This study aimed to examine the health effects of fitness training and team-sport training in a pragmatic community health centre set-up for women with lifestyle diseases. The methods included training intensity evaluations and measurements of VO₂max, blood pressure, body composition and exercise performance. In all, 40 women in the fitness training group (FG) and 34 women in the team-sport training group (TG) completed a test before they were offered 12–16 weeks of twice-weekly training sessions lasting 60–90 min and after. Mean heart rate during training was not significantly different (P = 0.569) between FG (72.7 ± 4.2%HR_max) and TG (71.4 ± 6.8%HR_max). TG achieved improvements in aerobic fitness of 0.9 ± 2.0 mlO₂·kg·min⁻¹ (P = 0.034) and in resting heart rate of 3.7 ± 9.1 bpm (P = 0.026), as well as in sit-to-stand performance (STS: 3.5 ± 3.3 stands · 30 s⁻¹; P = 0.003) and 6‑min walking test performance (6MWT: 53 ± 29 m; P < 0.001), while fat percentage was reduced by 0.6 ± 1.6% (P = 0.038). FG achieved within-group improvements (P < 0.001) in STS performance (3.1 ± 2.8 stands · 30 s⁻¹) and 6MWT performance (41 ± 47 m), with fat percentage reduced by 0.9 ± 1.7% (P = 0.003). Overall, the study revealed no significant between-group differences in training effects. However, there was a between-group difference in training attendance (P = 0.001), with the fitness group having the highest attendance (1.5 ± 0.4 vs. 1.1 ± 0.5 per week). In conclusion, small-sided team-sport training and fitness training conducted in a pragmatic set-up induce similar positive health effects for women with lifestyle diseases. Team-sport training is considered a feasible and worthy alternative to fitness training for sedentary women in community health centres.