Effects of Citrulline Malate Supplementation on Exercise Performance: A Systematic Review and Three-Level
Xuexiang Wang1, Xiaohan Fan2, Jindong Chang3
1College of Aviation Electronics and Electrical Engineering, Civil Aviation Flight University of China, Deyang 618307, China.
Nutrients
|June 26, 2026
Summary
Citrulline malate (CM) may offer small exercise performance benefits, but evidence is limited and uncertain. More research is needed to establish optimal CM dosing, timing, and target populations for ergogenic effects.
Area of Science:
- Sports Science
- Nutritional Biochemistry
- Exercise Physiology
Background:
- Citrulline malate (CM) is a popular ergogenic supplement.
- Its impact on exercise performance and perceived exertion requires further clarification.
Purpose of the Study:
- To systematically review and meta-analyze the effects of CM supplementation on exercise performance and perceived exertion.
- To investigate differences between acute and chronic CM supplementation protocols.
Main Methods:
- Systematic review and meta-analysis of 30 randomized controlled trials (644 participants).
- Synthesis of effect sizes using three-level random-effects models.
- Subgroup and moderator analyses to explore various factors influencing CM efficacy.
Main Results:
- CM supplementation showed a small improvement in overall exercise performance (g = 0.16, p = 0.01), with wide prediction intervals and limited statistical power.
- No significant effect on perceived exertion was observed.
- Evidence was more stable for acute than chronic supplementation, but subgroup differences remained uncertain.
Conclusions:
- CM supplementation may yield small, context-dependent exercise performance improvements, but current evidence is limited and uncertain.
- Optimal CM dosing, timing, and target populations are not yet established.
- Larger, high-quality trials are necessary to confirm findings and establish reliable protocols.
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