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The Effect of Creatine Supplementation on Resistance Training-Based Changes to Body Composition: A Systematic Review and Meta-analysis

PRISMA systematic review and random-effects meta-analysis (12 RCTs; adults <50 years) finding creatine plus resistance training versus resistance training alone increased lean body mass by 1.14 kg (95% CI 0.69–1.59) and reduced body fat percentage (−0.88%, CI −1.66 to −0.11) and fat mass (−0.73 kg, CI −1.34 to −0.11); carbohydrate co-ingestion did not significantly moderate hypertrophy in pooled subgroup framing.

Design

  • Registry: preregistered on Open Science Framework (osf.io/x48a6/)
  • Population: adults <50 years
  • Intervention: creatine + resistance training vs placebo + RT (or RT-only comparators per inclusion rules)
  • Primary outcome: lean body mass (LBM)
  • Secondary: body fat %, body fat mass (kg)
  • Included trials: 12 RCTs (1,694 records screened; 67 full texts assessed)

Pooled vs RT-alone (random effects; abstract-reported)

  • LBM: +1.14 kg (95% CI 0.69 to 1.59)
  • Body fat %: −0.88% (95% CI −1.66 to −0.11)
  • Fat mass: −0.73 kg (95% CI −1.34 to −0.11)

Moderators / subgroups (abstract)

  • Training status and carbohydrate co-ingestion subgroups: no significant differences in pooled framing reported in the abstract.
  • Meta-regression: total training volume not associated with effect sizes for these outcomes in the abstract-reported analysis.
  • Practical translation (authors): about 7 g/day or ~0.3 g/kg/day creatine is described as likely to add ~1 kg LBM and ~0.7 kg fat-mass reduction vs RT alone in this pooled set—always read forest plots for heterogeneity.

Risk-of-bias snapshot (abstract)

Roughly 52% low risk, 41% some concerns, 7% high risk across included studies—interpret confidence intervals accordingly.

Outcomes

  • Effect Size (Cohen's d / SMD)
    Creatine + RT vs RT alone: lean body mass +1.14 kg (95% CI 0.69–1.59; random-effects meta-analysis of 12 RCTs, adults <50 y).
  • Body Fat Mass
    Body fat percentage −0.88% (95% CI −1.66 to −0.11) vs RT alone.
  • Body Fat Mass
    Body fat mass −0.73 kg (95% CI −1.34 to −0.11) vs RT alone; carbohydrate co-ingestion subgroup did not significantly change pooled hypertrophy signals per abstract.
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