{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:04:06Z","timestamp":1790024646952,"version":"4.0.1"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["SFB1052"],"award-info":[{"award-number":["SFB1052"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Israel Ministry of Science and Technology","award":["3-13604"],"award-info":[{"award-number":["3-13604"]}]},{"name":"Dr. Robert C. and Veronica Atkins Research Foundation","award":["1"],"award-info":[{"award-number":["1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Accumulation of cervical and chin subcutaneous adipose tissues (SAT) represent known phenotypes of obesity. We aimed to evaluate the sensitivity of these fat storages to long-term weight-loss directed lifestyle-intervention and to assess their relations to bodily-adiposity, insulin-resistance, and cardiometabolic risk; We randomly assigned 278 participants with abdominal-obesity\/dyslipidemia to low-fat or Mediterranean\/low-carbohydrate diets +\/\u2212 physical-activity. All participants underwent an 18 month whole-body magnetic resonance imaging follow-up, from which we assessed cervical and chin SAT-areas; Participants (age = 48 years; 90% men; body-mass-index = 30.9 kg\/m2) had an 18-month adherence-rate of 86%. Cervical-SAT and chin-SAT decreased after 6-months (\u221213.1% and \u22125.3%, respectively, p &lt; 0.001). After 18-months only cervical-SAT remained decreased compared to baseline (\u22125%, p &lt; 0.001). Cervical and chin-SAT 18-month changes were associated with changes in weight (r = 0.70, r = 0.66 respectively; &lt;0.001 for both) and visceral-adipose-tissue (VAT; r = 0.35, r = 0.42 respectively; &lt;0.001 for both). After adjustment to VAT, waist-circumference, or weight-changes, chin-SAT 18-month reduction was associated with favorable changes in fasting-glucose (\u03b2 = 0.10; p = 0.05), HbA1c (\u03b2 = 0.12; p = 0.03), and homeostasis-model-assessment-of-insulin-resistance (\u03b2 = 0.12; p = 0.03). Cervical-SAT 18-month reduction was associated with decreased triglycerides (\u03b2 = 0.16; p = 0.02) and leptin (\u03b2 = 0.19; p = 0.01) independent of VAT; Cervical and chin-SATs are dynamic fat depots that correspond with weight-loss and are associated with changes in cardiometabolic profile. In long-term, chin-SAT displays a larger rebound compared with cervical-SAT. Chin-SAT accumulation is associated with in insulin-resistance, independent of central obesity. (ClinicalTrials identifier NCT01530724)<\/jats:p>","DOI":"10.3390\/nu13113827","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T23:24:42Z","timestamp":1635377082000},"page":"3827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Effect of Weight-Loss Interventions on Cervical and Chin Subcutaneous Fat Depots; the CENTRAL Randomized Controlled Trial"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4234-6504","authenticated-orcid":false,"given":"Gal","family":"Tsaban","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"},{"name":"Department of Cardiology, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avital","family":"Bilitzky-Kopit","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2480-3751","authenticated-orcid":false,"given":"Anat","family":"Yaskolka Meir","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hila","family":"Zelicha","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3128-3539","authenticated-orcid":false,"given":"Yftach","family":"Gepner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, School of Public Health, Tel-Aviv University, Tel-Aviv 96678, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8398-6455","authenticated-orcid":false,"given":"Ilan","family":"Shelef","sequence":"additional","affiliation":[{"name":"Division of Clinical Radiology, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omri","family":"Orr","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoash","family":"Chassidim","sequence":"additional","affiliation":[{"name":"Research Center, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Sarusi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nuclear Research Center Negev, Dimona 84190, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta","family":"Ceglarek","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stumvoll","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0208-2065","authenticated-orcid":false,"given":"Matthias","family":"Bl\u00fcher","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meir J.","family":"Stampfer","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9050-4605","authenticated-orcid":false,"given":"Iris","family":"Shai","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"},{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Schwarzfuchs","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nuclear Research Center Negev, Dimona 84190, Israel"},{"name":"Emergency Medicine Division, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.3945\/ajcn.114.088450","article-title":"Compartmental neck fat accumulation and its relation to cardiovascular risk and metabolic syndrome","volume":"100","author":"Torriani","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1161\/CIRCULATIONAHA.106.675355","article-title":"Abdominal Visceral and Subcutaneous Adipose Tissue Compartments","volume":"116","author":"Fox","year":"2007","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.2337\/dc08-2280","article-title":"Abdominal Subcutaneous Adipose Tissue: A Protective Fat Depot?","volume":"32","author":"Porter","year":"2009","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"E1756","DOI":"10.1210\/jc.2011-0615","article-title":"Preferential Fat Deposition in Subcutaneous Versus Visceral Depots Is Associated with Insulin Sensitivity","volume":"96","author":"McLaughlin","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4206","DOI":"10.1210\/jc.2004-0631","article-title":"Regional Adiposity and Insulin Resistance","volume":"89","author":"Garg","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_6","first-page":"E941","article-title":"Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance","volume":"278","author":"Kelley","year":"2000","journal-title":"Am. J. Physiol. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"640","DOI":"10.2337\/dc11-1583","article-title":"Abdominal Superficial Subcutaneous Fat: A putative distinct protective fat subdepot in type 2 diabetes","volume":"35","author":"Golan","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"s57","DOI":"10.1210\/jc.2008-1585","article-title":"Role of Body Fat Distribution and the Metabolic Complications of Obesity","volume":"93","author":"Jensen","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.amjmed.2017.01.044","article-title":"Upper Body Subcutaneous Fat Is Associated with Cardiometabolic Risk Factors","volume":"130","author":"Lee","year":"2017","journal-title":"Am. