A healthy lifestyle with regular exercise, a balanced diet, moderate alcohol consumption and no smoking is associated with lower levels of visceral adipose tissue (VAT). This is shown by recent analyses by international researchers from the German National Cohort( NAKO), which involved more than 18,000 adults undergoing magnetic resonance imaging (MRI)-based measurements of body fat distribution.
An indicator of a healthy lifestyle
The research team has further developed the Lifestyle Risk Factor Index (LSRI), which takes into account four health-related behaviours: not smoking, at least 150 minutes of physical activity per week, no or moderate alcohol consumption (≤1 drink/day for women, ≤2 for men) and adherence to at least three of seven dietary recommendations. Participants were awarded 0 to 4 points depending on how well they met these criteria, with higher scores reflecting a healthier lifestyle.
Results from the NAKO analysis
Among the 18,508 participants with an average age of 48, the LSRI scores were distributed as follows: 7 per cent scored 0 or 1 point, 24 per cent scored 2 points, 51 per cent scored 3 points, and 18 per cent scored the full 4 points.
The evaluations showed that individuals with the highest LSRI had significantly lower amounts of visceral fat than individuals with a low LSRI (2.26 litres vs. 2.99 litres). 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,” emphasises Prof. Dr. Getraud Maskarinec from the University of Hawaii Cancer Center, 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.”
Strengths and outlook
“NAKO offers unique opportunities to investigate the links between lifestyle, body composition and disease risks. Thanks to standardised MRI measurements taken on over 30,000 participants in Germany, it is possible to make precise statements about fat distribution,” says Prof. Dr Tobias Pischon, last author of the publication and member of the board of NAKO e.V.
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.
Originalpublication
Maskarinec G, Klapp R, Nöthlings,U et al. Association of a Lifestyle Risk Index With Visceral and Subcutaneous Adipose Tissue in the German National Cohort (NAKO). Obesity. https://doi.org/10.1002/oby.70071