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. 2025 Jul 25:12:1586569.
doi: 10.3389/fnut.2025.1586569. eCollection 2025.

Association of dietary creatine intake from meat protein sources with different types of intestinal problems: insights from NHANES 2005-2010

Baohua Zheng #  1 , Zhicheng Huang #  1 , Zhiwei Wang  1 , Junhao Du  2 , Junhui Jiang  3 , Chunhong Xiao  1 , Yu Wang  1
Affiliations

Association of dietary creatine intake from meat protein sources with different types of intestinal problems: insights from NHANES 2005-2010

Baohua Zheng et al. Front Nutr. .

Abstract

Background: Given the growing interest in gut health, particularly in the context of irritable bowel syndrome (IBS), this study investigates the potential effects of dietary creatine intake on measures of gut health. Additionally, in response to anecdotal reports on the internet that have not been corroborated by clinical trials, this research examines the relationship between creatine consumption and gastrointestinal outcomes, aiming to address the existing knowledge gap in this area.

Methods: This study utilized data from the 2005-2010 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression and subgroup analyses were conducted to examine the association between dietary creatine intake and the risk of diarrhea and constipation. Additionally, restricted cubic spline (RCS) analysis was employed to assess potential nonlinear relationships.

Results: In the fully adjusted model, each one-unit increase in the log-transformed 2-day average dietary creatine intake-equivalent to a tenfold increase in absolute intake-was associated with a 19% lower risk of chronic constipation (adjusted OR = 0.81, 95% CI: 0.65-0.96, p = 0.015). However, no significant association was found between dietary creatine intake and chronic diarrhea (adjusted OR = 1.04, 95% CI: 0.87-1.36, p = 0.421). The protective effect of higher dietary creatine intake against chronic constipation was more pronounced in males (adjusted OR = 0.77, 95% CI: 0.66-0.89, p < 0.001), younger individuals (adjusted OR = 0.89, 95% CI: 0.79 ∼ 0.99, p = 0.047)), and participants without cardiovascular disease (adjusted OR = 0.91, 95% CI: 0.83 ∼ 0.99, p = 0.047). RCS analysis confirmed a linear relationship between 2-day average dietary creatine intake and the risk of chronic constipation after adjusting for confounding variables.

Conclusion: Higher dietary creatine intake may offer protective benefits against chronic constipation, particularly in specific subgroups, while showing no significant association with chronic diarrhea. Further large-scale studies are warranted to clarify creatine's role in gastrointestinal health. These findings highlight the potential of creatine as a dietary factor in promoting gut health.

Keywords: NHANES; constipation; creatine; diarrhea; gut health; nutrition.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Flowchart depicting participant exclusion criteria from NHANES 2005-2010. Starting with 31,034 participants, exclusions occur for missing bowel habits (16,443), dietary creatine intake (1,784), education, PIR, BMI, hypertension, diabetes, smoking, and drinking data (1,041 total), physical activity information (998), and cardiovascular disease data (47). Final included participants total 10,721.
FIGURE 1
Flowchart of study participant inclusion and exclusion criteria.
Two histograms compare the 2-day average dietary creatine intake. Chart A shows a right-skewed distribution, with density peaking near zero and tapering off. Chart B shows a normal distribution centered around zero, with symmetrical tapering. Both charts have axes labeled for density and creatine intake.
FIGURE 2
Normality test of 2-day average dietary creatine intake. (A) Original distribution of 2-day average dietary creatine intake. (B) Logarithmically transformed 2-day average dietary creatine intake.
Heatmaps display odds ratios for bowel habits and dietary creatine intake across four models (A: chronic constipation and diarrhea; B and C: log two-day average dietary creatine intake groups). Colors range from light (higher odds) to dark (lower odds), with significant values marked by asterisks.
FIGURE 3
Heat map of the correlation between 2-day average dietary creatine intake and different types of intestinal problems. (A) OR values of continuous variables between 2-day average dietary creatine intake and different types of intestinal problems. (B) Quantile model of 2-day average dietary creatine intake and chronic constipation. (C) Quantile model of 2-day average dietary creatine intake and chronic diarrhea. *p < 0.05, **p < 0.01, ***p < 0.001.
Forest plot displaying odds ratios (OR) with 95% confidence intervals (CI) for various health and demographic variables related to an outcome. Variables include sex, age, BMI, hypertension, diabetes, smoking, drinking, physical activity, and cardiovascular disease. Results show the OR, confidence intervals, and p-values for interaction, with green squares indicating OR and blue lines representing CIs. Values are compared against a reference line at 1 indicating no effect. Significant associations are highlighted by deviation of the confidence intervals from one.
FIGURE 4
Subgroup analysis of the relationship between 2-day average dietary creatine intake and the risk of chronic constipation.
Forest plot showing odds ratios (OR) with 95% confidence intervals for various variables: sex, age, BMI, hypertension, diabetes, smoking, drinking, physical activity, and cardiovascular disease. Each line represents a variable with its corresponding OR. Variables are compared, showing statistical significance with p-values for interaction on the right. Most p-values indicate no significant interaction.
FIGURE 5
Subgroup analysis of the relationship between 2-day average dietary creatine intake and the risk of chronic diarrhea.
Four line graphs display the relationship between log base 2 of average dietary creatine intake and outcome prediction incidence. Each graph includes a blue trend line with shaded confidence intervals. Graph A shows significant negative correlation (p for overall < 0.001, p for nonlinear = 0.571), Graph B also shows significant negative correlation (p for overall < 0.001, p for nonlinear = 0.532). Graph C and D display weaker, non-significant correlations with respective p values (Graph C: p for overall = 0.343, p for nonlinear = 0.338; Graph D: p for overall = 0.510, p for nonlinear = 0.333).
FIGURE 6
RCS analysis between 2-day average dietary creatine intake and different intestinal health problems. (A) Chronic constipation without adjustment; (B) chronic diarrhea without adjustment; (C) chronic constipation with adjustment; (D) chronic diarrhea with adjustment.
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