“…Indeed, the prevailing hypothesis over the last few decades has been that BMAT is a filler, passively occupying space vacated by other cells as hematopoiesis in the appendicular skeleton wanes (Gimble et al,1996; Tavassoli,1984). However, elevated BMAT and low bone mass are also seen in pathological conditions including anorexia, osteoporosis, skeletal unloading or disuse, and sometimes (but not always) obesity, suggesting marrow fat may be bad for bone (Bredella et al,2009, 2010; Dudley‐Javoroski and Shields,2008; Ecklund et al,2009; Trudel et al,2009; Yeung et al,2005). It has even been reported that there is a reciprocal relationship of bone mass and marrow fat in young, healthy individuals (Di Iorgi et al,2008, 2010; Wren et al,2011), although high marrow fat can cause bone mineral density (BMD) to be underestimated (Bolotin et al,2003; Hangartner and Johnston,1990).…”