Dietary creatine intake and mental health among the Korean population

Several population-based studies suggest that dietary creatine may benefit depression and cognitive function, but no research has examined overall mental health in a non-U.S. population or included adolescents. This cross-sectional study investigated the relationship between daily creatine consumption and mental health indicators using data from the 2022 Korean National Health and Nutrition Examination Survey (KNHANES). Data were analyzed from 5,257 individuals (56% female, mean age 51.1 ± 19.0 years) who provided dietary intake information and completed at least one mental health assessment. The mean daily creatine intake was 10.3 ± 9.5 mg/kg body mass (95% CI, 10.0 -10.5). One-way ANOVA showed significant differences in depression scores across quartiles of creatine intake (F = 4.003, p = 0.007), with higher depression scores in the lowest quartile compared to all others (p ≤ 0.05). The prevalence of depression was greatest among participants in the lowest quartile (6.9%) versus Q2 (3.3%), Q3 (4.3%), and Q4 (3.6%) (p≤0.05). Participants in the lowest quartile also reported higher rates of suicidal thoughts, plans, and attempts compared to those in higher quartiles (p ≤ 0.05). Higher creatine intake was associated with lower odds of generalized anxiety disorder after controlling for biomarkers of creatine turnover and demographic variables (p ≤ 0.05), but this relationship was not significant when lifestyle factors were included (p > 0.05). These findings suggest that higher dietary creatine intake may have modest protective effects against depression, suicidality, and anxiety. However, given the cross-sectional design, causality cannot be inferred, and further longitudinal and interventional studies are needed to confirm these associations and explore underlying mechanisms.