Evaluation of creatinine and urea levels in crossfit athletes using nutritional supplements and on high-protein diets
Abstract
Background: CrossFit is a modality of high intensity exercise with an increasing popularity. Furthermore, the rising use of nutritional supplements by amateurs and professional athletes of elite sports bring up a new discussion for the safety of both practices. Here, we aim to evaluate whether use of nutritional supplements by CrossFit athletes affect normal renal function. Materials and Methods: We used male CrossFit athletes separated into three groups: a control (C) and a nutritional supplement user group (NSU), and an additional group with NSU who were on a diet (NSDU). The creatinine and urea levels were obtained by two isolated samples of urine (pre and post training) and then analyzed by spectrophotometry. A t test was applied to verify possible differences between C, NSU and NSDU groups. Results: The most used nutritional supplements were creatine and whey protein, and 8 of NSU declared to be on a high protein diet (forming NSDU group). Creatinine levels significantly increased after training, but not urea levels, and samples above normal range were frequently observed after training. However, comparison of creatinine and urea levels among C, NSU and NSDU groups showed no statistical difference in pre and post training conditions. Conclusion: Our data suggest that the use of nutritional supplements and high-energetic diets did not significantly affect urinary creatinine and urea levels, and that the clinical alterations observed here are probably related to a transitory effect of high-intensity training as CrossFit.
References
-Bemben, M. G.; Lamont, H. S. Creatine supplementation and exercise performance: recent findings. Sports medicine. Vol. 35. Num. 2. p.107-25. 2005.
-Bongers, C. C. W. G.; Alsady, M.; Nijenhuis, T.; Tulp, A. D. M.; Eijsvogels, T. M. H.; Deen, P. M. T.; Hopman, M. T. E. Impact of acute versus prolonged exercise and dehydration on kidney function and injury. Physiological reports. Vol. 6. Num. 11. p.e13734. 2018.
-Butts, J.; Jacobs, B.; Silvis, M. Creatine Use in Sports. Sports Health: A Multidisciplinary Approach. Vol. 10. Num. 1. p.31-34. 2018.
-Cadegiani, F. A.; Kater, C. E. Basal Hormones and Biochemical Markers as Predictors of Overtraining Syndrome in Male Athletes: The EROS-BASAL Study. Journal of athletic training. Vol. 54. Num. 8. p.906-914. 2019.
-Cadegiani, F. A.; Kater, C. E.; Gazola, M. Clinical and biochemical characteristics of high-intensity functional training (HIFT) and overtraining syndrome: findings from the EROS study (The EROS-HIFT). Journal of sports sciences. Vol. 37. Num. 11. p.1296-1307. 2019.
-Chen, Y.-M.; Lin, C.-L.; Wei, L.; Hsu, Y.-J; Chen, K.-N.; Huang, C.-C.; Kao, C.-H. Sake Protein Supplementation Affects Exercise Performance and Biochemical Profiles in Power-Exercise-Trained Mice. Nutrients. Vol. 8. Num. 2. p.106. 2016.
-Choi, E.-J.; So, W.-Y.; Jeong, T. T. Effects of the CrossFit Exercise Data Analysis on Body Composition and Blood Profiles. Iranian journal of public health. Vol. 46. Num. 9. p.1292-1294. 2017.
-Edmunds, J. W.; Jayapalan, S.; DiMarco, N. M.; Saboorian, H.; Aukema, H. M. J. W. Creatine Supplementation Increases Renal Disease Progression in Han:SPRD-cy Rats. American Journal of Kidney Diseases. Vol. 37. Num. 1. p.73-78. 2001.
-Feigenbaum, J.; Hoffman, R.; Hunt, K. Dietary creatine supplements raise serum creatinine mimicking acute kidney injury. Starting Strength. 2017.
-Glassman, G. CrossFit Forging Elite Fitness. CrossFit Journal. 2002. Disponível em: <https://journal.crossfit.com/article/foundations-classics>.
-Guyton, A. C.; Hall, J. E. Tratado de Fisiologia Médica. Elsevier. 11ª edição. 2006.
-Hameed, M.; Sahu, A.; Johnson, M. B. Muscle mania: the quest for the perfect body. BMJ case reports, Vol. 2016. 2016.
-Helms, E. R.; Aragon, A. A.; Fitschen. P.J. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. Journal of the International Society of Sports Nutrition. Vol. 11. p.20. 2014.
-Hopkins, B. S.; Li, D.; Svet, M.; Kesavabhotla, K.; Dahdaleh, N. S.; CrossFit and rhabdomyolysis: A case series of 11 patients presenting at a single academic institution. Journal of science and medicine in sport. Vol. 22. Num. 7. p.758-762. 2019.
