Resistance training combined with creatine supplementation: a three-level meta-analysis of multidimensional outcomes from strength enhancement to body composition remodeling
Study Details
This three-level meta-analysis included 63 randomised trials and 1,489 adults, examining whether creatine supplementation enhances strength and body-composition adaptations to resistance training 🔍
Here are the key findings ⬇️
Key Findings
💪 Creatine produced a moderate additional improvement in upper-body strength versus resistance training alone (g = 0.54)
🦵 Lower-body strength also improved by a moderate amount (g = 0.55) after removal of one influential outlier
📈 Lean mass increased significantly more with creatine (g = 0.30), representing a small-to-moderate additional benefit
⚖️ Total body mass increased slightly (g = 0.12), consistent with the additional gain in lean mass
🔥 Absolute fat mass was not significantly changed by creatine (g = −0.10)
📉 Body-fat % decreased slightly (g = −0.14), likely because lean mass increased while fat mass remained relatively stable
💧 Some early creatine-associated weight gain will reflect increased intracellular water, but the available studies could not separate water from longer-term tissue accretion
👥 Strength benefits were evident across athletes, resistance-trained and previously untrained participants, with no clear difference according to training status
🙅♀️ There was also no statistically significant evidence that responses differed between men and women, although women were underrepresented
🧐 Exploratory analyses suggested larger strength effects in younger participants, but this age effect should be treated cautiously because age groups were unevenly represented
🥄 Creatine dose, fixed versus weight-based dosing, loading strategy, training frequency and intervention duration did not consistently modify the benefits
📊 Evidence certainty across outcomes was rated low to moderate
⚠️ Publication bias may have inflated the raw strength effects slightly, but adjusted analyses still showed significant benefits
Conclusion
The primary body-composition effect of creatine is therefore more lean mass rather than less fat 🏋️
Adding creatine monohydrate to a well-designed resistance-training programme reliably improves strength and lean-mass gains, and these benefits do not appear to require complex loading or high-dose protocols ✅
Reference
https://pubmed.ncbi.nlm.nih.gov/42765482/
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