Intermuscular adipose tissue and thigh muscle area dynamics during an 18-month randomized weight loss trial

Anat Yaskolka Meir, Ilan Shelef, Dan Schwarzfuchs, Yftach Gepner, Lilac Tene, Hila Zelicha, Gal Tsaban, Avital Bilitzky, Oded Komy, Noa Cohen, Nitzan Bril, Michal Rein, Dana Serfaty, Shira Kenigsbuch, Yoash Chassidim, Lior Zeller, Uta Ceglarek, Michael Stumvoll, Matthias Blüher, Joachim ThieryMeir J. Stampfer, Assaf Rudich, Iris Shai*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


It remains unclear whether intermuscular adipose tissue (IMAT) has any metabolic influence or whether it is merely a marker of abnormalities, as well as what are the effects of specific lifestyle strategies for weight loss on the dynamics of both IMAT and thigh muscle area (TMA). We followed the trajectory of IMAT and TMA during 18-mo lifestyle intervention among 278 sedentary participants with abdominal obesity, using magnetic resonance imaging. We measured the resting metabolic rate (RMR) by an indirect calorimeter. Among 273 eligible participants (47.8=9.3 yr of age), the mean IMAT was 9.6=4.6 cm2. Baseline IMAT levels were directly correlated with waist circumference, abdominal subdepots, C-reactive protein, and leptin and inversely correlated with baseline TMA and creatinine (P<0.05 for all). After 18 mo (86.3% adherence), both IMAT (1.6%) and TMA (3.3%) significantly decreased (P<0.01 vs. baseline). The changes in both IMAT and TMA were similar across the lifestyle intervention groups and directly corresponded with moderate weight loss (P<0.001). IMAT change did not remain independently associated with decreased abdominal subdepots or improved cardiometabolic parameters after adjustments for age, sex, and 18-mo weight loss. In similar models, 18-mo TMA loss remained associated with decreased RMR, decreased activity, and with increased fasting glucose levels and IMAT (P<0.05 for all). Unlike other fat depots, IMAT may not represent a unique or specific adipose tissue, instead largely reflecting body weight change per se. Moderate weight loss induced a significant decrease in thigh muscle area, suggesting the importance of resistance training to accompany weight loss programs.

Original languageEnglish
Pages (from-to)518-527
Number of pages10
JournalJournal of Applied Physiology
Issue number2
StatePublished - Aug 2016
Externally publishedYes


  • Intermuscular adipose tissue
  • Magnetic resonance imaging
  • Muscle area
  • Obesity
  • Physical activity


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