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Research Paper – Structure, Examples and Writing Guide

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Research Paper

Definition:

Research Paper is a written document that presents the author’s original research, analysis, and interpretation of a specific topic or issue.

It is typically based on Empirical Evidence, and may involve qualitative or quantitative research methods, or a combination of both. The purpose of a research paper is to contribute new knowledge or insights to a particular field of study, and to demonstrate the author’s understanding of the existing literature and theories related to the topic.

Structure of Research Paper

The structure of a research paper typically follows a standard format, consisting of several sections that convey specific information about the research study. The following is a detailed explanation of the structure of a research paper:

The title page contains the title of the paper, the name(s) of the author(s), and the affiliation(s) of the author(s). It also includes the date of submission and possibly, the name of the journal or conference where the paper is to be published.

The abstract is a brief summary of the research paper, typically ranging from 100 to 250 words. It should include the research question, the methods used, the key findings, and the implications of the results. The abstract should be written in a concise and clear manner to allow readers to quickly grasp the essence of the research.

Introduction

The introduction section of a research paper provides background information about the research problem, the research question, and the research objectives. It also outlines the significance of the research, the research gap that it aims to fill, and the approach taken to address the research question. Finally, the introduction section ends with a clear statement of the research hypothesis or research question.

Literature Review

The literature review section of a research paper provides an overview of the existing literature on the topic of study. It includes a critical analysis and synthesis of the literature, highlighting the key concepts, themes, and debates. The literature review should also demonstrate the research gap and how the current study seeks to address it.

The methods section of a research paper describes the research design, the sample selection, the data collection and analysis procedures, and the statistical methods used to analyze the data. This section should provide sufficient detail for other researchers to replicate the study.

The results section presents the findings of the research, using tables, graphs, and figures to illustrate the data. The findings should be presented in a clear and concise manner, with reference to the research question and hypothesis.

The discussion section of a research paper interprets the findings and discusses their implications for the research question, the literature review, and the field of study. It should also address the limitations of the study and suggest future research directions.

The conclusion section summarizes the main findings of the study, restates the research question and hypothesis, and provides a final reflection on the significance of the research.

The references section provides a list of all the sources cited in the paper, following a specific citation style such as APA, MLA or Chicago.

How to Write Research Paper

You can write Research Paper by the following guide:

• Choose a Topic: The first step is to select a topic that interests you and is relevant to your field of study. Brainstorm ideas and narrow down to a research question that is specific and researchable.
• Conduct a Literature Review: The literature review helps you identify the gap in the existing research and provides a basis for your research question. It also helps you to develop a theoretical framework and research hypothesis.
• Develop a Thesis Statement : The thesis statement is the main argument of your research paper. It should be clear, concise and specific to your research question.
• Plan your Research: Develop a research plan that outlines the methods, data sources, and data analysis procedures. This will help you to collect and analyze data effectively.
• Collect and Analyze Data: Collect data using various methods such as surveys, interviews, observations, or experiments. Analyze data using statistical tools or other qualitative methods.
• Organize your Paper : Organize your paper into sections such as Introduction, Literature Review, Methods, Results, Discussion, and Conclusion. Ensure that each section is coherent and follows a logical flow.
• Write your Paper : Start by writing the introduction, followed by the literature review, methods, results, discussion, and conclusion. Ensure that your writing is clear, concise, and follows the required formatting and citation styles.
• Edit and Proofread your Paper: Review your paper for grammar and spelling errors, and ensure that it is well-structured and easy to read. Ask someone else to review your paper to get feedback and suggestions for improvement.
• Cite your Sources: Ensure that you properly cite all sources used in your research paper. This is essential for giving credit to the original authors and avoiding plagiarism.

Research Paper Example

Note : The below example research paper is for illustrative purposes only and is not an actual research paper. Actual research papers may have different structures, contents, and formats depending on the field of study, research question, data collection and analysis methods, and other factors. Students should always consult with their professors or supervisors for specific guidelines and expectations for their research papers.

Research Paper Example sample for Students:

Title: The Impact of Social Media on Mental Health among Young Adults

Abstract: This study aims to investigate the impact of social media use on the mental health of young adults. A literature review was conducted to examine the existing research on the topic. A survey was then administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO (Fear of Missing Out) are significant predictors of mental health problems among young adults.

Introduction: Social media has become an integral part of modern life, particularly among young adults. While social media has many benefits, including increased communication and social connectivity, it has also been associated with negative outcomes, such as addiction, cyberbullying, and mental health problems. This study aims to investigate the impact of social media use on the mental health of young adults.

Literature Review: The literature review highlights the existing research on the impact of social media use on mental health. The review shows that social media use is associated with depression, anxiety, stress, and other mental health problems. The review also identifies the factors that contribute to the negative impact of social media, including social comparison, cyberbullying, and FOMO.

Methods : A survey was administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The survey included questions on social media use, mental health status (measured using the DASS-21), and perceived impact of social media on their mental health. Data were analyzed using descriptive statistics and regression analysis.

Results : The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO are significant predictors of mental health problems among young adults.

Discussion : The study’s findings suggest that social media use has a negative impact on the mental health of young adults. The study highlights the need for interventions that address the factors contributing to the negative impact of social media, such as social comparison, cyberbullying, and FOMO.

Conclusion : In conclusion, social media use has a significant impact on the mental health of young adults. The study’s findings underscore the need for interventions that promote healthy social media use and address the negative outcomes associated with social media use. Future research can explore the effectiveness of interventions aimed at reducing the negative impact of social media on mental health. Additionally, longitudinal studies can investigate the long-term effects of social media use on mental health.

Limitations : The study has some limitations, including the use of self-report measures and a cross-sectional design. The use of self-report measures may result in biased responses, and a cross-sectional design limits the ability to establish causality.

Implications: The study’s findings have implications for mental health professionals, educators, and policymakers. Mental health professionals can use the findings to develop interventions that address the negative impact of social media use on mental health. Educators can incorporate social media literacy into their curriculum to promote healthy social media use among young adults. Policymakers can use the findings to develop policies that protect young adults from the negative outcomes associated with social media use.

References :

• Twenge, J. M., & Campbell, W. K. (2019). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive medicine reports, 15, 100918.
• Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., … & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among US young adults. Computers in Human Behavior, 69, 1-9.
• Van der Meer, T. G., & Verhoeven, J. W. (2017). Social media and its impact on academic performance of students. Journal of Information Technology Education: Research, 16, 383-398.

Appendix : The survey used in this study is provided below.

Social Media and Mental Health Survey

• How often do you use social media per day?
• Less than 30 minutes
• 30 minutes to 1 hour
• 1 to 2 hours
• 2 to 4 hours
• More than 4 hours
• Which social media platforms do you use?
• Others (Please specify)
• How often do you experience the following on social media?
• Social comparison (comparing yourself to others)
• Cyberbullying
• Fear of Missing Out (FOMO)
• Have you ever experienced any of the following mental health problems in the past month?
• Do you think social media use has a positive or negative impact on your mental health?
• Very positive
• Somewhat positive
• Somewhat negative
• Very negative
• In your opinion, which factors contribute to the negative impact of social media on mental health?
• Social comparison
• In your opinion, what interventions could be effective in reducing the negative impact of social media on mental health?
• Education on healthy social media use
• Counseling for mental health problems caused by social media
• Social media detox programs
• Regulation of social media use

Thank you for your participation!

Applications of Research Paper

Research papers have several applications in various fields, including:

• Advancing knowledge: Research papers contribute to the advancement of knowledge by generating new insights, theories, and findings that can inform future research and practice. They help to answer important questions, clarify existing knowledge, and identify areas that require further investigation.
• Informing policy: Research papers can inform policy decisions by providing evidence-based recommendations for policymakers. They can help to identify gaps in current policies, evaluate the effectiveness of interventions, and inform the development of new policies and regulations.
• Improving practice: Research papers can improve practice by providing evidence-based guidance for professionals in various fields, including medicine, education, business, and psychology. They can inform the development of best practices, guidelines, and standards of care that can improve outcomes for individuals and organizations.
• Educating students : Research papers are often used as teaching tools in universities and colleges to educate students about research methods, data analysis, and academic writing. They help students to develop critical thinking skills, research skills, and communication skills that are essential for success in many careers.
• Fostering collaboration: Research papers can foster collaboration among researchers, practitioners, and policymakers by providing a platform for sharing knowledge and ideas. They can facilitate interdisciplinary collaborations and partnerships that can lead to innovative solutions to complex problems.

When to Write Research Paper

Research papers are typically written when a person has completed a research project or when they have conducted a study and have obtained data or findings that they want to share with the academic or professional community. Research papers are usually written in academic settings, such as universities, but they can also be written in professional settings, such as research organizations, government agencies, or private companies.

Here are some common situations where a person might need to write a research paper:

• For academic purposes: Students in universities and colleges are often required to write research papers as part of their coursework, particularly in the social sciences, natural sciences, and humanities. Writing research papers helps students to develop research skills, critical thinking skills, and academic writing skills.
• For publication: Researchers often write research papers to publish their findings in academic journals or to present their work at academic conferences. Publishing research papers is an important way to disseminate research findings to the academic community and to establish oneself as an expert in a particular field.
• To inform policy or practice : Researchers may write research papers to inform policy decisions or to improve practice in various fields. Research findings can be used to inform the development of policies, guidelines, and best practices that can improve outcomes for individuals and organizations.
• To share new insights or ideas: Researchers may write research papers to share new insights or ideas with the academic or professional community. They may present new theories, propose new research methods, or challenge existing paradigms in their field.

Purpose of Research Paper

The purpose of a research paper is to present the results of a study or investigation in a clear, concise, and structured manner. Research papers are written to communicate new knowledge, ideas, or findings to a specific audience, such as researchers, scholars, practitioners, or policymakers. The primary purposes of a research paper are:

• To contribute to the body of knowledge : Research papers aim to add new knowledge or insights to a particular field or discipline. They do this by reporting the results of empirical studies, reviewing and synthesizing existing literature, proposing new theories, or providing new perspectives on a topic.
• To inform or persuade: Research papers are written to inform or persuade the reader about a particular issue, topic, or phenomenon. They present evidence and arguments to support their claims and seek to persuade the reader of the validity of their findings or recommendations.
• To advance the field: Research papers seek to advance the field or discipline by identifying gaps in knowledge, proposing new research questions or approaches, or challenging existing assumptions or paradigms. They aim to contribute to ongoing debates and discussions within a field and to stimulate further research and inquiry.
• To demonstrate research skills: Research papers demonstrate the author’s research skills, including their ability to design and conduct a study, collect and analyze data, and interpret and communicate findings. They also demonstrate the author’s ability to critically evaluate existing literature, synthesize information from multiple sources, and write in a clear and structured manner.

Characteristics of Research Paper

Research papers have several characteristics that distinguish them from other forms of academic or professional writing. Here are some common characteristics of research papers:

• Evidence-based: Research papers are based on empirical evidence, which is collected through rigorous research methods such as experiments, surveys, observations, or interviews. They rely on objective data and facts to support their claims and conclusions.
• Structured and organized: Research papers have a clear and logical structure, with sections such as introduction, literature review, methods, results, discussion, and conclusion. They are organized in a way that helps the reader to follow the argument and understand the findings.
• Formal and objective: Research papers are written in a formal and objective tone, with an emphasis on clarity, precision, and accuracy. They avoid subjective language or personal opinions and instead rely on objective data and analysis to support their arguments.
• Citations and references: Research papers include citations and references to acknowledge the sources of information and ideas used in the paper. They use a specific citation style, such as APA, MLA, or Chicago, to ensure consistency and accuracy.
• Peer-reviewed: Research papers are often peer-reviewed, which means they are evaluated by other experts in the field before they are published. Peer-review ensures that the research is of high quality, meets ethical standards, and contributes to the advancement of knowledge in the field.
• Objective and unbiased: Research papers strive to be objective and unbiased in their presentation of the findings. They avoid personal biases or preconceptions and instead rely on the data and analysis to draw conclusions.

Advantages of Research Paper

Research papers have many advantages, both for the individual researcher and for the broader academic and professional community. Here are some advantages of research papers:

• Contribution to knowledge: Research papers contribute to the body of knowledge in a particular field or discipline. They add new information, insights, and perspectives to existing literature and help advance the understanding of a particular phenomenon or issue.
• Opportunity for intellectual growth: Research papers provide an opportunity for intellectual growth for the researcher. They require critical thinking, problem-solving, and creativity, which can help develop the researcher’s skills and knowledge.
• Career advancement: Research papers can help advance the researcher’s career by demonstrating their expertise and contributions to the field. They can also lead to new research opportunities, collaborations, and funding.
• Academic recognition: Research papers can lead to academic recognition in the form of awards, grants, or invitations to speak at conferences or events. They can also contribute to the researcher’s reputation and standing in the field.
• Impact on policy and practice: Research papers can have a significant impact on policy and practice. They can inform policy decisions, guide practice, and lead to changes in laws, regulations, or procedures.
• Advancement of society: Research papers can contribute to the advancement of society by addressing important issues, identifying solutions to problems, and promoting social justice and equality.

Limitations of Research Paper

Research papers also have some limitations that should be considered when interpreting their findings or implications. Here are some common limitations of research papers:

• Limited generalizability: Research findings may not be generalizable to other populations, settings, or contexts. Studies often use specific samples or conditions that may not reflect the broader population or real-world situations.
• Potential for bias : Research papers may be biased due to factors such as sample selection, measurement errors, or researcher biases. It is important to evaluate the quality of the research design and methods used to ensure that the findings are valid and reliable.
• Ethical concerns: Research papers may raise ethical concerns, such as the use of vulnerable populations or invasive procedures. Researchers must adhere to ethical guidelines and obtain informed consent from participants to ensure that the research is conducted in a responsible and respectful manner.
• Limitations of methodology: Research papers may be limited by the methodology used to collect and analyze data. For example, certain research methods may not capture the complexity or nuance of a particular phenomenon, or may not be appropriate for certain research questions.
• Publication bias: Research papers may be subject to publication bias, where positive or significant findings are more likely to be published than negative or non-significant findings. This can skew the overall findings of a particular area of research.
• Time and resource constraints: Research papers may be limited by time and resource constraints, which can affect the quality and scope of the research. Researchers may not have access to certain data or resources, or may be unable to conduct long-term studies due to practical limitations.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Body functionality: A review of the literature

Affiliations.

• 1 Department of Clinical Psychological Science, Maastricht University, the Netherlands. Electronic address: [email protected].
• 2 Department of Psychology, The Ohio State University, United States.
• PMID: 33321273
• DOI: 10.1016/j.bodyim.2020.11.006

Body functionality describes everything that the body is able to do, across diverse domains (e.g., bodily senses, creative endeavours). Nearly a decade ago, leading scholars identified research on body functionality as a priority for the body image field. The field has responded, as shown by the recent rise of body functionality research. We considered this an opportune time to (a) define body functionality (what it is and is not); (b) present theoretical frameworks of body functionality; (c) articulate first-generation and current measures relating to body functionality; (d) offer functionality-focused body image interventions that can improve appreciation for one's body functionality (and body image more broadly); (e) summarise additional areas of research related to body functionality and positive body image; and (f) provide considerations and directions for future research and interventions incorporating body functionality. Research has underscored body functionality as a valuable construct with respect to positive body image and well-being, particularly when individuals appreciate what their bodies can do and conceptualise their body functionality holistically. Yet, the experience of body functionality is nuanced across social identities. Overall, the field has greatly advanced knowledge about body functionality, and we are excited to see the next generation of research that emerges.

Keywords: Body appreciation; Body functionality; Embodiment; Functionality appreciation; Positive body image.

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

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Conflict of interest statement

Declaration of Competing Interest The authors report no declarations of interest.

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How to Write a Research Paper: Parts of the Paper

• Choosing Your Topic
• Citation & Style Guides This link opens in a new window
• Critical Thinking
• Evaluating Information
• Parts of the Paper
• Writing Tips from UNC-Chapel Hill
• Librarian Contact

Parts of the Research Paper Papers should have a beginning, a middle, and an end. Your introductory paragraph should grab the reader's attention, state your main idea, and indicate how you will support it. The body of the paper should expand on what you have stated in the introduction. Finally, the conclusion restates the paper's thesis and should explain what you have learned, giving a wrap up of your main ideas.

1. The Title The title should be specific and indicate the theme of the research and what ideas it addresses. Use keywords that help explain your paper's topic to the reader. Try to avoid abbreviations and jargon. Think about keywords that people would use to search for your paper and include them in your title.

2. The Abstract The abstract is used by readers to get a quick overview of your paper. Typically, they are about 200 words in length (120 words minimum to  250 words maximum). The abstract should introduce the topic and thesis, and should provide a general statement about what you have found in your research. The abstract allows you to mention each major aspect of your topic and helps readers decide whether they want to read the rest of the paper. Because it is a summary of the entire research paper, it is often written last. 

3. The Introduction The introduction should be designed to attract the reader's attention and explain the focus of the research. You will introduce your overview of the topic,  your main points of information, and why this subject is important. You can introduce the current understanding and background information about the topic. Toward the end of the introduction, you add your thesis statement, and explain how you will provide information to support your research questions. This provides the purpose and focus for the rest of the paper.

4. Thesis Statement Most papers will have a thesis statement or main idea and supporting facts/ideas/arguments. State your main idea (something of interest or something to be proven or argued for or against) as your thesis statement, and then provide your supporting facts and arguments. A thesis statement is a declarative sentence that asserts the position a paper will be taking. It also points toward the paper's development. This statement should be both specific and arguable. Generally, the thesis statement will be placed at the end of the first paragraph of your paper. The remainder of your paper will support this thesis.

Students often learn to write a thesis as a first step in the writing process, but often, after research, a writer's viewpoint may change. Therefore a thesis statement may be one of the final steps in writing. 

Examples of Thesis Statements from Purdue OWL

5. The Literature Review The purpose of the literature review is to describe past important research and how it specifically relates to the research thesis. It should be a synthesis of the previous literature and the new idea being researched. The review should examine the major theories related to the topic to date and their contributors. It should include all relevant findings from credible sources, such as academic books and peer-reviewed journal articles. You will want  to:

• Explain how the literature helps the researcher understand the topic.
• Try to show connections and any disparities between the literature.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.

More about writing a literature review. . .

6. The Discussion ​The purpose of the discussion is to interpret and describe what you have learned from your research. Make the reader understand why your topic is important. The discussion should always demonstrate what you have learned from your readings (and viewings) and how that learning has made the topic evolve, especially from the short description of main points in the introduction.Explain any new understanding or insights you have had after reading your articles and/or books. Paragraphs should use transitioning sentences to develop how one paragraph idea leads to the next. The discussion will always connect to the introduction, your thesis statement, and the literature you reviewed, but it does not simply repeat or rearrange the introduction. You want to: 

• Demonstrate critical thinking, not just reporting back facts that you gathered.
• If possible, tell how the topic has evolved over the past and give it's implications for the future.
• Fully explain your main ideas with supporting information.
• Explain why your thesis is correct giving arguments to counter points.

