Association of a lifestyle risk index with visceral and subcutaneous adipose tissue in the German National Cohort (NAKO)

Maskarinec, Gertraud; Klapp, Rebecca; Nöthlings, Ute; Schulze, Matthias B.; Bamberg, Fabian; Machann, Jürgen; Schlesinger, Sabrina; Leitzmann, Michael; Sedlmeier, Anja; Bohmann, Patricia; Rospleszcz, Susanne; Nattenmüller, Johanna; Haueise, Tobias; Steindorf, Karen; Niendorf, Thoralf; Schlett, Christopher L.; Greiser, Karin Halina; Panreck, Leo; Linseisen, Jakob; Conzen, Christina-Alexandra; Gastell, Sylvia; Schikowski, Tamara; Völzke, Henry; Bülow, Robin; Peters, Annette; Niedermayer, Fiona; Kaaks, Rudolf; Becher, Heiko; Karch, André; Berger, Klaus; Keil, Thomas; Krist, Lilian; Hoffmeister, Michael; Mons, Ute; Schmidt, Boerge; Stang, Andreas; Mikolajczyk, Rafael; Kluttig, Alexander; Lieb, Wolfgang; Övermöhle, Cara; Hebestreit, Antje; Günther, Kathrin; Harth, Volker; Obi, Nadia; Castell, Stefanie; Kettlitz, Robyn; Nimptsch, Katharina; Pischon, Tobias

Association of a lifestyle risk index with visceral and subcutaneous adipose tissue in the German National Cohort (NAKO)

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Item Type:	Article
Title:	Association of a lifestyle risk index with visceral and subcutaneous adipose tissue in the German National Cohort (NAKO)
Creators Name:	Maskarinec, Gertraud, Klapp, Rebecca, Nöthlings, Ute, Schulze, Matthias B., Bamberg, Fabian, Machann, Jürgen, Schlesinger, Sabrina, Leitzmann, Michael, Sedlmeier, Anja, Bohmann, Patricia, Rospleszcz, Susanne, Nattenmüller, Johanna, Haueise, Tobias, Steindorf, Karen, Niendorf, Thoralf, Schlett, Christopher L., Greiser, Karin Halina, Panreck, Leo, Linseisen, Jakob, Conzen, Christina-Alexandra, Gastell, Sylvia, Schikowski, Tamara, Völzke, Henry, Bülow, Robin, Peters, Annette, Niedermayer, Fiona, Kaaks, Rudolf, Becher, Heiko, Karch, André, Berger, Klaus, Keil, Thomas, Krist, Lilian, Hoffmeister, Michael, Mons, Ute, Schmidt, Boerge, Stang, Andreas, Mikolajczyk, Rafael, Kluttig, Alexander, Lieb, Wolfgang, Övermöhle, Cara, Hebestreit, Antje, Günther, Kathrin, Harth, Volker, Obi, Nadia, Castell, Stefanie, Kettlitz, Robyn, Nimptsch, Katharina and Pischon, Tobias
Abstract:	OBJECTIVE: This cross-sectional study examined a Lifestyle Risk Factor Index (LSRI) in relation to adiposity measures including visceral adipose tissue (VAT) in the German National Cohort (NAKO). METHODS: Based on self-reports at baseline among 30,920 of > 205,000 NAKO eligible participants with magnetic resonance imaging (MRI) scans, one point each for not smoking, adhering to ≥ 3/7 diet recommendations, consuming ≤ 1 (women)/≤ 2 (men) alcoholic drinks/day, and ≥ 150 min/week physical activity was assigned. VAT volume, obtained from whole-body MRI at 3T, was analyzed by deep learning-based image segmentation. General linear models estimated adjusted geometric mean adiposity measures by LSRI and stratified analyses by sex and BMI. RESULTS: Of 18,508 participants aged 48.2 ± 12.2 years, the respective proportions for 0/1, 2, 3, and 4 LSRI points were 7%, 24%, 51%, and 18%. Participants with LSRI scores of 4 versus 0/1 had lower adjusted geometric mean volumes of VAT (2.3; 95% CI 2.2, 2.3 vs. 3.0; 95% CI 2.9, 3.1 L). These differences were slightly attenuated after adding BMI. This association was weaker for individuals with obesity than normal/overweight. CONCLUSION: A combination of lifestyle factors appears to be associated with lower VAT volume, but an elevated BMI may have a greater influence on VAT accumulation than lifestyle behaviors alone.
Keywords:	Body Fat Distribution, Cohort Study, Lifestyle Behaviors, Obesity
Source:	Obesity
ISSN:	1930-7381
Publisher:	Wiley / The Obesity Society
Date:	19 November 2025
Official Publication:	https://doi.org/10.1002/oby.70071
PubMed:	View item in PubMed

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