Lifestyle linked to body fat composition
A healthy lifestyle not only affects the amount of adipose tissue in the body, but also its distribution. A cross-sectional analysis of data collected from more than 18,000 participants in the German NAKO health study strengthens the evidence for this link. The researchers measured body fat distribution using magnetic resonance imaging (MRI). An international team led by Professor Tobias Pischon, head of the Molecular Epidemiology Lab at the Max Delbrück Center and member of the board of NAKO e.V., also further developed the Lifestyle Risk Factor Index (LSRI).
The index takes into account four health-related behaviors: not smoking, at least 150 minutes of physical activity per week, no or moderate alcohol consumption (less than one drink/day for women, less than two for men) and adherence to at least three of seven dietary recommendations. Participants were awarded zero to four points depending on how well they met these criteria, with higher scores reflecting a healthier lifestyle.
A lifestyle index
Among the 18,508 participants with an average age of 48, the LSRI scores were distributed as follows: 7 % scored 0 or 1 point, 24 percent scored 2 points, 51 percent scored 3 points, and 18 percent scored the full 4 points. The results were published in “Obesity.”
The evaluations showed that individuals with the highest LSRI had significantly lower amounts of visceral fat than individuals with a low LSRI (2.26 liters vs. 2.99 liters). This correlation remained even after taking age, gender and body mass index (BMI) into account, albeit to a lesser extent. The association between lifestyle and visceral fat was more pronounced in individuals with normal or slightly elevated BMI than in participants with obesity. This suggests that in individuals with higher body weight, the influence of BMI on fat distribution is stronger than that of individual lifestyle factors.
Understanding body fat distribution better
Visceral fat, which accumulates around the internal organs, is considered particularly risky for cardiovascular and metabolic diseases. “Our findings show that a healthy lifestyle affects not only the amount of body fat, but also its distribution,” emphasizes Professor Getraud Maskarinec from the University of Hawaii Cancer Center and lead author of the study whose work as a visiting professor at the Max Delbrück Centre in Berlin was supported by the Charité Foundation. “Physical activity in particular showed the strongest correlation with lower visceral fat levels, followed by diet and moderate alcohol consumption.”
“NAKO offers unique opportunities to investigate the links between lifestyle, body composition and disease risks. Thanks to standardized MRI measurements taken on over 30,000 participants in Germany, it is possible to make precise statements about fat distribution,” says Tobias Pischon, senior author of the publication.
However, as the current evaluation is a cross-sectional analysis, no conclusions can be drawn about causality. Future studies will examine whether targeted lifestyle changes – particularly through exercise – can reduce visceral fat in the long term.
Further information
Literature
Gertraud Maskarinec et al. (2025): “Association of a Lifestyle Risk Index With Visceral and Subcutaneous Adipose Tissue in the German National Cohort (NAKO).” In: Obesity, DOI: 10.1002/oby.70071
