Resistance training combined with creatine supplementation: a three-level meta-analysis of multidimensional outcomes from strength enhancement to body composition remodeling
Abstract
Abstract Objective This study aimed to determine (1) the effects of resistance training combined with creatine supplementation on muscle strength (upper- and lower-body strength) and body composition (lean mass, fat mass, body-fat percentage, and body mass), and (2) whether these effects were moderated by participant characteristics (age, gender, and training experience) and intervention protocols (intervention duration, weekly frequency, dosing strategy, daily dose, and supplementation protocol). Methods We conducted a systematic search of PubMed, Web of Science, Cochrane Library, Embase, and EBSCO from database inception through April 21 2025, and performed backward citation tracking to identify additional relevant trials. Hedge's g (g) served as the summary effect size for each outcome. Meta-analysis was performed using a three-level random-effects model in the metafor package (R). Potential moderators were explored via subgroup analyses and meta-regression. Results Sixty-three studies (n = 1489) were included. Compared with resistance training alone (RT), resistance training plus creatine (RT + CR) produced significant increases in upper-body strength (g = 0.54, p < 0.001), lower-body strength (g = 0.55, p < 0.001), lean mass (g = 0.30, p < 0.001), and body mass (g = 0.12, p = 0.04), and a significant reduction in body-fat percentage (g = −0.14, p = 0.02). No significant difference emerged for fat mass (g = −0.10, p = 0.14). Exploratory subgroup analyses suggested that…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,489 participants or records.
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