The present review addresses the physiological demands during recreational football training and the effects on central health variables that influence the risk of life-style diseases of young and middle-aged men. Recent studies have established that recreational football, carried out as small-sided games can be characterized as having a high aerobic component with mean heart rates of 80–85% of maximum heart rate, which is similar to values observed for elite football players. In addition, the training includes multiple high-speed runs, sprints, turns, jumps and tackles, which provide a high impact on muscles and bones. Recreational football training in untrained men results in marked improvements in maximum aerobic power, blood pressure, muscle capillarization and intermittent exercise performance, and those effects are similar to interval training and more pronounced than moderate-intensity continuous running and strength training. Further, recreational football training enhances fat oxidation during exercise and results in a higher fat loss than interval training and strength training, and results in marked muscle hypertrophy and elevates bone mass, more than interval and continuous running. Taken together, recreational football appears to effectively stimulate musculoskeletal, metabolic and cardiovascular adaptations of importance for health and thereby reduces the risk of developing life-style diseases.