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The best conclusion is E) The risk of fatal disease can be altered by certain changes in lifestyle.
The passage states that smoking, drinking, and exercise can influence cholesterol levels, and high cholesterol is linked to an increased risk of fatal heart disease.
This means that lifestyle changes related to these factors can affect a person's risk.

Explanation of why other options are incorrect:

A) If a person has low blood cholesterol, then that person's risk of fatal heart disease is low.
While low cholesterol generally lowers the risk, the passage doesn't make this a direct correlation. It only states that more cholesterol means higher risk, not a guarantee if one is lower risk.

B) Smoking in moderation can entail as great a risk of fatal heart disease as does heavy smoking.
The passage does not compare the risk of moderate vs. heavy smoking. It only states that smoking can increase the risk.

C) A high-cholesterol diet is the principal cause of death in North America.
The passage does not say diet is the principal cause, just that it's a factor. It also doesn't specify that a high-cholesterol diet is the only factor.

D) The only way that smoking increases one's risk of fatal heart disease is by influencing the levels of cholesterol in the blood.
The passage only says smoking influences cholesterol levels, but it doesn't say it's the only way smoking increases risk. Other factors could be involved.

Source: AI Overview
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