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Br J Nutr. 2018 Apr;119(7):759-770. doi: 10.1017/S000711451800017X.

Changing to a vegetarian diet reduces the body creatine pool in omnivorous women, but appears not to affect carnitine and carnosine homeostasis: a randomised trial.

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1Department of Movement and Sports Sciences,Ghent University,9000 Ghent,Belgium.
2Department of Clinical Chemistry,Ghent University Hospital,9000 Ghent,Belgium.
3Department of Internal Medicine,Ghent University,9000 Ghent,Belgium.
4Laboratory of Pharmaceutical Technology,Ghent University,9000 Ghent,Belgium.
5Department of Public Health,Ghent University,9000 Ghent,Belgium.
6School of Life Sciences,Medical Research Council (MRC)/Arthritis Research UK Centre for Musculoskeletal Ageing Research,Queen's Medical Centre,University of Nottingham Medical School,NottinghamNG7 2UH,UK.


Balanced vegetarian diets are popular, although they are nearly absent in creatine and carnosine and contain considerably less carnitine than non-vegetarian diets. Few longitudinal intervention studies investigating the effect of a vegetarian diet on the availability of these compounds currently exist. We aimed to investigate the effect of transiently switching omnivores onto a vegetarian diet for 6 months on muscle and plasma creatine, carnitine and carnosine homeostasis. In a 6-month intervention, forty omnivorous women were ascribed to three groups: continued omnivorous diet (control, n 10), vegetarian diet without supplementation (Veg+Pla, n 15) and vegetarian diet combined with daily β-alanine (0·8-0·4 g/d) and creatine supplementation (1 g creatine monohydrate/d) (Veg+Suppl, n 15). Before (0 months; 0M), after 3 months (3M) and 6 months (6M), a fasted venous blood sample and 24-h urine was collected, and muscle carnosine content was determined by proton magnetic resonance spectroscopy (1H-MRS). Muscle biopsies were obtained at 0M and 3M. Plasma creatine and muscle total creatine content declined from 0M to 3M in Veg+Pla (P=0·013 and P=0·009, respectively), whereas plasma creatine increased from 0M in Veg+Suppl (P=0·004). None of the carnitine-related compounds in plasma or muscle showed a significant time×group interaction effect. 1H-MRS-determined muscle carnosine content was unchanged over 6M in control and Veg+Pla, but increased in Veg+Suppl in soleus (P<0·001) and gastrocnemius (P=0·001) muscle. To conclude, the body creatine pool declined over a 3-month vegetarian diet in omnivorous women, which was ameliorated when accompanied by low-dose dietary creatine supplementation. Carnitine and carnosine homeostasis was unaffected by a 3- or 6-month vegetarian diet, respectively.



β-Alanine; 0M 0 months (baseline); 3M 3 months; 6M 6 months; TTE time to exhaustion; VDBP vitamin-D-binding protein; Veg+Pla vegetarian diet without supplementation; Veg+Suppl vegetarian diet with supplemental creatine and β-alanine; Homeostasis; Lacto-ovo-vegetarians; Supplements

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