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The mean creatine intake of 0.83 g per day for pregnant women is ∼11% above the estimated dietary creatine requirements. However, approximately 6 out of 10 pregnant women (57.2%) consumed creatine below the recommended amounts for an adult female, suggesting a possible risk of creatine malnutrition in this population.

The average daily intake of creatine across the entire sample was 0.70 ± 0.78 g (95% confidence interval [CI], from 0.69 to 0.71) and 13.1 ± 16.5 mg/kg body weight (95% CI, from 13.0 to 13.2). A significant negative trend for dietary creatine intake was found in infants (r = − 0.019; P = 0.042), and children and adolescents (r = − 0.024; P < 0.001).

Nonhuman milk, infant formulas, and other milk products were a source of creatine in 438 out of 597 children (73.4%), and creatine-containing meat-based foods were consumed by 205 children (34.3%). A total of 149 children (24.9%) were exclusively fed with breast milk (number of breastfeeding sessions 1–31 per day). The mean dietary intake of creatine across the sample was 0.28 ± 0.24 g/day (95% confidence interval, from 0.25 to 0.30).

The average intake of creatine in the U.S. population is 1.38 g/d. Of the studied population, 42.8% have an average intake below the recommended levels of 1 g/d of dietary creatine, indicating widespread creatine malnutrition in the U.S. population.

After salmon intake, serum concentrations of 1-MeHis and creatine, and urine concentrations (relative to creatinine) of 1-MeHis and creatine were increased when compared to control group.

The branched-chain amino acids, creatine, lysine, 2-aminobutyrate, glutamine, glycine, trimethylamine, and 1 unidentified metabolite were among the most important metabolites in the discriminating patterns in relation to intake of both meat and other animal products.

Previous risk assessments (AESAN, 2012; EFSA, 2004; SCF, 2000; VKM, 2010) all concluded
that creatine supplementation with 3.0 g/day is unlikely to cause adverse health effects in
adults. This is supported by human and animal data obtained in a literature search and
assessed in the present report.

Metabolite super-pathways affected by meat consumption were primarily amino acids, in particular creatine, trans-4-hydroxyproline and pyroglutamine. We report a novel association between reported red meat intake and trans-4-hydroxyproline, an amino acid that forms part of the collagen structure with elevated levels observed following gelatin consumption. We also identified a unique association between reported intakes of red meat and poultry and circulating creatine levels, of which red meat is the major source and vegetarians have lower blood levels.

Creatine can be identified in a variety of biological samples, such as urine, plasma, or cerebrospinal fluid. Several reference ranges for Cr have been established by different authors, and all agreed with the fact that plasma Cr is age dependent, decreasing its concentration with age.