Tier 1 — highest

Effects of Citrulline Malate Supplementation on Exercise Performance: A Systematic Review and Three-Level Meta-Analysis

Xuexiang Wang, Xiaohan Fan, Jindong Chang, Hansen Li, Xing Zhang, Yilin Zhang, Tianyu Song, Ping Liu, Qing Huang, Mohamed Nashrudin Bin Naharudin, Hengzhi Deng
Nutrients 2026 18(12):1881

Bibliography

PubMed
PMID 42356270
PubMed Central
PMC13304508
DOI
10.3390/nu18121881
Funding
Not yet independently verified in full text
Competing interests
Not yet independently verified in full text

Study snapshot

DesignSystematic review and three-level meta-analysis of randomized controlled trials
ModelAdults participating in varied exercise studies
Sample30 randomized trials; 644 participants; 138 effect sizes
InterventionCitrulline malate supplementation versus placebo across acute and chronic protocols
DurationAcute and chronic protocols varying by study
EndpointsOverall exercise performance; Perceived exertion; Aerobic and anaerobic exercise tasks

What the study showed, in plain terms

Citrulline malate was associated with a small pooled performance improvement, but results were inconsistent and the certainty of evidence was low to very low.

Key findings

Overall exercise performance Hedges g 0.16 (p=0.01); perceived exertion not significantly improved. Dose, timing and target population are not firmly established.

What this study can and cannot tell us

Wide prediction intervals, heterogeneous exercise tests and uncertain supplement composition; cannot generalize this result to pure L-citrulline or Nitralis.

Citation network

Articles citing this research paper

4 articles

Biohack Blueprint analyses that reference this study in their evidence base.

Editorial review

Reviewed by the Biohack Blueprint research team

Last verified

Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction