Category: English

Source: The Conversation – USA – By Alexandria Mitchem Hansen, Ph.D. Candidate in Anthropology, Columbia University

Rats and other rodents and pests can make great archivists.

That’s because they forage food and build dens, storing fabric, paper, animal bones, plant remains and other materials under floorboards, behind walls and in attics, crawl spaces and wells. There, these materials might dry out and remain undisturbed for hundreds of years.

By analyzing the materials in these nests, archaeologists like me can learn more about the people who once lived nearby.

I studied a rat nest that was used by generations of rats over several decades and was found under the floorboards in the attic of the historic home at Bartram’s Garden in southwest Philadelphia. In 1728, Quaker farmer and naturalist John Bartram began to plant his garden, which is considered the oldest botanic garden in North America. I studied thousands of plants collected by rats and learned how the Bartram family used these plants for food, medicine, trade and study.

A 200-year-old nest

Rat nests are common in historic structures, particularly homes like Bartram’s that contained kitchens and buildings that were used for food storage, such as cellars.

Bartram collected plants from around eastern North America along with those sent to him by naturalists in Europe. His sons, John Jr. and William, and later his granddaughter Ann Bartram Carr, continued to expand the garden, which gained international fame during the 18th and 19th centuries.

The rat nest was discovered during historic preservation work at the Bartram home in 1977. My analysis of the materials in the nest indicates that it was formed in the late 18th and early 19th century. The materials are representative of the plants rodents would have been foraging from the Bartram home and garden.

The plants I identified weren’t restricted to those sold by the Bartram family as a part of their nursery business. Nor were they limited to plants that were traded between naturalists hoping to learn more about the flora of the American Colonies. They included crops such as wheat, buckwheat, corn, parsnips and beans grown by the family to feed themselves; herbs such as lemongrass, basil and mint used for medicine by the family; and many wild and weedy plants – for example, brambles, corn cockle, and broom and needle grasses – that were not intentionally grown by the Bartrams but were nonetheless collected by the rats on the property.

By studying the plants foraged by these rats, I learned not only about the important scientific and commercial plants in the garden, but also about the food and medicine the family were eating and using, including imported snacks such as peanuts and Brazil nuts, which were not grown in the garden but could have been purchased in Philadelphia.

Sorting 11 pounds of material

I am an archaeobotanist, which means I recover and identify plants from the past.

Over the course of almost three years, I sorted through over 11 pounds (5 kilograms) of material from the rat nest recovered from the Bartrams’ home and stored at the Center for the Analysis of Archaeological Materials at the Penn Museum.

Because there is often a lot of material, archaeologists divide these kinds of samples using geological sieves, which are scientific screening tools that filter samples by size. This makes the material easier to sort.

Then I used a microscope to sort and identify the plants therein. Archaeobotanists find various parts of plants, including seeds, chaff, fruit pits, nutshells and cobs. The plants I identified ranged in size from whole corncobs to weed seeds smaller than half a millimeter.

To identify the species of plants, I used reference manuals, comparative collections of plant seeds and other parts, and help from the archaeobotanists at the Penn Museum. I also studied images from herbaria, which are collections of historic plants that have been preserved and archived.

In the future, I plan to focus on the weedy plants recovered from the rat nest. The majority of invasive species in the United States were originally introduced in horticultural contexts, including botanic gardens and nurseries. Data from Bartram’s Garden will help me and other scholars better understand the timing and details of this process.

Read more of our stories about Philadelphia, or sign up for our Philadelphia newsletter on Substack.

Alexandria Mitchem Hansen receives funding from the McNeil Center for Early American Studies, the American Philosophical Society, the Explorer’s Club, the Society for Historical Archaeology, the Society for Ethnobiology, and Columbia University.

– ref. I study rat nests − here’s why rodents make great archivists – https://theconversation.com/i-study-rat-nests-heres-why-rodents-make-great-archivists-270357

Source: The Conversation – USA – By Adrian Kuenzler, Scholar-in-Residence, University of Denver; University of Hong Kong

Meta’s decision to end its professional fact-checking program sparked a wave of criticism in the tech and media world. Critics warned that dropping expert oversight could erode trust and reliability in the digital information landscape, especially when profit-driven platforms are mostly left to police themselves.

What much of this debate has overlooked, however, is that today, AI large language models are increasingly used to write up news summaries, headlines and content that catch your attention long before traditional content moderation mechanisms can step in. The issue isn’t clear-cut cases of misinformation or harmful subject matter going unflagged in the absence of content moderation. What’s missing from the discussion is how ostensibly accurate information is selected, framed and emphasized in ways that can shape public perception.

Large language models gradually influence the way people form opinions by generating the information that chatbots and virtual assistants present to people over time. These models are now also being built into news sites, social media platforms and search services, making them the primary gateway to obtain information.

Studies show that large language models do more than simply pass along information. Their responses can subtly highlight certain viewpoints while minimizing others, often without users realizing it.

Communication bias

My colleague, computer scientist Stefan Schmid, and I, a technology law and policy scholar, show in a forthcoming accepted paper in the journal Communications of the ACM that large language models exhibit communication bias. We found that they may have a tendency to highlight particular perspectives while omitting or diminishing others. Such bias can influence how users think or feel, regardless of whether the information presented is true or false.

Empirical research over the past few years has produced benchmark datasets that correlate model outputs with party positions before and during elections. They reveal variations in how current large language models deal with public content. Depending on the persona or context used in prompting large language models, current models subtly tilt toward particular positions – even when factual accuracy remains intact.

These shifts point to an emerging form of persona-based steerability – a model’s tendency to align its tone and emphasis with the perceived expectations of the user. For instance, when a user describes themselves as an environmental activist and another as a business owner, a model may answer the same question about a new climate law by emphasizing different, yet factually accurate, concerns for each of them. For example, the criticisms could be that the law does not go far enough in promoting environmental benefits and that the law imposes regulatory burdens and compliance costs.

Such alignment can easily be misread as flattery. The phenomenon is called sycophancy: Models effectively tell users what they want to hear. But while sycophancy is a symptom of user-model interaction, communication bias runs deeper. It reflects disparities in who designs and builds these systems, what datasets they draw from and which incentives drive their refinement. When a handful of developers dominate the large language model market and their systems consistently present some viewpoints more favorably than others, small differences in model behavior can scale into significant distortions in public communication.

What regulation can and can’t do

Modern society increasingly relies on large language models as the primary interface between people and information. Governments worldwide have launched policies to address concerns over AI bias. For instance, the European Union’s AI Act and the Digital Services Act attempt to impose transparency and accountability. But neither is designed to address the nuanced issue of communication bias in AI outputs.

Proponents of AI regulation often cite neutral AI as a goal, but true neutrality is often unattainable. AI systems reflect the biases embedded in their data, training and design, and attempts to regulate such bias often end up trading one flavor of bias for another.

And communication bias is not just about accuracy – it is about content generation and framing. Imagine asking an AI system a question about a contentious piece of legislation. The model’s answer is not only shaped by facts, but also by how those facts are presented, which sources are highlighted and the tone and viewpoint it adopts.

This means that the root of the bias problem is not merely in addressing biased training data or skewed outputs, but in the market structures that shape technology design in the first place. When only a few large language models have access to information, the risk of communication bias grows. Apart from regulation, then, effective bias mitigation requires safeguarding competition, user-driven accountability and regulatory openness to different ways of building and offering large language models.

Most regulations so far aim at banning harmful outputs after the technology’s deployment, or forcing companies to run audits before launch. Our analysis shows that while prelaunch checks and post-deployment oversight may catch the most glaring errors, they may be less effective at addressing subtle communication bias that emerges through user interactions.

Beyond AI regulation

It is tempting to expect that regulation can eliminate all biases in AI systems. In some instances, these policies can be helpful, but they tend to fail to address a deeper issue: the incentives that determine the technologies that communicate information to the public.

Our findings clarify that a more lasting solution lies in fostering competition, transparency and meaningful user participation, enabling consumers to play an active role in how companies design, test and deploy large language models.

The reason these policies are important is that, ultimately, AI will not only influence the information we seek and the daily news we read, but it will also play a crucial part in shaping the kind of society we envision for the future.

Adrian Kuenzler does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. People are getting their news from AI – and it’s altering their views – https://theconversation.com/people-are-getting-their-news-from-ai-and-its-altering-their-views-269354

Source: The Conversation – USA (3) – By Carl Kurlander, Senior Lecturer, Film and Media Studies, University of Pittsburgh

It was like a horror movie. The invisible polio virus would strike, leaving young children on crutches, in wheelchairs or in a dreaded “iron lung” ventilator. Each summer, the fear was so great that public pools and movie theaters closed. Parents canceled birthday parties, afraid their child might be the next victim. A U.S. president paralyzed by polio called for Americans to send dimes to the White House to support the nonprofit National Foundation for Infantile Paralysis, established by President Franklin D. Roosevelt and his lawyer, Basil O’Connor. Celebrities from Lucille Ball to Elvis were enlisted to promote this “March of Dimes,” and mothers went door to door raising funds to conquer this dreaded disease.

Some of those funds went to 33-year-old scientist Jonas Salk and his team at the University of Pittsburgh, where they worked in a lab between a morgue and a darkroom to develop the world’s first successful polio vaccine.

To prove it worked, the experimental vaccine was tested on Pittsburgh schoolchildren and then 1.8 million children from around the country as part of the largest medical field trial in history. On April 12, 1955, when the Salk polio vaccine was declared “safe and effective,” church bells rang out, kids were let out of school, and headlines around the world celebrated the victory over polio.

When asked whether he was going to patent the vaccine, Salk told journalist Edward R. Murrow it belonged to the people and would be like “patenting the sun.”

I first learned about this 20 years ago when my students and I filmed the 50th anniversary celebration of the Salk polio vaccine at the University of Pittsburgh. I had just started teaching after working in Los Angeles as a screenwriter and TV producer, and the footage became “The Shot Felt Round the World,” a documentary that featured those we met that day.

The ‘Pittsburgh polio pioneers’

Among the people we interviewed was Ethyl “Mickey” Bailey, who worked in the lab pipetting the deadly polio virus by mouth, and Julius Youngner, the lab’s senior scientist who had worked on the Manhattan Project before coming to Pittsburgh. Within a decade, Youngner had worked on both the atomic bomb – which killed tens of thousands of people in just seconds in Hiroshima and Nagasaki, and hundreds of thousands more in the aftermath of the bombings – as well as the Salk vaccine, which spared millions from the scourge of “The Great Crippler.”

Three floors above the lab, Dr. Sidney Busis performed tracheotomies on 2-year-old iron lung patients, opening their windpipes so the ventilator could help them breath. The fierce Dr. Jesse Wright, an innovator in the field of rehabilitation sciences, ran the polio ward and she was also the medical director of the D.T. Watson Home for Crippled Children, where the Salk vaccine was first tested on humans. Polio victims like Jimmy Sarkett and Ron Flynn volunteered themselves as guinea pigs for a vaccine they knew would never benefit them.

Many “Pittsburgh polio pioneers,” as they called the local children who were given Salk’s still-experimental vaccine, in our documentary recalled getting the shot from Dr. Salk himself. Salk also gave it to his own children, including his eldest son Peter, then 10 years old, who later worked with his father on trying to develop an AIDS vaccine.

While Jonas Salk became the most famous scientist in the world, his relationship with the University of Pittsburgh became complicated and the administration rejected his plans for an institute. As a result, the Salk Institute for Biological Studies was built in 1963 on the coastline in La Jolla, California, where it fueled San Diego’s biotech industry.

