Background: Despite creatine is well-known to increase performance in acute high intensity exercises, its role in aerobic performance based on VO2max is more controversial. Objectives:To perform a systematic review and meta-analysis on the effects of creatine supplementation on VO2max.Method: PubMed, Cochrane, Embase and ScienceDirect were searched for randomized controlled trials (RCTs) reporting VO2max in both a creatine supplementation and placebo group, after and before supplementation. We computed random-effects meta-analysis on VO2max at baseline, within groups following supplementation, on changes in VO2max between groups, as well after supplementation between groups. Sensitivity analyses were conducted after exclusion of studies outside funnel plots and on young and healthy individuals.Metaregressions were computed to search for influential factors of VO2max. Results:We included 19 RCTs for a total of 424 individuals (mean age 30 years old, 82% men).VO2max did not differ at baseline between groups (creatine and placebo). Both groups had a training in most studies (80%). Using changes in VO2max, VO2max increased in both groups but increased less after creatine than placebo (effect size -0.32, CI95% -0.51 to -0.12).Comparisons after supplementation confirmed a lower VO2max in the creatine group compared to the placebo group (-0.20, -0.39 to -0.001). Meta-analysis after exclusion from meta-funnel gave similar results, as well as in a subgroup of young and healthy participants. Metaregressions on characteristics of supplementation, physical training, or sociodemographic were not significant. Conclusion:Creatine supplementation has negative effect on VO2max, regardless of the characteristics of training, supplementation, or population characteristics.
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