NAKO

The German National Cohort (NAKO Gesundheitsstudie) is Germany’s largest long-term population study. Since 2014, the study prospectively investigates more than 205,000 adults in 18 study centers nation-wide. NAKO is a major resource for population-based epidemiology, aiming to provide unique data and biosamples for innovative research today, and cutting-edge next-generation research tomorrow.

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The German National Cohort (NAKO Gesundheitsstudie) is Germany’s largest long-term population study. Since 2014, the study prospectively investigates more than 205,000 adults in 18 study centers nation-wide. NAKO is a major resource for population-based epidemiology, aiming to provide unique data and biosamples for innovative research today, and cutting-edge next-generation research tomorrow.

Visit the NAKO website

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NAKO aims to investigate the causes of major diseases and to identify new and tailored strategies for early detection, prevention and treatment.

Between 2014 and 2019, more than 205,000 men and women aged 20-69 years were recruited from a random sample of the general population and examined in 18 study centers across Germany. In the baseline assessment, participants were deeply phenotyped using a comprehensive set of examinations, which included quantitative measurements, clinical examinations, touchscreen-based self-report questionnaires, a face-to-face interview, and the collection of biological material. In a subgroup of more than 30,000 participants, whole-body 3T magnetic resonance imaging was performed.

All study participants are invited for re-examinations at the study centers in regular intervals. The 5yr follow-up was completed in 2024, the 10yr follow-up is currently ongoing. In-between, follow-up information on incident diseases is collected via written questionnaires and record linkages.

NAKO is an interdisciplinary endeavor of 26 German scientific institutions, including Helmholtz health centers, universities, institutes of the Leibniz Association and other national research institutions. The study is funded by the Federal Ministry of Education and Research (BMBF), the participating federal states and the Helmholtz Association, with additional financial support by the participating universities and the institutes of the Leibniz Association.

The Institute of Epidemiology has a leading role in design, leadership and implementation of NAKO. EPI operates the study center in Augsburg, the Central Biorepository at Helmholtz Munich and the Environmental Data Unit. Besides being a NAKO PI, Annette Peters currently chairs the NAKO board of directors.

The NAKO study center Augsburg is located at and operated by the University Hospital Augsburg, as a contractor on behalf of Helmholtz Munich. The Institute of Epidemiology leads the study center scientifically. The study center has recruited more than 20.000 participants from the City of Augsburg and its two surrounding counties and hosts one of the five NAKO MRI facilities. It is headed by Sigrid Thierry.

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More than two thirds of all NAKO biosamples are stored in the NAKO Central Biorepository at Helmholtz Munich. This internationally unique storage facility provides storage for up to 20 million aliquots - fully automated at -180°C including single-tube picking and semi-automated at -80°C. Currently, the Biorepository is upgraded to allow sorting and sample retrieval at top capacity. The Central Biorepository is headed by Andreas Hörlein.

The NAKO Environmental Data Unit (EDU), operated by Helmholtz Munich, harmonises and assigns spatio-temporal environmental data to participants’ residential addresses to enable research on environmental and socioeconomic determinants of disease. EDU also provides standardized metadata descriptions and guidance in environmental research demands. The unit is headed by Kathrin Wolf.

Three major NAKO omics projects have been launched by Helmholtz Munich in cooperation with different NAKO partner institutions. A genotyping effort including all 200.000 participants as well as a HGF-funded whole genome sequencing approach of >15.000 participants will comprehensively dissect the genetic architecture of the German population. Additional levels of molecular layers including metabolomic, proteomic, serolomic, epigenetic and metagenomic data are made available within a proof-of concept study in a subgroup of 5.000 NAKO participants and will allow for in-depth multi omics phenotyping. The GenOMICs approaches are led by Christian Gieger and Harald Grallert.