Near the end of his life, Jonas would say sometimes he would run into people who didn’t know what polio was, and he found that gratifying. But today the world is paying a high price for those who don’t remember what life was like before these events and now question the value of vaccines. The polio virus may not be visible, but it is still with us.

The final mile to eradication

On Oct. 24, 2025, as the Salk vaccine turned 70, I was invited to screen the trailer for “The Shot Felt Round the World” at a World Polio Day event on Roosevelt Island in New York City, in a building next to the ruins of the Smallpox Hospital – a legacy of the only human disease ever eradicated.

Those present included the executive director of UNICEF, the polio director from the Gates Foundation, the U.N. representative for Rotary International, and government officials from around the world who spoke about the global coalition dedicated to eradicating this disease. Since the 1980s, the Global Polio Eradication Initiative has put tremendous resources into taking polio from being endemic in 125 countries to now just in two: Pakistan and Afghanistan. This group whom I like to call “The Avengers of Public Health,” continue to work relentlessly to make the world polio-free.

My greatest fear is that when polio is finally defeated, the world won’t recognize what an extraordinary achievement it is. In our film, Dr. Jonathan Salk, Jonas Salk’s youngest son, recalls his father wondering whether the model that developed the polio vaccine could be used to conquer poverty and other social problems.

Many of the polio survivors we spoke to at the 50th anniversary are no longer with us. To ensure future generations know this story, perhaps now is the time to launch a “March of Dimes” marketing techniques to engage young people from around the world to help finish the job that began in the Salk lab in Pittsburgh.

One polio survivor who is still alive is “The Godfather” director Francis Ford Coppola, who has spoken about contracting polio as a child. Imagine him being interviewed by his granddaughter Romy Mars, a TikTok influencer, and his daughter Sophia Coppola, the film director and actress. They could make a video that features cameos from actor and comedian Bill Murray, who played Franklin D. Roosevelt in a movie and whose sister had polio, U.S. Senator Mitch McConnell, who is a polio survivor, and Secretary of State Marco Rubio, whose grandfather was crippled from polio. For such a cruel disease, polio has a strange way of bringing us together.

I pray when we finally wipe polio off the planet, a feat the Global Polio Eradication Initiative targets for 2029, the whole world will celebrate and realize the power of pulling together to defeat a common enemy.

Read more of our stories about Philadelphia and Pennsylvania, or sign up for our Philadelphia newsletter on Substack.

Carl Kurlander has previously received grants from the Grable Foundation, the Pittsburgh Foundation, and the R.K. Mellon Foundation years ago for the making of the polio movie. He receives no residuals or revenues from thef ilm.

– ref. The world risks forgetting one of humanity’s greatest triumphs as polio nears global eradication − 70 years after Jonas Salk developed the vaccine in a Pittsburgh lab – https://theconversation.com/the-world-risks-forgetting-one-of-humanitys-greatest-triumphs-as-polio-nears-global-eradication-70-years-after-jonas-salk-developed-the-vaccine-in-a-pittsburgh-lab-270042

Source: The Conversation – USA (3) – By Robert Applebaum, Senior Research Scholar in Gerontology, Miami University

Dec. 15, 2025 – the deadline for enrolling in a marketplace plan through the Affordable Care Act for 2026 – came and went without an agreement on the federal subsidies that kept ACA plans more affordable for many Americans. Despite a last-ditch attempt in the House to extend ACA subsidies, with Congress adjourning for the year on Dec. 19, it’s looking almost certain that Americans relying on ACA subsidies will face a steep increase in health care costs in 2026.

As a gerontologist who studies the U.S. health care system, I’m aware that disagreements about health care in America have a long history. The main bone of contention is whether providing health care is the responsibility of the government, or of individuals or their employers.

