{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T20:44:17Z","timestamp":1788295457264,"version":"build-2803163510"},"reference-count":78,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Education Science Planning Foundation of China","award":["No.BLA230107"],"award-info":[{"award-number":["No.BLA230107"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Evidence for herbal ergogenic aids remains uncertain, and ashwagandha trials span heterogeneous performance domains. This review evaluated oral Withania somnifera supplementation on exercise performance and explored participant-, outcome-, formulation-, and supplementation-related moderators. Methods: PubMed, Web of Science, Cochrane Library, Embase, and SPORTDiscus-EBSCO were searched from inception to 1 April 2026. Eligible randomized controlled trials compared oral ashwagandha with placebo or control conditions and reported objective exercise-performance outcomes. Dependent effects were synthesized using restricted-maximum-likelihood three-level random-effects models; 95% prediction intervals, GRADE certainty ratings, subgroup analyses, and dose\/duration meta-regressions were reported. Results: Thirteen trials involving 599 participants contributed 79 effect sizes. Samples were mainly young adults or athletes; reported ages included one 18\u201340-year trial and one late-adolescent athlete cohort aged 17.4 \u00b1 1.7 years. Trial-level sex composition was four male-only, one female-only, three mixed-sex, and five incompletely reported cohorts. Ashwagandha improved overall exercise performance on average (Hedges\u2019 g = 0.47, 95% CI [0.25, 0.69], p &lt; 0.001; I2 = 60%; 95% prediction interval [\u22120.40, 1.33]), but the prediction interval crossed zero. Exercise type was the clearest moderator (P_between = 0.006): evidence was most consistent for aerobic endurance (g = 0.54, 95% CI [0.22, 0.85], p = 0.002), whereas strength effects were positive but uncertain and power or muscular endurance evidence remained sparse. Dose analyses were hypothesis-generating; 500\u2013600 mg\/day was the most evidence-supported extract-dose range. Conclusions: Oral ashwagandha may improve selected exercise-performance outcomes, particularly aerobic endurance, but benefits are not uniform across contexts. Future trials should be preregistered, adequately powered, double-blind, formulation-standardized, sex-stratified, and include rigorous blinding checks, mechanistic endpoints, adverse-event monitoring, and sport-specific performance tests.<\/jats:p>","DOI":"10.3390\/nu18121915","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:01:27Z","timestamp":1781492487000},"page":"1915","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Withania somnifera (Ashwagandha) Supplementation on Exercise Performance: A Systematic Review and Three-Level Meta-Analysis"],"prefix":"10.3390","volume":"18","author":[{"given":"Xiupeng","family":"Li","sequence":"first","affiliation":[{"name":"School of Physical Education, Shaanxi Normal University, Xi\u2019an 710119, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6147-1362","authenticated-orcid":false,"given":"Hansen","family":"Li","sequence":"additional","affiliation":[{"name":"School of Physical Education, Sichuan Agricultural University, Ya\u2019an 625014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8509-4696","authenticated-orcid":false,"given":"Shuqi","family":"Yao","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shaanxi Normal University, Xi\u2019an 710119, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Hou","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shaanxi Normal University, Xi\u2019an 710119, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6804-2731","authenticated-orcid":false,"given":"Aiping","family":"Chi","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shaanxi Normal University, Xi\u2019an 710119, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1249\/MSS.0000000000000852","article-title":"Nutrition and athletic performance","volume":"48","author":"Thomas","year":"2016","journal-title":"Med. 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