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This study aimed to compare the effectiveness of recreational football performed once (LOW) vs. twice (MOD) a week on cardiovascular risk factors in healthy, sedentary men. Body composition, resting blood pressure, blood lipid profile and maximal oxygen consumption (VO2max) were measured at baseline, after a 12-week control and training period, using an interrupted time-series study (study 1, n = 18: n = 8, LOW and n = 10, MOD) nested in a randomized parallel trial (study 2, n = 34: n = 18 LOW and n = 16 MOD). After the intervention in study 1, LDL-cholesterol (−12.3 mg·dLˉ1 [−22.7 to −2.0]) and VO2max (4.5 ml·kgˉ1·minˉ1 [1.2–7.8 ]) changed in LOW whereas differences were found in weight (−2.1 kg [−3.7 to −0.4]), BMI (−0.7 kg·m−2 [−1.2 to −0.1]), total cholesterol (−22.2 mg·dLˉ1 [−36.0 to −8.4]), no-HDL-cholesterol (−17.5 mg·dLˉ1 [−30.5 to −4.5]), LDL-cholesterol (−14.9 mg·dLˉ1 [−23.6 to −6.2]) and VO2max (5.7 ml·kgˉ1·minˉ1 [2.8–8.6]) in MOD. Study 2 showed no evidence of differences between groups. Our results therefore suggest positive health effects of recreational football even when performed at low frequency as it can happen in real context. Highlights Moderate and high amount of recreational football practice (i.e. 2 or 3 h a week) have been shown to be effective to improve health-related factors in both healthy and unhealthy people. Scarce data are present regarding the effect of a low frequency of recreational football practice (i.e. 1 h a week) that is often usual in a real context. Our results showed the practice of recreational football, once a week, is effective for improving some cardiovascular risk factors (maximal oxygen consumption and LDL-cholesterol) in sedentary, healthy middle-aged men. Moreover, practising recreational football once or twice a week seems to lead to similar positive health adaptations. [ABSTRACT FROM AUTHOR]