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Burke et al. 2003: Creatine and Vegetarian Athletes

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Study Overview

Citation: Burke DG, Chilibeck PD, Parise G, Candow DG, Mahoney D, Tarnopolsky M. (2003).

Effect of creatine and weight training on muscle creatine and performance in vegetarians. Medicine and Science in Sports and Exercise, 35(11), 1946-1955.

This study directly compared the effects of creatine supplementation in vegetarian versus omnivore participants during a resistance training programme.

It provided key evidence that vegetarians may be “super-responders” to creatine supplementation.

Vegetarians showed larger improvements in muscle creatine, lean mass, and performance compared to omnivores

Study Design and Methods

Male and female participants were divided into vegetarian and omnivore groups, then further randomised to creatine or placebo.

All participants completed 8 weeks of resistance training.

The creatine protocol included a 7-day loading phase (0.25g/kg/day) followed by maintenance (0.0625g/kg/day). Muscle biopsies, body composition (DEXA), and performance tests were conducted before and after the intervention.

Key Findings

Greater Creatine Uptake in Vegetarians

Vegetarians had significantly lower baseline muscle creatine levels compared to omnivores, confirming that dietary creatine from meat contributes meaningfully to muscle stores.

After supplementation, vegetarians showed a greater absolute increase in muscle creatine content.

Superior Lean Mass Gains

Vegetarian participants supplementing with creatine showed greater increases in lean body mass compared to omnivore creatine users.

This aligns with the “ceiling effect” — those starting with lower creatine stores have more room for improvement.

Enhanced Performance

Work capacity during resistance exercise improved more in vegetarian creatine users compared to their omnivore counterparts, suggesting that the performance-enhancing effects of creatine are amplified in populations with lower baseline stores.

(Kreider et al., 2017)

Practical Implications

  1. Vegetarians and vegans should strongly consider creatine — They stand to gain the most
  2. Creatine is arguably essential for plant-based athletes — No dietary source means reliance on endogenous synthesis alone
  3. Standard dosing protocols apply — 3-5g/day is effective for vegetarians
  4. Cognitive benefits may also be amplified — Rae et al. 2003 found 20% memory improvement in vegetarians
  5. Safe and well-tolerated — No unique risks for vegetarians

Malaysian Relevance

Malaysia has significant vegetarian and vegan populations, particularly within the Hindu and Buddhist communities. Malaysian vegetarian restaurants are widespread, but none provide dietary creatine.

For Malaysian vegetarians — whether for religious, ethical, or health reasons — creatine monohydrate is one of the most impactful supplements available, with halal-certified options readily accessible.

Dietary creatine from plant-based foods — vegetarians must rely on endogenous synthesis or supplementation

Where This Fits in the Evidence

Burke et al. (2003) matters because it isolated baseline creatine status as the variable that predicts response: by recruiting both vegetarians and omnivores into the same training programme, it showed the largest gains in muscle creatine, lean mass and work capacity accrued to those who started with the least. That “low baseline, bigger response” pattern recurs across the supplement’s literature, which is why the ISSN position stand singles out vegetarians as likely strong responders. It also dovetails with the cognitive side of the same population, where Rae et al. (2003) reported memory gains in vegetarians. The wider body of work is gathered in our research library.

Sources and References

  • Burke DG, et al. (2003). Effect of creatine and weight training on muscle creatine and performance in vegetarians. MSSE, 35(11), 1946-1955.
  • Rae C, et al. (2003). Oral creatine monohydrate supplementation improves brain performance. Proc R Soc B, 270(1529), 2147-2150.
  • Kreider RB, et al. (2017). ISSN position stand. JISSN, 14, 18.

Further Reading

Mechanism of Action

Understanding the biochemistry behind creatine's effects provides context for the practical recommendations in this guide. Creatine functions primarily through the ATP-phosphocreatine (ATP-PCr) system:

  1. Storage: Approximately 95% of the body's creatine is stored in skeletal muscle, with the remaining 5% in the brain, kidneys, and liver
  2. Conversion: The enzyme creatine kinase attaches a high-energy phosphate group to free creatine, creating phosphocreatine (PCr)
  3. Energy release: During high-intensity activity, PCr rapidly donates its phosphate group to ADP, regenerating ATP within milliseconds
  4. Resynthesis: During rest periods, the process reverses — ATP donates a phosphate back to creatine, replenishing PCr stores

This cycle operates continuously in all metabolically active tissues. Supplementation increases the total creatine pool by 20-40%, expanding the energy buffer available for intense physical and cognitive work.

References

  1. Burke DG, Chilibeck PD, Parise G, Candow DG, Mahoney D, Tarnopolsky M. (2003). Effect of creatine and weight training on muscle creatine and performance in vegetarians. *Medicine and Science in Sports and Exercise*. doi:10.1249/01.MSS.0000093614.17517.79 PubMed
  2. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. *Journal of the International Society of Sports Nutrition*. doi:10.1186/s12970-017-0173-z PubMed

Frequently Asked Questions

Do vegetarians benefit more from creatine supplementation?

Yes. Vegetarians have lower baseline creatine stores due to zero dietary creatine from meat, meaning they experience greater relative increases from supplementation.

Why do vegetarians have lower creatine levels?

Creatine in the diet comes exclusively from animal products (meat, fish). Vegetarians rely entirely on endogenous synthesis, which may not fully saturate muscle stores.

Should all vegetarians take creatine?

Creatine is one of the most evidence-based supplements for vegetarians and vegans, offering performance and cognitive benefits that may be greater than for omnivores.

This content is for educational purposes only and is not medical advice. Consult a healthcare provider before starting any supplementation.

Reviewed by T. Dinaiz, BSc (Molecular Biology), MSc (Biotechnology)

Reviewed against peer-reviewed research · Our editorial policy