7. The Conclusion A concluding paragraph is a brief summary of your main ideas and restates the paper's main thesis, giving the reader the sense that the stated goal of the paper has been accomplished. What have you learned by doing this research that you didn't know before? What conclusions have you drawn? You may also want to suggest further areas of study, improvement of research possibilities, etc. to demonstrate your critical thinking regarding your research.

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• A Research Guide
• Research Paper Guide

Research Paper Body Paragraph Structure

Introduction.

• Referrences
• Ways to start paragraph
• Step by step guide
• Research paragraph examples

Learning the basics of a paragraph structure

• Title (cover page).
• Introduction.
• Literature review.
• Research methodology.
• Data analysis.
• Conclusion.
• Reference page.

5 winning ways to start a body paragraph

• Topic Sentence : it should provide a clear focus and introduce the specific aspect you will discuss. For example, “One key factor influencing climate change is…”.
• Opening Statement: grab your readers’ attention with a thought-provoking or surprising statement related to your topic. For instance, “The alarming increase in global temperatures has reached a critical point, demanding immediate action.”
• Quotation: find a relevant quote from a reputable source. It won’t only add credibility to your research but will also engage the reader right from the start.
• Anecdote or example: start your academic paragraph with a funny story or a real-world example that illustrates the significance of your research topic.
• Background information : provide a brief background or context for the topic you are about to discuss. For example, “In recent years, the prevalence of cyber-attacks has skyrocketed, posing a severe threat to individuals, organizations, and even national security.”

A step-by-step guide to starting a concise body paragraph

Step 1: introduce the main point or argument., step 2: provide evidence or examples., step 3: explain and analyze., step 4: connect to the main argument., step 5: review and revise., flawless body paragraph example: how does it look.

• Topic Sentence: Rising global temperatures have significant implications for ecosystems and biodiversity.
• Evidence/Example 1: According to a study by the Intergovernmental Panel on Climate Change (IPCC), global average temperatures have increased by 1.1 degrees Celsius since pre-industrial times (IPCC, 2021). This temperature rise has led to melting polar ice caps and glaciers, rising sea levels, and coastal erosion (Smith et al., 2019).
• Explanation/Analysis 1: The significant increase in global temperatures has caused observable changes in the Earth’s physical environment. The melting of polar ice caps not only contributes to the rise in sea levels but also disrupts marine ecosystems.
• Evidence/Example 2: In addition to the loss of coastal habitats, higher temperatures have also resulted in shifts in the geographical distribution of species. Research by Parmesan and Yohe (2019) indicates that many plant and animal species have altered their ranges and migration patterns in response to changing climate conditions.
• Explanation/Analysis 2: The observed shifts in species distribution highlight the vulnerability of ecosystems to climate change. As temperature zone modification, species that cannot adapt or migrate to suitable habitats may face reduced reproductive success and increased risk of extinction.
• Connect to the main argument: These examples demonstrate that the rising global temperatures associated with climate change have profound implications for ecosystems and biodiversity.

The bottom line

• Writing a Research Paper
• Research Paper Title
• Research Paper Sources
• Research Paper Problem Statement
• Research Paper Thesis Statement
• Hypothesis for a Research Paper
• Research Question
• Research Paper Outline
• Research Paper Summary
• Research Paper Prospectus
• Research Paper Proposal
• Research Paper Format
• Research Paper Styles
• AMA Style Research Paper
• MLA Style Research Paper
• Chicago Style Research Paper
• APA Style Research Paper
• Research Paper Structure
• Research Paper Cover Page
• Research Paper Abstract
• Research Paper Introduction
• Research Paper Body Paragraph
• Research Paper Literature Review
• Research Paper Background
• Research Paper Methods Section
• Research Paper Results Section
• Research Paper Discussion Section
• Research Paper Conclusion
• Research Paper Appendix
• Research Paper Bibliography
• APA Reference Page
• Annotated Bibliography
• Bibliography vs Works Cited vs References Page
• Research Paper Types
• What is Qualitative Research

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13.1 Formatting a Research Paper

Learning objectives.

• Identify the major components of a research paper written using American Psychological Association (APA) style.
• Apply general APA style and formatting conventions in a research paper.

In this chapter, you will learn how to use APA style , the documentation and formatting style followed by the American Psychological Association, as well as MLA style , from the Modern Language Association. There are a few major formatting styles used in academic texts, including AMA, Chicago, and Turabian:

• AMA (American Medical Association) for medicine, health, and biological sciences
• APA (American Psychological Association) for education, psychology, and the social sciences
• Chicago—a common style used in everyday publications like magazines, newspapers, and books
• MLA (Modern Language Association) for English, literature, arts, and humanities
• Turabian—another common style designed for its universal application across all subjects and disciplines

While all the formatting and citation styles have their own use and applications, in this chapter we focus our attention on the two styles you are most likely to use in your academic studies: APA and MLA.

If you find that the rules of proper source documentation are difficult to keep straight, you are not alone. Writing a good research paper is, in and of itself, a major intellectual challenge. Having to follow detailed citation and formatting guidelines as well may seem like just one more task to add to an already-too-long list of requirements.

Following these guidelines, however, serves several important purposes. First, it signals to your readers that your paper should be taken seriously as a student’s contribution to a given academic or professional field; it is the literary equivalent of wearing a tailored suit to a job interview. Second, it shows that you respect other people’s work enough to give them proper credit for it. Finally, it helps your reader find additional materials if he or she wishes to learn more about your topic.

Furthermore, producing a letter-perfect APA-style paper need not be burdensome. Yes, it requires careful attention to detail. However, you can simplify the process if you keep these broad guidelines in mind:

• Work ahead whenever you can. Chapter 11 “Writing from Research: What Will I Learn?” includes tips for keeping track of your sources early in the research process, which will save time later on.
• Get it right the first time. Apply APA guidelines as you write, so you will not have much to correct during the editing stage. Again, putting in a little extra time early on can save time later.
• Use the resources available to you. In addition to the guidelines provided in this chapter, you may wish to consult the APA website at http://www.apa.org or the Purdue University Online Writing lab at http://owl.english.purdue.edu , which regularly updates its online style guidelines.

General Formatting Guidelines

This chapter provides detailed guidelines for using the citation and formatting conventions developed by the American Psychological Association, or APA. Writers in disciplines as diverse as astrophysics, biology, psychology, and education follow APA style. The major components of a paper written in APA style are listed in the following box.

These are the major components of an APA-style paper:

Body, which includes the following:

• Headings and, if necessary, subheadings to organize the content
• In-text citations of research sources
• References page

All these components must be saved in one document, not as separate documents.

The title page of your paper includes the following information:

• Title of the paper
• Author’s name
• Name of the institution with which the author is affiliated
• Header at the top of the page with the paper title (in capital letters) and the page number (If the title is lengthy, you may use a shortened form of it in the header.)

List the first three elements in the order given in the previous list, centered about one third of the way down from the top of the page. Use the headers and footers tool of your word-processing program to add the header, with the title text at the left and the page number in the upper-right corner. Your title page should look like the following example.

The next page of your paper provides an abstract , or brief summary of your findings. An abstract does not need to be provided in every paper, but an abstract should be used in papers that include a hypothesis. A good abstract is concise—about one hundred fifty to two hundred fifty words—and is written in an objective, impersonal style. Your writing voice will not be as apparent here as in the body of your paper. When writing the abstract, take a just-the-facts approach, and summarize your research question and your findings in a few sentences.

In Chapter 12 “Writing a Research Paper” , you read a paper written by a student named Jorge, who researched the effectiveness of low-carbohydrate diets. Read Jorge’s abstract. Note how it sums up the major ideas in his paper without going into excessive detail.

Write an abstract summarizing your paper. Briefly introduce the topic, state your findings, and sum up what conclusions you can draw from your research. Use the word count feature of your word-processing program to make sure your abstract does not exceed one hundred fifty words.

Depending on your field of study, you may sometimes write research papers that present extensive primary research, such as your own experiment or survey. In your abstract, summarize your research question and your findings, and briefly indicate how your study relates to prior research in the field.

Margins, Pagination, and Headings

APA style requirements also address specific formatting concerns, such as margins, pagination, and heading styles, within the body of the paper. Review the following APA guidelines.

Use these general guidelines to format the paper:

• Set the top, bottom, and side margins of your paper at 1 inch.
• Use double-spaced text throughout your paper.
• Use a standard font, such as Times New Roman or Arial, in a legible size (10- to 12-point).
• Use continuous pagination throughout the paper, including the title page and the references section. Page numbers appear flush right within your header.
• Section headings and subsection headings within the body of your paper use different types of formatting depending on the level of information you are presenting. Additional details from Jorge’s paper are provided.

Begin formatting the final draft of your paper according to APA guidelines. You may work with an existing document or set up a new document if you choose. Include the following:

• Your title page
• The abstract you created in Note 13.8 “Exercise 1”
• Correct headers and page numbers for your title page and abstract

APA style uses section headings to organize information, making it easy for the reader to follow the writer’s train of thought and to know immediately what major topics are covered. Depending on the length and complexity of the paper, its major sections may also be divided into subsections, sub-subsections, and so on. These smaller sections, in turn, use different heading styles to indicate different levels of information. In essence, you are using headings to create a hierarchy of information.

The following heading styles used in APA formatting are listed in order of greatest to least importance:

• Section headings use centered, boldface type. Headings use title case, with important words in the heading capitalized.
• Subsection headings use left-aligned, boldface type. Headings use title case.
• The third level uses left-aligned, indented, boldface type. Headings use a capital letter only for the first word, and they end in a period.
• The fourth level follows the same style used for the previous level, but the headings are boldfaced and italicized.
• The fifth level follows the same style used for the previous level, but the headings are italicized and not boldfaced.

Visually, the hierarchy of information is organized as indicated in Table 13.1 “Section Headings” .

Table 13.1 Section Headings

Level of Information	Text Example
Level 1
Level 2
Level 3
Level 4
Level 5

A college research paper may not use all the heading levels shown in Table 13.1 “Section Headings” , but you are likely to encounter them in academic journal articles that use APA style. For a brief paper, you may find that level 1 headings suffice. Longer or more complex papers may need level 2 headings or other lower-level headings to organize information clearly. Use your outline to craft your major section headings and determine whether any subtopics are substantial enough to require additional levels of headings.

Working with the document you developed in Note 13.11 “Exercise 2” , begin setting up the heading structure of the final draft of your research paper according to APA guidelines. Include your title and at least two to three major section headings, and follow the formatting guidelines provided above. If your major sections should be broken into subsections, add those headings as well. Use your outline to help you.

Because Jorge used only level 1 headings, his Exercise 3 would look like the following:

Level of Information	Text Example
Level 1
Level 1
Level 1
Level 1

Citation Guidelines

In-text citations.

Throughout the body of your paper, include a citation whenever you quote or paraphrase material from your research sources. As you learned in Chapter 11 “Writing from Research: What Will I Learn?” , the purpose of citations is twofold: to give credit to others for their ideas and to allow your reader to follow up and learn more about the topic if desired. Your in-text citations provide basic information about your source; each source you cite will have a longer entry in the references section that provides more detailed information.

In-text citations must provide the name of the author or authors and the year the source was published. (When a given source does not list an individual author, you may provide the source title or the name of the organization that published the material instead.) When directly quoting a source, it is also required that you include the page number where the quote appears in your citation.

This information may be included within the sentence or in a parenthetical reference at the end of the sentence, as in these examples.

Epstein (2010) points out that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (p. 137).

Here, the writer names the source author when introducing the quote and provides the publication date in parentheses after the author’s name. The page number appears in parentheses after the closing quotation marks and before the period that ends the sentence.

Addiction researchers caution that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (Epstein, 2010, p. 137).

Here, the writer provides a parenthetical citation at the end of the sentence that includes the author’s name, the year of publication, and the page number separated by commas. Again, the parenthetical citation is placed after the closing quotation marks and before the period at the end of the sentence.

As noted in the book Junk Food, Junk Science (Epstein, 2010, p. 137), “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive.”

Here, the writer chose to mention the source title in the sentence (an optional piece of information to include) and followed the title with a parenthetical citation. Note that the parenthetical citation is placed before the comma that signals the end of the introductory phrase.

David Epstein’s book Junk Food, Junk Science (2010) pointed out that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (p. 137).

Another variation is to introduce the author and the source title in your sentence and include the publication date and page number in parentheses within the sentence or at the end of the sentence. As long as you have included the essential information, you can choose the option that works best for that particular sentence and source.

Citing a book with a single author is usually a straightforward task. Of course, your research may require that you cite many other types of sources, such as books or articles with more than one author or sources with no individual author listed. You may also need to cite sources available in both print and online and nonprint sources, such as websites and personal interviews. Chapter 13 “APA and MLA Documentation and Formatting” , Section 13.2 “Citing and Referencing Techniques” and Section 13.3 “Creating a References Section” provide extensive guidelines for citing a variety of source types.

Writing at Work

APA is just one of several different styles with its own guidelines for documentation, formatting, and language usage. Depending on your field of interest, you may be exposed to additional styles, such as the following:

• MLA style. Determined by the Modern Languages Association and used for papers in literature, languages, and other disciplines in the humanities.
• Chicago style. Outlined in the Chicago Manual of Style and sometimes used for papers in the humanities and the sciences; many professional organizations use this style for publications as well.
• Associated Press (AP) style. Used by professional journalists.

References List

The brief citations included in the body of your paper correspond to the more detailed citations provided at the end of the paper in the references section. In-text citations provide basic information—the author’s name, the publication date, and the page number if necessary—while the references section provides more extensive bibliographical information. Again, this information allows your reader to follow up on the sources you cited and do additional reading about the topic if desired.

The specific format of entries in the list of references varies slightly for different source types, but the entries generally include the following information:

• The name(s) of the author(s) or institution that wrote the source
• The year of publication and, where applicable, the exact date of publication
• The full title of the source
• For books, the city of publication
• For articles or essays, the name of the periodical or book in which the article or essay appears
• For magazine and journal articles, the volume number, issue number, and pages where the article appears
• For sources on the web, the URL where the source is located

The references page is double spaced and lists entries in alphabetical order by the author’s last name. If an entry continues for more than one line, the second line and each subsequent line are indented five spaces. Review the following example. ( Chapter 13 “APA and MLA Documentation and Formatting” , Section 13.3 “Creating a References Section” provides extensive guidelines for formatting reference entries for different types of sources.)

In APA style, book and article titles are formatted in sentence case, not title case. Sentence case means that only the first word is capitalized, along with any proper nouns.

Key Takeaways

• Following proper citation and formatting guidelines helps writers ensure that their work will be taken seriously, give proper credit to other authors for their work, and provide valuable information to readers.
• Working ahead and taking care to cite sources correctly the first time are ways writers can save time during the editing stage of writing a research paper.
• APA papers usually include an abstract that concisely summarizes the paper.
• APA papers use a specific headings structure to provide a clear hierarchy of information.
• In APA papers, in-text citations usually include the name(s) of the author(s) and the year of publication.
• In-text citations correspond to entries in the references section, which provide detailed bibliographical information about a source.

Writing for Success Copyright © 2015 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

How to Write a Research Paper

If you already have a headache trying to understand what research paper is all about, we have created an ultimate guide for you on how to write a research paper. You will find all the answers to your questions regarding structure, planning, doing investigation, finding the topic that appeals to you. Plus, you will find out the secret to an excellent paper. Are you at the edge of your seat? Let us start with the basics then.

• What is a Research Paper
• Reasons for Writing a Research Paper
• Report Papers and Thesis Papers
• How to Start a Research Paper
• How to Choose a Topic for a Research Paper
• How to Write a Proposal for a Research Paper
• How to Write a Research Plan
• How to Do Research
• How to Write an Outline for a Research Paper
• How to Write a Thesis Statement for a Research Paper
• How to Write a Research Paper Rough Draft
• How to Write an Introduction for a Research Paper
• How to Write a Body of a Research Paper
• How to Write a Conclusion for a Research Paper
• How to Write an Abstract for a Research Paper
• How to Revise and Edit a Research Paper
• How to Write a Bibliography for a Research Paper
• What Makes a Good Research Paper

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What is a research paper.

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You probably know the saying ‘the devil is not as black as he is painted’. This particular saying is absolutely true when it comes to writing a research paper. Your feet are cold even with the thought of this assignment. You have heard terrifying stories from older students. You have never done this before, so certainly you are scared. What is a research paper? How should I start? What are all these requirements about?

Luckily, you have a friend in need. That is our writing service. First and foremost, let us clarify the definition. A research paper is a piece of academic writing that provides information about a particular topic that you’ve researched . In other words, you choose a topic: about historical events, the work of some artist, some social issues etc. Then you collect data on the given topic and analyze it. Finally, you put your analysis on paper. See, it is not as scary as it seems. If you are still having doubts, whether you can handle it yourself, we are here to help you. Our team of writers can help you choose the topic, or give you advice on how to plan your work, or how to start, or craft a paper for you. Just contact us 24/7 and see everything yourself.

5 Reasons for Writing a Research Paper

Why should I spend my time writing some academic paper? What is the use of it? Is not some practical knowledge more important? The list of questions is endless when it comes to a research paper. That is why we have outlined 5 main reasons why writing a research paper is a good thing.

• You will learn how to organize your time

If you want to write a research paper, you will have to learn how to manage your time. This type of assignment cannot be done overnight. It requires careful planning and you will need to learn how to do it. Later, you will be able to use these time-managing skills in your personal life, so why not developing them?

• You will discover your writing skills

You cannot know something before you try it. This rule relates to writing as well. You cannot claim that you cannot write until you try it yourself. It will be really difficult at the beginning, but then the words will come to your head themselves.

• You will improve your analytical skills

Writing a research paper is all about investigation and analysis. You will need to collect data, examine and classify it. These skills are needed in modern life more than anything else is.

• You will gain confidence

Once you do your own research, it gives you the feeling of confidence in yourself. The reason is simple human brain likes solving puzzles and your assignment is just another puzzle to be solved.

• You will learn how to persuade the reader

When you write your paper, you should always remember that you are writing it for someone to read. Moreover, you want this someone to believe in your ideas. For this reason, you will have to learn different convincing methods and techniques. You will learn how to make your writing persuasive. In turns, you will be able to use these methods in real life.

What is the Difference between Report and Thesis Papers?

A common question is ‘what is the difference between a report paper and a thesis paper?’ The difference lies in the aim of these two assignments. While the former aims at presenting the information, the latter aims at providing your opinion on the matter. In other words, in a report paper you have to summarize your findings. In a thesis paper, you choose some issue and defend your point of view by persuading the reader. It is that simple.

A thesis paper is a more common assignment than a report paper. This task will help a professor to evaluate your analytical skills and skills to present your ideas logically. These skills are more important than just the ability to collect and summarize data.

