Focus on NAKO results
Here you will find key results and highlights of the German National Cohort (NAKO) — find out about the progress and findings that will improve the health of many people.
Researchers work
with NAKO data
Study results by subject area
Discover the results of the German National Cohort (NAKO) in various topics and find out more about the most important widespread diseases and health issues.
- Physical activity
Insufficient physical activity in the home office
The majority of people surveyed reported a significant decrease in physical activity and an increasingly sedentary lifestyle during the pandemic, especially among those who switched to working from home.
- MRI
Chronic back pain
The analysis of MRI data from around 30,000 participants in the NAKO health study showed that a higher proportion of adipose tissue in the back muscles was associated with chronic back pain. The study clearly shows how helpful it could be to take the composition of the muscles into account when assessing the risk of chronic back pain.
- Anthropometry
Measuring the body
Participants from the southern study centres were generally smaller than those from the northern study centres. The participants from the study centres in Neubrandenburg, Augsburg, Saarbrücken and Essen had the highest body mass index (BMI) values.
Participation in mammography screening
The study shows that participation in mammography screening in Germany is below European recommendations and is strongly linked to general preventive behaviour, socio-economic status and lifestyle factors. The results underscore the need for targeted information and intervention measures.
- Environment
Traffic noise
Two thirds of over 86,000 participants did not feel disturbed by traffic noise. One in ten reported strong/very strong disturbance, with the highest numbers in Berlin-Mitte and Leipzig. The strongest associations with noise disturbance were observed for factors relating to the individual living situation, such as the position of the bedroom facing the main road compared to the garden/courtyard.
- Health risks
Hand gripping strength and physical fitness
Hand grip strength and its maintenance in old age are an important indicator of health and physical performance, particularly in older people. Adults around the age of 40 had the highest hand grip strength. Up to this age, the hand grip strength of adults increased and then fell with age.
- Mental health
Mental health during the pandemic
A recent analysis of the German National Cohort (NAKO) involving around 80,000 adults shows that while the majority of NAKO participants were able to maintain stable mental health throughout the COVID-19 pandemic, depressive symptoms, anxiety symptoms and stress increased until 2022 – particularly among younger adults under the age of 40 and among women.
- Corona
Loneliness
32 per cent of NAKO participants described themselves as lonely during the pandemic – 26 per cent of men and 37 per cent of women. Older people were less affected than young people. One in two people felt lonelier during the first lockdown than before.
- Diabetes
Birth order
The risk of type 1 diabetes was highest in only one child and decreased with higher birth order.
- Physical activity
Insufficient physical activity associated with higher healthcare costs
Insufficient physical activity was associated with higher costs for the healthcare system. A positive effect on costs was shown by free-time sport, while a high level of physical activity at work was associated with higher costs.
- Cardiovascular system, Health risks
Uric acid is an underestimated risk factor even in the normal range
A recent study found that uric acid levels even in the normal range are linked to vascular stiffness and can therefore be a risk factor for cardiovascular disease. The analysis was based on data and samples from over 70,000 NAKO participants and showed that this link is more pronounced in women.
- Environment
Extensive data set with Germany-wide environmental factors
For the first time, a large population-based data set with high-quality environmental indicators is now available for Germany. This opens up new possibilities for innovative research and the derivation of policy-relevant information. The expansion of the database includes indicators such as light pollution, mobility and biodiversity as well as socio-economic factors such as the unemployment rate and geographical disadvantage.
- Corona
SARS-CoV-2 infections
As part of the IMMUNEBRIDGE project, data and biosamples from nine population- and hospital-based studies were analysed to provide estimates of protection against SARS-CoV-2 infections and severe COVID-19 infections between June and November 2022. The researchers found relevant protection gaps in the oldest age group and in people with comorbidities.
- Health risks
Health risks for people on low incomes
In order to remain mentally fit for as long as possible in old age, it is important to understand which risk factors could affect cognitive performance at an early age. The study showed that cognitive performance was lower in people with an income below the poverty line compared to people with an income above the poverty line.
- All Topics, Physical activity
- Environment, MRI
Road traffic noise
Researchers used imaging data from MRI examinations of over 11,000 participants in the NAKO and combined this with road traffic noise data in Germany. The results of the analysis suggest that exposure to traffic noise may be associated with a higher proportion of adipose tissue in the body, which could also increase the risk of associated diseases.
- Cardiovascular system, Health risks, MRI
Healthy lifestyle and body fat distribution
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).
- Cardiovascular system, Health risks
Effects of high blood pressure
Younger age at hypertension diagnosis was associated with a higher risk of associated cardiovascular disease.
- Health risks, MRI
Ageing processes
People are known to age at different speeds. The study, based on MRI data from the UK Biobank and the NAKO, was able to show how differently body composition affects health risks. Women often have higher levels of subcutaneous adipose tissue and intramuscular fat, while men have more visceral fat and muscle volume. The method could help to better identify high-risk individuals in order to improve personalised prevention measures.
- Health risks
Smoking behaviour and depression
A group of researchers has confirmed for the first time within the German National Cohort (NAKO) a link between cigarette consumption and depression. The evaluations show that depression occurs more frequently over the lifetime of current and former smokers than among non-smokers. The study focused in particular on the dose-dependent effects of smoking behaviour.
- Corona
Anxiety and stress
The coronavirus pandemic and its protective measures have had an impact on the general and mental health of the population in Germany. There has been a significant increase in depressive symptoms, anxiety and stress.
- Environment
Ultrafine particles
The study developed and validated two models for estimating long-term ultrafine particulate matter concentrations for Augsburg and Regensburg based on NAKO data. Both models demonstrated high predictive accuracy and were able to reliably map spatial patterns, confirming their transferability between cities with similar structures.
