Acute Effect of Citrulline Malate on Repetition Performance During Strength Training: A Systematic Review and Meta-Analysis

Int J Sport Nutr Exerc Metab. 2021 Jul 1;31(4):350-358. doi: 10.1123/ijsnem.2020-0295. Epub 2021 May 19.

Abstract

Citrulline malate (CitMal) is a dietary supplement that is suggested to enhance strength training performance. However, there is conflicting evidence on this matter. Thus, the purpose of this meta-analysis was to determine whether supplementing with CitMal prior to strength training could increase the total number of repetitions performed before reaching voluntary muscular failure. A systematic search was conducted wherein the inclusion criteria were double-blind, placebo-controlled studies in healthy participants that examined the effect of CitMal on repetitions to failure during upper body and lower body resistance exercises. The Hedges's g standardized mean differences (SMD) between the placebo and CitMal trials were calculated and used in a random effect model. Two separate subanalyses were performed for upper body and lower body exercises. Eight studies, including 137 participants who consisted of strength-trained men (n = 101) and women (n = 26) in addition to untrained men (n = 9), fulfilled the inclusion criteria. Across the studies, 14 single-joint and multijoint exercises were performed with an average of 51 ± 23 total repetitions during 5 ± 3 sets per exercise at ∼70% of one-repetition maximum. Supplementing with 6-8 g of CitMal 40-60 min before exercise increased repetitions by 3 ± 5 (6.4 ± 7.9%) compared with placebo (p = .022) with a small SMD (0.196). The subanalysis for the lower body resulted in a tendency for an effect of the supplement (8.1 ± 8.4%, SMD: 0.27, p = .051) with no significant effect for the upper body (5.7 ± 8.4%, SMD: 0.16, p = .131). The current analysis observed a small ergogenic effect of CitMal compared with placebo. Acute CitMal supplementation may, therefore, delay fatigue and enhance muscle endurance during high-intensity strength training.

Keywords: L-citrulline; ergogenic aid; sports supplementation.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Bias
  • Citrulline / administration & dosage
  • Citrulline / analogs & derivatives*
  • Citrulline / pharmacology
  • Double-Blind Method
  • Female
  • Humans
  • Malates / administration & dosage
  • Malates / pharmacology*
  • Male
  • Performance-Enhancing Substances / pharmacology*
  • Physical Endurance / drug effects*
  • Physical Endurance / physiology
  • Physical Functional Performance*
  • Randomized Controlled Trials as Topic
  • Resistance Training / methods*
  • Time Factors
  • Young Adult

Substances

  • Malates
  • Performance-Enhancing Substances
  • Citrulline
  • citrulline malate