How to Write a Research Paper Step by Step

Research comes from the French word  rechercher , meaning “to seek out.” Writing a research paper requires you to seek out information about a subject, take a stand on it, and back it up with the opinions, ideas, and views of others. What results is a printed paper variously known as a term paper or library paper, usually between five and fifteen pages long—most instructors specify a minimum length—in which you present your views and findings on the chosen subject.

It is not a secret that the majority of students hate writing a research paper. The reason is simple it steals your time and energy. Not to mention, constant anxiety that you will not be able to meet the deadline or that you will forget about some academic requirement.

We will not lie to you; a research paper is a difficult assignment. You will have to spend a lot of time. You will need to read, to analyze, and to search for the material. You will probably be stuck sometimes. However, if you organize your work smart, you will gain something that is worth all the effort – knowledge, experience, and high grades.

The reason why many students fail writing a research paper is that nobody explained them how to start and how to plan their work. Luckily, you have found our writing service and we are ready to shed the light on this dark matter.

We have created a step by step guide for you on how to write a research paper. We will dwell upon the structure, the writing tips, the writing strategies as well as academic requirements. Read this whole article and you will see that you can handle writing this assignment and our team of writers is here to assist you.

How to Start a Research Paper?

It all starts with the assignment. Your professor gives you the task. It may be either some general issue or specific topic to write about. Your assignment is your first guide to success. If you understand what you need to do according to the assignment, you are on the road to high results. Do not be scared to clarify your task if you need to. There is nothing wrong in asking a question if you want to do something right. You can ask your professor or you can ask our writers who know a thing or two in academic writing.

It is essential to understand the assignment. A good beginning makes a good ending, so start smart.

Learn how to start a research paper .

Choosing a Topic for a Research Paper

We have already mentioned that it is not enough to do great research. You need to persuade the reader that you have made some great research. What convinces better that an eye-catching topic? That is why it is important to understand how to choose a topic for a research paper.

First, you need to delimit the general idea to a more specific one. Secondly, you need to find what makes this topic interesting for you and for the academia. Finally, you need to refine you topic. Remember, it is not something you will do in one day. You can be reshaping your topic throughout your whole writing process. Still, reshaping not changing it completely. That is why keep in your head one main idea: your topic should be precise and compelling .

Learn how to choose a topic for a research paper .

How to Write a Proposal for a Research Paper?

If you do not know what a proposal is, let us explain it to you. A proposal should answer three main questions:

• What is the main aim of your investigation?
• Why is your investigation important?
• How are you going to achieve the results?

In other words, proposal should show why your topic is interesting and how you are going to prove it. As to writing requirements, they may differ. That is why make sure you find out all the details at your department. You can ask your departmental administrator or find information online at department’s site. It is crucial to follow all the administrative requirements, as it will influence your grade.

Learn how to write a proposal for a research paper .

How to Write a Research Plan?

The next step is writing a plan. You have already decided on the main issues, you have chosen the bibliography, and you have clarified the methods. Here comes the planning. If you want to avoid writer’s block, you have to structure you work. Discuss your strategies and ideas with your instructor. Think thoroughly why you need to present some data and ideas first and others second. Remember that there are basic structure elements that your research paper should include:

• Thesis Statement
• Introduction
• Bibliography

You should keep in mind this skeleton when planning your work. This will keep your mind sharp and your ideas will flow logically.

Learn how to write a research plan .

How to Do Research?

Your research will include three stages: collecting data, reading and analyzing it, and writing itself.

First, you need to collect all the material that you will need for you investigation: films, documents, surveys, interviews, and others. Secondly, you will have to read and analyze. This step is tricky, as you need to do this part smart. It is not enough just to read, as you cannot keep in mind all the information. It is essential that you make notes and write down your ideas while analyzing some data. When you get down to the stage number three, writing itself, you will already have the main ideas written on your notes. Plus, remember to jot down the reference details. You will then appreciate this trick when you will have to write the bibliography.

If you do your research this way, it will be much easier for you to write the paper. You will already have blocks of your ideas written down and you will just need to add some material and refine your paper.

Learn how to do research .

How to Write an Outline for a Research Paper?

To make your paper well organized you need to write an outline. Your outline will serve as your guiding star through the writing process. With a great outline you will not get sidetracked, because you will have a structured plan to follow. Both you and the reader will benefit from your outline. You present your ideas logically and you make your writing coherent according to your plan. As a result, this outline guides the reader through your paper and the reader enjoys the way you demonstrate your ideas.

Learn how to write an outline for a research paper . See research paper outline examples .

How to Write a Thesis Statement for a Research Paper?

Briefly, the thesis is the main argument of your research paper. It should be precise, convincing and logical. Your thesis statement should include your point of view supported by evidence or logic. Still, remember it should be precise. You should not beat around the bush, or provide all the possible evidence you have found. It is usually a single sentence that shows your argument. In on sentence you should make a claim, explain why it significant and convince the reader that your point of view is important.

Learn how to write a thesis statement for a research paper . See research paper thesis statement examples .

Should I Write a Rough Draft for a Research Paper?

Do you know any writer who put their ideas on paper, then never edited them and just published? Probably, no writer did so. Writing a research paper is no exception. It is impossible to cope with this assignment without writing a rough draft.

Your draft will help you understand what you need to polish to make your paper perfect. All the requirements, academic standards make it difficult to do everything flawlessly at the first attempt. Make sure you know all the formatting requirements: margins, words quantity, reference requirements, formatting styles etc.

Learn how to write a rough draft for a research paper .

How to Write an Introduction for a Research Paper?

Let us make it more vivid for you. We have narrowed down the tips on writing an introduction to the three main ones:

• Include your thesis in your introduction

Remember to include the thesis statement in your introduction. Usually, it goes at the end of the first paragraph.

• Present the main ideas of the body

You should tell the main topics you are going to discuss in the main body. For this reason, before writing this part of introduction, make sure you know what is your main body is going to be about. It should include your main ideas.

• Polish your thesis and introduction

When you finish the main body of your paper, come back to the thesis statement and introduction. Restate something if needed. Just make it perfect; because introduction is like the trailer to your paper, it should make the reader want to read the whole piece.

Learn how to write an introduction for a research paper . See research paper introduction examples .

How to Write a Body of a Research Paper?

A body is the main part of your research paper. In this part, you will include all the needed evidence; you will provide the examples and support your argument.

It is important to structure your paragraphs thoroughly. That is to say, topic sentence and the evidence supporting the topic. Stay focused and do not be sidetracked. You have your outline, so follow it.

Here are the main tips to keep in head when writing a body of a research paper:

• Let the ideas flow logically
• Include only relevant information
• Provide the evidence
• Structure the paragraphs
• Make the coherent transition from one paragraph to another

See? When it is all structured, it is not as scary as it seemed at the beginning. Still, if you have doubts, you can always ask our writers for help.

Learn how to write a body of a research paper . See research paper transition examples .

How to Write a Conclusion for a Research Paper?

Writing a good conclusion is important as writing any other part of the paper. Remember that conclusion is not a summary of what you have mentioned before. A good conclusion should include your last strong statement.

If you have written everything according to the plan, the reader already knows why your investigation is important. The reader has already seen the evidence. The only thing left is a strong concluding thought that will organize all your findings.

Never include any new information in conclusion. You need to conclude, not to start a new discussion.

Learn how to write a conclusion for a research paper .

How to Write an Abstract for a Research Paper?

An abstract is a brief summary of your paper, usually 100-200 words. You should provide the main gist of your paper in this short summary. An abstract can be informative, descriptive or proposal. Depending on the type of abstract, you need to write, the requirements will differ.

To write an informative abstract you have to provide the summary of the whole paper. Informative summary. In other words, you need to tell about the main points of your work, the methods used, the results and the conclusion of your research.

To write a descriptive abstract you will not have to provide any summery. You should write a short teaser of your paper. That is to say, you need to write an overview of your paper. The aim of a descriptive abstract is to interest the reader.

Finally, to write a proposal abstract you will need to write the basic summary as for the informative abstract. However, the difference is the following: you aim at persuading someone to let you write on the topic. That is why, a proposal abstract should present your topic as the one worth investigating.

Learn how to write an abstract for a research paper .

Should I Revise and Edit a Research Paper?

Revising and editing your paper is essential if you want to get high grades. Let us help you revise your paper smart:

• Check your paper for spelling and grammar mistakes
• Sharpen the vocabulary
• Make sure there are no slang words in your paper
• Examine your paper in terms of structure
• Compare your topic, thesis statement to the whole piece
• Check your paper for plagiarism

If you need assistance with proofreading and editing your paper, you can turn to the professional editors at our service. They will help you polish your paper to perfection.

Learn how to revise and edit a research paper .

How to Write a Bibliography for a Research Paper?

First, let us make it clear that bibliography and works cited are two different things. Works cited are those that you cited in your paper. Bibliography should include all the materials you used to do your research. Still, remember that bibliography requirements differ depending on the formatting style of your paper. For this reason, make sure you ask you professor all the requirements you need to meet to avoid any misunderstanding.

Learn how to write a bibliography for a research paper .

The Key Secret to a Good Research Paper

Now when you know all the stages of writing a research paper, you are ready to find the key to a good research paper:

• Choose the topic that really interests you
• Make the topic interesting for you even if it is not at the beginning
• Follow the step by step guide and do not get sidetracked
• Be persistent and believe in yourself
• Really do research and write your paper from scratch
• Learn the convincing writing techniques and use them
• Follow the requirements of your assignment
• Ask for help if needed from real professionals

Feeling more confident about your paper now? We are sure you do. Still, if you need help, you can always rely on us 24/7.

We hope we have made writing a research paper much easier for you. We realize that it requires lots of time and energy. We believe when you say that you cannot handle it anymore. For this reason, we have been helping students like you for years. Our professional team of writers is ready to tackle any challenge.

All our authors are experienced writers crafting excellent academic papers. We help students meet the deadline and get the top grades they want. You can see everything yourself. All you need to do is to place your order online and we will contact you. Writing a research paper with us is truly easy, so why do not you check it yourself?

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• Anthropology Research
• Career Research
• Communication Research
• Criminal Justice Research
• Health Research
• Political Science Research
• Psychology Research
• Sociology Research

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How to Write the Body of a Research Paper?

The body of your research paper serves as the heart of your scholarly work, where you present and support your ideas, arguments, and findings. In this comprehensive guide, we'll walk you through the essential steps to write an impactful and well-structured body for your research paper.

1. Start with a Solid Introduction:

• Begin your body by summarizing the main purpose and scope of your research.
• Clearly state your research question or thesis to provide readers with a roadmap for what to expect.

2. Organize Your Ideas Logically:

• Create a clear and logical flow of ideas. Organize your content in a way that builds a coherent and cohesive argument.
• Use headings and subheadings to guide readers through different sections.

3. Present Your Literature Review:

• If applicable, integrate a literature review to provide context and highlight existing research on your topic.
• Synthesize and critique relevant studies, identifying gaps in the current knowledge.

4. Methodology Section:

• Clearly describe your research design, methods, and procedures.
• Include details on your sample, data collection instruments, and data analysis techniques.

5. Results Presentation:

• Present your research findings objectively and concisely.
• Utilize tables, figures, and graphs to enhance the clarity and visual appeal of your results.

6. Interpret Your Results:

• Move beyond presenting raw data by interpreting the significance of your findings.
• Discuss patterns, trends, and relationships observed in the results.

7. Discussion Section:

• Engage in critical analysis and interpretation of your results.
• Relate your findings back to your research question or thesis.
• Discuss implications, limitations, and the broader significance of your research.

8. Address Counterarguments:

• Anticipate and address potential counterarguments to strengthen your position.
• Demonstrate a nuanced understanding of differing perspectives within your field.

9. Maintain a Consistent Tone and Style:

• Ensure a consistent tone throughout the body of your paper. Match the formality and style required by your academic discipline.
• Use clear and concise language to convey your ideas effectively.

10. Cite Sources Appropriately:

• Properly cite all sources used within the body of your paper.
• Follow the citation style specified by your academic institution or the guidelines of the journal to which you plan to submit.

11. Balance Detail and Brevity:

• Provide enough detail to support your arguments but avoid unnecessary repetition.
• Be mindful of the overall length of your paper and stay focused on your main points.

12. Revise and Edit:

• Review and revise your body several times to ensure clarity and coherence.
• Check for grammatical errors, typos, and proper formatting.

13. Seek Peer Feedback:

• Share your work with peers or mentors to get constructive feedback.
• Consider others' perspectives to refine your arguments and improve the overall quality of your writing.

Conclusion:

Writing the body of a research paper requires a careful blend of research, analysis, and effective communication. By following these steps, you'll be well on your way to creating a compelling and well-supported body that contributes meaningfully to your academic field. Remember, the body is where your ideas come to life, so take the time to craft it with precision and purpose. Happy writing!

Related Guides

• How to Write the Abstract of Your Research Paper?
• How to Write a Research Question?
• How to Write a Literature Review in 5 Steps
• How to Write a Research Paper?
• Research Methods : A Comprehensive Guide
• How to Create Bibliography or References Page

Table of Contents

Collaboration, information literacy, writing process.

• © 2023 by Jennifer Janechek - IBM Quantum

Review APA guidelines for the body of an APA-style paper.

Beginning at the top of a new page, the main body of the research paper follows the abstract and precedes the References page. Comprised of the introduction, method, results, and discussion subsections, the main body acts as the third major section of the document and typically begins on the third page of the paper.

General Format

Like the rest of the paper, the pages of the main body should be double-spaced and typed in Times New Roman, 12 pt. The margins are set at 1” on all sides. While the running head is flush with the upper left-hand corner of every page, the page number is flush with the upper right-hand corner of every page. Note that all letters of the running head should be capitalized and should not exceed 50 characters, including punctuation, letters, and spaces.

The full title of the paper is centered directly above the introduction with no extra space between the title and the first paragraph. Avoid formatting the title with bold, italics, underlining, or quotation marks. The first letter of each major word in the title should be capitalized. Unlike other sections of the main body, the introduction does not require a heading or label.

When writing each paragraph, note that the APA recommends using two spaces after sentences that end in a period; however, sentences that end in other punctuation marks may be followed by a single space.

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Writing a Research Paper

This page lists some of the stages involved in writing a library-based research paper.

Although this list suggests that there is a simple, linear process to writing such a paper, the actual process of writing a research paper is often a messy and recursive one, so please use this outline as a flexible guide.

Discovering, Narrowing, and Focusing a Researchable Topic

• Try to find a topic that truly interests you
• Try writing your way to a topic
• Talk with your course instructor and classmates about your topic
• Pose your topic as a question to be answered or a problem to be solved

Finding, Selecting, and Reading Sources

You will need to look at the following types of sources:

• library catalog, periodical indexes, bibliographies, suggestions from your instructor
• primary vs. secondary sources
• journals, books, other documents

Grouping, Sequencing, and Documenting Information

The following systems will help keep you organized:

• a system for noting sources on bibliography cards
• a system for organizing material according to its relative importance
• a system for taking notes

Writing an Outline and a Prospectus for Yourself

Consider the following questions:

• What is the topic?
• Why is it significant?
• What background material is relevant?
• What is my thesis or purpose statement?
• What organizational plan will best support my purpose?

Writing the Introduction

In the introduction you will need to do the following things:

• present relevant background or contextual material
• define terms or concepts when necessary
• explain the focus of the paper and your specific purpose
• reveal your plan of organization

Writing the Body

• Use your outline and prospectus as flexible guides
• Build your essay around points you want to make (i.e., don’t let your sources organize your paper)
• Integrate your sources into your discussion
• Summarize, analyze, explain, and evaluate published work rather than merely reporting it
• Move up and down the “ladder of abstraction” from generalization to varying levels of detail back to generalization

Writing the Conclusion

• If the argument or point of your paper is complex, you may need to summarize the argument for your reader.
• If prior to your conclusion you have not yet explained the significance of your findings or if you are proceeding inductively, use the end of your paper to add your points up, to explain their significance.
• Move from a detailed to a general level of consideration that returns the topic to the context provided by the introduction.
• Perhaps suggest what about this topic needs further research.

Revising the Final Draft

• Check overall organization : logical flow of introduction, coherence and depth of discussion in body, effectiveness of conclusion.
• Paragraph level concerns : topic sentences, sequence of ideas within paragraphs, use of details to support generalizations, summary sentences where necessary, use of transitions within and between paragraphs.
• Sentence level concerns: sentence structure, word choices, punctuation, spelling.
• Documentation: consistent use of one system, citation of all material not considered common knowledge, appropriate use of endnotes or footnotes, accuracy of list of works cited.

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• Knowledge Base
• Research paper

How to Create a Structured Research Paper Outline | Example

Published on August 7, 2022 by Courtney Gahan . Revised on August 15, 2023.

A research paper outline is a useful tool to aid in the writing process , providing a structure to follow with all information to be included in the paper clearly organized.

A quality outline can make writing your research paper more efficient by helping to:

• Organize your thoughts
• Understand the flow of information and how ideas are related
• Ensure nothing is forgotten

A research paper outline can also give your teacher an early idea of the final product.

Instantly correct all language mistakes in your text

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Table of contents

Research paper outline example, how to write a research paper outline, formatting your research paper outline, language in research paper outlines.

• Definition of measles
• Rise in cases in recent years in places the disease was previously eliminated or had very low rates of infection
• Figures: Number of cases per year on average, number in recent years. Relate to immunization
• Symptoms and timeframes of disease
• Risk of fatality, including statistics
• How measles is spread
• Immunization procedures in different regions
• Different regions, focusing on the arguments from those against immunization
• Immunization figures in affected regions
• High number of cases in non-immunizing regions
• Illnesses that can result from measles virus
• Fatal cases of other illnesses after patient contracted measles
• Summary of arguments of different groups
• Summary of figures and relationship with recent immunization debate
• Which side of the argument appears to be correct?

Receive feedback on language, structure, and formatting

Professional editors proofread and edit your paper by focusing on:

• Academic style
• Vague sentences
• Style consistency

See an example

Follow these steps to start your research paper outline:

• Decide on the subject of the paper
• Write down all the ideas you want to include or discuss
• Organize related ideas into sub-groups
• Arrange your ideas into a hierarchy: What should the reader learn first? What is most important? Which idea will help end your paper most effectively?
• Create headings and subheadings that are effective
• Format the outline in either alphanumeric, full-sentence or decimal format

There are three different kinds of research paper outline: alphanumeric, full-sentence and decimal outlines. The differences relate to formatting and style of writing.

• Alphanumeric
• Full-sentence

An alphanumeric outline is most commonly used. It uses Roman numerals, capitalized letters, arabic numerals, lowercase letters to organize the flow of information. Text is written with short notes rather than full sentences.

• Sub-point of sub-point 1

Essentially the same as the alphanumeric outline, but with the text written in full sentences rather than short points.

