Cholesterol is a major risk factor for heart disease. In managing cholesterol, sometimes medications are not necessarily the first and only step in dealing with cholesterol. Diet and exercise play a role in the management of cholesterol. Testing genetic markers on how food is metabolized may be helpful. There are environmental factors that influence these genes’ expression, such as the amount of carbohydrates eaten or the amount of fats consumed, as being part of successful cholesterol management. Included in this analysis is incorporating foods which may be more helpful in dealing with cholesterol issues. Vitamin intake and possibly, moderate alcohol consumption (6 ozs or less per day)  become considered as part of the plan, while cholesterol is monitored. Medications are then used if the cholesterol cannot be managed through diet, or if there is evidence of plaque formation seen on screening tests. Medication is sometimes not the best answer, and steps are taken to analyze how to best manage the cholesterol issues.