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17 april 2026: Bron: PLOS medicine

Op basis van de uitkomsten van een eerder uitgevoerde gerandomiseerde studie onder 11.169 vrouwen zouden vrouwen vanaf de middelbare leeftijd aangemoedigd moeten worden om vanaf hun middelbare leeftijd te voldoen aan de aanbevelingen voor het doen van fysieke activiteiten zoals sporten en bewegen om zo de kans aan overlijden aan alle oorzaken te verminderen. Dat blijkt uit een simulatiestudie gebaseerd op de eerdere resultaten. 

Deze Australische simulatiestudie gebruikte de eerder gevonden data om een ​​gerandomiseerde gecontroleerde trial na te bootsen en vergeleek verschillende fysieke activiteitspatronen gedurende 15 jaar in relatie tot de sterfte door alle oorzaken, overlijden aan hart- en vaatziekten (HVZ) en overlijden door kanker bij Australische vrouwen van middelbare leeftijd.

De onderzoekers simuleerden twee interventies, vergeleken met consistente niet-naleving van de aanbevelingen voor matig tot intensieve fysieke activiteit (MVPA) en controle:

1. Consistente naleving van de WHO-aanbevelingen voor matig tot intensieve fysieke activiteit (MVPA) gedurende de gehele studieperiode.
2. Beginnen met het voldoen aan de aanbevelingen op 55 jaar, 60 jaar of 65 jaar.

De onderzoekers evalueerden het effect dat verwacht zou worden als alle deelnemers deze specifieke patronen van fysieke activiteit gedurende de studieperiode zouden volgen. We schatten het effect van het voldoen aan de aanbevelingen voor fysieke activiteit tot het einde van de studieperiode van 15 jaar of tot het moment van overlijden, afhankelijk van wat zich het eerst voordeed. Zie o.a. S1 Text.

Belangrijkste resultaten van de analyses:

  • Gedurende de periode waarin de uitkomsten werden bekeken (enquêtes 4 tot 9 keer; leeftijd tussen 53-58 en 68-73 jaar), overleed 5,8% van de oorspronkelijke deelnemende vrouwen aan de steekproef aan alle oorzaken, 1,8% aan hart- en vaatziekten en 1,7% aan kanker.(Zie Table 3).
  • De incidentiecijfers van sterfte door alle oorzaken, hart- en vaatziekten en kanker varieerden respectievelijk van 5,3%, 2,1% en 1,7% bij consistente naleving van de aanbevelingen, tot 10,4%, 4,2% en 5,0% bij consistente niet-naleving van de aanbevelingen.(Zie Fig 3).

Het volledige studierapport is gratis in te zien of te downloaden met als belangrijkste conclusie dat bij een vergelijking tussen consistente naleving van de MVPA-aanbevelingen en consistente niet-naleving, bleek er een duidelijk bewijs te zijn voor een beschermend effect op de totale sterfte.
De bevindingen voor hart- en vaatziekten en kankersterfte waren minder eenduidig, evenals de bevindingen met betrekking tot het effect van het beginnen met het voldoen aan de aanbevelingen voor matig tot intensieve fysieke activiteit (MVPA) rond het vijftigste levensjaar op de sterftecijfers.

Maar zie hier het studierapport. Klik op de titel van het abstract:

Physical activity across mid-life and mortality outcomes in Australian women: A target trial emulation using a prospective cohort

Abstract

Background

Long-term causal evidence comparing different physical activity patterns and mortality outcomes is needed. Using observational data to emulate an RCT, this study compared different physical activity patterns over 15 years in relation to mortality from all causes, cardiovascular disease (CVD) and cancer in mid-aged Australian women.

