NAKO
German National Cohort
Germany's largest long-term study on widespread diseases

The NAKO study is a large-scale epidemiological observational research project involving over 200,000 participants from across Germany, who took part in the initial survey conducted at 18 study centers. The primary goal of this research is to gain a better understanding of how diseases such as cancer, diabetes, dementia, and heart attacks develop. This knowledge aims to enhance prevention, early detection, and treatment options in Germany.
A central component of the department is studying physical activity, inactivity, and related factors such as physical fitness. The importance of these factors in preventing various diseases is becoming increasingly evident. Previous studies often relied on subjective and simplified methods to assess physical activity levels. By utilizing more precise approaches that combine both objective and subjective data, researchers can obtain more accurate results regarding the connection between an active lifestyle and the risks of different diseases.

From the planning stages, our department advocated for innovative data collection methods involving various instruments. A questionnaire that we developed and validated, known as the "Questionnaire of Annual Physical Activity Patterns (QUAP)," is now an integral part of the NAKO surveys.
The third phase of the study is already in progress, enabling more evaluations to be conducted with NAKO data in the coming years. Thus, the NAKO study represents an important and innovative research platform for our future investigations.
As part of the NAKO, our department is currently addressing the following research questions:
How much exercise do you get? This seemingly simple question becomes more complex upon closer examination. Should we consider exercise at work and in the garden, or should we only count planned leisure activities and sports? At what level of duration and intensity does physical activity become significant for our health? To address these questions, the NAKO Study has decided to investigate various aspects of physical activity. This includes not only retrospective surveys but also diary entries and activity measurements using an accelerometer. By examining this data comprehensively, we aim to gain a clearer understanding of the physical activity levels among NAKO participants.
Health organizations like the World Health Organization (WHO) frequently issue recommendations regarding physical activity. The most recent guidelines from the WHO were published in 2020 and emphasize the importance of incorporating both endurance activities (such as jogging, swimming, and cycling) and muscle-strengthening exercises (like strength training). However, there is limited research on how well these recommendations are being followed by the general population.
What exercise options does the living environment provide? Are there stores, schools, recreational facilities, or other everyday destinations that can be easily reached on foot or by bike? The opportunity for physical activity largely depends on the characteristics of the living environment. A well-designed environment can encourage residents to be more active, thereby enhancing their overall quality of life and health. This project aims to investigate the conditions of an environment that promotes physical activity. We will examine aspects such as the accessibility of facilities, the infrastructure for pedestrians and cyclists, and the availability of green spaces and leisure facilities. The goal is to identify the factors that can positively influence the physical activity behaviors of residents.
We can improve our fitness and build muscle mass through physical activity. Endurance activities, such as jogging and cycling, are particularly important for enhancing our stamina and supporting our cardiovascular health. On the other hand, muscle-strengthening activities like strength training are effective for improving muscular fitness, increasing our strength, and enabling us to lift heavier weights. These activities also help build or maintain muscle mass. However, there is limited research on how following physical activity recommendations relates to actual physical fitness and the amount of skeletal muscle a person has. It is possible that some individuals may have lower fitness levels even if they adhere to these recommendations, which is not ideal since physical fitness offers numerous health benefits.
Research has shown that individuals with different personality traits engage in physical activity in various ways. For instance, conscientious people tend to be more physically active. As part of the NAKO study, we can build on previous findings and explore how participants' personalities relate to their adherence to physical activity recommendations and overall fitness levels. Additionally, it will be particularly interesting to examine how the interaction of specific personality traits, such as high conscientiousness combined with high emotional instability, affects physical activity levels.
In the future, we will also investigate chronic diseases, for instance, to determine the extent to which an active lifestyle can contribute to cancer prevention.
Current status
Ongoing.
Publications
Stein, M.J., Weber, A., Bamberg, F. et al.
Gottschalk, S., König, HH., Weber, A. et al.
Herbolsheimer F, Peters A, Wagner S, et al.
Contact
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Julian Brummer
PhD student
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Dr. Florian Herbolsheimer
Senior Scientist