• Additional sub-point to conclude discussion of point of evidence introduced in point A

A decimal outline is similar in format to the alphanumeric outline, but with a different numbering system: 1, 1.1, 1.2, etc. Text is written as short notes rather than full sentences.

• 1.1.1 Sub-point of first point
• 1.1.2 Sub-point of first point
• 1.2 Second point

To write an effective research paper outline, it is important to pay attention to language. This is especially important if it is one you will show to your teacher or be assessed on.

There are four main considerations: parallelism, coordination, subordination and division.

Parallelism: Be consistent with grammatical form

Parallel structure or parallelism is the repetition of a particular grammatical form within a sentence, or in this case, between points and sub-points. This simply means that if the first point is a verb , the sub-point should also be a verb.

Example of parallelism:

• Include different regions, focusing on the different arguments from those against immunization

Coordination: Be aware of each point’s weight

Your chosen subheadings should hold the same significance as each other, as should all first sub-points, secondary sub-points, and so on.

Example of coordination:

• Include immunization figures in affected regions
• Illnesses that can result from the measles virus

Subordination: Work from general to specific

Subordination refers to the separation of general points from specific. Your main headings should be quite general, and each level of sub-point should become more specific.

Example of subordination:

Division: break information into sub-points.

Your headings should be divided into two or more subsections. There is no limit to how many subsections you can include under each heading, but keep in mind that the information will be structured into a paragraph during the writing stage, so you should not go overboard with the number of sub-points.

Ready to start writing or looking for guidance on a different step in the process? Read our step-by-step guide on how to write a research paper .

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

Gahan, C. (2023, August 15). How to Create a Structured Research Paper Outline | Example. Scribbr. Retrieved June 10, 2024, from https://www.scribbr.com/research-paper/outline/

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Writing the Body Of the Paper

Ask these questions:

What is it?

It is putting all of your research together in a format that you can present to people.

There are many different ways to put together and present your thesis statement and supporting evidence.

Once you have an '); Activate();" onmouseout="deActivate()">outline that you like, you will be able to link your ideas and evidence either with sentences and paragraphs, visuals, sounds, movements, or a combination of any of these.

This tip sheet will focus on the written research paper, which is the format most commonly required.

If you have some flexibility in how you present your project, see Alternative Formats for the Presentation of Research Projects.

How do I begin to write the body of a research paper?

• You will continue in this manner until you reach the conclusion section of your outline.

:

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Writing a Research Paper

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The Research Paper

There will come a time in most students' careers when they are assigned a research paper. Such an assignment often creates a great deal of unneeded anxiety in the student, which may result in procrastination and a feeling of confusion and inadequacy. This anxiety frequently stems from the fact that many students are unfamiliar and inexperienced with this genre of writing. Never fear—inexperience and unfamiliarity are situations you can change through practice! Writing a research paper is an essential aspect of academics and should not be avoided on account of one's anxiety. In fact, the process of writing a research paper can be one of the more rewarding experiences one may encounter in academics. What is more, many students will continue to do research throughout their careers, which is one of the reasons this topic is so important.

Becoming an experienced researcher and writer in any field or discipline takes a great deal of practice. There are few individuals for whom this process comes naturally. Remember, even the most seasoned academic veterans have had to learn how to write a research paper at some point in their career. Therefore, with diligence, organization, practice, a willingness to learn (and to make mistakes!), and, perhaps most important of all, patience, students will find that they can achieve great things through their research and writing.

The pages in this section cover the following topic areas related to the process of writing a research paper:

• Genre - This section will provide an overview for understanding the difference between an analytical and argumentative research paper.
• Choosing a Topic - This section will guide the student through the process of choosing topics, whether the topic be one that is assigned or one that the student chooses themselves.
• Identifying an Audience - This section will help the student understand the often times confusing topic of audience by offering some basic guidelines for the process.
• Where Do I Begin - This section concludes the handout by offering several links to resources at Purdue, and also provides an overview of the final stages of writing a research paper.

Welcome to 2024! Happy New Year!

Research Writing ~ How to Write a Research Paper

• Choosing A Topic
• Critical Thinking
• Domain Names
• Starting Your Research
• Writing Tips
• Parts of the Paper
• Edit & Rewrite
• Citations This link opens in a new window

Papers should have a beginning, a middle, and an end. Your introductory paragraph should grab the reader's attention, state your main idea and how you will support it. The body of the paper should expand on what you have stated in the introduction. Finally, the conclusion restates the paper's thesis and should explain what you have learned, giving a wrap up of your main ideas.   

1. The Title The title should be specific and indicate the theme of the research and what ideas it addresses. Use keywords that help explain your paper's topic to the reader. Try to avoid  abbreviations  and  jargon.  Think about keywords that people would use to search for your paper and include them in your title. 

2. The Abstract The abstract is used by readers to get a quick overview of your paper. Typically, they are about 200 words in length (120 words minimum to  250 words maximum). The abstract should introduce the topic and thesis, and should provide a general statement about what you have found in your research. The abstract allows you to mention each major aspect of you topic and helps readers decide whether they want to read the rest of the paper. Because it is a summary of the entire research paper, it is often written last. 

3. The Introduction The introduction should be designed to attract the reader's attention and explain the focus of the research. You will introduce your overview of the topic, your main points of information, and why this subject is important. You can introduce the current understanding and background information about the topic. Toward the end of the introduction, you add your thesis statement, and explain how you will provide information to support your research questions. This provides the purpose, focus, and structure for the rest of the paper.

4. Thesis Statement Most papers will have a thesis statement or main idea and supporting facts/ideas/arguments. State your main idea (something of interest or something to be proven or argued for or against) as your thesis statement, and then provide  supporting facts and arguments. A thesis statement is a declarative sentence that asserts the position a paper will be taking. It also points toward the paper's development. This statement should be both specific and arguable. Generally, the thesis statement will be placed at the end of the first paragraph of your paper. The remainder of your paper will support this thesis.

Students often learn to write a thesis as a first step in the writing process, but often, after research, a writers viewpoint may change. Therefore a thesis statement may be one of the final steps in writing. 

Examples of thesis statements from Purdue OWL. . .

5. The Literature Review The purpose of the literature review is to describe past important research and how it specifically relates to the research thesis. It should be a synthesis of the previous literature and the new idea being researched. The review should examine the major theories related to the topic to date and their contributors. It should include all relevant findings from credible sources, such as academic books and peer-reviewed journal articles. You will want  to:

• Explain how the literature helps the researcher understand the topic.
• Try to show connections and any disparities between the literature.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.

More about writing a literature review. . .  from The Writing Center at UNC-Chapel Hill More about summarizing. . . from the Center for Writing Studies at the University of Illinois-Urbana Champaign

6. The Discussion ​The purpose of the discussion is to interpret and describe what you have learned from your research. Make the reader understand why your topic is important. The discussion should always demonstrate what you have learned from your readings (and viewings) and how that learning has made the topic evolve, especially from the short description of main points in the introduction. Explain any new understanding or insights you have had after reading your articles and/or books. Paragraphs should use transitioning sentences to develop how one paragraph idea leads to the next. The discussion will always connect to the introduction, your thesis statement, and the literature you reviewed, but it does not simply repeat or rearrange the introduction. You want to: 

• Demonstrate critical thinking, not just reporting back facts that you gathered.
• If possible, tell how the topic has evolved over the past and give it's implications for the future.
• Fully explain your main ideas with supporting information.
• Explain why your thesis is correct giving arguments to counter points.

​7. The Conclusion A concluding paragraph is a brief summary of your main ideas and restates the paper's main thesis, giving the reader the sense that the stated goal of the paper has been accomplished. What have you learned by doing this research that you didn't know before? What conclusions have you drawn? You may also want to suggest further areas of study, improvement of research possibilities, etc. to demonstrate your critical thinking regarding your research.

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Cultural differences in body image: a systematic review.

1. Introduction

2. materials and methods, 2.1. study protocol, 2.2. eligibility criteria and study selection.

• Inclusion criteria
• Original peer-reviewed research articles published in English;
• Including human subjects of any gender and ethnicity;
• Participants with age more than 4 years old;
• Empirical research articles, including cross-sectional, longitudinal, and experimental designs;
• Published between 1990 and 2023;
• Focus on body image, body dissatisfaction, or related constructs with a cultural or cross-cultural component.
• Exclusion criteria
• Conference papers, review papers, book chapters, etc.;
• Participants less than the age of 4 years old;
• Non-English research articles;
• Articles not focusing on body image or related constructs;
• Studies without a cultural or cross-cultural component.

2.3. Assessment of Quality

3.1. sample characteristics, 3.2. body image and culture, 3.3. vulnerable groups, 3.4. mental health, 4. discussion, 5. limitations and future directions, 6. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Database	Query	Number of Results
PubMed	(“Culture” OR “Cultural Norms” OR “Cultural Expectations” OR “Cultural Influences” OR “Cultural Values” OR “Cultural Factors” OR “ethnic” OR “ethnicity”) AND (“Cultural Differences” OR “Cultural Variation” OR “Cultural Diversity” OR “Cross-Cultural Differences” OR “Intercultural Differences” OR “Cross-Cultural Studies” OR “Cross-Cultural Comparison” OR “Cross-Cultural Analysis” OR “Cross-Cultural Research”) AND (“Body” OR “Body Image” OR “Self-Image” OR “Body Perception” OR “Body Esteem” OR “Body Attitudes” OR “Body Dissatisfaction” OR “Body Concerns” OR “Body Image Disturbance” OR “Negative Body Image” OR “Body Image Issues” OR “Body Discontent” OR “Appearance” OR “Negative Body Attitudes” OR “Body Image Dissatisfaction” OR “Beauty Ideals” OR “Beauty Standards” OR “Idealized Beauty” OR “Physical Attractiveness Standards” OR “Sociocultural Beauty Ideals” OR “Cultural Expectations” OR “Cultural Standards” OR “Societal Expectations” OR “Social Norms” OR “Cultural Norms” OR “Internalization of Standards” OR “Internalization” OR “Beauty Ideal Internalization” OR “Thin-Ideal Internalization” OR “Internalization of Sociocultural Standards” OR “Internalization of Body Ideals”) Filters: English, from 1990–2023	1003
Scopus	TITLE-ABS-KEY (“Culture” OR “Cultural Norms” OR “Cultural Expectations” OR “Cultural Influences” OR “Cultural Values” OR “Cultural Factors” OR “ethnic” OR “ethnicity”) AND TITLE-ABS-KEY (“Cultural Differences” OR “Cultural Variation” OR “Cultural Diversity” OR “Cross-Cultural Differences” OR “Intercultural Differences” OR “Cross-Cultural Studies” OR “Cross-Cultural Comparison” OR “Cross-Cultural Analysis” OR “Cross-Cultural Research”) AND TITLE-ABS-KEY (“Body” OR “Body Image” OR “Self-Image” OR “Body Perception” OR “Body Esteem” OR “Body Attitudes” OR “Body Dissatisfaction” OR “Body Concerns” OR “Body Image Disturbance” OR “Negative Body Image” OR “Body Image Issues” OR “Body Discontent” OR “Appearance” OR “Negative Body Attitudes” OR “Body Image Dissatisfaction” OR “Beauty Ideals” OR “Beauty Standards” OR “Idealized Beauty” OR “Physical Attractiveness Standards” OR “Sociocultural Beauty Ideals” OR “Cultural Expectations” OR “Cultural Standards” OR “Societal Expectations” OR “Social Norms” OR “Cultural Norms” OR “Internalization of Standards” OR “Internalization” OR “Beauty Ideal Internalization” OR “Thin-Ideal Internalization” OR “Internalization of Sociocultural Standards” OR “Internalization of Body Ideals”) AND PUBYEAR > 1989 AND PUBYEAR < 2024 AND (LIMIT-TO (DOCTYPE, “ar”)) AND (LIMIT-TO (LANGUAGE, “English”)) AND (LIMIT-TO (SRCTYPE, “j”))	2382
Web of Science	TS = (“Culture” OR “Cultural Norms” OR “Cultural Expectations” OR “Cultural Influences” OR “Cultural Values” OR “Cultural Factors” OR “ethnic” OR “ethnicity”) AND TS = (“Cultural Differences” OR “Cultural Variation” OR “Cultural Diversity” OR “Cross-Cultural Differences” OR “Intercultural Differences” OR “Cross-Cultural Studies” OR “Cross-Cultural Comparison” OR “Cross-Cultural Analysis” OR “Cross-Cultural Research”) AND TS = (“Body” OR “Body Image” OR “Self-Image” OR “Body Perception” OR “Body Esteem” OR “Body Attitudes” OR “Body Dissatisfaction” OR “Body Concerns” OR “Body Image Disturbance” OR “Negative Body Image” OR “Body Image Issues” OR “Body Discontent” OR “Appearance” OR “Negative Body Attitudes” OR “Body Image Dissatisfaction” OR “Beauty Ideals” OR “Beauty Standards” OR “Idealized Beauty” OR “Physical Attractiveness Standards” OR “Sociocultural Beauty Ideals” OR “Cultural Expectations” OR “Cultural Standards” OR “Societal Expectations” OR “Social Norms” OR “Cultural Norms” OR “Internalization of Standards” OR “Internalization” OR “Beauty Ideal Internalization” OR “Thin-Ideal Internalization” OR “Internalization of Sociocultural Standards” OR “Internalization of Body Ideals”)	992

Authors	Screening Questions		Quantitative Descriptive
	Are There Clear Research Questions?	Do the Collected Data Allow the Research Questions to Be Addressed?	Is the Sampling Strategy Relevant to Address the Research Question?	Is the Sample Representative of the Target Population?	Are the Measurements Appropriate?	Is the Risk of Nonresponse Bias Low?	Is the Statistical Analysis Appropriate to Answer the Research Question?
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( )	Y	Y	Y	Y	Y	Y	Y
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( )	Y	Y	Y	Y	Y	C	Y
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( )	Y	Y	Y	Y	Y	C	Y
( )	Y	Y	Y	Y	Y	Y	Y
( )	Y	Y	Y	Y	Y	Y	Y
( )	Y	Y	Y	Y	Y	Y	Y
( )	Y	Y	Y	Y	Y	C	Y
( )	Y	Y	Y	Y	Y	Y	Y
( )	Y	Y	Y	Y	Y	Y	Y
( )	Y	Y	Y	Y	Y	Y	Y
( )	Y	Y	Y	Y	Y	Y	Y
( )	Y	Y	Y	Y	Y	C	Y
( )	Y	Y	Y	Y	Y	Y	Y

