context: High cholesterol, also called hypercholesteremia, puts men at greater risk for heart attacks, strokes, and peripheral artery disease. For many men, the risk from high cholesterol starts in their 20s and increases with age. High cholesterol tends to run in families, so obviously genes play a role. But a variety of lifestyle choices -- including diet, activity, and body weight -- also affect cholesterol levels. The only way to know how high your cholesterol levels are is to get a simple blood test. Everyone over 20 should get a cholesterol test at least once every 5 years. If your numbers are high, your doctor may recommend the test more often. What is high cholesterol? Cholesterol is a waxy, fat-like substance made in the liver and other cells. It's also found in certain foods, such as dairy products, eggs, and meat. Your body needs some cholesterol to produce hormones, vitamin D, and the bile acids that help you digest fat. But the body only needs a limited amount of cholesterol. When there's too much, health problems, such as heart disease, may develop. There are different kinds of cholesterol, and if there's too much of certain kinds in your blood, a fatty deposit called plaque can build up on the walls of your arteries. It's like rust on the inside of a pipe. This plaque build-up can block blood flow to the heart muscle, reducing its oxygen supply. If levels of blood and oxygen to the heart drop far enough, you may start feeling chest pain or find yourself short of breath. A heart attack happens when the plaque completely blocks a blood vessel feeding a section of the heart muscle. If the plaque blocks a blood vessel going to your brain, you can have a stroke. The cholesterol that blocks arteries is called low-density lipoprotein, or LDL. Another kind of cholesterol called high-density lipoprotein or HDL is known as good cholesterol because it helps remove LDL from the blood and eventually from the body. For good health, you ideally want to keep the LDL levels down and the HDL levels up. If this balance isn't maintained, especially if it's reversed, you are said to have high cholesterol. What are the risk factors for having high cholesterol? Your risk of having high cholesterol increases if: Your diet is high in saturated fat. These fats, found in meat and full-fat dairy products, raise LDL cholesterol. Dietary cholesterol, found in eggs and organ meats, can also raise blood cholesterol levels, but not as much as saturated fat does. You eat foods containing trans fats. These are artificially made fats found in partially hydrogenated oils. They raise LDL cholesterol and lower HDL cholesterol -- exactly the wrong combination. You eat processed foods or foods high in carbohydrates. These types of foods have also been shown to increase LDL cholesterol. You are overweight or obese. Excess weight increases LDL and lowers HDL. You don't get much exercise. Studies show that frequent exercise can boost HDL, the good cholesterol. Lack of exercise can lead to weight gain. How does the doctor know I have high cholesterol? There are two different types of cholesterol tests. The simplest measures total cholesterol levels in the blood. Most doctors, though, use a lipoprotein analysis, which includes: Total cholesterol level LDL cholesterol level HDL cholesterol level Triglycerides (another fat in your blood that raises the risk of heart disease) How can I prevent high cholesterol? To reduce your cholesterol, one of the most important change to make is to cut back on the amount of saturated fat and trans fats in your diet. That means cutting back on meat and poultry -- either by eating smaller portions or eating them less often -- and choosing skim or low-fat dairy products. It also means eating less fried food, processed food, and foods high in sugar. It is also important to increase the amount of soluble fiber you eat. This form of fiber, found in oatmeal, kidney beans, and apples, for example, helps remove LDL from the body. If you are overweight or obese, losing even just a few pounds can help lower your cholesterol levels. There is no magical formula for weight loss, of course, but reducing portion sizes and cutting out things you can easily live without, such as beverages sweetened with sugar, is a good place to start. The average American now gets more than 20% of calories from beverages. Switching to water is painless and can make a big difference in total calories. Regular exercise -- as little as a brisk 30-minute walk most days -- raises HDL and may also slightly lower LDL. Exercise is especially important if you have high triglyceride and LDL levels and more than your share of abdominal fat. What are the treatments for high cholesterol? The first treatment of choice for high cholesterol is adopting a healthier lifestyle. In many people who have cholesterol in the borderline high category, healthier habits can bring the numbers down to normal. If lifestyle changes are not enough, a variety of cholesterol-lowering medications are available. The leading choice -- statin drugs -- are very effective at lowering LDL. Recent studies have confirmed that, by lowering cholesterol levels, these drugs reduce the risk of heart disease.