Nutritional Supplementation Combined with Exercise for Musculoskeletal Health in Women: A Systematic Review and Meta-Analysis Evaluating Proteins, Amino Acids, and Creatine across Reproductive Stages
Chen KH, Yeh TP, Lin SC, Liu PJ, Bai D, Chen IH
International journal of medical sciences · 0 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- University or hospital
- Taipei Medical University
- University or hospital
- Wan Fang Hospital
- Grants
- Wan Fang Hospital (111-wf-f-11)
Based on 2 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2026-04-16 · Int J Med Sci · vol. 23 · issue 6 · pp. 1933–1951
- Publisher
- Ivyspring International Publisher
- Cited
- 0 citations · more than 21% of similar papers · 0.0× the field average
- References
- 0 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Muscle metabolism and nutrition · Gestational Diabetes Research and Management · Birth, Development, and Health
- Keywords
- Creatine, Nutritional Supplementation, MEDLINE, Physical activity, Creatine Monohydrate, Creatine kinase
- MeSH
- muscle, skeletal, humans, creatine, amino acids, dietary proteins, exercise, menopause, bone density, dietary supplements, middle aged, female, muscle strength, randomized controlled trials as topic
6 authors
From TW, US
- Kee‐Hsin ChenWan Fang Hospital; Taipei Medical University
- Tzu-Pei YehChina Medical University; China Medical University Hospital
- Shu-Cheng LinNational Chiayi University
- Pi‐Ju LiuPurdue University West Lafayette
- Dorothy BaiTaipei Medical University
- I‐Hui ChenTaipei Medical University
Abstract
Background
Women experience progressive musculoskeletal deterioration across reproductive stages, with accelerated changes during the menopausal transition. Exercise provides established benefits, but the additive effects of nutritional supplementation strategies, including proteins, amino acids, and related compounds such as creatine, remain uncertain. Previous systematic reviews focused on older adults aged 65 years and above, leaving a knowledge gap regarding women facing unique metabolic challenges related to reproductive hormones. Therefore, this systematic review and meta-analysis was conducted to evaluate whether nutritional supplementation combined with exercise enhances muscle mass, strength, and bone health outcomes in women across reproductive stages, with particular attention to the menopausal transition.
Methods
Eight databases were searched from inception to July 2025: CINAHL, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, MEDLINE/PubMed, Scopus, and Web of Science. We included randomized controlled trials examining nutritional supplementation combined with exercise in women across reproductive stages. Interventions comprised whole proteins, amino acids, amino acid derivatives, or protein-derived peptides administered with structured exercise programs. Comparators included exercise alone or a placebo plus exercise. Primary outcomes were muscle mass measures. Secondary outcomes included muscle strength, bone health parameters, body composition, and adverse events. Random-effects meta-analyses calculated Hedges' g with 95% confidence intervals (CIs).
Results
Fourteen trials including 763 women across reproductive stages met the inclusion criteria, which evaluated whole-protein supplements (five studies), amino acids and derivatives (six studies), and creatine monohydrate (three studies). The combined intervention showed no significant effects on muscle mass measures: skeletal muscle mass (g=0.065, 95% CI: -0.353 to 0.482, p=0.762), appendicular lean mass (g=0.197, 95% CI: -0.177 to 0.571, p=0.302), or fat-free mass (g=0.069, 95% CI: -0.110 to 0.249, p=0.447). Significant improvements occurred in bench press (g=0.279, 95% CI: 0.008 to 0.550, p=0.043) and handgrip strength (g=0.412, 95% CI: 0.039 to 0.786, p=0.031). No significant effects emerged for bone mineral content (g=0.195, 95% CI: -0.281 to 0.671, p=0.421) or bone mineral density (g=0.087, 95% CI: -0.129 to 0.303, p=0.430). No increase in adverse events was observed.
Conclusions
Current evidence does not support robust additive effects of nutritional supplementation on muscle mass or bone health when combined with exercise in women across reproductive stages. Selective upper-body strength improvements were observed, particularly in studies using creatine supplementation. Exercise alone provides reliable musculoskeletal health benefits. Given the heterogeneity of supplement types examined, future research should employ longer intervention durations (≥12 months) with site-specific bone measurements and conduct head-to-head comparisons of specific supplement types.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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