Authors	Study Aim	Age Range	Sample	Instruments	Cultures/Ethnicities	Countries
( )	To assess positive body image, body satisfaction, weight bias, and appearance comparison in emerging adults across eight different countries	18–30	6272	Body Appreciation Scale-2, Body Areas Satisfaction Scale, Physical Appearance Comparison Scale, and Weight Bias Internalization Scale	Australian, Belgian, Canadian, Chinese, Italian, Japanese, Spanish, and American	Australia, Belgium, Canada, China, Italy, Japan, Spain, and United States
( )	Eating attitudes/behaviours, body image, and psychological functioning in college women from different ethnic groups	18–21	98	Self-Consciousness Scale, Rosenberg Self-Esteem Scale, Eating Attitudes Test, Goldfarb Fear of Fat Scale, Eating Disorder Examination—Questionnaire Version, Physical Appearance Related Teasing Scale, Body Shape Questionnaire, Black Racial Identity Attitudes Scale, and Suinn–Lew Acculturation Scale	African American, Asian American, and Caucasian	United States
( )	Differences in current and ideal body size among preschool children	4–6	237	Modified 7-point Collins pictorial scale	Japanese and Croatian	Japan and Croatia
( )	The commonness of body image concerns and body dysmorphic disorder among American and German students	17–27	234	Body Dysmorphic Disorder Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Maudsley Obsessive-Compulsive Inventory, Self-Esteem Scale, and Skin-Picking Inventory	American and German	United States and Germany
( )	Relationship between modernity, acculturation to slim ideals, and body size among Samoans	30–43	301	Visual Scale for Body Image, Anthropometric Measurements		Samoa, American Samoa, and New Zealand
( )	Cultural influences on body image among Japanese adolescents in comparison with peers from China, Malaysia, Australia, Tonga, and Fiji	12–18	2382	Body Dissatisfaction Measure, media subscale of the Perceived Sociocultural Influences on Body Image and Body Change Questionnaire	Japanese, Chinese, Malaysian, Australian, Tongan, and Fijian	Japan, China, Malaysia, Australia, Tonga, and Fiji
( )	Eating attitudes/problems and associated psychological problems in different ethnic groups	18–27	235	Eating Attitudes Test (EAT-26), Rosenberg Self-Esteem Scale, and The Hospital Anxiety and Depression Scale	Caucasian, Asian (originating from the Indian subcontinent), Black (Afro-Caribbean), and Chinese	United Kingdom
( )	Differences in eating attitudes and body shape concerns among South African schoolgirls from diverse ethnic backgrounds	15–18	228	Eating Attitudes Test, Body Shape Questionnaire, and Body Silhouette Chart	Black, mixed-race, and White	South Africa
( )	Body image perceptions and dissatisfaction among Hispanic/Latino and European American adolescents	12–15	319	Computerized survey, FRS, ChEAT-26, and Body Stereotypes Assessment	Hispanic/Latino and European American	United States
( )	Body shape perception and body affect among Chinese and American college students	21–23	605	Body-image Questionnaire, BMI-based Silhouette-Matching Test, Rosenberg Self-Esteem Scale, Depression Anxiety Stress Scales-21, UCLA Loneliness Scale, Satisfaction With Life Scale, and Eating Behaviors and Weight Control Questionnaire	Chinese and American	China and United States
( )	Body satisfaction and enforcement to be thin in young and old Muslim and non-Muslim women, investigating the effect of Western and non-Western dress preferences	18–74	201	Demographic Questionnaire, Figure Rating Scale, Eating Disorder Inventory 3, and Sociocultural Attitudes Toward Appearance Questionnaire-3	Muslim and non-Muslim women	United States
( )	Symptoms of eating disorders among Filipino and Caucasian college students and variables associated with disordered eating	18–33	290	Self Loathing Subscales, Figure Drawings, Drive for Thinness Subscale, and Eating Disorder Inventory-2	Filipino and Caucasian	United States (Hawaii)
( )	Levels of body dissatisfaction, attitudes associated with disordered eating, and the influence of cultural appearance standards among young women from Argentina, Brazil, and the U.S.	18–24	301	Body Mass Index, Figure Rating Scale, Body Esteem Scale for Adolescents and Adults, and Eating Disorders Inventor Perceived Sociocultural Pressure Scale, Sociocultural Attitudes Toward Appearance Questionnaire, and Objectified Body Consciousness Scale	Argentinian, Brazilian, and American	Argentina, Brazil, and the United States
( )	Body image and eating attitudes among adolescent girls in Hong Kong	15–21	358	Body Mass Index (BMI), Body Parts Satisfaction Scale-Revised, and Eating Attitudes Test-26.	Chinese	Hong Kong
( )	To examine the shared Western fat lived experience and its perpetuation of a stigmatized gendered landscape in the lives of fat women in North America and Finland	19–65	121	In-depth interviews, autobiographical writings, and thematic analysis	North American (Latina, Native American, African American, and Caucasian) and Finnish (white ethnic Finns) women	Finland, United States, and Canada
( )	Cultural values influencing attitudes toward cosmetic surgery among Chinese, Japanese, and Korean students	18–21	206	A questionnaire study focused on invasive surgical cosmetic procedures and qualitative data collection (comments to support their attitudes towards cosmetic surgery)	Chinese, Japanese, and South Korean	China, Japan, and South Korea
( )	Cross-cultural differences in various aspects of body image, including body size ratings of self, ideal and ideal opposite sex, and predictions about the opposite sex’s preferences	19–20	240	Body Image Assessment	Spanish and American	Spain and United States
( )	Body image, eating disorder symptoms, and acculturation-relevant variables among White, Latina, and Black college women	17–49	276	Eating Disorder Inventory, Stunkard Body Figure Scale, Stephenson Multigroup Acculturation Scale, Societal, Attitudinal, Familial, and Environmental Acculturative Stress Scale, and Rosenberg Self-Esteem Scale	White, Latina, and Black	United States
( )	The influence of sociocultural attitudes toward the body on motivation for physical activity among Polish and Chinese youth	18–30	467	Sociocultural Attitudes Towards Appearance Questionnaire-3, and Inventory of Physical Activity Objectives	Polish and Chinese	Poland and China
( )	Ethnic differences in body satisfaction and the influence of social feedback	M = 21	117	Body Esteem Scale, Eating Disorders Inventory, Social Rating Scale, Manipulation Check, and Deception Check	White and Black American	United States
( )	Examine body type preferences and characteristics associated with attractiveness in African culture	~21	83	The Body Type Preferences Survey	African American and Anglo American	United States
( )	Body dissatisfaction and disordered eating among college women in China, South Korea, and the United States based on sociocultural and feminist theories.	18–25	348	Body Mass Index, Figure Rating Scale, Body Esteem Scale, Body Esteem Scale for Adolescents and Adults, Eating Disorder Inventory (EDI), and Sociocultural Attitudes Towards Appearance Questionnaire	Chinese, Korean, and American	China, South Korea, and United States
( )	Ideal body size beliefs and perceptions among White and Black adolescent females	13–16	344	A 30-item questionnaire and a series of nine female and male body size drawings	White and Black	United States
( )	How cultural background and self-construal (interdependent vs. independent) influence women’s perception of their body weight and participation in health-related activities.	18–25	Phase One: 277 Phase Two: 182	Phase One: Body Mass Index, Subjective Evaluation of Obesity, and Measures of Engagement in Healthy Behavior Phase Two: Weight Overestimation Measurement, Health Activities Engagement, Exploratory Factor Analysis, Self-Criticism Measurement, Self-Construal Measure, and Self-Deprecation Measurement	Japanese, Korean, and American	Japan, South Korea, and United States
( )	Age and cultural differences in obesity stereotypes among adolescents	13–16	335	Silhouette Matching Task, Obesity Attribution Questionnaire, and Sociocultural Attitudes Toward Appearance Questionnaire	Chinese and American	China and USA
( )	Ethnic and racial differences in body size perception and satisfaction	25–45	4023	General Eating and Dieting Questions and Figural Stimuli Questionnaire	Hispanic, non-Hispanic, White, Black or African American, Asian, Native Hawaiian, and American Indian	United States
( )	To compare the prevalence of body image and eating distress among adolescents in Japan and Finland, examine associated factors	13–14	2975	Body Image and Eating Distress Scale and Strengths and Difficulties Questionnaire	Japanese and Finnish	Japan and Finland
( )	Cross-cultural differences in body image ideals among Arab immigrants and Germans	12–34	180	Body Shape Perception Measures, Ideal Body Image Indication, and Self-Placement on Body Size Scale	Arab and German	Germany
( )	Sociocultural pressures on body change behaviours	13–19	4904	Sociocultural effect on Body Image, Body Change Questionnaire, and surveys including questions about actual body change strategies	Australian, Chilean, Chinese, Indo-Fijian, Indigenous Fijian, Greek, Malaysian, Chinese Malaysian, and Tongan	Australia, Chile, China, Fiji, Greece, Malaysia, New Zealand, and Tonga
( )	Cultural values connected to body image and eating practices in Western and non-Western societies	10–19	2223	Cultural Values Scale (assessing Pacific Islander values on body size and religious impacts on eating, including ideals and practices)	Fijian, Indo-Fijian, Tongan, and Australian	Fiji, Tonga, and Australia
( )	Body features associated with male adolescents’ body dissatisfaction in different cultures	12–19	462	Extended version of the Body Image Dissatisfaction subscale from the Body Image and Body Change Inventory	Malaysian Malay, Malaysian Chinese, Chinese, and Australian	Malaysia, China, and Australia
( )	Intercultural variation in attention to male body features	18–30	59	Free listing, pile sorting, rating tasks, cultural consensus analysis	South Korean and American	South Korea and United States
( )	Body weight concerns among female university students	17–32	1134	Modified questionnaire from previously validated questions translated into Arabic	Arab	Bahrain, Egypt, Jordan, Oman, and Syria
( )	Internalization of Western beauty ideals and depressive symptoms and the mediating role of self-esteem	16–23	222	The Sociocultural Attitudes Towards Appearance Questionnaire-3 and Beck Depression Inventory-II	African	Jamaica
( )	Body image ideals and dieting behaviours among African American and White adolescent females	14–18	296	Interviews, surveys, and focus groups	African American and White	United States
( )	Exploring weight bias and its predictors in the United States, Canada, Iceland, and Australia	≥18	2866	Fat Phobia Scale, Universal Measure of Bias-FAT version, Beliefs about the Causes of Obesity, Experiences of Weight Bias, and Attributions of Weight-Related Blame and Willpower	American, Canadian, Icelandic, and Australian	Iceland, the United States, Canada, and Australia
( )	The correlates of adolescent body image perception, including ethnicity and weight-related behaviour	~16	251	Eating Attitudes Test, Body Shape Questionnaire, Rosenberg Self-Esteem Scale, Drive-for-Thinness subscale of the Eating Disorder Inventory–2, and Discriminant body silhouette chart	Indo-Trinidadian, Afro-Trinidadian, Indo-Afro mixed Trinidadian, and other ethnicities	Trinidad
( )	Investigate the Body Appreciation Scale-2 (BAS-2) measurement invariance across adults from five countries	18–82	2944	Body Appreciation Scale-2	American, Polish, Serbian, and Iranian	Iran, Japan, Poland, Serbia, and the United States
( )	Examine body-related emotions in Canada and Poland	19–30	561	Body and Appearance Self-Conscious Emotions Scale	Canadian and Polish	Canada and Poland
( )	Differences in physical appearance identity among young women in four regions of Thailand	18–24	200	Q methodology (cards each labelled with a physical appearance characteristic)	Thai	Thailand
( )	Body image perceptions among African American college-age women from different university settings	18–25	651	“The Young Women’s Experiences with Body Weight and Shape” survey assessing weight dissatisfaction, body image, and other factors	African American	United States
( )	Cross-cultural differences in body image disturbance and eating pathology risk factors	18–30	2275	Sociocultural Attitudes Towards Appearance Questionnaire-4	Italian, English, Australian, American	United States, Italy, England, and Australia
( )	Cultural differences in body dissatisfaction, stress relationships, and body ideals	18–26	96	Body Shape Questionnaire, Impact of Event Scale, and Body Figure Rating Scale	Bosnian and American	Bosnia and United States
( )	Body dissatisfaction, thin-ideal internalization, sociocultural influences, problematic weight-related behaviours, and health behaviours, examining how body dissatisfaction is linked with health behaviours like smoking, alcohol and drug use, and sexual activities across different cultures	18–25	830	Sociocultural Attitudes Towards Appearance Questionnaire 4, Body Image Concern (BIC) subscale of the Body Image and Body Change Questionnaire, Restrained Eating Subscale of the Dutch Eating Behaviour Questionnaire, Bulimia subscale of the Eating Attitudes Test, and Youth Risk Behavior Survey	Malaysian and Australian	Australi and Malaysia
( )	Body image dissatisfaction and eating disturbance among Australian and Hong Kong women, examining the validity of a biopsychosocial mediation model	17–28	148	EDI-2-BD (Eating Disorders Inventory-2—Body Dissatisfaction Scale), Rosenberg Self-Esteem Inventory (RSE), Multidimensional Media Influence Scale (MMIS), and Physical Appearance Related Teasing Scale (PARTS)	Australian Caucasian and Hong Kong Chinese	Australia and Hong Kong
( )	Body image discrepancies and perceived weight status in adult Japanese women, comparing Japanese and American body ideals	21–56	45	Stunkard Body Figure Scale, Perceived Weight Status Rating, and Eating Disorders Inventory	Japanese	Japan
( )	Body perception among Jamaican adolescent girls	15–18	122	Questionnaire including demographic data, pregnancy status, and perception of weight	Jamaican	Jamaica
( )	Examine leg-to-body ratio preferences in a traditional semi-nomadic group	15–18	81	Silhouette stimuli and attractiveness assessment (participants were asked to rate the attractiveness of each silhouette)	Himba	Namibia
( )	Global differences in ideal female body weight and body dissatisfaction	Various (General public and college students)	7434	Female Contour Drawing Figure Rating Scale and media exposure scale	Various	North America (Canada and USA), South America (Chile), Western Europe (Austria, Belgium, Germany, Portugal, Switzerland, and UK), Eastern Europe (Croatia, Estonia, and Poland), Scandinavia (Finland and Sweden), Oceania (Australia and New Zealand), Southeast Asia (Indonesia, Malaysia, Philippines, and Singapore), East Asia (China and South Korea), South and West Asia (India and Turkey), and Africa (South Africa)
( )	Cross-cultural body figure preference in South African adolescents, examining the relationship between body dissatisfaction and eating disorders	13–18	1714	Body Figure Preference Test, Eating Attitudes Test, and body mass index	Black and White South African	South Africa
( )	Differences in body size and composition between young adult Japanese Americans and nationals of Japan.	18–23	100	Underwater weighing for body composition measurement, anthropometric measurements, body mass index, body surface area, and ratios like the length of lower limbs to body height	Japanese Americans, and Japanese nationals	United States and Japan
( )	Investigate cultural influences on body image by comparing body size ideals, body image, and dieting concerns in young White and Asian British women	14–15 19–22	274	General information, height/weight change, weight loss, weighing frequency, restraint (DEBQ), size judgments, body parts perception, Figure Rating Scale (Stunkard et al.), Body Shape Questionnaire (BSQ), and reading and viewing habits	Asian and Caucasian British	United Kingdom
( )	Body shape indices between white British and American adults and among different American ethnic groups	>17 years	12,244	Three-dimensional (3D) body-scanning instrumentation and general linear models	British, African American, Hispanic American, and American	United Kingdom and United States
( )	Perceptions of ideal body size among black and white adolescent females	14–17	173	Body Size Values instrument and demographic and weight control attitude questions	Black and White	United States

The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

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Abdoli, M.; Scotto Rosato, M.; Desousa, A.; Cotrufo, P. Cultural Differences in Body Image: A Systematic Review. Soc. Sci. 2024 , 13 , 305. https://doi.org/10.3390/socsci13060305

Abdoli M, Scotto Rosato M, Desousa A, Cotrufo P. Cultural Differences in Body Image: A Systematic Review. Social Sciences . 2024; 13(6):305. https://doi.org/10.3390/socsci13060305

Abdoli, Marzieh, Marco Scotto Rosato, Avinash Desousa, and Paolo Cotrufo. 2024. "Cultural Differences in Body Image: A Systematic Review" Social Sciences 13, no. 6: 305. https://doi.org/10.3390/socsci13060305

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First steps toward a whole-body map of molecular responses to exercise

by Coydon Ireland, Pacific Northwest National Laboratory

Research definitively confirms that muscle-moving, calorie-burning activity slows the advance of disease, improves cognitive function, boosts the immune system, and reduces rates of mortality from all causes.

Scientists are now going even deeper into the effects of exercise on humans and other mammals by investigating the impacts of exercise at the molecular level. They aim to uncover, at the smallest scales, the impacts of exercise and to better understand how the body works in states of health and disease.

Molecules are clusters of atoms. They represent the smallest unit of a chemical compound that can take part in a chemical reaction. Such chemical reactions in proteins, carbohydrates, lipids (fats), and nucleic acids—the "omics" (cellular components) that control the inner workings of every organ system.

Exercise appears to change these molecular workhorses in ways that are poorly understood. Identifying such changes, however, holds out the promise of clinical benefits for all humans, regardless of age, sex, body composition, or fitness level.

The genesis of MoTrPAC

In late 2016, to find out more about exercise-induced changes at the molecular level , the National Institutes of Health Common Fund began supporting expanded research into mapping the smallest details of how exercise helps maintain healthy tissues and organ systems. That led to establishing a national group of collaborative experts called the Molecular Transducers of Physical Activity Consortium (MoTrPAC).

From the start, Pacific Northwest National Laboratory (PNNL)—under the direction of biochemists Josh Adkins and Wei-Jun Qian—has been among MoTrPAC's nationwide centers of expertise in animal and human exercise, biomolecular analyses, and bioinformatics.

The consortium's biomolecular analysis centers use an omics approach to analyze genes, proteins, or other biomolecules at a whole-body level. Ultimately, the goal of MoTrPAC is to create a molecular map of exercise responses in both human and animal models. From muscle to molecule, such a map would help reveal how exercise affects health.

"The ability to see broad molecular responses across organs in the body is particularly intriguing," said Qian of molecular mapping. "Such knowledge could be a strong motivating factor for exercising."

An emphasis on proteomics

PNNL's main role in MoTrPAC is to investigate exercise-induced changes in proteins and post-translational modifications (PTMs). Proteins are made of amino acid chains that fold into three-dimensional structures and that then regulate tissue and organ structure and function. PTMs are processing events that alter protein functions by chemically modifying specific amino acids within a given protein. Studying changes in all detectable proteins and their PTMs in a sample is called proteomics.

"We've been central to the study design of the consortium from the very beginning, with an emphasis on proteomics," said Adkins. He acknowledged a critical partner: Steven Carr and his proteomics group at the Broad Institute, a research center directed by Harvard University and the Massachusetts Institute of Technology.

A mapping challenge

In a 2020 perspective overview in the journal Cell , Adkins and PNNL biomedical scientist James Sanford joined with other co-authors to describe molecular "cross talk," a kind of chemical telegraph prompted by exercise among a variety of tissues. The study also outlined the importance of mapping such molecular exchanges.

The Cell paper also introduced the idea of a public MoTrPAC dataset to help find the hidden mechanisms behind the benefits of exercise. It is now thriving and growing. One of the lead analysts for the dataset is PNNL chemist Paul Piehowski.

For Adkins, Qian and others on PNNL's MoTrPAC team, proteomics research depends on instruments at the Environmental Molecular Sciences Laboratory (EMSL), a Department of Energy Office of Science user facility located on the PNNL campus. EMSL's capabilities include an array of high-end orbitrap mass spectrometers. They produce analyses that help identify and quantify proteins and other molecules from a variety of tissue types and samples.

MoTrPAC "is huge in scope," said Adkins. "PNNL's scale of operation allows us to do something of this size with very high quality and high operational reproducibility." He called the PNNL-EMSL role in MoTrPAC "a tour de force for a proteomic study. Few on this scale have been done before."

A first major paper

MoTrPAC researchers nationwide contributed to a May 2, 2024, study in the journal Nature . This first major paper to come out of the consortium provides the first whole-organism map of molecular responses to endurance exercise training.

The experiment's model organism was the rat. Male and female rats of the same species ran on motorized treadmills for 1-, 2-, 4-, and 8-week periods. For controls, researchers used sedentary, untrained rats, matched for sex with their exercising counterparts.

Within 48 hours of each training interval, researchers collected samples of whole blood, plasma, and 18 solid tissues and dispersed them to omics centers like PNNL for intensive analysis.

Of the numerous samples, said Adkins, "We want to understand the integration of organ systems." Molecular responses in the body to endurance training are system-wide, say authors of the Nature paper—a conclusion confirmed by integrating tissue samples in a range of omics analyses.

Other results were finer tuned. Exercise enhances liver health and metabolism, for instance. It also remodels and strengthens the structure of the heart, improves pathways related to gut integrity (gut health is linked to inflammation throughout the body), enriches immune pathways, and reduces inflammation in the lungs and small intestine. Importantly, the authors relate, the sex differences observed in training responses highlight how important it is to include both sexes in exercise research.

The rat–human problem

Translating rat data into conclusions relevant to humans is challenging. However, rats are the preferred animal model because rat–human skeletal muscle and organ system signaling patterns are similar. So are exercise-induced glucose metabolism and cardiac responses. In addition, the large tissue masses of rats provide better samples than mice for multiomics analysis.

"These data will help us bring knowledge from the rat into the human sphere," said Adkins.

To help close the rat–human data gap, the MoTrPAC consortium has an exercise-response experiment underway that records molecular responses to endurance training and resistance training across a cohort of 2,000 adult human volunteers.

Insights, with more on the way

The recent Nature paper provides what Adkins called "a landscape view" of multi-center national MoTrPAC research. At the same time, other studies in progress are taking narrower and more detailed views of consortium data. PNNL's Sanford is part of a research team showing how multiomics help identify key gene regulatory programs that come into play during exercise.

The Sanford team is looking at thousands of observed molecular alterations. They included how exercise regulates gene expression related to mitochondrial changes, heat shock responses, immune regulation, and other molecular processes.

Sanford has also joined PNNL biostructure and function biochemist Gina Many and PNNL data scientist Tyler Sagendorf in an analysis of the running-rats data to investigate sexual dimorphism in white adipose tissue responses .

White adipose is a storage and secretory organ system linked to the development of obesity, cardiovascular disease, type 2 diabetes, cancer, and other conditions. This fat type also has important effects on the immune system and other biological processes that maintain systemic health.

So far, the analysis seems to demonstrate that in rats there are "profound" differences in white adipose tissue response between the sexes. While physical training benefits rats of both sexes, only male rats respond to exercise by losing white adipose tissue. In female rats , exercise prevents them from gaining fat mass.

Such narrowly focused investigations use the MoTrPAC dataset to look for insights on how exercise affects individual tissues or specific biological processes.

One MoTrPAC investigation underway, for instance, looks at how exercise affects gene transcription. That's the process of copying information from a strand of DNA onto a molecule called messenger RNA (mRNA), which relays genetic information to the areas of cells where proteins are made. Another example of research in progress deals with the impact of exercise on mitochondrial response. Mitochondria, present in mammalian cells, regulate energy production and stress response.

