Effects of Recreational Football on Body Composition and Cardiometabolic Health in Overweight or Obese Individuals: A...

Objective: This study systematically examined the effects of recreational football on body composition and cardiometabolic health in overweight or obese individuals via subgroup analyses of potential moderators. Methods: A systematic search was conducted across six databases (PubMed, Web of Science, the Cochrane Library, CNKI, VIP, and Wanfang Data) in May and July 2025 to identify controlled trials evaluating recreational football among overweight or obese individuals. A meta-analysis was performed to pool the effect estimates, reported as standardized mean differences (SMDs), with heterogeneity explored through subgroup analyses. Results: Recreational football interventions across 32 studies (1126 participants, aged 11-68) led to significant improvements in body composition and cardiometabolic health. The training programs ranged from 4 to 48 weeks, with sessions lasting 4 to 30 min. Key body composition outcomes included reductions in body weight (SMD = -0.51), body mass index (SMD = -0.41), body fat percentage (SMD = -0.53), fat mass (SMD = -0.40), and waist circumference (SMD = -1.43), along with increases in lean body mass (SMD = 0.18). The effects were more pronounced in females and younger participants (≤18 years). Cardiometabolic benefits included reductions in systolic blood pressure (SMD = -0.59), diastolic blood pressure (SMD = -0.75), and mean arterial pressure (SMD = -0.91), as well as resting heart rates (SMD = -0.85), especially among females, obese males, and those subject to shorter rest intervals. Participants' peak oxygen uptake also improved (SMD = 0.81). Concerning lipid metabolism, participants' total cholesterol, low-density lipoprotein cholesterol, and triglycerides decreased significantly, particularly in females, younger and obese individuals, and those who trained more than twice per week. High-density lipoprotein cholesterol increased significantly only in females and those involved in frequent training. In regard to glucose metabolism, participants' fasting insulin declined (SMD = -0.47), especially in regard to programs exceeding 12 weeks, whereas no significant changes were observed in fasting blood glucose, glycated hemoglobin, or the homeostatic model assessment of insulin resistance. According to the GRADE assessments, the certainty of the evidence ranged from very low to moderate across these outcomes. Conclusions: Recreational football improves the body composition and cardiometabolic health in overweight or obese individuals, resulting in reductions in adiposity, blood pressure, lipids, and insulin, with greater benefits observed in females, younger individuals, and those engaging in more frequent training. These findings support its potential as a practical intervention for weight and cardiometabolic risk management, in both clinical and community settings.