Which of the following people has the highest risk of cardiovascular disease and type 2 diabetes based on body shape and BMI?

• A. Mark: apple shape, BMI 24
• B. Consuelo: apple shape, BMI 31
• C. Pedro: pear shape, BMI 27
• D. Christa: pear shape, BMI 18

Answer: (C)

Central obesity drives cardiovascular and type 2 diabetes risk more strongly than fat distribution alone, and BMI adds another layer of risk—the higher the BMI, the greater the risk. An apple-shaped (abdominal) pattern is associated with higher metabolic risk than a pear-shaped pattern (gluteofemoral fat dominates), because abdominal fat tends to promote insulin resistance, dyslipidemia, and hypertension. With that in mind, Consuelo has both central obesity (apple shape) and a BMI of 31, putting her in the obesity range with the highest cardiometabolic risk among the four. Mark also has an apple shape, but his BMI is normal, so his risk is elevated compared to a pear shape with normal BMI, yet not as high as Consuelo’s. Pedro has a pear shape and a BMI of 27, which increases risk from overweight but without the added central obesity that elevates risk more—generally lower than Consuelo’s. Christa is pear-shaped and underweight, which carries the lowest risk here. So, based on fat distribution and BMI, Consuelo would typically be considered at the highest risk. If the provided key marks Pedro, there may be a discrepancy or a different weighting used in that item.