Trial reportJournal of the International Society of Sports Nutrition2026
Load and breath-hold: impact of 7-day creatine monohydrate loading on breath-hold exercise performance - a double-blind randomized controlled trial.
Trial report in Journal of the International Society of Sports Nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07233707 (Impact of Creatine Monohydrate Supplementation on Breath-Hold Exercise Performance on a Bicycle Ergometer), which is not on this map. Not yet cited in PubMed.
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Impact of Creatine Monohydrate Supplementation on Breath-Hold Exercise Performance on a Bicycle Ergometer
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8 authors.
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Abstract
backgroundCreatine supplementation enhances anaerobic energy availability and buffering capacity; however, its impact on muscle work under voluntary breath-hold (BH) remains unexplored. BH exercise increases reliance on anaerobic ATP production and creates a metabolic environment in which phosphocreatine-derived ATP may be particularly valuable. The aim of this study was to determine whether creatine monohydrate loading improves BH exercise performance in trained BH divers.
methodsA double-blind, randomized, placebo-controlled study assessed the effects of a 7-day creatine monohydrate loading protocol (20 g/day) on performance outcomes and fatigue markers during BH exercise performed on a bicycle ergometer in 20 trained BH divers (18 males, 2 females; mean age 41.6 ± 8.6 years). The trial was registered at ClinicalTrials.gov (Identifier: NCT07233707) on 16th November 2025 under the title Load and Hold: Impact of 7-Day Creatine Monohydrate Loading on Breath-Hold Cycling Performance (BREATHE-C). Testing consisted of a brief warm-up followed by a maximal cycling trial performed on a single breath, during which participants aimed to cover the greatest possible distance. Following pre-supplementation testing, participants were randomly assigned to either the creatine monohydrate (CR) or the placebo (PL) group. Pre- and post-supplementation measurements included total work (TW), time to exhaustion (TTE), peripheral blood lactate accumulation (LA), mean partial pressure of carbon dioxide (pCO₂) in exhaled air following BH exercise, and ratings of perceived exertions for BH (RPE-BH) and muscle fatigue (RPE-MF). In addition, participants underwent dual-energy X-ray absorptiometry to assess changes in body composition.
resultsSignificant Time × Group interactions were observed for TW (
conclusionsCreatine enhanced performance, as reflected by increases in TW and TTE, without elevating RPE-BH, although a slight increase in RPE-MF was observed. LA was lower in the CR compared to PL group, despite greater performance improvements. Overall, creatine appears to enhance BH exercise performance in trained BH divers, suggesting a potentially effective ergogenic strategy for BH-related sports.
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