Effects of recreational football on body composition, cardiometabolic health, and functional performance in children and adolescents: a systematic review and meta-analysis

TL;DR

Recreational football helps children and teens lose weight, improve heart health, and boost physical performance, especially for those who are overweight or obese.

Contribution

This study provides a comprehensive meta-analysis of recreational football's health benefits in youth, identifying effective intervention parameters.

Findings

Recreational football significantly reduces BMI, body fat, and waist circumference in children and adolescents.

It improves physical performance metrics like sprint speed, balance, and endurance, but not vertical jump.

Longer and more frequent football sessions lead to greater reductions in body fat and resting heart rate.

Abstract

The systematic review and meta-analysis aimed to evaluate the effects of recreational football on body composition, cardiometabolic health, and functional performance in children and adolescents. Additionally, it explored potential moderators through subgroup analyses.

A systematic search was conducted in six databases in May 2025. A random-effects model was employed for the meta-analysis, and effect sizes were reported as standardized mean differences (SMD, Hedges’ g). Subgroup and sensitivity analyses were conducted to examine sources of heterogeneity.

A total of 20 studies (N = 2,906; age range: 8–17 years) were included. Of the participants, 1,524 (52.44%) were male, 1,174 (40.40%) were female, and 208 (7.16%) did not clearly report their gender. Recreational football significantly reduced BMI (SMD = −0.13 [−0.24, −0.02]), body fat percentage (SMD = −0.37 [−0.63, −0.11]), and waist circumference (SMD = −1.38 [−2.65, −0.11]), with a slight increase in lean mass (SMD = 0.13 [0.02, 0.24]). It also reduced mean arterial pressure (SMD = −1.06 [−2.03, −0.10]), systolic blood pressure (SMD = −0.71 [−1.19, −0.23]), and triglycerides (SMD = −0.95 [−1.74, −0.15]), while having no effect on diastolic blood pressure, resting heart rate, VO2peak, blood glucose, or cholesterol. Additionally, it improved interval endurance (SMD = 0.15 [0.04, 0.25]), sprint speed (SMD = −0.72 [−1.22, −0.22]), standing long jump (SMD = 0.53 [0.10, 0.97]), and balance (SMD = 0.84 [0.21, 1.46]), but had no effect on vertical jump. Subgroup analyses showed greater reductions in BMI (g = −0.54) and body weight (g = −0.89) in overweight/obese individuals, and significant weight improvement in adolescents >12 years (g = −1.35). Longer interventions (≥12 weeks) and higher frequencies (>2 sessions/week) were associated with greater body fat reduction (g = −0.82 and g = −0.74), with reductions in resting heart rate observed mainly in interventions ≥12 weeks (g = −0.72). According to the GRADE assessment, the overall quality of evidence was rated as low to very low.

Recreational football is efficacious in improving body composition, select cardiometabolic risk factors, and physical performance in children and adolescents, especially individuals classified as overweight or obese. Even with limitations in sample size, intervention diversity, and methodological quality, resulting in an overall low to low quality assessment of the evidence, the comprehensive evidence still provides preliminary quantitative support for incorporating recreational football into youth health promotion; future efforts will require larger samples, standardized protocols, and rigorous design to enhance the strength of the evidence. Based on existing evidence, a reference protocol may consist of a 12-week program with 2–3 weekly sessions (45–60 min each), including a FIFA 11+ warm-up, 3–4 bouts of 4–6 min at up to 80% HRmax with 2-min recovery intervals, and a cool-down.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251106734, identifier CRD420251106734.

Figures