The ACA, passed in 2010 as the country’s first major piece of health legislation since the passage of Medicare and Medicaid in 1965, represents one more chapter in that long-standing debate. That debate explains why the health law has fueled so much political divisiveness – including a standoff that spurred a record-breaking 43-day-long government shutdown, which began on Oct. 1, 2025.

In my view, regardless of how Congress resolves, or doesn’t resolve, the current dispute over ACA subsidies, a durable U.S. health care policy will remain out of reach until lawmakers address the core question of who should shoulder the cost of health care.

The ACA’s roots

In the years before the ACA’s passage, some 49 million Americans – 15% of the population – lacked health insurance. This number had been rising in the wake of the 2008 recession. That’s because the majority of Americans ages 18 to 64 with health insurance receive their health benefits through their employer. In the 2008 downturn, people who lost their jobs basically lost their health care coverage.

For those who believed government had a primary role in providing health insurance for its citizens, the growing number of people lacking coverage hit a crisis point that required an intervention. Those who place responsibility on individuals and employers saw the ACA as perversion of the government’s purpose. The political parties could find no common ground – and this challenge continues.

The major goal of the ACA was to reduce the number of uninsured Americans by about 30 million people, or to about 3% of the U.S. population. It got about halfway there: Today, about 26 million Americans, or 8%, are uninsured, though this number fluctuates based on changes in the economy and federal and state policy.

Health insurance for all?

The ACA implemented an array of strategies to accomplish this goal. Some were popular, such as allowing parents to keep their kids on their family insurance until age 26. Some were unpopular, such as the mandate that everyone must have insurance.

But two strategies in particular had the biggest impact on the number of uninsured. One was expanding the Medicaid program to include workers whose income was below 138% of the poverty line. The other was providing subsidies to people with low and moderate incomes that could help them buy health insurance through the ACA marketplace, a state or federal health exchange through which consumers could choose health insurance plans.

Medicaid expansion was controversial from the start. Originally, the ACA mandated it for all states, but the Supreme Court eventually ruled that it was up to each state, not the federal government, to decide whether to do so. As of December 2025, 40 states and the District of Columbia have implemented Medicaid expansion, insuring about 20 million Americans.

Meanwhile, the marketplace subsidies, which were designed to help people who were working but could not access an employer-based health plan, were not especially contentious early on. Everyone receiving a subsidy was required to contribute to their insurance plan’s monthly premium. People earning US$18,000 or less annually, which in 2010 was 115% of the income threshold set by the federal government as poverty level, contributed 2.1% of their plan’s cost, and those earning $60,240, which was 400% of the federal poverty level, contributed 10%. People making more than that were not eligible for subsidies at all.

In 2021, legislation passed by the Biden administration to stave off the economic impact of the COVID-19 pandemic increased the subsidy that people could receive. The law eliminated premiums entirely for the lowest income people and reduced the cost for those earning more. And, unlike before, people making more than 400% of the federal poverty level – about 10% of marketplace enrollees – could also get a subsidy.

These pandemic-era subsidies are set to expire at the end of 2025.

Cost versus coverage

If the COVID-19-era subsidies expire, health care costs would increase substantially for most consumers, as ACA subsidies return to their original levels. So someone making $45,000 annually will now need to pay $360 a month for health insurance, increasing their payment by 74%, or $153 monthly. What’s more, these changes come on top of price hikes to insurance plans themselves, which are estimated to increase by about 18% in 2026.

With these two factors combined, many ACA marketplace users could see their health insurance cost rise more than 100%. Some proponents of extending COVID-19-era subsidies contend that the rollback will result in an estimated 6 million to 7 million people leaving the ACA marketplace and that some 5 million of these Americans could become uninsured in 2026.

Policies in the tax and spending package signed into law by President Donald Trump in July 2025 are amplifying the challenge of keeping Americans insured. The Congressional Budget Office projects that the Medicaid cuts alone, stipulated in the package, may result in more than 7 million people becoming uninsured. Combined with other policy changes outlined in the law and the rollback of the ACA subsidies, that number could hit 16 million by 2034 – essentially wiping out the majority of gains in health insurance coverage that the ACA achieved since 2010.

