Burke · Nutrients 2023 · systematic review and meta-analysis · n=10 studies

The Effects of Creatine Supplementation Combined with Resistance Training on Regional Measures of Muscle Hypertrophy: A Systematic Review with Meta-Analysis.

Cited 74 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of randomized controlled trials

PubMed 37432300 · doi:10.3390/nu15092116 · record verified 2026-08-29

What was done

Authors performed a systematic review and meta-analysis of randomized controlled trials lasting at least 6 weeks in healthy adults to evaluate the combined effects of resistance training and creatine supplementation versus resistance training with placebo on direct site-specific imaging measures of muscle hypertrophy (MRI, CT, or ultrasound).

What was found

Across 10 included studies evaluating 44 outcomes, univariate analysis showed a pooled mean estimate of 0.11 (95% Credible Interval [CrI]: -0.02 to 0.25) favoring creatine supplementation. Multivariate analyses demonstrated small additive benefits for upper and lower body muscle thickness of 0.10 to 0.16 cm. Moderation analysis showed a small superior benefit in younger versus older adults (0.17, 95% CrI: -0.09 to 0.45).

Why it matters

It demonstrates that creatine's additive hypertrophic effect when combined with resistance training is positive but very small when evaluated specifically with direct imaging modalities.

Limits

Only 10 studies met the inclusion criteria, and 95% credible intervals for both the overall pooled effect and the age moderation analysis crossed zero. Total participant count, creatine dosing protocols, and resistance training adherence were not reported in the abstract.

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