Methods and findings

A target trial emulation framework was used to emulate an RCT, based on data collected every 3 years (nine surveys between 1996 and 2019) from 11,169 women in the Australian Longitudinal Study on Women’s Health (ALSWH; 1946−51 cohort). Two emulated interventions were compared against consistent non-adherence (control) to WHO moderate-to-vigorous physical activity (MVPA) recommendations during the 15-year ‘exposure period’: (1) consistent adherence to recommendations (at least 150 min/week) over 15 years (2001−2016; women were 50−55–65−70 years); and (2) starting to meet the recommendations at age 55, 60, or 65 years. Analyses were adjusted for sociodemographic and health variables using marginal structural models with the assumptions of conditional exchangeability, positivity, consistency, and no interference. Mortality outcomes that occurred between surveys 4−9 (women were 53−58 to 68−73 years), were ascertained from Australian death registries. Comparing consistent adherence to MVPA recommendations with consistent non-adherence, there was evidence (Bayes factor = 5.71) for a protective effect for all-cause mortality (risk ratio : 0.50, 99.5% CI [0.27, 0.94]; risk difference : −5.2%, 99.5% CI [−10.5%, 0.1%]). Findings for CVD (BF = 2.05; RR: 0.50, 99.5% CI [0.19, 1.30]; RD: −2.1%, 99.5% CI [−5.3%, 1.1%]) and cancer mortality (BF = 2.26; RR: 0.35, 99.5% CI [0.10, 1.17]; RD: −3.3%, 99.5% CI [−8.4%, 1.9%]) were more uncertain and less conclusive, as were those for an effect of starting to meet MVPA recommendations in the mid-fifties on mortality outcomes. The main study limitations included reliance of self-reported physical activity and that findings may not be generalisable to all mid-aged Australian women.

Conclusions

Based on findings from this target trial emulation, women should be encouraged to meet physical activity recommendations throughout mid-age to derive mortality benefits.

Author summary

Why was this study done?

  • The evidence for an association between physical activity and mortality outcomes has generally been based on epidemiological studies relying on a single measurement of physical activity and not examining causal effects.
  • Studies that examine the effect of longer-term patterns of physical activity on mortality outcomes are needed.

What did the researchers do and find?

  • Using a causal inference framework to imitate a randomised controlled trial based on observational data, this study offers long-term evidence comparing different physical activity patterns during mid-life in relation to all-cause, cardiovascular disease and cancer mortality in a cohort of Australian women.
  • In this emulated target trial (n = 11,169), consistently meeting the World Health Organization’s recommendations of moderate-to-vigorous physical activity over 15 years was protective for all-cause mortality compared to consistent non-adherence to recommendations. Findings were uncertain and not conclusive for cardiovascular disease and cancer mortality, possibly due to insufficient statistical power from the smaller number of observed deaths from cardiovascular disease and cancer.
  • Findings were also more uncertain and inconclusive for whether starting to meet guidelines earlier in mid-life (e.g., by the mid-fifties) resulted in lower risks of all-cause, cardiovascular disease and cancer mortality by the end of the study.

What do these findings mean?

  • Staying physically active at recommended levels throughout midlife provides protective benefits against premature mortality in women.
  • This study supports the growing evidence that maintaining an active lifestyle in midlife provides health benefits.
  • Limitations of the study included the use of self-reported physical activity, and findings may not apply to all mid-aged Australian women.

Citation: Nguyen B, Owen KB, Luo M, Brown W, Mielke GI, Clare PJ, et al. (2026) Physical activity across mid-life and mortality outcomes in Australian women: A target trial emulation using a prospective cohort. PLoS Med 23(3): e1004976. https://doi.org/10.1371/journal.pmed.1004976

Academic Editor: Peter WG Tennant, University of Leeds, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND

Received: June 17, 2025; Accepted: February 19, 2026; Published: March 26, 2026

Copyright: © 2026 Nguyen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data underlying this study are owned by the Australian Government Department of Health (ALSWH). The process for data access is documented on the Australian Longitudinal Study on Women’s Health website [http://www.alswh.org.au] which includes all the survey questionnaires, data books of frequency tables for all surveys, meta-data, conditions of data access and request form. The code used for analysis is available online (https://www.philipclare.com/code/alswh).

Funding: The Australian Longitudinal Study on Women’s Health is funded by the Australian Government Department of Health. GIM is supported by a National Health and Medical Research Council Investigator Grant (APP2008702). DD is funded by an Emerging Leader Fellowship from the National Health and Medical Research Council (APP2009254) and an Early-Mid Career Researcher Grant under the New South Wales Cardiovascular Research Capacity Program. URLs: https://www.nhmrc.gov.au and https://www.medicalresearch.nsw.gov.au. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Acknowledgments

The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health by the University of Queensland and the University of Newcastle. We are grateful to the Australian Government Department of Health and Age Care for funding and to the women who provided the survey data. This research includes computations using the computational cluster Katana supported by Research Technology Services at UNSW Sydney.

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                    Bewegen, sporten, overlijden, Australische studie, aanmoedigen, PLOS medicine, overlijden aan hart- en vaatziektes, sterven aan kanker


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