosphocreatine, which in turn supplies high-energy phosphates for the synthesis of adenosine  triphosphate. Creatine is naturally present in food, predominantly in meat and fish. It can be  synthesised endogenously in the pancreas, the kidneys and the liver from the amino acids glycine,  arginine and methionine. Creatine can be measured by established methods.   
The Panel considers that the food constituent, creatine, which is the subject of the health claims, is  sufficiently characterised.   
		
	
	
    
	
	
		
 
	
	2. Znaczenie oświadczenia dla zdrowia człowieka
	
        
		
		
	
	
    
	
	
		
			
2.1. Zwiększenie uwagi (ID 1524)
	
	
			The claimed effect is “cognitive performance”. The Panel assumes that the target population is the  general population.   
In the context of the proposed wordings, the Panel assumes that the claimed effect refers to attention.  Attention is a well defined construct which can be measured by validated psychometric tests.  
The Panel considers that increased attention is a beneficial physiological effect.  
	
    
			
	
		
			
2.2. Poprawa pamięci (ID 1528)
	
	
			The claimed effect is “brain/memory/older people/parents”. The Panel assumes that the target  population is the general population.   
The Panel assumes that the claimed effect refers to memory, which can be measured by validated  psychometric tests.  
The Panel considers that improvement of memory is a beneficial physiological effect.  
	
    
			
	
		
 
	
	3. Naukowe uzasadnienia wpływu na zdrowie człowieka
	
        
		
		
	
	
    
	
	
		
			
3.1. Zwiększenie uwagi (ID 1524)
	
	
			None of the references provided addressed relevant endpoints in relation to attention, and included  references on, for example, physical performance, recovery from brain injury, “mental fatigue”,  memory and alertness. The Panel considers that no conclusions can be drawn from these references  for the scientific substantiation of the claim.   
The Panel concludes that a cause and effect relationship has not been established between the  consumption of creatine and increased attention.  
	
    
			
	
		
			
3.2. Poprawa pamięci (ID 1528)
	
	
			Four of the references provided did not address relevant endpoints in relation to memory, and  addressed endpoints such as physical performance, recovery from brain injury, and “mental fatigue”.  The Panel considers that no conclusions can be drawn from these references for the scientific  substantiation of the claim.  
McMorris et al. (2006) studied the effects of creatine supplementation on working memory (measured  by the random movement generation test, and by forward and backward verbal and spatial short-term  recall tests) in 19 healthy young subjects, in a double-blind, placebo-controlled design. Participants  took 20 g/day creatine monohydrate (n=9 males, 1 female) or placebo (glucose polymer supplement,  n=7 males, 2 females) for seven days prior to the day of the test. Measures of psychological,  psychomotor and physiological endpoints were taken at baseline, and after 6 and 12 hours, with  intermittent sessions of mild exercise, and after 24 hours of sleep deprivation. The Panel notes the  methodological limitations of this study, including the lack of information on randomisation and  between-group comparisons at baseline, and that multiple pairwise comparisons were performed  without appropriate correction. The Panel considers that no conclusions can be drawn from this study  for the scientific substantiation of the claim.  
In a double-blind, placebo-controlled study, McMorris et al. (2007) examined the effects of creatine  supplementation on performance in memory tests (a random number generation test of working  memory, forward and backward verbal and spatial short-term recall tests, and one long-term  recognition test) in healthy elderly people (n=32, mean age 76.4 years) who attended a day centre.  Group 1 (n=15) was given placebo (glucose polymer supplement) for one week, followed by a further  week of pure creatine monohydrate (20 g/day). Group 2 (n=17) was given placebo for two weeks.  Subjects were assigned to Group 1 or 2 depending on the days that they attended the day centre.  Baseline measures on all tests were obtained prior to the dietary intervention, and again after one and  two weeks. The Panel notes that the statistical approach used did not adequately address the  differences between groups observed at baseline, and that multiple pairwise comparisons were  performed with an inappropriate level of significance. The Panel considers that no conclusions can be  drawn from this study for the scientific substantiation of the claim.  
Rae et al. (2003) investigated the effects of creatine supplementation on verbal working memory  (Wechsler Auditory backward digit span) in a double-blind, cross-over study of 45 young vegetarian  adults (aged 18-40 years) of whom 18 were vegan. Participants received either 5 g/day creatine  monohydrate or placebo (maltodextrin) for the first six weeks, followed by a six week wash-out  period (no supplement), and the supplements were reversed during the final six weeks. The memory  test was administered at baseline, week 6, 12 and 18. The Panel notes that while the study used a 
cross-over design, insufficient information was provided on the statistical model employed for the  treatment of this design, and that multiple pairwise comparisons were performed without appropriate  correction. The Panel considers that no conclusions can be drawn from this study for the scientific  substantiation of the claim.   
The Panel concludes that a cause and effect relationship has not been established between the  consumption of creatine and improvement of memory.  
	
    
			
	
		
 
Wnioski
	
		On the basis of the data presented, the Panel concludes that:  
The food constituent, creatine, which is the subject of the health claims, is sufficiently  characterised.  
Increased attention (ID 1524)  
The claimed effect is “cognitive performance”. The target population is assumed to be the  general population. Increased attention is a beneficial physiological effect.  
A cause and effect relationship has not been established between the consumption of creatine  and increased attention.  
Improvement of memory (ID 1528)  
The claimed effect is “brain/memory/older people/parents”. The target population is assumed  to be the general population. Improvement of memory is a beneficial physiological effect.  
A cause and effect relationship has not been established between the consumption of creatine  and improvement of memory.