Creatine for Cardio: Does It Boost Endurance?

meta-analysis PMID: 34859731

Quick Summary: Research suggests that taking creatine can improve your VO2 max, a measure of how well your body uses oxygen during exercise. This means creatine might help you perform better during cardio activities, especially if you're already in good shape.

Does Creatine Improve Cardio Performance?

Yes, research indicates that creatine can help improve your VO2 max. VO2 max is a key indicator of aerobic fitness, meaning how efficiently your body uses oxygen during exercise. This study found that creatine supplementation, especially when combined with exercise, led to a noticeable improvement in VO2 max.

Study Details

Who was studied: The study looked at the results of 36 different studies, including a total of 625 people. Some were already trained athletes, while others were less active.

How long: The studies varied, but some lasted longer than 8 weeks.

What they took: Most people took creatine in a "loading phase" (a higher dose for a short time) followed by a lower daily dose. The doses varied slightly between studies.

What This Means For You

Better Workouts: If you're looking to improve your cardio, like running, swimming, or cycling, creatine might give you an extra boost.

More Effective Training: Combining creatine with your regular exercise routine could help you see better results, especially if you're already in decent shape.

Long-Term Benefits: The research suggests that longer-term creatine use (over 8 weeks) may lead to even greater improvements.

Study Limitations

Different Doses: The amount of creatine people took varied across the studies.

Varied Training: The types of exercise programs used were different, making it hard to compare results directly.

More Research Needed: While promising, more research is needed to understand the best way to use creatine for endurance and its long-term effects.

Individual Results May Vary: Not everyone will experience the same benefits.

Key Findings

This 2023 meta-analysis found that creatine supplementation significantly improves VO2 max (maximal oxygen uptake), a key marker of aerobic performance, particularly when combined with exercise training. The standardized mean difference (SMD) was 0.34 (p=0.001), indicating a moderate effect. Subgroup analysis revealed greater efficacy in trained individuals (SMD=0.45, p<0.001) and protocols lasting >8 weeks (SMD=0.41, p=0.003).

Study Design

A systematic review and meta-analysis of 36 randomized controlled trials (RCTs) involving 625 participants. Studies were sourced from PubMed, with inclusion criteria requiring creatine supplementation, VO2 max measurement, and adult populations. Methodological quality was assessed using Cochrane Risk of Bias tools. Duration and exercise protocols varied across trials.

Dosage & Administration

Most studies used a standard creatine loading phase (20g/day for 5–7 days) followed by maintenance (3–10g/day). Some trials employed lower doses (e.g., 3–5g/day without loading). Supplementation was typically administered alongside resistance or aerobic training programs, with timing (pre/post-exercise) and co-ingestion with carbohydrates or protein noted in select trials.

Results & Efficacy

Creatine increased VO2 max compared to placebo (SMD=0.34, 95% CI: 0.18–0.50, p=0.001). Trained individuals showed larger improvements (SMD=0.45, p<0.001) versus untrained (SMD=0.22, p=0.04). Long-term supplementation (>8 weeks) yielded stronger effects (SMD=0.41, p=0.003). Heterogeneity was moderate (I²=42%), with no significant publication bias detected.

Limitations

Heterogeneity in dosing regimens, participant demographics (age, sex, fitness level), and exercise protocols limited generalizability. Most trials included small sample sizes (<30 participants per group), potentially reducing statistical power. The meta-analysis could not isolate the independent effect of creatine from concurrent training. Long-term safety (>12 weeks) and optimal dosing for endurance-specific outcomes require further study.

Clinical Relevance

Creatine may enhance aerobic capacity in both trained athletes and sedentary individuals, though effects are more pronounced in trained populations. Users aiming to improve VO2 max should consider combining creatine with structured aerobic or resistance training for 8+ weeks. While safe short-term, individual responses may vary. Athletes should consult healthcare providers to tailor protocols and monitor outcomes. Future research should explore dose-response relationships in endurance-focused cohorts.

Note: This analysis is limited to the study’s reported data; full access to individual trials may reveal additional nuances.