A clinician evaluates two patients: one with very low body fat and persistent cold intolerance, and another with high visceral adiposity and metabolic syndrome. Which evaluation best captures the contrasting clinical implications?

• A. Low body fat always protects from infections and is therefore clinically beneficial, whereas high visceral fat is protective against trauma and cannot contribute to metabolic disease.
• B. Both conditions are clinically identical because adipose tissue has no physiological roles other than passive energy storage, so neither cold intolerance nor metabolic syndrome are related to fat distribution.
• C. High visceral adiposity eliminates the need for any dietary fat because the body can borrow this fat for vitamin transport, therefore those patients never need dietary lipids.
• D. Low body fat can reduce thermal insulation causing cold intolerance and may impair hormone synthesis; high visceral fat increases risk of cardiometabolic disease and mechanically cushions organs but in excess contributes to inflammation and disease risk.

Answer: (D)