A Comprehensive Theory of Lipid
Metabolism and Atherosclerosis
Kyle Serreyn
Abstract. This paper seeks to examine the
shortcomings of the prevailing medical and nutritional paradigms surrounding
lipids, cardiometabolic disease, and macronutrient consumption, and to explain
these factors in a more complete, evidence-based fashion. For decades, the diet-heart
and lipid-heart hypotheses have dominated, propagating both public belief and an
entrenched institutional model that dietary fat and elevated serum cholesterol
are interlinked drivers of cardiovascular and other chronic disease. However,
each of these assertions has little to no scientific backing, and the
overarching notion that LDL-C and cholesterol are primary risks is both incorrect
and fails to appreciate the role of lipids in the human body. Rather than
insist on LDL-C as a disease state to be minimized, an energy deliver model of
lipid metabolism succinctly clarifies the glaring deficits in traditional
models while also explaining how and why markers of cardiovascular and chronic
disease risk arise from metabolic dysfunction. Through this lens, it is
incredibly clear why diverse cardiometabolic risk factors are universally made
worse with increased adherence to traditional, carbohydrate-based dietary
guidance. Indeed, the hyperglycemia, insulin resistance, and decreased capacity
to utilize fat as a fuel source that result from these guidelines are the prime
drivers of atherosclerosis and a host of chronic cardiometabolic diseases. Only
an energy deliver model of lipid metabolism explains the true nature of lipids
in the human body, the genuine drivers and markers of chronic disease, and the
critical importance of emphasizing proper macronutrient consumption in treating
and preventing metabolic dysfunction.
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