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Synergistic effect of long-term L-citruline supplementation combined with exercise on body composition in adults: A systematic review and meta-analysis of randomized controlled trials.

  • 2026-06
  • Complementary therapies in medicine 98
    • Weizheng Wang
    • Shanshan Cai
    • Kang Liu
    • Ping Luo

Study Design

Type
Review
Population
adults
Methods
Meta-analysis of 9 RCTs; used RevMan (Version 5.4); outcome indicators included BW, BMI, BF (FM and BFP), AFM, GFM, TLM

Objective

This study aims to systematically evaluate the synergistic effects of long-term supplementation of L-citrulline combined with exercise on body composition in adults through a meta-analysis.

Methods

This study primarily summarized and analyzed outcome indicators including body weight (BW), body mass index (BMI), body fat (BF) (including fat mass [FM] and body fat percentage [BFP]), android fat mass (AFM), gynoid fat mass (GFM), and total lean mass (TLM). Statistical analyses were performed using RevMan (Version 5.4) software provided by the Cochrane Collaboration. For continuous variables, the pooled effect sizes were expressed as standardized mean differences (SMD) with their 95% confidence intervals (CI).

Results

A total of 9 randomized controlled trials (RCTs) were included that investigated the effects of long-term supplementation of L-citrulline combined with exercise on body composition in adults. The results indicated that, compared to exercise alone, L-citrulline supplementation combined with exercise significantly improved BF (SMD = -0.21, 95% CI: -0.40 to -0.01, P = 0.03) and AFM (SMD = -0.32, 95% CI: -0.57 to -0.07, P = 0.01). However, no significant effects were observed on BW (SMD = -0.01, 95% CI: -0.27-0.25, P = 0.95), BMI (SMD = 0.01, 95% CI: -0.31-0.33, P = 0.93), GFM (SMD = -0.17, 95% CI: -0.42-0.08, P = 0.18), and TLM (SMD = -0.02, 95% CI: -0.23-0.19, P = 0.83).

Conclusion

This study is the first to demonstrate through a meta-analysis that long-term supplementation of L-citrulline combined with exercise can synergistically improve BF and AFM in adults.

Research Insights

  • L-Citrulline→Increased Lean Mass

    no significant effects were observed on ... TLM (SMD = -0.02, 95% CI: -0.23-0.19, P = 0.83)

    Effect
    Neutral
    Effect size
    Small
  • L-Citrulline→Reduced Body Fat

    L-citrulline supplementation combined with exercise significantly improved BF (SMD = -0.21, 95% CI: -0.40 to -0.01, P = 0.03)

    Effect
    Beneficial
    Effect size
    Small
  • L-Citrulline→Reduced Body Mass Index

    no significant effects were observed on ... BMI (SMD = 0.01, 95% CI: -0.31-0.33, P = 0.93)

    Effect
    Neutral
    Effect size
    Small
  • L-Citrulline→Reduced Body Weight

    no significant effects were observed on BW (SMD = -0.01, 95% CI: -0.27-0.25, P = 0.95)

    Effect
    Neutral
    Effect size
    Small
  • L-Citrulline→Reduced Gynoid Fat Mass

    no significant effects were observed on ... GFM (SMD = -0.17, 95% CI: -0.42-0.08, P = 0.18)

    Effect
    Neutral
    Effect size
    Small
  • L-Citrulline→Reduced Visceral Fat

    L-citrulline supplementation combined with exercise significantly improved ... AFM (SMD = -0.32, 95% CI: -0.57 to -0.07, P = 0.01)

    Effect
    Beneficial
    Effect size
    Moderate
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