-Huidobro E., J. P.; Tagle, R.; Guzmán, A. M. Estimation of glomerular filtration rate with creatinine [in spanish]. Revista médica de Chile. Vol. 146. Num. 3. p.344-350. 2018.
-Jacob, N.; Novaes, J. S.; Behm, D. G.; Vieira, J. G.; Dias, M. R.; Vianna, J. M. Characterization of Hormonal, Metabolic, and Inflammatory Responses in CrossFit® Training: A Systematic Review. Frontiers in physiology. Vol. 11. p.1001. 2020.
-Kreider, R. B.; Kalman, D. S.; Antonio, J.; Ziegenfuss, T. N.; Wildman, R.; Collins, R.; Candow, D. G.; Kleiner, S. M.; Almada, A. L.; Lopez, H. L. 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. Vol. 14. Num. 1. p.18. 2017.
-Laboratório Biomédico. Ureia urinária (Urinary urea). Disponível em: <https://www.labbiomedico.com.br/copia-copia-17>.
-Lima, C.; Macedo, E. Urinary Biochemistry in the Diagnosis of Acute Kidney Injury. Disease markers. Vol. 2018. p.4907024. 2018.
-Martin, W. F.; Armstrong, L. E.; Rodriguez. N. R. Dietary protein intake and renal function. Nutrition & metabolism. Vol. 2. p.25. 2005.
-Melo Neto, O. P.; Carvalho, A. S.; Nicolau, L. S.; Costa, A. C.; Dias, G. P. S. Análise da proteinúria após exercício físico intenso (Analysis of proteinuria after intense physical exercise). Revista Brasileira de Análises Clínicas. Vol. 49. Num. 3. 2017.
-Poortmans, J. R.; Francaux, M. Adverse effects of creatine supplementation: fact or fiction? Sports medicine. Vol. 30. Num. 3. p.155-70. 2000.
-Rocha, L. P.; Pereira, M. V. L. Consumo de suplementos nutricionais por praticantes de exercícios físicos em academias (Use of nutritional supplements by subjects enrolled in physical fitness programs). Revista de Nutrição. Vol. 11. Num. 1. p.76-82. 1998.
-Rogero, M. M.; Mendes, R. R.; Tirapegui, J. Neuroendocrine and nutritional aspects of overtraining [in portuguese]. Arquivos Brasileiros de Endocrinologia & Metabologia. Vol. 49. Num. 3. p.359-368. 2005.
-Souza e Silva, A.; Pertille, A.; Reis Barbosa, C. G.; Aparecida de Oliveira Silva, J.; de Jesus, D. V.; Ribeiro, A. G. S. V.; Baganha, R. J.; Oliveira, J. J. Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis. Journal of Renal Nutrition. Vol. 29. Num. 6. p.480-489. 2019.
-Siqueira, L. O.; Muccini, T.; Dall Agnol, I.; Filla, L.; Tibbola, P.; Luvison, A.; Costa, L.; Moreira, J. C. F. Análise de parâmetros bioquímicos séricos e urinários em atletas de meia maratona. Arquivos Brasileiros de Endocrinologia & Metabologia. Vol. 53. Num. 7. p.844-852. 2009.
-Szeles, P. R. Q.; Costa, T. S. da; Cunha, R. A. da; Hespanhol, L.; Pochini, A. C.; Ramos, L. A.; Cohen, M. CrossFit and the Epidemiology of Musculoskeletal Injuries: A Prospective 12-Week Cohort Study. Orthopaedic Journal of Sports Medicine. Vol. 8. Num. 3. p.232596712090888. 2020.
-Timón, R.; Olcina, G.; Camacho-Cardeñosa, M.; Camacho-Cardenosa, A.; Martinez-Guardado, I.; Marcos-Serrano, M. 48-hour recovery of biochemical parameters and physical performance after two modalities of CrossFit workouts. Biology of sport. Vol. 36. Num. 3. p.283-289. 2019.
-Vega, J.; Huidobro E.; J. P. Efectos en la función renal de la suplementación de creatina con fines deportivos. Revista médica de Chile. Vol. 147. Num. 5. p.628-633. 2019.
-Wang, C.-C.; Fang, C.-C.; Lee, Y.-H.; Yang, M.-T.; Chan, K.-H. Effects of 4-Week Creatine Supplementation Combined with Complex Training on Muscle Damage and Sport Performance. Nutrients. Vol. 10. Num. 11. p.1640. 2018.
-West, D.; Abou Sawan, S.; Mazzulla, M.; Williamson, E.; Moore, D. Whey Protein Supplementation Enhances Whole Body Protein Metabolism and Performance Recovery after Resistance Exercise: A Double-Blind Crossover Study. Nutrients. Vol. 9. Num. 7. p.735. 2017.
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