Every smaller study based on separate facets of MoTrPAC data, said Adkins, "is one piece of a greater vision." That vision is the consortium's: to map the body's molecular changes after exercise .

Journal information: Nature , Cell

Provided by Pacific Northwest National Laboratory

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Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?

Jose antonio.

1 Department of Health and Human Performance, Nova Southeastern University, Davie, Florida USA

Darren G. Candow

2 Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada

Scott C. Forbes

3 Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB Canada

Bruno Gualano

4 Applied Physiology & Nutrition Research Group; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP Brazil

Andrew R. Jagim

5 Sports Medicine Department, Mayo Clinic Health System, La Crosse, WI USA

Richard B. Kreider

6 Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, USA

Eric S. Rawson

7 Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA USA

Abbie E. Smith-Ryan

8 Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC USA

Trisha A. VanDusseldorp

9 Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA USA

Darryn S. Willoughby

10 School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX USA

Tim N. Ziegenfuss

11 The Center for Applied Health Sciences, Canfield, Ohio USA

Associated Data

Not applicable.

Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine ‘loading-phase’ required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.

Introduction

Creatine (methylguanidine-acetic acid) is endogenously formed from reactions involving the amino acids arginine, glycine and methionine in the kidneys and liver [ 1 ]. Exogenously, creatine is primarily consumed from meat and/or as a dietary supplement. According to PubMed (archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine) there are over 500 peer-refereed publications involving various aspects of creatine supplementation. Based on the enormous popularity of creatine supplementation, the International Society of Sports Nutrition (ISSN) published an updated position stand in 2017 on the safety and efficacy of creatine supplementation in exercise, sport, and medicine [ 2 ]. This comprehensive paper provided an evidence-based review of the literature examining the effects of creatine supplementation on performance, recovery, injury prevention, exercise tolerance and rehabilitation, neuroprotection, aging, clinical and disease state populations, and pregnancy. Importantly, the safety profile of creatine was also reviewed. As of September 1, 2020, the paper has been viewed 179,000 times and cited 100 times (according to Web of Science). Furthermore, Altmetric data indicates that the paper has been mentioned in 19 news outlets, 4 blogs, 492 tweets, 54 Facebook pages, and been uploaded 69 times in video posts. Instagram stories and posts are not included as Altmetric data.

Despite the widespread outreach of the 2017 ISSN position stand paper [ 2 ], along with other evidence-based review/meta-analysis papers involving various aspects of creatine supplementation published after the 2015 Creatine in Health, Sport and Medicine Conference in Germany [ 3 – 34 ], questions and misconceptions involving creatine supplementation still remain. These include, but are not limited to: 1. Does creatine supplementation lead to water retention? 2. Is creatine is an anabolic steroid? 3. Does creatine supplementation cause kidney damage / renal dysfunction? 4. Does creatine supplementation cause hair loss / baldness? 5. Does creatine supplementation lead to dehydration and muscle cramping? 6. Is creatine supplementation harmful for children and adolescents? 7. Does creatine supplementation increase body fat? 8. Is a creatine supplementation ‘loading-phase’ required? 9. Is creatine supplementation beneficial for older adults? 10. Is creatine supplementation only useful for resistance/power type activities? 11. Is creatine supplementation only effective for males? 12. Are other forms of creatine similar or superior to monohydrate? Is creatine stable in solutions/beverages? To address these questions, an internationally renowned team of research experts, who have collectively published over 200 peer-refereed articles involving creatine supplementation, was formed to perform an evidence-based scientific evaluation of the literature. Each question was answered by one researcher, chosen according to her/his expertise on the topic. Then, the final version of this manuscript was reviewed and approved by all authors, therefore reflecting the group opinion.

Does creatine lead to water retention?

The purported myth of creatine supplementation increasing body water (TBW) is likely due to early research which showed that creatine supplementation at 20 g/day for six days was associated with water retention [ 35 ]. It does appear that the most common adverse effect of creatine supplementation is water retention in the early stages (first several days) [ 36 ]. For example, studies have shown that three days of creatine supplementation increased TBW and extracellular body water (ECW) [ 37 ] and intracellular water (ICW) [ 38 ]. Unfortunately, based on these short-term responses, this notion that creatine increases water retention over the long-term has been widely accepted [ 39 ].

Creatine is an osmotically active substance. Thus, an increase in the body's creatine content could theoretically result in increased water retention. Creatine is taken up into muscle from circulation by a sodium-dependent creatine transporter [ 1 ]. Since the transport involves sodium, water will also be taken up into muscle to help maintain intracellular osmolality. However, considering the activity of the sodium-potassium pumps, it is not likely that intracellular sodium concentration is dramatically affected by creatine supplementation [ 39 ].

A number of exercise training studies (e.g., 5-10 weeks) incorporating creatine supplementation have shown no increases in total body water (TBW). For example, resistance-trained males who received creatine at a dose of 0.3 g/kg lean body mass/day for 7 days (approximately 20 g/day) followed by 4 weeks at 0.075 g/kg lean body mass/day for 28 days (approximately 5 g/day) experienced no significant change in ICW, ECW, or TBW [ 40 ]. Furthermore, resistance-trained males who consumed creatine supplementation (20 g/day for seven days followed by 5 g/day for 21 days) had no significant increase in ICW, ECW, or TBW [ 41 ]. Similarly, males and females ingesting creatine (0.03 g/kg/day for six weeks) experienced no significant increase in TBW [ 42 ]. Six weeks of creatine supplementation in non-resistance-trained males at a dosage of 0.3 g/kg lean body mass for five days followed by 0.075 g/kg lean body mass for 42 days produced no significant changes in TBW [ 43 ]. In contrast, when assessing TBW, ICW, and ECW content before and after 28 days of creatine supplementation in healthy males and females (n = 32), Powers et al. [ 44 ] showed that creatine supplementation was effective at increasing muscle creatine content which was associated with an increase in body mass and TBW but did not alter ICW or ECW volumes. In a recent study examining the effects of creatine supplementation combined with resistance exercise for 8 weeks, Ribeiro et al. [ 45 ] found a significant increase in TBW (7.0%) and ICW (9.2%) volume compared to placebo (TBW: 1.7%; ICW: 1.6%), with both groups similarly increasing ECW (CR: 1.2% vs. Placebo = 0.6%). Importantly, the ratio of skeletal muscle mass to ICW remained similar in both groups. It is important to highlight that the ICW is an important cellular signal for protein synthesis and thus drives an increase in muscle mass over time [ 46 ].

In summary, while there is some evidence to suggest that creatine supplementation increases water retention, primarily attributed to increases in intracellular volume, over the short term, there are several other studies suggesting it does not alter total body water (intra or extracellular) relative to muscle mass over longer periods of time. As a result, creatine supplementation may not lead to water retention.

Is creatine an anabolic steroid?

Anabolic steroids are a synthetic version of testosterone, an androgenic hormone which is also produced endogenously within both males and females, and is used in conjunction with resistance training with the intent of enhancing muscle mass and strength due to increases in muscle protein synthesis [ 47 ]. This increase in MPS is due to testosterone’s ability to enter the muscle cell, bind with the intracellular androgen receptor, and increase the expression of various muscle-specific genes [ 48 ]. Creatine is converted to phosphocreatine (PCr), regulated by the enzyme creatine kinase (CK) in muscle and used to create intracellular adenosine triphosphate (ATP) production [ 1 ]. Creatine supplementation, however, can increase the capacity of ATP and energy produced during heavy anaerobically-related exercise, thereby possibly increasing muscle power, repetitions and exercise volume which can subsequently contribute to muscle performance and hypertrophy over the course of a training period [ 2 ].

While the physiological and performance outcomes of anabolic steroids and creatine can be similar, their mechanisms of action and legal categorization are not. Anabolic steroids are drugs, with a different chemical structure than creatine, and are Class C, Schedule III controlled substances regulated by the Food and Drug Administration (FDA) and subject to the regulatory control provisions of the Controlled Substances Act (CSA) set forth by the Drug Enforcement Association (DEA). Creatine, on the other hand, like many other dietary supplements fits well within the confines of The Dietary Supplement Health and Education Act of 1994 ("DSHEA"), which is a statute of United States Federal legislation which defines and regulates dietary supplements by the Federal Drug Administration (FDA) for Good Manufacturing Practices (GMP). It is illegal to possess and administer anabolic steroids without a physician’s prescription. However, there are no legal ramifications for the possession or ingestion of creatine.

In summary, because creatine has a completely different chemical structure, it is not an anabolic steroid.

Does creatine cause kidney damage/renal dysfunction?

Questions and concerns involving creatine supplementation and kidney damage/renal dysfunction are common. In terms of pervasive misinformation in the sport nutrition arena, the notion that creatine supplementation leads to kidney damage/renal dysfunction is perhaps second only to the myth that protein supplementation and high habitual protein intake causes kidney damage. Today, after > 20 years of research which demonstrates no adverse effects from recommended dosages of creatine supplements on kidney health, unfortunately, this concern persists. While the origin is unknown, the connection between creatine supplementation and kidney damage/renal dysfunction could be traced back to two things: a poor understanding of creatine and creatinine metabolism and a case study published in 1998.

In skeletal muscle, both creatine and PCr are degraded non-enzymatically to creatinine, which is exported to the blood and excreted in the urine [ 1 ]. Healthy kidneys filter creatinine, which would otherwise increase in the blood. Therefore, blood creatinine levels can be used as a proxy marker of kidney function. However, the amount of creatinine in the blood is related to muscle mass (i.e. males have higher blood creatinine than females) and both dietary creatine and creatinine intake [ 35 ]. Both blood and urinary creatinine may be increased by ingestion of creatine supplementation and creatine containing foods, such as meat. Creatine is normally not present in urine, but can reach very high levels (>10 g/day) during creatine supplementation [ 49 ]. There appears to be an unsubstantiated perspective that if the kidneys are “forced” to excrete higher than normal levels of creatine or creatinine, some sort of kidney “overload” will take place, causing kidney damage and/or renal dysfunction. In reality, transient increases in blood or urinary creatine or creatinine due to creatine supplementation are unlikely to reflect a decrease in kidney function. Additionally, one must exercise caution when using blood creatinine and estimated creatinine clearance/glomerular filtration rate in individuals who consume high meat intake or supplement with creatine. In a review of creatine supplementation studies, Persky and Rawson [ 50 ] found no increase in serum creatinine in 12 studies, 8 studies showed an increase that remained within the normal range, and only 2 studies showed an increase above normal limits (although not different from the control group in one study).

In 1998, a case study of a young male with focal segmental glomerulosclerosis and relapsing nephrotic syndrome was reported [ 51 ]. The young male, who had kidney disease for 8 years and was treated with cyclosporine (i.e., immunosuppressant) for 5 years, had recently begun ingesting creatine supplementation (15 g/day for 7 days; followed by 2 g/day for 7 weeks). Based on increased blood levels of creatinine and subsequent estimate of calculated creatinine clearance, his kidney health was presumed to be deteriorating, although he was otherwise in good health. The patient was encouraged to discontinue creatine supplementation. At this time, it was already known that blood and urine creatinine levels can increase following ingestion of creatine containing food products, including creatine supplements [ 35 ]. This was ignored by the authors of this case study, as was the inclusion of two investigations which demonstrated that creatine supplementation did not negatively impact renal function [ 52 , 53 ]. The dosage of creatine during the maintenance phase, which was also ignored, was only slightly higher than the daily creatine intake of a typical omnivore’s dietary intake, or in terms of food, a large hamburger or steak per day (meat contains about 0.7 g of creatine / 6 oz. serving; see [ 54 ]). In response to this case study, two separate teams of experts in creatine metabolism wrote letters to the editor of Lancet [ 53 , 55 ]. However, the notion that creatine supplementation leads to kidney damage and/or renal dysfunction gained traction and momentum.

Since this case study was reported in 1998, experimental and controlled research trials investigating the effects of creatine supplementation on kidney/renal function has substantially increased [ 50 , 56 – 58 ]. Overall, in healthy individuals, there appears to be no adverse effects from consuming recommended doses of creatine supplements on kidney/renal function [ 50 , 56 – 58 ]. Interestingly, Gualano et al. [ 58 ] reviewed a small number of case studies which reported renal dysfunction in individuals who were supplementing with creatine. Similar to the case report by Pritchard and Kalra [ 51 ], these additional case reports were confounded by medications, pre-existing kidney disease, concomitant supplement ingestion, inappropriate creatine dosages (e.g., 100 X recommended dose), and anabolic androgenic steroid use.

It is prudent to be cautious when ingesting any dietary supplement or medication. Survey data indicates that creatine supplementation usage ranges between 8-74% in athletes and other exercising individuals (reviewed in Rawson et al. [ 59 ]). Even with a low estimate of 8% of exercising individuals using creatine supplements, this indicates thousands of exposures across several decades. If the link between creatine supplementation and kidney health was valid, there would be an expected increase in kidney damage / renal dysfunction in low risk (i.e. young, physically fit, healthy) individuals since 1992 after Harris et al. published their seminal work [ 60 ]. After nearly 30 years of post-marketing surveillance, thousands of exposures, and multiple clinical trials, no such evidence exists.

In summary, experimental and controlled research indicates that creatine supplementation, when ingested at recommended dosages, does not result in kidney damage and/or renal dysfunction in healthy individuals.

Does creatine cause hair loss / baldness?

The vast majority of speculation regarding the relationship between creatine supplementation and hair loss/baldness stems from a single study by van der Merwe et al. [ 61 ] where college-aged male rugby players who supplemented with creatine (25 g/day for 7 days, followed by 5 g/day thereafter for an additional 14 days) experienced an increase in serum dihydrotestosterone (DHT) concentrations over time. Specifically, DHT increased by 56% after the seven-day loading period, and remained 40% above baseline values after the 14-day maintenance period. These results were statistically significant compared to when the subjects consumed a placebo (50 g of glucose per day for 7 days, followed by 30 g/day for 14 days thereafter). Given that changes in these hormones, particularly DHT, have been linked to some (but not all) occurrences of hair loss/baldness [ 62 ], the theory that creatine supplementation leads to hair loss / baldness gained some momentum and this potential link continues to be a common question / myth today. It is important to note that the results of van der Merwe et al. [ 61 ] have not been replicated, and that intense resistance exercise itself can cause increases in these androgenic hormones.

DHT is a metabolite of testosterone, formed when the enzyme 5-alpha-reductase converts free testosterone to DHT [ 63 ]. In males, DHT can bind to androgen receptors in susceptible hair follicles and cause them to shrink, ultimately leading to hair loss [ 64 ]. However, in the van der Merwe et al. [ 61 ] study, no increase in total testosterone was found in the 16 males who completed the study. Free testosterone was not measured. Moreover, the increase in DHT and the DHT: testosterone ratio remained well within normal clinical limits. Furthermore, baseline (prior to supplementation), DHT was 23% lower in the creatine group (0.98 nmol/L) compared to the placebo group (1.26 nmol/L). Thus the small increase in DHT in the creatine group (+ 0.55 nmol/L after 7 days of supplementation and + 0.40 nmol/L after 21 days of supplementation), in combination with a small decrease in the placebo DHT response (-0.17 nmol/L after 7 days of supplementation and -0.20 nmol/L after 21 days of supplementation) explains the “statistically significant” increase in DHT noted by van der Merwe et al. [ 61 ]. While it is possible that creatine supplementation upregulated 5-alpha-reductase activity in these males (potentially leading to increased formation of DHT), no study has reported hair loss/baldness in humans.

To date, 12 other studies have investigated the effects of creatine supplementation (i.e. doses ranging from 3-25 g/day for 6 days to 12 weeks) on testosterone. Two studies reported small, physiologically insignificant increases in total testosterone after six and seven days of supplementation [ 65 , 66 ], while the remaining ten studies reported no change in testosterone concentrations. In five of these studies [ 67 – 71 ], free testosterone, which the body uses to produce DHT, was also measured and no increases were found.

In summary, the current body of evidence does not indicate that creatine supplementation increases total testosterone, free testosterone, DHT or causes hair loss/baldness.

Does creatine lead to dehydration and muscle cramping?

Speculation exists that creatine supplementation causes dehydration and muscle cramping [ 72 , 73 ]. In the early 2000’s, with limited data and based primarily on speculation, the American College of Sports Medicine (ACSM) recommended that individuals controlling their weight and exercising intensely or in hot environments should avoid the use of creatine supplementation [ 74 ]. The physiological rationale suggesting that creatine supplementation may cause dehydration and muscle cramping is based on the premise that creatine is an osmotically active substance found primarily in skeletal muscle and may alter whole-body fluid distribution by preferentially increasing intracellular water uptake and retention, particularly over the short-term [ 38 , 75 ]. In situations of body water loss, such as severe sweating from exercise and/or increased environmental temperature, the bound intracellular fluid, in theory, may be detrimental to thermal regulation and lead to extracellular dehydration, electrolyte imbalance and muscle cramping or other heat-related musculoskeletal issues [ 44 ]. The initial loading phase of creatine supplementation (i.e. 20 g/day for 5-7 days) typically results in a 1-3 kg increase in body mass, mostly attributable to net body water retention [ 75 , 76 ]. Some anecdotal evidence indicates that creatine users perceive supplementation to result in some adverse effects [ 77 ]. For example, in a survey involving 219 athletes, 90 participants reported using creatine with 34 of them (38%) reporting perceived negative effects such as cramping (27%) [ 77 ]. Similarly, in National Collegiate Athletic Association (NCAA) Division 1 baseball and football players (N=52) using creatine, 25% reported incidences of muscle cramping and 13.5% reported symptoms of dehydration. Importantly, these studies failed to control for the use of other supplements and the dosage of creatine ingested. Greenwood et al. [ 77 ] noted that 91% of participants exceeded the recommended creatine maintenance dose of 5 g/day. However, these self-report surveys are in contradiction to experimental and clinical evidence. Greenwood et al. [ 78 ] monitored injury rates in Division IA NCAA collegiate football players (N=72; age: 19.7 ± 1.0 yrs) where environmental conditions were hot (27.3 ± 10.9 0 C) and humid (54.2 ± 9.7%). Participants chose to receive either creatine (n = 38: 0.3 g/kg/day for 5 days; followed by 0.03 g/kg/day for 115 days) or a sport drink placebo (n = 34) throughout the football season. Injuries treated by the athletic training staff were monitored. Creatine users had significantly less cramping (p = 0.021), heat illnesses and dehydration (p = 0.043), muscle tightness (p = 0.020), muscle strains (p = 0.021), and total injuries (p < 0.001) compared to non-users. Non-contact joint injuries, contact injuries, illnesses, missed practices due to injuries, and players lost for the season were not different between groups. In a clinical setting, haemodialysis patients (n = 10) who frequently reported muscle cramping were provided creatine (12 g) 5 minutes prior to haemodialysis [ 79 ]. Creatine supplementation reduced the frequency of symptomatic muscle cramping by 60% [ 79 ]. These beneficial effects from creatine may be explained by fluid distribution and electrolyte imbalances, as previously discussed.

