Intervention Effects of Recreational Football on Obesity-Related Health Outcomes: A Systematic Review and Meta-Analysis

Obesity is a major public health concern, and effective yet engaging exercise strategies are needed to improve obesity-related health outcomes. This systematic review and meta-analysis aimed to evaluate the effects of recreational football on body composition and cardiometabolic outcomes in individuals with overweight or obesity. Five electronic databases were searched from inception to December 2025 for English-language randomized controlled trials (RCTs) comparing recreational football with non-football control conditions. Meta-analyses were performed using RevMan 5.4. Publication bias was assessed using funnel plots and Egger’s regression test where applicable, and certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Sixteen RCTs involving 387 participants were included, with the available evidence derived predominantly from children/adolescents and male participants. In the primary between-group meta-analyses, recreational football significantly improved body mass index (BMI), body fat percentage (BFP), waist circumference (WC), triglycerides (TG), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Findings for lean body mass (LBM) were inconsistent, and no significant between-group effects were observed for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), or high-density lipoprotein cholesterol (HDL-C). Overall, recreational football may be a promising exercise modality for improving several obesity-related health outcomes in individuals with overweight or obesity, particularly body composition, TG, and blood pressure. These findings should nevertheless be interpreted in light of the predominantly male and pediatric/adolescent samples, the inconsistent LBM results, and the overall moderate-to-low certainty of evidence. Large, well-designed RCTs with standardized protocols and longer follow-up are warranted.