familial longevity is marked by an exceptionally healthy metabolic profile and low prevalence of cardiometabolic disease observed already at middle age. We aim to investigate whether regional body fat distribution, which has previously shown to be associated with cardiometabolic risk, is different in offspring of long-lived siblings compared with controls. our institutional review board approved the study, and all participants (n = 344, average age in years 65.6) gave written informed consent. Offspring (n = 175) of non-agenarian siblings were included. Their partners (n = 169) were enrolled as controls. For abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) measurements, a single-slice 8.0 mm computed tomography (CT) acquisition was planned at the level of the 5th lumbar vertebra. In addition, participants underwent prospectively electrocardiography-triggered unenhanced volumetric CT of the heart. Abdominal VAT and SAT areas (cm(2)) and epicardial adipose tissue (EAT) volumes (ml) were acquired by semi-automated segmentation techniques. Linear regression analysis was performed adjusting for cardiovascular risk factors. total abdominal fat areas were smaller in male offspring compared with controls (353.0 versus 382.9 cm(2), P = 0.022). The association between low abdominal VAT areas in male offspring (149.7 versus 167.0 cm(2) in controls, P = 0.043) attenuated after additional adjustment for diabetes (P = 0.078). Differences were not observed for females. EAT volumes were similar between offspring of long-lived siblings and controls. males who have genetically determined prospect to become long-lived have less abdominal fat and in particular less abdominal VAT compared with controls.