In summary, experimental and clinical research does not validate the notion that creatine supplementation causes dehydration and muscle cramping.

Is creatine harmful for children and adolescents?

Concerns regarding the safety of creatine supplementation in children and adolescents (< 19 yrs) continues to be highly prevalent. The overwhelming majority of evidence in adult populations indicates that creatine supplementation, both short- and longer-term, is safe and generally well tolerated [ 2 ]. However, the question of whether or not this holds true for children and adolescents is relatively unclear. The physiological rationale supporting the potential ergogenic benefits of creatine supplementation in children and adolescents was first postulated by Unnithan and colleagues in 2001 [ 80 ]; which established a strong basis for future applications of creatine for younger athletes. More recently, in a comprehensive review examining the safety of creatine supplementation in adolescents, Jagim et al. [ 16 ] summarized several studies that examined the efficacy of creatine supplementation among various adolescent athlete populations and found no evidence of adverse effects. However, it is important to note that none of the performance-focused studies included in the Jagim et al. [ 16 ] review provided data examining specific markers of clinical health and whether or not they were impacted by the supplementation protocols.

From a clinical perspective, creatine supplementation has been found to potentially offer health benefits with minimal adverse effects in younger populations. Hayashi et al. [ 81 ] found improvements in pediatric patients with systemic lupus erythematosus and reported no adverse changes in laboratory parameters of hematology, kidney function, liver function or inflammatory markers after 12 weeks of creatine supplementation. Tarnopolsky et al. [ 82 ] reported significant improvements in fat-free mass and hand grip strength in 30 pediatric patients with Duchenne muscular dystrophy following 4 months of creatine supplementation. Importantly, the creatine supplementation protocol appeared to be well tolerated and did not adversely affect laboratory markers of kidney function, oxidative stress, and bone health [ 81 – 83 ]. In addition, Sakellaris et al. [ 83 ] reported significant improvements in traumatic brain injury-related outcomes in children and adolescents who received oral creatine supplementation (0.4 g/kg/day) for 6 months. These neurological benefits may have potential applications for young athletes participating in collision sports, which pose underlying risks of concussions or sub-concussive impacts. Further, several of these clinical trials implemented strict clinical surveillance measures, including continual monitoring of laboratory markers of kidney health, inflammation, and liver function; none of which were negatively impacted by the respective creatine supplementation interventions. These findings support the hypothesis of creatine supplementation likely being safe for children and adolescents. However, perhaps the strongest supporting evidence for the safety of creatine is the recent classification of creatine as generally recognized as safe (GRAS) by the United States Food and Drug Administration (FDA) in late 2020 ( https://www.fda.gov/media/143525/download ). Ultimately, this classification indicates that the currently available scientific data pertaining to the safety of creatine, is sufficient and has been agreed upon by a consensus of qualified experts, thereby determining creatine to be safe under the conditions of its intended use ( https://www.fda.gov/media/143525/download ). Even though infants and young children are excluded from GRAS, this would still apply to older children and adolescent populations.

The majority of dietary supplement survey data indicates that a relatively high percentage of youth and adolescent athletes are currently or have previously supplemented with creatine. For example, Kayton et al. [ 84 ] found that in a sample of 270 high school boys and girls, 21% of boys and 3% of girls reported supplementing with creatine. Furthermore, in a sample of elite Olympic level sample of young German athletes (14-18 yrs), 12% of those surveyed reported supplementing with creatine [ 85 ]. Therefore, these trends warrant additional research to determine with greater certainly whether creatine supplementation, both acute and longer-term, is safe for children and adolescents.

In summary, based on the limited evidence, creatine supplementation appears safe and potentially beneficial for children and adolescents.

Does creatine increase fat mass?

The theory that creatine supplementation increases fat mass is a concern amongst exercising individuals, possibly because some experience a gain in body mass from creatine supplementation. However, randomized controlled trials (one week to two years in duration) do not validate this claim. Acute creatine supplementation (7 days) had no effect on fat mass in young and older adults; however, fat-free mass was increased [ 86 , 87 ]. Furthermore, three weeks of creatine supplementation had no effect on body composition in swimmers [ 88 ]. The addition of creatine to high-intensity interval training had no effect on body composition in recreationally active females [ 89 ]. In addition, the effects of creatine supplementation during resistance training overreaching had no effect on fat mass [ 70 ]. Moreover, in a group of healthy recreational male bodybuilders, 5 g/day of creatine consumed either pre- or post-training had no effect on fat mass [ 90 ]. In other short-terms studies lasting 6-8 weeks, there were no changes in fat mass from creatine supplementation. Becque et al. [ 91 ] found no changes in fat mass after six weeks of supplementation plus resistance training. In another 6-week investigation, no significant differences in fat mass or percentage body fat were observed after creatine supplementation [ 42 ]. Furthermore, creatine supplementation during an 8-week rugby union football season also had no effect on fat mass [ 92 ].

One might suggest that eight weeks or less of creatine supplementation is insufficient to arrive at a definitive conclusion regarding creatine’s effect on fat mass. Nonetheless, there are several investigations that have used much longer treatment periods. For example, healthy resistance-trained males were randomly assigned in a double-blind fashion to supplement with creatine (i.e., 20 g/day for 1 week followed by 5 g/day for 11 weeks) or placebo [ 93 ]. Lean body mass and muscle fiber size increased; percent body fat and fat mass were unaffected over the 12-week training period [ 93 ]. In older males (~70 yrs), 12 weeks of creatine supplementation during resistance training had no effect (compared to placebo) on fat mass [ 94 ]. Furthermore, Gualano et al. assessed the effects of creatine supplementation (24 weeks), with and without resistance training, in older females. Results showed no effect from creatine on fat mass [ 95 ]. Candow et al. [ 96 ] examined the effects of creatine supplementation in older adults (50-71 years) over a 32-week treatment period. Study participants were randomized to supplement with creatine or placebo before or after resistance training (3 days per week). There was an increase over time for lean tissue and strength with a decrease in fat mass. From a clinical perspective, children with acute lymphoblastic leukemia who supplemented with creatine (0.1 g/kg/day) for two sequential periods of 16 weeks experienced a significant reduction in fat mass. In contrast, the children who did not consume creatine gained fat mass [ 97 ]. In two studies involving postmenopausal women, Lobo et al. [ 98 ] found no change in absolute or relative body fat from one-year of low-dose creatine supplementation. Furthermore, two years of creatine supplementation also had no effect on fat mass [ 99 ].

Recently, Forbes et al. [ 100 ] conducted a systematic review and meta-analysis on randomized controlled trials involving creatine supplementation in conjunction with resistance training on fat mass in older adults (≥ 50 yrs). Nineteen studies with a total of 609 participants were included. Participants supplementing with creatine had a greater reduction in body fat percentage. There was no significant difference in absolute fat mass loss; however, the creatine group lost ~0.5 kg more fat mass compared to those on placebo.

In summary, creatine supplementation does not increase fat mass across a variety of populations.

Is a creatine ‘loading-phase’ required?

Pioneering research in the early 1900’s using animal models showed that creatine supplementation could augment creatine content by 70% [ 101 , 102 ]. Decades later, Harris et al. [ 60 ] published a seminal paper which showed that ‘loading’ with creatine increased skeletal muscle creatine stores, as evaluated from muscle biopsies collected from the vastus lateralis in young, healthy human participants. This research sparked incredible interest in studying creatine supplementation strategies that would increase intramuscular creatine content, helping shape current recommendations.

Creatine ‘loading’ is defined as supplementing with oral creatine for 5–7 days with a dosage of 20–25 g/day, often divided into smaller doses throughout the day (e.g., four to five, 5 g servings/day). Creatine ‘loading’ may also be prescribed relative to body mass, for example, 0.3 g/kg/d for 5-7 days (i.e., 21 g/day for a 70 kg individual). The ‘loading’ phase of creatine supplementation is followed by a daily ‘maintenance’ phase often ranging from daily 3–5 g servings/day (Figure ​ (Figure1, 1 , side A). In addition to the seminal work of Harris et al. [ 60 ], several other investigations have demonstrated increased intramuscular creatine stores in humans from the creatine ‘loading’ phase [ 35 , 103 , 104 ]. A common misconception regarding creatine supplementation is that individuals must ‘load’ with creatine to increase intramuscular creatine stores and subsequently experience the purported ergogenic benefits of creatine supplementation. However, lower daily creatine supplementation dosing strategies (i.e., 3-5 g/day) are well established throughout the scientific literature for increasing intramuscular creatine stores leading to greater improvements in muscle mass, performance and recovery compared to placebo [ 2 ]. While effective, these non-loading creatine supplementation dosing strategies (Figure ​ (Figure1, 1 , side B) delay maximum intramuscular creatine storage. For example, in the classic ‘loading’ vs. daily ‘maintenance’ dose comparison study by Hultman et al. [ 35 ], creatine accumulation in muscle was similar (~ 20% increase) after participants consumed 3 g/day for 28 days or 20 g/day for 6 days [ 35 ]. Thus, it is currently recommended that individuals consume ~3-5 g/day of creatine for a minimum of 4 weeks in order to experience similar skeletal muscle saturation levels. Determination of which creatine supplementation strategy is preferred may depend on the goal of the individual. For instance, if an athlete is hoping to maximize the ergogenic potential of creatine supplementation in a very short period of time (< 30 days), adopting the creatine ‘loading’ strategy may be advised. However, if an athlete or exercising individual is planning to ingest creatine over an extended period of time (> 30 days), or if avoiding potential weight gain which can sometimes occur during creatine ‘loading’, the creatine ‘maintenance’ strategy would be a viable option. Athletes who are carrying out a creatine loading phase (i.e., 20 g/day) should emphasize the smaller dosing strategies (e.g. less than or equal to 10 gram servings) throughout the day, as dosages of greater than 10 grams may potentially lead to gastrointestinal distress (i.e., diarrhea) [ 105 ].

Creatine supplementation strategies.

In summary, accumulating evidence indicates that you do not have to ‘load’ creatine. Lower, daily dosages of creatine supplementation (i.e. 3-5 g/day) are effective for increasing intramuscular creatine stores, muscle accretion and muscle performance/recovery.

Is creatine beneficial for older adults?

There has been an increasing number of studies showing that creatine supplementation plays a therapeutic role in a variety of clinical conditions (see Gualano et al. [ 106 ] for a comprehensive review on this topic).

Perhaps one of the most promising conditions that could benefit from creatine supplementation is age-related sarcopenia. Sarcopenia is defined as a progressive and generalized skeletal muscle condition (i.e. decrease in muscle mass, strength, and functionality) that is associated with increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality [ 107 ]. While resistance training is considered cornerstone in the treatment of sarcopenia [ 108 ], accumulating evidence indicates that creatine supplementation may enhance the anabolic environment produced by resistance training, subsequently mitigating indices of sarcopenia [ 9 , 10 , 19 , 27 ].

Creatine supplementation can increase functionality (e.g., strength, activities of daily living, delay fatigue) and muscle mass in older adults [ 9 , 10 , 19 , 87 , 95 , 109 , 110 ]. However, the literature indicates that creatine alone (that is, without a concomitant resistance training program) is unlikely to result in substantial gains in muscle strength and functional performance [ 95 , 111 – 113 ], although it does improve some parameters of muscle fatigue [ 114 – 116 ]. Likewise, most studies failed to show a beneficial effect of chronic creatine supplementation alone (≥ 30 days) on lean mass [ 98 , 99 , 113 , 114 ]. For instance, we recently showed that creatine supplementation was not able to increase lean mass in postmenopausal women who supplemented with creatine (3 g/day) for 2 years, suggesting that creatine supplementation without exercise may be ineffective to prevent sarcopenia [ 99 ]. It is likely that increases in lean mass occasionally attributed to creatine supplementation in short-term studies (e.g., 7 days) are explained by increased body water, since creatine is osmotically active and it can sometimes induce water retention.

Conversely, substantial evidence indicates that creatine supplementation is capable of augmenting the hypertrophic response to resistance training in young adults [ 117 ], which is extended to older adults, as confirmed by three systematic reviews and meta-analyses [ 19 , 118 , 119 ]. The fact that creatine is more effective when combined with a training stimulus suggests that the main mechanistic action of creatine is its ability to enhance training volume and/or intensity, which may influence muscle protein kinetics, growth factors, satellite cells, inflammation and/or oxidative stress [ 9 , 10 , 19 ], ultimately resulting in greater skeletal muscle adaptations.

Regarding aging bone, emerging research over the past decade has shown some benefits from creatine supplementation. For example, healthy older males (> 50 yrs) who supplemented with creatine and performed whole-body resistance training for 10-12 weeks experienced an increase in upper limb bone mineral content [ 120 ] and a reduction in bone resorption compared to placebo [ 121 ]. More recently, Chilibeck et al. [ 122 ] showed that 52 weeks of creatine supplementation and supervised whole-body resistance training attenuated the rate of bone mineral loss in the hip region compared to placebo in postmenopausal females. However, a 2 year creatine supplementation protocol was infective for improving bone mass or bone geometry in post-menopausal women, again suggesting that creatine should be combined with resistance-type exercise to produce beneficial bone adaptations [ 99 ].

From a clinical and healthy aging perspective, it is recommended that creatine supplementation be combined with resistance training to produce the greatest adaptations in older adults. Future clinical trials involving frail populations with long-term follow-up(s) and larger samples are needed. The therapeutic potential of creatine supplementation for cachexia, myopathies, post-surgery rehabilitation, bed rest, other muscle/bone wasting condition/diseases and brain health warrants further investigation.

In summary, there is growing body of evidence showing that creatine supplementation, particularly when combined with exercise, provides musculoskeletal and performance benefits in older adults.

Is creatine only useful for resistance / power type activities?

Although creatine supplementation has been theorized to primarily benefit athletes involved in high-intensity intermittent resistance/power type activities, there is a growing body of evidence suggesting that creatine supplementation may also provide beneficial effects for other activities. For example, creatine supplementation with carbohydrate [ 123 ] or carbohydrate and protein [ 124 ] has been reported to promote greater muscle glycogen storage than carbohydrate supplementation alone. Since glycogen replenishment is important for promoting recovery and preventing overtraining during intensified training periods [ 2 , 125 ], creatine supplementation may help athletes who deplete large amounts of glycogen during training and/or performance (i.e., sporting events) to maintain optimal glycogen levels. Second, there is evidence that creatine supplementation may reduce muscle damage and/or enhance recovery from intense exercise. For example, Cooke and colleagues [ 126 ] reported that creatine supplementation during recovery from exercise-induced muscle damage promoted less muscle enzyme efflux and better maintenance of isokinetic muscle performance. Moreover, there is evidence that individuals supplementing their diet with creatine experienced less muscle damage, inflammation, and muscle soreness in response to running 30-km [ 127 ] as well as during 4-weeks of intensified training [ 70 ]. Consequently, creatine supplementation may help athletes recover from intense exercise and/or tolerate intensified periods of training to a greater degree. Third, there is evidence that athletes who supplement with creatine during training experience fewer musculoskeletal injuries, accelerated recovery time from injury [ 78 , 128 ] and less muscle atrophy after immobilization [ 129 , 130 ]. Whether this is due to a greater resistance to injury and/or ability to recover from injury remains unclear. Fourth, creatine supplementation (with or without glycerol) has been reported to help athletes hyper-hydrate and thereby enhance tolerance to exercise in the heat [ 28 , 37 , 131 – 145 ]. Therefore, creatine supplementation may reduce the risk of heat related-illness when athletes train and/or compete in hot and humid environments [ 72 , 146 ]. Finally, there is evidence from animal models that creatine supplementation is neuroprotective [ 147 – 149 ] and can reduce the severity of spinal cord injury [ 150 , 151 ], cerebral ischemia [ 152 – 155 ], and concussion/traumatic brain injury [ 2 , 7 , 12 , 22 , 32 , 33 , 156 ]. This evidence was so compelling that the International Society of Sports Nutrition recommended that athletes engaged in sports that have a potential for concussion and/or spinal cord injury take creatine for its neuroprotective effects [ 2 ]. Thus, there are a number of reasons beyond the ergogenic benefit that all types of athletes may benefit.

In summary, there is a variety of athletic events, not just resistance/power activities, which may benefit from creatine supplementation.

Is creatine only effective for males?

Creatine kinetics may vary between healthy males and females [ 157 ]. Females may have higher intramuscular creatine concentrations [ 158 ] possibly due to lower skeletal muscle mass [ 159 ]. Potentially, the higher resting intramuscular creatine concentration in females (based on the upper limit of intramuscular creatine storage) may help explain some research showing diminished responsiveness and/or performance effects on females [ 160 , 161 ].

As a result of hormone-driven changes in endogenous creatine synthesis, creatine transport, and creatine kinase (CK) kinetics, creatine bioavailability throughout various stages of female reproduction is altered, highlighting the potential positive implications for creatine supplementation in females [ 29 ]. The implications of hormone-related changes in creatine kinetics has been largely overlooked in performance-based studies [ 29 ]. Specifically, creatine supplementation may be of particular importance during menses, pregnancy, post-partum, perimenopause and postmenopause. Creatine kinase, as well as enzymes associated with creatine synthesis, are influenced by estrogen and progesterone [ 1 ]. Creatine kinase levels are significantly elevated during menstruation [ 162 ], with CK levels decreasing throughout the menstrual cycle, pregnancy, and with age. The lowest range of CK values have been reported during early pregnancy (20 weeks or less), equating to about half the concentration found at peak levels (teenage girls) [ 162 , 163 ].

Maternal creatine supplementation during pregnancy in pre-clinical animal studies have demonstrated a protective effect against fetal death and organ damage associated with intrapartum hypoxia [ 164 , 165 ]. Reduced creatine levels in late pregnancy have also been associated with low fetal growth [ 165 ]. There is additional data that metabolic demand from the placenta during gestation further lowers the creatine pool of the mother [ 166 ], which may be associated with low birth weight and pre-term birth. Creatine supplementation during pregnancy has been shown to enhance neuronal cell uptake of creatine and support mitochondrial integrity in animal offspring, thereby reducing brain injury induced by intrapartum asphyxia [ 167 , 168 ]. Although there are no human studies evaluating the effects of creatine supplementation during pregnancy, creatine could provide a safe, low-cost nutritional interventional for reducing intra- and post-partum complications associated with cellular energy depletion [ 169 ]. This may be more important if the female is vegetarian, or unable to consume meat due to nausea or taste preferences (i.e. meat contains about 0.7 g of creatine/6 oz serving [ 54 ];).

