Abdominal fat sub-depots and energy expenditure: Magnetic resonance imaging study

Dana Serfaty, Michal Rein, Dan Schwarzfuchs, Ilan Shelef, Yftach Gepner, Nitzan Bril, Noa Cohen, Elad Shemesh, Benjamin Sarusi, Julia Kovsan, Shira Kenigsbuch, Yoash Chassidim, Rachel Golan, Shula Witkow, Yaakov Henkin, Meir J. Stampfer, Assaf Rudich, Iris Shai

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background & aims We aimed to assess the association between the distinct abdominal sub-depots and resting energy expenditure (REE). Methods We performed magnetic resonance imaging (MRI) to quantify abdominal visceral-adipose-tissue (VAT), deep-subcutaneous-adipose-tissue (deep-SAT), and superficial-subcutaneous-adipose-tissue (superficial-SAT). We measured REE by indirect-calorimetry. Non-exercise activity thermogenesis (NEAT) [1–3 metabolic equivalents (METs)] and exercise thermogenesis (activities of 4+METS) were estimated based on 6-days of accelerometry to assess total physical activity energy expenditure (PAEE). Results We studied 282 participants: 249 men [mean age = 47.4 years, body-mass-index (BMI) = 31 kg/m2, mean VAT proportion from total abdominal fat = 34.5%, mean superficial-SAT proportion from total abdominal fat = 24.3%] and 33 women (mean age = 51.2 years, BMI = 30.1 kg/m2, mean VAT proportion from total abdominal fat = 22.8%, mean superficial-SAT proportion from total abdominal fat = 37.8%). As expected, women had lower REE [by 32.4% (1488 ± 234 kcal/day vs. 1971 ± 257 kcal/day; p < 0.01)] and lower REE/kg [by 8% (19.6 ± 3 kcal/kg vs. 21.2 ± 2 kcal/kg; p < 0.01)] than men. Exercise and total PAEE were positively associated with REE/kg (p < 0.01 for both) and a positive correlation between NEAT and REE/kg was borderline (p = 0.056). Participants, in whom abdominal VAT was the dominant proportional depot, had higher REE (1964 ± 297 kcal/day vs. 1654 ± 352 kcal/day; p < 0.01) and higher REE∖kg (22.2 ± 2.3 kcal/kg/day vs. 19.6 ± 2.5 kcal/kg/day; p < 0.01) than participants in whom superficial-SAT was the largest proportional depot. In multivariate models, adjusted for age, gender and residual BMI, increased VAT proportion was independently associated with higher REE (β = 0.181; p = 0.05). Likewise, increased VAT proportion (β = 0.482; p < 0.01) remained independently associated with higher REE/kg. In this model younger age (β = −0.329; p < 0.01) was associated with higher REE/kg. Conclusions Abdominal fat distribution patterns are associated with varying levels of resting energy expenditure, potentially reflecting different metabolic rates of adipose sub-depots and providing an anatomic/anthropometric link to physiological obese sub-phenotypes.

Original languageEnglish
Pages (from-to)804-811
Number of pages8
JournalClinical Nutrition
Issue number3
StatePublished - 1 Jun 2017


  • Deep-subcutaneous-adipose-tissue
  • Non-exercise activity thermogenesis
  • Resting energy expenditure
  • Superficial-subcutaneous-adipose-tissue
  • Visceral-adipose-tissue

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine


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