Energy expenditure and physical activity responses to football for 
health training in adults with metabolic syndrome: a randomized 
clinical trial

Athanasios Poulios; Lambros Tsiokanos; Dimitrios Draganidis; Konstantinos Papanikolaou; Panagiotis Tsimeas; Niki Syrou; Georgios Metsios; Athanasios Chatzinikolaou; Georgios Ermidis; Athanasios Tsiokanos; Aggelos Pappas; Magni Mohr; Peter Krustrup; Athanasios Z. Jamurtas; Ioannis Fatouros

doi:10.5114/biolsport.2026.154146

eISSN: 2083-1862
ISSN: 0860-021X

Biology of Sport

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abstract:

Original paper

Energy expenditure and physical activity responses to football for health training in adults with metabolic syndrome: a randomized clinical trial

Athanasios Poulios

¹

,

Lambros Tsiokanos

¹

,

Dimitrios Draganidis

¹

,

Konstantinos Papanikolaou

^{1, 2}

,

Panagiotis Tsimeas

¹

,

Niki Syrou

¹

,

Georgios Metsios

³

,

Athanasios Chatzinikolaou

⁴

,

Georgios Ermidis

⁵

,

Athanasios Tsiokanos

¹

,

Aggelos Pappas

¹

,

Magni Mohr

^{5, 6}

,

Peter Krustrup

^{5, 7, 8}

,

Athanasios Z. Jamurtas

¹

,

Ioannis G. Fatouros

¹

Department of Physical Education and Sport Science, University of Thessaly, Karies, Trikala, Greece
Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
Faculty of Health Sciences, University of the Faroe Islands, Torshavn, Faroe Islands
Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
Sport and Health Sciences, University of Exeter, Exeter, United Kingdom

Biol Sport. 2026;43:449–461

DOI: https://doi.org/10.5114/biolsport.2026.154146

Online publish date: 2025/10/01

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AMA

Poulios A, Tsiokanos L, Draganidis D, et al. Energy expenditure and physical activity responses to football for 
health training in adults with metabolic syndrome: a randomized 
clinical trial. Biology of Sport. 2026;43(1):449-461. doi:10.5114/biolsport.2026.154146.

APA

Poulios, A., Tsiokanos, L., Draganidis, D., Papanikolaou, K., Tsimeas, P.,  & Syrou, N. et al. (2026). Energy expenditure and physical activity responses to football for 
health training in adults with metabolic syndrome: a randomized 
clinical trial. Biology of Sport, 43(1), 449-461. https://doi.org/10.5114/biolsport.2026.154146

Chicago

Poulios, Athanasios, Lambros Tsiokanos, Dimitrios Draganidis, Konstantinos Papanikolaou, Panagiotis Tsimeas, Niki Syrou,  and Georgios Metsios et al. 2026. "Energy expenditure and physical activity responses to football for 
health training in adults with metabolic syndrome: a randomized 
clinical trial". Biology of Sport 43 (1): 449-461. doi:10.5114/biolsport.2026.154146.

Harvard

Poulios, A., Tsiokanos, L., Draganidis, D., Papanikolaou, K., Tsimeas, P., Syrou, N., Metsios, G., Chatzinikolaou, A., Ermidis, G., Tsiokanos, A., Pappas, A., Mohr, M., Krustrup, P., Jamurtas, A.,  and Fatouros, I. (2026). Energy expenditure and physical activity responses to football for 
health training in adults with metabolic syndrome: a randomized 
clinical trial. Biology of Sport, 43(1), pp.449-461. https://doi.org/10.5114/biolsport.2026.154146

MLA

Poulios, Athanasios et al. "Energy expenditure and physical activity responses to football for 
health training in adults with metabolic syndrome: a randomized 
clinical trial." Biology of Sport, vol. 43, no. 1, 2026, pp. 449-461. doi:10.5114/biolsport.2026.154146.

Vancouver

Poulios A, Tsiokanos L, Draganidis D, Papanikolaou K, Tsimeas P, Syrou N et al. Energy expenditure and physical activity responses to football for 
health training in adults with metabolic syndrome: a randomized 
clinical trial. Biology of Sport. 2026;43(1):449-461. doi:10.5114/biolsport.2026.154146.

PlumX metrics:

This investigation determined the energy expenditure (EE), physical activity (PA), and physiological responses of football for health training (FFH). Twenty middle-aged males with metabolic syndrome (MetS) completed a 60-min FFH and a control trial using a randomized crossover design. The FFH load and EE were determined using a mobile gas analyzer, heart rate (HR) monitors, blood lactate measurements, a global positioning system, and accelerometry. Participants in FFH run a total distance of ~3.800 m (1,121 m at > 7 km/h, accelerations of 141 m, decelerations of 162 m) using a mean and maximal speed of 4.1 km/h and 20.6 km/h, respectively. FFH demonstrated a moderate-to-vigorous PA of > 41 min and a step count of ~4900. FFH increased (p < .001) the perceived exertion (55.8%, 13.6 ± 2.6), HR_mean (151.1 ± 15.2 beats/min, 83.1 ± 10.9 %HRmax), lactate (80.8%, 5.4 ± 0.9 mmol/L), V ̇ O₂ (88.6%, 1.9 ± 0.3 L/min, 79.9 ± 10.5% V ̇ O_2max, 6.7 ± 0.8 METs), breathing frequency (32.6 ± 3.0 breaths/min), and respiratory exchange ratio (0.98 ± 0.03) compared to the control trial. Total EE reached 524.2 ± 81.0 kcals (mitochondrial energy production: 476.8 kcals; anaerobic energy production: AS 5.4 ± 1.0 kcals; EPOC: 42.0 ± 11.8 kcals). The present results suggest that FFH meets the international PA and EE standards for adults with MetS, with participants taking part in moderate-to-vigorous PA (MVPA) for approximately 68% of each session, rendering it a suitable and efficient strategy to lower cardiometabolic risk.

keywords:

Energy expenditure and physical activity responses to football for health training in adults with metabolic syndrome: a randomized clinical trial

Recreational football, Caloric expenditure, Blood lactate, Obesity, Dyslipidemia