Science | Supplements
Creatine
Recent research underscores the diverse health benefits of creatine supplementation across various domains. Creatine supplementation combined with resistance training promotes muscle hypertrophy in both the upper and lower body (Nutrients. 2023). However, it is ineffective in enhancing endurance performance in trained individuals (Sports Med. 2023) and negatively affects VO2max (Crit Rev Food Sci Nutr. 2023). Creatine does not significantly enhance aerobic or phosphagen metabolism performance but shows beneficial effects on anaerobic performance in soccer players (Nutrients. 2019).
In terms of body composition, creatine supplementation combined with resistance exercise significantly increases fat-free mass and improves overall body composition in recreationally active men (Nutrients. 2019). It also leads to a small but significant reduction in body fat percentage among adults under 50 (Nutrients. 2023). Males respond more favorably to creatine supplementation combined with resistance training (Nutrition. 2022), and gains in lean tissue mass and strength are augmented irrespective of dosing strategy (Nutrients. 2021).
Regarding recovery, creatine supplementation significantly reduces creatine kinase concentration post-exercise (J Food Biochem. 2021) and attenuates creatine kinase activity post-exercise (Int J Sport Nutr Exerc Metab. 2021). Creatine has a paradoxical effect on muscle damage markers, reducing them as an acute training response but increasing them as a chronic training response (Sports Med. 2022).
Creatine also shows potential benefits for memory enhancement, particularly in older adults (Nutr Rev. 2023). However, evidence regarding its efficacy in improving glycemic control and insulin resistance in both healthy and diabetic individuals remains insufficient (Clin Nutr ESPEN. 2022). These findings collectively highlight the multifaceted benefits of creatine supplementation.
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Could creatine supplementation combined with physical rehabilitation accelerate return to play in athletes with patellar tendinopathy?
J Int Soc Sports Nutr. 2026 Dec 31;23(sup1):2718846.
Design: In a triple-blind trial, 20 athletes with patellar tendinopathy were randomized to creatine or placebo for 8 weeks while everyone followed the same rehab program.
Summary: Pain, tendon thickness, and strength improved with rehab in both creatine and placebo groups. Only creatine significantly reduced pain by week 4; jump height rose on creatine, but the supplement-by-time interaction was only a trend (p = 0.099).
Resistance Exercise and Creatine Supplementation on Fat Mass in Adults < 50 Years of Age: A Systematic Review and Meta-Analysis.
Nutrients. 2023 Oct 12;15(20):4343.
Design: Systematic review and meta-analysis of studies comparing resistance exercise with creatine supplementation to resistance exercise with placebo on fat mass and body fat percentage in adults under 50 years of age.
Summary: Creatine supplementation combined with resistance exercise led to a very small yet significant reduction in body fat percentage but did not significantly affect absolute fat mass.
Effects of Creatine Monohydrate on Endurance Performance in a Trained Population: A Systematic Review and Meta-analysis.
Sports Med. 2023 May;53(5):1017-1027.
Design: Systematic review and meta-analysis of controlled trials evaluating creatine monohydrate’s effects on endurance performance in trained individuals.
Summary: Creatine monohydrate supplementation was found to be ineffective in enhancing endurance performance in a trained population.
The Effects of Creatine Supplementation Combined with Resistance Training on Regional Measures of Muscle Hypertrophy: A Systematic Review with Meta-Analysis.
Nutrients. 2023 Apr 28;15(9):2116.
Design: Systematic review and meta-analysis of RCTs examining the combined effects of creatine supplementation and resistance training on muscle hypertrophy using direct imaging measures.
Summary: The combination of creatine supplementation and resistance training promoted a small increase in muscle hypertrophy in both the upper and lower body.
Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials.
Nutr Rev. 2023 Mar 10;81(4):416-427.
Design: Systematic review and meta-analysis of RCTs examining the effects of creatine supplementation on memory performance in healthy individuals.
Summary: Creatine supplementation improved memory measures, particularly in older adults, but showed no significant effect in younger individuals.
Creatine supplementation and VO(2)max: a systematic review and meta-analysis.
Crit Rev Food Sci Nutr. 2023;63(21):4855-4866.
Design: Systematic review and meta-analysis of RCTs evaluating the effects of creatine supplementation on VO2max.
Summary: Creatine supplementation had a negative effect on VO2max, with a smaller increase compared to the placebo group.
Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: A systematic review and meta-analysis of randomized clinical trials.
Nutrition. 2022 Nov-Dec;103-104:111791.
Design: Systematic review and meta-analysis of RCTs investigating the effects of creatine supplementation on lean body mass, with sub-analyses based on age, sex, and type of exercise.
Summary: Creatine supplementation combined with resistance training significantly increased lean body mass, with males responding more favorably than females.
The Paradoxical Effect of Creatine Monohydrate on Muscle Damage Markers: A Systematic Review and Meta-Analysis.
Sports Med. 2022 Jul;52(7):1623-1645.
Design: Systematic review and meta-analysis of studies examining the effects of creatine monohydrate on muscle damage markers and performance following muscle-damaging exercises.
Summary: Creatine monohydrate supplementation reduced muscle damage markers as an acute training response but increased them as a chronic training response.
Does creatine supplementation improve glycemic control and insulin resistance in healthy and diabetic patients? A systematic review and meta-analysis.
Clin Nutr ESPEN. 2022 Feb;47:128-134.
Design: Systematic review and meta-analysis of studies evaluating the effects of creatine supplementation on glycemic control and insulin resistance in healthy and diabetic individuals.
Summary: There was insufficient evidence to state that creatine positively affects diabetes parameters, suggesting the need for further studies with diabetic individuals.
Creatine supplementation effect on recovery following exercise-induced muscle damage: A systematic review and meta-analysis of randomized controlled trials.
J Food Biochem. 2021 Oct;45(10):e13916.
Design: Systematic review and meta-analysis of RCTs evaluating creatine’s effects on recovery following exercise-induced muscle damage.
Summary: Creatine supplementation significantly reduced creatine kinase concentration post-exercise but had no significant effect on lactate dehydrogenase concentration.
Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults.
Nutrients. 2021 Jun 2;13(6):1912.
Design: Meta-analysis of studies comparing creatine vs. placebo during resistance training programs, with sub-analyses examining different creatine dosing strategies.
Summary: Creatine (independent of dosing strategy) augmented gains in lean tissue mass and strength from resistance training, with specific dosing strategies showing varying levels of effectiveness.
The Effect of Creatine Supplementation on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention Trials.
Int J Sport Nutr Exerc Metab. 2021 May 1;31(3):276-291.
Design: Systematic review and meta-analysis of RCTs examining the effects of creatine supplementation on recovery from exercise-induced muscle damage.
Summary: Creatine supplementation did not significantly alter muscle strength, soreness, range of motion, or inflammation but attenuated creatine kinase activity at 48 hours post-exercise.
Effects of Creatine Supplementation on Athletic Performance in Soccer Players: A Systematic Review and Meta-Analysis.
Nutrients. 2019 Mar 31;11(4):757.
Design: Systematic review and meta-analysis of studies evaluating the efficacy of creatine supplementation for improving physical performance in soccer players.
Summary: Creatine supplementation did not significantly enhance aerobic or phosphagen metabolism performance but showed beneficial effects on anaerobic performance tests.
