Women who consistently meet recommended physical activity levels during middle age have approximately half the risk of dying from any cause compared with women who remain inactive, a new study led by researchers at the University of Sydney has found.  
 
The research, published in PLOS Medicine and led by Dr Binh Nguyen from the Prevention Research Collaboration at the University of Sydney’s Charles Perkins Centre and the School of Public Health, tracked 11,169 Australian women over 15 years, offering rare insight into the long-term health effects of sustained physical activity across midlife. 

Researchers analysed data from women born between 1946 and 1951 (aged 47-52 years at the beginning of the study) who took part in the Australian Longitudinal Study on Women’s Health. Participants completed nine surveys between 1996 and 2019, reporting how often they met the World Health Organisation guideline of at least 150 minutes of moderate-to-vigorous physical activity each week, such as brisk walking, cycling or swimming.

5.3 percent of women who remained active died during the study period, compared with 10.4 percent of those who remained inactive. This means women who met the guidelines consistently throughout midlife had about half the risk of death of those who did not. 

The researchers evaluated the expected effects if all participants consistently met, or did not meet, WHO recommendations over 2001–2016 (surveys 3–8), using methods that modelled these hypothetical interventions across the entire sample, and also explored scenarios in which women started or stopped meeting the recommendations at different mid-life ages, although these latter analyses were inconclusive due to uncertainty in the findings.

“Staying active throughout midlife can make a real difference for women’s long-term health,” said Dr Nguyen. “Maintaining recommended levels of physical activity over multiple years helps protect against early death.”

Unlike much previous research, this study followed the same women for over 15 years, allowing researchers to examine how sustained physical activity and ongoing inactivity across midlife relates to long-term health outcomes.  

Physical activity is well established as a key protective factor against chronic disease and premature death. For many women, staying active through midlife can be harder during perimenopause and menopause, when physical changes can disrupt energy levels and make regular exercise more difficult to sustain. This coincides with high rates of inactivity nationally: around 43 percent of Australian women aged 45-64 were insufficiently active in 2022 according to the Australian Institute of Health and Welfare. The findings of Professor Nguyen’s study suggest that supporting women to remain physically active during this life stage may be particularly important for long-term health. 

“This study adds to growing evidence that an active lifestyle during midlife provides important health benefits,” said Dr Nguyen. “A lot of research captures physical activity at just one time point. By following women across midlife, we can better see how sustained activity, or long periods of inactivity, relate to long-term health.”

Similar patterns were observed for deaths from cardiovascular disease and cancer, although estimates for these outcomes were less certain due to smaller numbers of deaths, making the findings less conclusive. It was also unclear whether starting to meet recommended physical activity levels later in midlife – such as between the ages of 55 and 65 – offered the same level of protection as being active throughout midlife. 

The researchers note that physical activity was self-reported, and that the study sample may not represent all mid-aged Australian women.

Research

Nguyen, B., 'Physical activity across mid-life and mortality outcomes in Australian women: A target trial emulation using a prospective cohort' (PLOS Medicine, 2026)

DOI: doi.org/10.1371/journal.pmed.1004976

Declaration

The research was conducted as part of the Australian Longitudinal Study on Women’s Health, which is managed by the University of Queensland and the University of Newcastle. The study was funded by the Australian Government Department of Health and Aged Care. 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. The authors declare no competing interests.

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