Females have been reported to have lower levels of creatine in the brain (frontal lobe) [ 170 ]. Increasing creatine concentrations in the brain as a result of supplementation, particularly in females, may support the reported benefits of reducing symptoms of depression [ 171 , 172 ] and ameliorating the effects of traumatic brain injury [ 12 , 22 ]. Depression is about 2 times higher among females throughout the reproductive years [ 173 ] and accelerates around pubertal hormonal changes [ 174 ]. Altered brain bioenergetics and mitochondrial dysfunction have been linked with depression, particularly as it relates to CK, ATP, and inorganic phosphate (P i ). Creatine supplementation has been shown to significantly augment cerebral PCr and P i [ 175 ], particularly in females. The increase in cerebral PCr from 10 g of creatine supplementation was reported to be inversely related to symptoms of depression in adolescent females resistant to selective serotonin reuptake inhibitors [ 171 ] It appears that creatine supplementation may be effective for supporting creatine kinetics, mood, and pregnancy/fetal outcomes.

There is a small body of research that has investigated the effects of creatine supplementation in younger females. For example, Vandenberghe et al. [ 176 ] showed that creatine supplementation (20 g/day for 4 days followed by 5 g/day thereafter) during 10 weeks of resistance training significantly increased intramuscular concentrations, muscle mass and strength compared to placebo in females (19-22 yrs). In elite female soccer players (22 ± 5 yrs), creatine supplementation (20 g/day for 6 days) improved sprint and agility performance compared to placebo [ 177 ]. Hamilton et al. [ 178 ] showed that creatine supplementation (25 g for 7 days) augmented upper-body exercise capacity in strength-trained females (21-33 yrs) compared to placebo (19-29 yrs). Furthermore, in college-aged females (20 yrs), creatine supplementation (0.5 g/kg of fat-free mass for 5 days) improved knee extension muscle performance compared to placebo [ 179 ]. In contrast, not all data show improved performance in females [ 89 , 160 , 161 ]. Additionally, Smith-Ryan et al. [ 180 ] reported no significant effects of creatine loading on neuromuscular properties of fatigue in young adult females. It is important to evaluate the benefit to risk ratio; as noted elsewhere in this document, there are minimal risks associated with creatine supplementation, particularly when it is evaluated against the potential benefits in females.

Accumulating research over the past decade in postmenopausal females demonstrates that creatine supplementation during a resistance training program can improve muscle mass, upper- and lower-body strength, and tasks of functionality (30-s chair stand, lying prone-to-stand test, arm curl test) (for detailed review see Candow et al. [ 9 ]). Creatine supplementation appears to be a viable option for post-menopausal females to improve muscle quality and performance. In addition to its beneficial effects on aging muscle, creatine supplementation may also have favorable effects on bone in postmenopausal females, if combined with resistance training. For example, postmenopausal females who supplemented daily with 0.1 g/kg/day of creatine during 52-weeks of supervised whole-body resistance training experienced an attenuation in the rate of bone mineral loss at the femoral neck (hip), compared to females on placebo during training [ 122 ]. Furthermore, 5 g/day of creatine supplementation during 12 weeks of resistance training in postmenopausal females resulted in a significant increase in muscle mass and upper- and lower-body strength, compared to placebo [ 181 ]. However, even without the stimulus of resistance training, there is some evidence that creatine supplementation can still be beneficial. For example, in aging females (n=10; 67 ± 6 yrs), acute creatine supplementation (0.3 g/kg/day for 7 days) significantly improved lower-extremity physical performance (sit-to-stand test) [ 110 ], and fat-free mass and upper- and lower-body strength compared to placebo [ 86 ].

In summary, there is accumulating evidence that creatine supplementation has the potential to be a multifactorial therapeutic intervention across the lifespan in females, with little to no side effects.

Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages?

Creatine monohydrate powder has been the most extensively studied and commonly used form of creatine in dietary supplements since the early 1990s [ 2 , 125 ]. Creatine monohydrate was used in early studies to assess bioavailability, determine proper dosages, and assess the impact of oral ingestion of creatine on blood creatine and intramuscular creatine stores [ 35 , 60 , 182 ]. These studies indicated that orally ingested creatine monohydrate (e.g., 3–5 g/day) increases blood concentrations of creatine for 3-4 hours after ingestion thereby facilitating the uptake of creatine into tissue through diffusion and creatine transporters [ 1 , 183 , 184 ]. Additionally, it is well established that ~99% of orally ingested creatine monohydrate is either taken up by tissue or excreted in the urine as creatine through normal digestion [ 60 , 185 , 186 ]. Short-term loading with creatine monohydrate (e.g., consuming 5 g, 4 times daily for 5-7 days) has been reported to increase intramuscular creatine stores by 20–40% and exercise performance capacity by 5–10% [ 2 , 125 ]. Creatine monohydrate supplementation during training (e.g., 5–25 g/day for 4–12 weeks) has been reported to promoted gains in muscle mass, strength, and exercise capacity [ 2 , 125 ]. Despite the known efficacy, safety, and low cost of creatine monohydrate; a number of different forms of creatine have been marketed as more effective with fewer anecdotally reported adverse effects [ 187 ]. These marketing efforts have fueled speculation that creatine monohydrate is not the most effective or safest form of creatine to consume. This notion is clearly refuted by understanding the well-known physio-chemical properties of creatine monohydrate, as well as current creatine supplementation literature.

A number of different forms of creatine (e.g., creatine salts, creatine complexed with other nutrients, creatine dipeptides, etc.) have been marketed as more effective sources of creatine than creatine monohydrate [ 187 ]. However, there are no peer-reviewed published papers showing that the ingestion of equal amounts of creatine salts [ 188 – 191 ] or other forms of creatine like effervescent creatine [ 128 ], creatine ethyl ester [ 43 , 192 , 193 ], buffered creatine [ 41 ], creatine nitrate [ 194 , 195 ], creatine dipeptides, or the micro amounts of creatine contained in creatine serum [ 196 ] and beverages (e.g., 25–50 mg) increases creatine storage in muscle to a greater degree than creatine monohydrate [ 187 ]. In fact, most studies show that ingestion of these other forms have less physiological impact than creatine monohydrate on intramuscular creatine stores and/or performance and that any performance differences were more related to other nutrients that creatine is bound to or co-ingested with in supplement formulations. This makes sense given that these other forms contain less creatine per gram than creatine monohydrate and that 99% of ingested creatine monohydrate is absorbed into the blood, then taken up into muscle, or excreted in urine [ 187 ].

Creatine monohydrate crystallizes from water as monoclinic prisms that hold one molecule of water of crystallization per molecule of creatine [ 187 ]. Subsequent drying of creatine monohydrate at about 100°C removes the water of crystallization yielding anhydrous creatine (100% creatine) [ 187 ]. Creatine is considered a weak base (pKb 11.02 at 25°C) that can only form salts with strong acids (i.e., pKa < 3.98). Creatine can also serve as a complexing agent with other compounds via ionic binding. Creatine monohydrate powder contains the highest percentage of creatine (87.9%) other than creatine anhydrous [ 187 ]. Creatine monohydrate manufactured in Germany involves adding acetic acid to sodium sarconsinate, heating, adding cyanamide, cooling to promote crystallization, separation and filtration, and drying has been reported to produce 99.9% pure creatine monohydrate with no contaminants. Meanwhile, other sources of creatine monohydrate that have different starting materials (e.g., sarcosinates and O-alkylisourea, sarcosinates and S-alkylisothiourea) and methods of creatine synthesis, particularly from sources produced in China, have been found to contain up to 5.4% dicyandiamide, 0.09% dihydrotriazine, 1.3% creatinine, dimethyl sulphate, thiourea, and/or higher concentrations of heavy metals like mercury and lead due to use of different chemical precursors, poorly controlled synthesis processes, and/or inadequate filtration methods that more readily produce these contaminants [ 197 ]. While the effects of ingesting these compounds on health are unknown, contamination with dihydrotriazine has been suggested to be of greatest concern since it is structurally related to carcinogenic compounds [ 197 ]. For this reason, German sourced creatine monohydrate has been primarily used in research to establish safety and efficacy and is therefore the recommended source of creatine monohydrate to use in dietary supplements [ 2 , 187 ].

Creatine monohydrate powder is very stable showing no signs of degradation into creatinine over years, even at elevated storage temperatures [ 187 ]. However, creatine is not stable in solution due to intramolecular cyclization that converts creatine to creatinine especially at higher temperatures and lower pH [ 187 , 198 – 200 ]. The degradation of creatine can be reduced or halted by lowering the pH under 2.5 or increasing the pH above 12.1 [ 187 ]. This is the reason that less than 1% of creatine monohydrate is degraded to creatinine during the digestive process and creatine is taken up by tissue or excreted in urine after ingestion [ 60 , 185 – 187 ]. Moreover, since creatine is an ampholytic amino acid, it is not very soluble in water (e.g., creatine monohydrate dissolves at 14 g/L at 20°C with a neutral pH of 7) [ 187 ]. Mixing creatine in higher temperature solution increase solubility, which is the reason why initial studies administered creatine in hot tea [ 35 , 60 , 103 , 104 , 123 , 182 ] but the solubility has no influence on tissue uptake [ 187 ]. The lack of solubility and stability of creatine in solution is the reason that creatine is primarily marketed in powder form and efforts to develop stable beverages containing physiologically effective doses of creatine (e.g., 3–5 g per serving) have been unsuccessful.

In summary, while some forms of creatine may be more soluble than creatine monohydrate when mixed in fluid, evidence-based research clearly shows creatine monohydrate to be the optimal choice.

Conclusions

Based on our evidence-based scientific evaluation of the literature, we conclude that:

• Creatine supplementation does not always lead to water retention.
• Creatine is not an anabolic steroid.
• Creatine supplementation, when ingested at recommended dosages, does not result in kidney damage and/or renal dysfunction in healthy individuals.
• The majority of available evidence does not support a link between creatine supplementation and hair loss / baldness.
• Creatine supplementation does not cause dehydration or muscle cramping.
• Creatine supplementation appears to be generally safe and potentially beneficial for children and adolescents.
• Creatine supplementation does not increase fat mass.
• Smaller, daily dosages of creatine supplementation (3-5 g or 0.1 g/kg of body mass) are effective. Therefore, a creatine ‘loading’ phase is not required.
• Creatine supplementation and resistance training produces the vast majority of musculoskeletal and performance benefits in older adults. Creatine supplementation alone can provide some muscle and performance benefits for older adults.
• Creatine supplementation can be beneficial for a variety of athletic and sporting activities.
• Creatine supplementation provides a variety of benefits for females across their lifespan.
• Other forms of creatine are not superior to creatine monohydrate.

Acknowledgments

Abbreviations.

ACSM	American College of Sports Medicine
ATP	Adenosine triphosphate
C	Celsius
CK	Creatine kinase
CSA	Controlled substances act
DEA	Drug enforcement association
DHT	Dihydrotestosterone
DSHEA	Dietary Supplement Health and Education Act
ECW	Extracellular water
FDA	Food and Drug Administration
G	Grams
GMP	Good Manufacturing Practices
ICW	Intracellular water
ISSN	International Society of Sports Nutrition
Kg	Kilogram
Km	Kilometer
L	Liter
MPS	Muscle protein synthesis
NCAA	National Collegiate Athletic Association
Nmol	Nanomole
Oz	Ounce
PCr	Phosphocreatine
pH	Potential hydrogen
s	Seconds
pKa	Acid dissociation constant
P	Inorganic phosphate
TBW	Total body water
Yrs	Years of age

Authors’ contributions

Conceptualization: DGC; Writing-original draft preparation: All authors. The authors declare that the content of this paper has not been published or submitted for publication elsewhere. The author(s) read and approved the final manuscript.

Availability of data and materials

Ethics approval and consent to participate, consent for publication.

Not applicable

Competing interests

JA is Chief Executive Officer of the ISSN, an academic non-profit that receives support and/or sponsorship from companies that manufacture and/or sell creatine or creatine-containing products.

DGC has received research grants and performed industry sponsored research involving creatine supplementation, received creatine donation for scientific studies and travel support for presentations involving creatine supplementation at scientific conferences. In addition, DGC serves on the Scientific Advisory Board for Alzchem (a company which manufactures creatine) and the editorial review board for the Journal of the International Society of Sports Nutrition and is a sports science advisor to the ISSN. Furthermore, DGC has previously served as the Chief Scientific Officer for a company that sells creatine products.

SCF has served as a scientific advisor for a company that sells creatine products.

BG has received research grants, creatine donation for scientific studies, travel support for participation in scientific conferences (includes the ISSN) and honorarium for speaking at lectures from AlzChem (a company which manufactures creatine). In addition, BG serves on the Scientific Advisory Board for Alzchem (a company that manufactures creatine).

ARJ has consulted with and received external funding from companies that sell certain dietary ingredients and also writes for online and other media outlets on topics related to exercise and nutrition

RBK is co-founder and member of the board of directors for the ISSN. In addition, RBK has conducted industry sponsored research on creatine, received financial support for presenting on creatine at industry sponsored scientific conferences (includes the ISSN), and served as an expert witness on cases related to creatine. Additionally, he serves as Chair of the Scientific Advisory Board for Alzchem that manufactures creatine monohydrate.

ESR serves on the Scientific Advisory Board for Alzchem (a company which manufactures creatine). In addition, ESR received financial compensation to deliver the President’s Lecture on creatine supplementation at the 2019 ISSN annual conference.

AESR has received research funding from industry sponsors related to sports nutrition products and ingredients. In addition, AESR serves on the Scientific Advisory Board for Alzchem (a company that manufactures creatine).

TAV has received funding to study creatine and is an advisor for supplement companies who sell creatine. In addition, TAV is the current president of the ISSN.

DSW serves as a scientific advisor to the ISSN and on the editorial review board for the Journal of the International Society of Sports Nutrition. In addition, DSW is Past President of the ISSN and has received financial compensation from the ISSN to speak about creatine supplementation.

TNZ has conducted industry sponsored research involving creatine supplementation and has received research funding from industry sponsors related to sports nutrition products and ingredients. In addition, TNZ serves on the editorial review board for the Journal of the International Society of Sports Nutrition and is Past President of the ISSN.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

COVID-19: Long-term effects

Some people continue to experience health problems long after having COVID-19. Understand the possible symptoms and risk factors for post-COVID-19 syndrome.

Most people who get coronavirus disease 2019 (COVID-19) recover within a few weeks. But some people — even those who had mild versions of the disease — might have symptoms that last a long time afterward. These ongoing health problems are sometimes called post- COVID-19 syndrome, post- COVID conditions, long COVID-19 , long-haul COVID-19 , and post acute sequelae of SARS COV-2 infection (PASC).

What is post-COVID-19 syndrome and how common is it?

Post- COVID-19 syndrome involves a variety of new, returning or ongoing symptoms that people experience more than four weeks after getting COVID-19 . In some people, post- COVID-19 syndrome lasts months or years or causes disability.

Research suggests that between one month and one year after having COVID-19 , 1 in 5 people ages 18 to 64 has at least one medical condition that might be due to COVID-19 . Among people age 65 and older, 1 in 4 has at least one medical condition that might be due to COVID-19 .

What are the symptoms of post-COVID-19 syndrome?

The most commonly reported symptoms of post- COVID-19 syndrome include:

• Symptoms that get worse after physical or mental effort
• Lung (respiratory) symptoms, including difficulty breathing or shortness of breath and cough

Other possible symptoms include:

• Neurological symptoms or mental health conditions, including difficulty thinking or concentrating, headache, sleep problems, dizziness when you stand, pins-and-needles feeling, loss of smell or taste, and depression or anxiety
• Joint or muscle pain
• Heart symptoms or conditions, including chest pain and fast or pounding heartbeat
• Digestive symptoms, including diarrhea and stomach pain
• Blood clots and blood vessel (vascular) issues, including a blood clot that travels to the lungs from deep veins in the legs and blocks blood flow to the lungs (pulmonary embolism)
• Other symptoms, such as a rash and changes in the menstrual cycle

Keep in mind that it can be hard to tell if you are having symptoms due to COVID-19 or another cause, such as a preexisting medical condition.

It's also not clear if post- COVID-19 syndrome is new and unique to COVID-19 . Some symptoms are similar to those caused by chronic fatigue syndrome and other chronic illnesses that develop after infections. Chronic fatigue syndrome involves extreme fatigue that worsens with physical or mental activity, but doesn't improve with rest.

Why does COVID-19 cause ongoing health problems?

Organ damage could play a role. People who had severe illness with COVID-19 might experience organ damage affecting the heart, kidneys, skin and brain. Inflammation and problems with the immune system can also happen. It isn't clear how long these effects might last. The effects also could lead to the development of new conditions, such as diabetes or a heart or nervous system condition.

The experience of having severe COVID-19 might be another factor. People with severe symptoms of COVID-19 often need to be treated in a hospital intensive care unit. This can result in extreme weakness and post-traumatic stress disorder, a mental health condition triggered by a terrifying event.

What are the risk factors for post-COVID-19 syndrome?

You might be more likely to have post- COVID-19 syndrome if:

• You had severe illness with COVID-19 , especially if you were hospitalized or needed intensive care.
• You had certain medical conditions before getting the COVID-19 virus.
• You had a condition affecting your organs and tissues (multisystem inflammatory syndrome) while sick with COVID-19 or afterward.

Post- COVID-19 syndrome also appears to be more common in adults than in children and teens. However, anyone who gets COVID-19 can have long-term effects, including people with no symptoms or mild illness with COVID-19 .

What should you do if you have post-COVID-19 syndrome symptoms?

If you're having symptoms of post- COVID-19 syndrome, talk to your health care provider. To prepare for your appointment, write down:

• When your symptoms started
• What makes your symptoms worse
• How often you experience symptoms
• How your symptoms affect your activities

Your health care provider might do lab tests, such as a complete blood count or liver function test. You might have other tests or procedures, such as chest X-rays, based on your symptoms. The information you provide and any test results will help your health care provider come up with a treatment plan.

In addition, you might benefit from connecting with others in a support group and sharing resources.

• Long COVID or post-COVID conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html. Accessed May 6, 2022.
• Post-COVID conditions: Overview for healthcare providers. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html. Accessed May 6, 2022.
• Mikkelsen ME, et al. COVID-19: Evaluation and management of adults following acute viral illness. https://www.uptodate.com/contents/search. Accessed May 6, 2022.
• Saeed S, et al. Coronavirus disease 2019 and cardiovascular complications: Focused clinical review. Journal of Hypertension. 2021; doi:10.1097/HJH.0000000000002819.
• AskMayoExpert. Post-COVID-19 syndrome. Mayo Clinic; 2022.
• Multisystem inflammatory syndrome (MIS). Centers for Disease Control and Prevention. https://www.cdc.gov/mis/index.html. Accessed May 24, 2022.
• Patient tips: Healthcare provider appointments for post-COVID conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/post-covid-appointment/index.html. Accessed May 24, 2022.
• Bull-Otterson L, et al. Post-COVID conditions among adult COVID-19 survivors aged 18-64 and ≥ 65 years — United States, March 2020 — November 2021. MMWR Morbidity and Mortality Weekly Report. 2022; doi:10.15585/mmwr.mm7121e1.

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