Buford et al. 2007: ISSN Position Stand on Creatine Supplementation and Exercise

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TL;DR — Buford et al. 2007

The International Society of Sports Nutrition (ISSN) published its first official position stand on creatine in 2007, authored by Buford, Kreider, Stout, and colleagues. The statement declared creatine monohydrate the most effective ergogenic nutritional supplement currently available for increasing high-intensity exercise capacity and lean body mass (TW et al., 2007) . This position stand became the authoritative reference point for creatine research and recommendations for the following decade.

5-15%
improvement in maximal power and strength with creatine supplementation
Buford et al., JISSN, 2007

Study Background and Rationale

By 2007, creatine monohydrate had been studied for over 15 years since the landmark Harris et al. (1992) paper (RC et al., 1992) . Hundreds of peer-reviewed studies had accumulated, along with meta-analyses like Branch (2003) that quantified creatine’s effects (JD, 2003) . Despite this robust evidence base, confusion persisted among athletes, coaches, and the general public about creatine’s safety, optimal dosing, and who should use it.

The ISSN — a leading international scientific organization focused on sport nutrition — convened a panel of experts to review the totality of evidence and issue a definitive position statement. The paper was published in the Journal of the International Society of Sports Nutrition.

The Nine Key Positions

The ISSN outlined nine specific positions on creatine supplementation:

Position 1: Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity and lean body mass during training.

Position 2: Creatine monohydrate supplementation is not only safe, but has been reported to have a number of therapeutic benefits in healthy and diseased populations ranging from infants to the elderly.

Position 3: There is no scientific evidence that the short- or long-term use of creatine monohydrate has any detrimental effects on otherwise healthy individuals.

9
official positions established by the ISSN on creatine safety and efficacy
Buford et al., 2007

Position 4: If proper precautions and supervision are provided, supplementation in young athletes is acceptable and may provide a nutritional alternative to potentially dangerous anabolic drugs.

Position 5: The only clinically significant side effect reported from creatine supplementation is weight gain (from lean mass and water retention).

Position 6: The quickest method of increasing muscle creatine stores is to consume approximately 0.3 g/kg/day of creatine monohydrate for 5 to 7 days (loading phase), followed by 3 to 5 g/day for maintenance.

Position 7: Ingesting creatine with carbohydrate or carbohydrate and protein can enhance creatine retention.

Position 8: Creatine monohydrate is the most extensively studied and clinically effective form of creatine for use in nutritional supplements.

Position 9: Creatine monohydrate supplementation is not a banned substance.

Performance Benefits Quantified

The position stand summarized the quantitative evidence for creatine’s ergogenic effects:

  • Maximal power/strength: 5-15% improvement
  • Work during maximal effort sets: 5-15% improvement
  • Single-effort sprint performance: 1-5% improvement
  • Repeated sprint performance: 5-15% improvement

These numbers represented the pooled findings from hundreds of studies across different populations, training levels, and exercise modalities.

1-5%
improvement in single sprint performance with creatine
Buford et al., JISSN, 2007

Safety Assessment

The safety section of the position stand was particularly significant. After reviewing all available evidence, the expert panel concluded:

  • No evidence of kidney damage in healthy individuals
  • No evidence of liver dysfunction
  • No increased risk of muscle cramping or dehydration (in fact, evidence suggested the opposite)
  • The only consistent “side effect” was weight gain — which is generally the desired outcome
  • Long-term studies of up to 5 years showed no adverse health effects

This definitive safety statement was important because persistent myths about creatine causing kidney damage and dehydration were widespread at the time.

The position stand provided clear dosing guidelines that remain relevant today:

Loading phase (optional but fastest):

  • 0.3 g/kg/day for 5 to 7 days
  • For a 70 kg individual, this equates to approximately 21 g/day, split into 4 doses of roughly 5 g

Maintenance phase:

  • 3 to 5 g/day indefinitely
  • No need for cycling on and off

Absorption enhancement:

  • Take with carbohydrates (approximately 50 to 100 g) to boost insulin-mediated uptake
  • Protein combined with carbohydrate may further enhance retention

Malaysian Context

For Malaysian athletes and gym-goers, the Buford 2007 position stand provides several important reassurances. First, creatine is explicitly not a banned substance — this matters for competitive athletes in Malaysia who are subject to anti-doping testing by ADAMAS (Anti-Doping Agency of Malaysia). Second, the dosing guidelines are straightforward and applicable regardless of geographic location. A 70 kg Malaysian adult would follow the same 3-5 g/day maintenance dose recommended for anyone globally.

The position stand’s endorsement of creatine monohydrate as the most effective form is also practically useful: it means that the affordable creatine monohydrate powder available on Shopee and Lazada is just as effective as more expensive proprietary forms.

Limitations

While the position stand was comprehensive, some limitations should be noted:

  • Publication era: The paper was limited to evidence available through 2007, missing a decade of subsequent research
  • Population gaps: Limited data was available for elderly, clinical, and female populations at the time
  • Cognitive effects not emphasized: The brain health benefits of creatine were not yet well-established in 2007
  • Newer forms not fully evaluated: Alternative creatine forms (HCl, Kre-Alkalyn, etc.) had minimal evidence at the time

These gaps were addressed in the updated 2017 ISSN position stand by Kreider et al. (RB et al., 2017) .

Practical Implications

  1. Creatine monohydrate is the gold standard: Do not be swayed by marketing for newer, more expensive forms
  2. It is safe for healthy individuals: Decades of research confirm no adverse effects at recommended doses
  3. It is not banned in any sport: Malaysian athletes can use creatine without concern about doping violations
  4. Start with 3-5 g/day: Loading is optional but speeds up the process
  5. Take with a meal: Carbohydrates and protein enhance absorption

Full Citation

Buford TW, Kreider RB, Stout JR, et al. International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition. 2007;4:6. doi:10.1186/1550-2783-4-6

Sources & References

This article is based on the ISSN position stand published in JISSN (2007) and contextualized with findings from Harris et al. (1992), Branch (2003), and the updated 2017 ISSN position stand by Kreider et al. All citations link to PubMed-indexed publications.

Further Reading

Frequently Asked Questions

What did the 2007 ISSN position stand conclude about creatine?

The 2007 ISSN position stand concluded that creatine monohydrate is the most effective ergogenic nutritional supplement available for increasing high-intensity exercise capacity and lean body mass. It affirmed creatine's safety for healthy individuals and confirmed it is not a banned substance.

How much strength improvement does creatine provide according to Buford 2007?

According to the 2007 ISSN position stand, short-term creatine supplementation improves maximal power and strength by 5-15%, work performed during sets of maximal effort contractions by 5-15%, and single-effort sprint performance by 1-5%.

Is creatine a banned substance according to the ISSN?

No. The 2007 ISSN position stand explicitly stated that creatine supplementation is not a banned substance and is not considered doping. It is legal and permitted by all major sports organizations including the International Olympic Committee.

What is the difference between the 2007 and 2017 ISSN position stands on creatine?

The 2017 update by Kreider et al. expanded on the 2007 stand by incorporating an additional decade of research, including evidence for creatine's benefits beyond exercise (brain health, clinical populations). The core safety and efficacy conclusions remained consistent.