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2802","DOI":"10.2337\/db10-1263","article-title":"Subcutaneous adipose tissue macrophage infiltration is associated with hepatic and visceral fat deposition, hyperinsulinemia, and stimulation of NF-\u03baB stress pathway","volume":"60","author":"Mahurkar","year":"2011","journal-title":"Diabetes"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1172\/JCI21047","article-title":"Splanchnic lipolysis in human obesity","volume":"113","author":"Nielsen","year":"2004","journal-title":"J. Clin. Investig."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3701","DOI":"10.1210\/jc.2009-1779","article-title":"Neck Circumference as a Novel Measure of Cardiometabolic Risk: The Framingham Heart Study","volume":"95","author":"Preis","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1002\/dmrr.2369","article-title":"Neck circumference is correlated with triglycerides and inversely related with HDL cholesterol beyond BMI and waist circumference","volume":"29","author":"Vallianou","year":"2013","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1111\/j.1365-2265.2012.04487.x","article-title":"Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: Results from the Brazilian Metabolic Syndrome Study","volume":"78","author":"Stabe","year":"2013","journal-title":"Clin. Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.diabres.2007.08.002","article-title":"Novel phenotypic markers and screening score for the metabolic syndrome in adult Asian Indians","volume":"79","author":"Misra","year":"2008","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/01.qai.0000147527.64863.1a","article-title":"Buffalo hump seen in HIV-associated lipodystrophy is associated with hyperinsulinemia but not dyslipidemia","volume":"38","author":"Mallon","year":"2005","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1161\/ATVBAHA.114.303035","article-title":"Links Between Ectopic Fat and Vascular Disease in Humans","volume":"34","author":"Lim","year":"2014","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e000979","DOI":"10.1161\/JAHA.114.000979","article-title":"Development and Reproducibility of a Computed Tomography\u2013Based Measurement for Upper Body Subcutaneous Neck Fat","volume":"3","author":"Rosenquist","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4736","DOI":"10.1210\/jc.2009-1942","article-title":"Interscapular Fat Is Strongly Associated with Insulin Resistance","volume":"95","author":"Thamer","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.2337\/diacare.26.5.1350","article-title":"Risk factors for diabetes in familial partial lipodystrophy, Dunnigan variety","volume":"26","author":"Haque","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/j.1467-789X.2006.00269.x","article-title":"Obesity, metabolic syndrome and sleep apnoea: All pro-inflammatory states","volume":"8","author":"Alam","year":"2007","journal-title":"Obes. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1161\/CIRCULATIONAHA.117.030501","article-title":"Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: The CENTRAL MRI Randomized Controlled Trial","volume":"137","author":"Gepner","year":"2017","journal-title":"Circulation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1161\/CIRCULATIONAHA.106.176158","article-title":"Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee","volume":"114","author":"Lichtenstein","year":"2006","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1056\/NEJMoa0708681","article-title":"Weight loss with a low-carbohydrate, mediterranean, or low-fat diet","volume":"359","author":"Shai","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"984","DOI":"10.3945\/ajcn.117.157115","article-title":"Dynamics of intrapericardial and extrapericardial fat tissues during long-term, dietary-induced, moderate weight loss","volume":"106","author":"Tsaban","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.jhep.2019.04.013","article-title":"The beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content","volume":"71","author":"Gepner","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.atherosclerosis.2008.06.013","article-title":"Nuchal thickness of subcutaneous adipose tissue is tightly associated with an increased LMW\/total adiponectin ratio in obese juveniles","volume":"203","author":"Mangge","year":"2009","journal-title":"Atherosclerosis"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Bhatt, S.P., Misra, A., Nigam, P., Guleria, R., and Pasha, M.A.Q. (2015). Phenotype, Body Composition, and Prediction Equations (Indian Fatty Liver Index) for Non-Alcoholic Fatty Liver Disease in Non-Diabetic Asian Indians: A Case-Control Study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0142260"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1056\/NEJM199503233321207","article-title":"Cushing\u2019s Syndrome","volume":"332","author":"Orth","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_30","first-page":"E1465","article-title":"Adrenocortical dysregulation as a major player in insulin resistance and onset of obesity","volume":"293","author":"Roberge","year":"2007","journal-title":"Am. J. Physiol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4845","DOI":"10.1210\/jc.2002-020794","article-title":"Lipodystrophy in Human Immunodeficiency Virus-Infected Patients","volume":"11","author":"Chen","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.mehy.2004.06.020","article-title":"Facial fat and its relationship to abdominal fat: A marker for insulin resistance?","volume":"63","author":"Johnson","year":"2004","journal-title":"Med. Hypotheses"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"18565","DOI":"10.1038\/srep18565","article-title":"Neck Circumference and Incidence of Diabetes Mellitus over 10 Years in the Korean Genome and Epidemiology Study (KoGES)","volume":"5","author":"Cho","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1089\/met.2013.0093","article-title":"Neck Circumference Is a Predictor of Metabolic Syndrome and Obstructive Sleep Apnea in Short-Sleeping Obese Men and Women","volume":"12","author":"Cizza","year":"2014","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1038\/nm.3187","article-title":"How brown is brown fat? It depends where you look","volume":"19","author":"Nedergaard","year":"2013","journal-title":"Nat. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1515\/hmbci-2014-0022","article-title":"Brown adipose tissue and thermogenesis","volume":"19","author":"Fenzl","year":"2014","journal-title":"Horm. Mol. Biol. Clin. Investig."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/nrendo.2013.204","article-title":"Adipose tissue browning and metabolic health","volume":"10","author":"Bartelt","year":"2014","journal-title":"Nat. Rev. Endocrinol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/11\/3827\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:21:18Z","timestamp":1760167278000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/11\/3827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,27]]},"references-count":37,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["nu13113827"],"URL":"https:\/\/doi.org\/10.3390\/nu13113827","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,27]]}}}