Open Access

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

• 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,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.…