The prevalence of lifestyle diseases associated with low cardiovascular and metabolic fitness is reaching pandemic proportions.1 Thus, the expected increases in people with type 2 diabetes (T2DM) signifies the major societal challenge associated with a sedentary life.2 It has been shown that regular participation in physical activities can markedly benefit individual health and that supervised training interventions can be used for both the prevention and treatment of lifestyle diseases.3,4 However, the long-term adherence rates to exercise on prescription programs are poor.5 In Denmark, the sporting associations Danmarks Idrætsforbund and Danmarks Gymnastik & Idrætsforeninger, supported by the Danish government, have a vision that, by 2025, 50% of the Danish population should be members of a local sporting association and 75% should be physically active.6 The sporting associations find it difficult keeping young members interested in their teenage years and reaching out to sedentary people with no or little experience of sport where competition is not a major element.6 Furthermore, it has been shown that the dropout rate with traditional “exercise on prescription programs” is high both in Denmark and worldwide,5,7 and new strategies for the prevention of lifestyle diseases should be aimed at identifying activities that can motivate participants to remain active and hence provide an effective, long-lasting lifestyle change with prolonged physiological perspectives. Previous observations from studies conducted on team sport, performed as small-sided games, have shown marked beneficial health effects and development of social relationships in untrained sedentary men and women as well as people with hypertension, T2DM, and prostate cancer.8
۱۹ However, different team sports may attract and motivate different populations and increase individual incentive for sustained participation and therefore induce long-lasting lifestyle changes. We believe that handball is a team sport that may have great potential to reach out to sedentary populations in Denmark and other European countries because of its popularity in terms of television time, fan base, and appeal. However, it remains unknown whether small-sided handball training provides a physiological training stimulus that is as potent for fitness and health effects as small-sided football, while the motivational and psychological aspects of participation in an intervention involving smallsided handball training also remain unevaluated.