Subsidy downsides

These enhanced ACA subsidies are so divisive now in part because they have dramatically driven up the federal government’s health care bill. Between 2021 and 2024, the number of people receiving subsidies doubled – resulting in many more people having health insurance, but also increasing federal ACA expenditures.

In 2025, almost 22 million Americans who purchased a marketplace plan received a federal subsidy to help with the costs, up from 9.2 million in 2020 – a 137% increase.

Those who oppose the extension counter that the subsidies cost the government too much and fund high earners who don’t need government support – and that temporary emergencies, even ones as serious as a pandemic, should not result in permanent changes.

Another critique is that employers are using the ACA to reduce their responsibility for employee coverage. Under the ACA, employers with more than 50 employees must provide health insurance, but for companies with fewer employers, that requirement is optional.

In 2010, 92% of employers with 25 to 49 workers offered health insurance, but by 2025, that proportion had dropped to 64%, suggesting that companies of this size are allowing the ACA to cover their employees.

Diverging solutions

The U.S. has the most expensive health care system in the world by far. The projected increase in the number of uninsured people over the next 10 years could result in even higher costs, as fewer people get preventive care and delayed health care interventions, ultimately leading to more complex medical care

Federal policy clearly shapes health insurance coverage, but state-level policies play a role too. Nationally, about 8% of people under age 65 were uninsured in 2023, yet that rate varied widely – from 3% in Massachusetts to 18.6% in Texas. States under Republican leadership on average have a higher percentage of uninsured people than do those under Democratic leadership, mirroring the political differences driving the national debate over who is responsible for shouldering the costs of health care.

With dueling ideologies come dueling solutions. For those who believe that the government is responsible for the health of its citizens, expanding health insurance coverage and financing this expansion through taxes presents a clear approach. For those who say the burden should fall on individuals, reliance on the free market drives the fix – on the premise that competition between health insurers and providers offers a more effective way to solve the cost challenges than a government intervention.

Without finding resolution on this core issue, the U.S. will likely still be embroiled in this same debate for years, if not decades, to come.

Robert Applebaum does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. As millions of Americans face a steep rise in health insurance costs, lawmakers continue a century-long battle over who should pay for health care – https://theconversation.com/as-millions-of-americans-face-a-steep-rise-in-health-insurance-costs-lawmakers-continue-a-century-long-battle-over-who-should-pay-for-health-care-271901

Source: The Conversation – USA (3) – By Mary J. Scourboutakos, Adjunct Assistant Professor in Family and Community Medicine, Macon & Joan Brock Virginia Health Sciences at Old Dominion University

Heart disease is the leading cause of death in the United States.

Since researchers first established the link between diet, cholesterol and heart disease in the 1950s, risk for heart disease has been partly assessed based on a patient’s cholesterol levels, which can be routinely measured via blood work at the doctor’s office.

However, accumulating evidence over the past two decades demonstrates that a biomarker called C-reactive protein – which signals the presence of low-grade inflammation – is a better predictor of risk for heart disease than cholesterol.

As a result, in September 2025, the American College of Cardiology published new recommendations for universal screening of C-reactive protein levels in all patients, alongside measuring cholesterol levels.

What is C-reactive protein?

C-reactive protein is created by the liver in response to infections, tissue damage, chronic inflammatory states from conditions like autoimmune diseases, and metabolic disturbances like obesity and diabetes. Essentially, it is a marker of inflammation – meaning immune system activation – in the body.

C-reactive protein can be easily measured with blood work at the doctor’s office. A low C-reactive protein level – under 1 milligram per deciliter – signifies minimal inflammation in the body, which is protective against heart disease. An elevated C-reactive protein level of greater than 3 milligrams per deciliter, signifies increased levels of inflammation and thus increased risk for heart disease. About 52% of Americans have an elevated level of C-reactive protein in their blood.

