Association of a Lifestyle Risk Index With Visceral and Subcutaneous Adipose Tissue in the German National Cohort (NAKO).
Authors
Affiliations (33)
Affiliations (33)
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA.
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Bonn, Germany.
- German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Munich at the University of Tübingen, Tübingen, Germany.
- German Center for Diabetes Research (DZD), Tübingen, Germany.
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich Heine University, Düsseldorf, Germany.
- Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
- Institute for Radiology and Nuclear Medicine Hirslanden Clinic St. Anna, Luzern, Switzerland.
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- NAKO e.V., Heidelberg, Germany.
- Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany.
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, München, Germany.
- Institute for Global Health, University Hospital Heidelberg, Heidelberg, Germany.
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany.
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Division of Primary Cancer Prevention, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
- Institute of Epidemiology, Kiel University, Kiel, Germany.
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department for Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Lower Saxony, Germany.
Abstract
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). 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. 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. 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.