Dr. Layne Norton

Actually, the overall study, I think, was five years, but the average length was two years of a person being in it.

And I think the average age was like late 40s.

How many people have heart attacks, even bad health, in their late 40s?

It's a pretty low number.

And so how many people are going to have heart attacks in a five-year time window?

Probably pretty low.

And if we think about like the mechanism, LDL cholesterol that we think is why saturated fat might be more – a bigger risk factor for heart disease, it is about lifetime exposure risk.

And this is something I changed my mind on.

When I got to grad school, I was very much of the opinion, well, it's more about the particle size, more about LDL to HDL ratio.

I don't think LDL really matters that much.

It's more about the overall –

And then about 10 years later, here come all these Mendelian randomization studies, which basically look at people who naturally secrete more or less LDL looking at lifetime exposure to LDL.

And that is what matters because a good example I like to use is investment.

So, Rhonda, if you and I –

do each invest the same amount of money in an investment and I invest in something that gets 7% and you invest in something that gets 8%.

If we look two years later, you'll have a little bit more money, but statistically probably not, right?

But if we look 40 years later, you're going to have a lot more money than me.

And so just looking at a sliver of time, this is where, yes, randomized control trials are the gold standard, but they also have limitations that we have to consider as well.

And so these Mendelian randomization studies, I mean, when they came out, you look at the lifetime exposure, you can draw a straight line through it.

I mean, you can literally draw a straight line through amount of LDL exposure throughout the course of someone's life and the risk for heart disease.