Research shows that C-reactive protein is a better predictive marker for heart attacks and strokes than “bad,” or LDL cholesterol, short for low-density lipoprotein, as well as another commonly measured genetically inherited biomarker called lipoprotein(a). One study found that C-reactive protein can predict heart disease just as well as blood pressure can.

Why does inflammation matter in heart disease?

Inflammation plays a crucial role at every stage in the development and buildup of fatty plaque in the arteries, which causes a condition called atherosclerosis that can lead to heart attacks and strokes.

From the moment a blood vessel is damaged, be it from high blood sugar or cigarette smoke, immune cells immediately infiltrate the area. Those immune cells subsequently engulf cholesterol particles that are typically floating around in the blood stream to form a fatty plaque that resides in the wall of the vessel.

This process continues for decades until eventually, one day, immune mediators rupture the cap that encloses the plaque. This triggers the formation of a blood clot that obstructs blood flow, starves the surrounding tissues of oxygen and ultimately causes a heart attack or stroke.

Hence, cholesterol is only part of the story; it is, in fact, the immune system that facilitates each step in the processes that drive heart disease.

Can diet influence C-reactive protein levels?

Lifestyle can significantly influence the amount of C-reactive protein produced by the liver.

Numerous foods and nutrients have been shown to lower C-reactive protein levels, including dietary fiber from foods like beans, vegetables, nuts and seeds, as well as berries, olive oil, green tea, chia seeds and flaxseeds.

Weight loss and exercise can also reduce C-reactive protein levels.

Does cholesterol still matter for heart disease risk?

Though cholesterol may not be the most important predictor of risk for heart disease, it does remain highly relevant.

However, it’s not just the amount of cholesterol – or more specifically the amount of bad, or LDL, cholesterol – that matters. Two people with the same cholesterol level don’t necessarily have the same risk for heart disease. This is because risk is determined more so by the number of particles that the bad cholesterol is packaged into, as opposed to the total mass of bad cholesterol that’s floating around. More particles means higher risk.

That is why a blood test known as apolipoprotein B, which measures the number of cholesterol particles, is a better predictor of risk for heart disease than measurements of total amounts of bad cholesterol.

Like cholesterol and C-reactive protein, apolipoprotein B is also influenced by lifestyle factors like exercise, weight loss and diet. Nutrients like fiber, nuts and omega-3 fatty acids are associated with a decreased number of cholesterol particles, while increased sugar intake is associated with a larger number of cholesterol particles.

Furthermore, lipoprotein(a), a protein that lives in the wall surrounding cholesterol particles, is another marker that can predict heart disease more accurately than cholesterol levels. This is because the presence of lipoprotein(a) makes cholesterol particles sticky, so to speak, and thus more likely to get trapped in an atherosclerotic plaque.

However, unlike other risk factors, lipoprotein(a) levels are purely genetic, thus not influenced by lifestyle, and need only be measured once in a lifetime.

What’s the best way to prevent heart disease?

Ultimately, heart disease is the product of many risk factors and their interactions over a lifetime.

Therefore, preventing heart disease is way more complicated than simply eating a cholesterol-free diet, as once thought.

Knowing your LDL cholesterol level alongside your C-reactive protein, apolipoprotein B and lipoprotein (a) levels paints a comprehensive picture of risk that can hopefully help motivate long-term commitment to the fundamentals of heart disease prevention. These include eating well, exercising consistently, getting adequate sleep, managing stress productively, maintaining healthy weight and, if applicable, quitting smoking.

Mary J. Scourboutakos does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. How C-reactive protein outpaced ‘bad’ cholesterol as leading heart disease risk marker – https://theconversation.com/how-c-reactive-protein-outpaced-bad-cholesterol-as-leading-heart-disease-risk-marker-271143