When it comes to fat, trans fat is considered by some doctors to be the worst of them all because of its double-barreled impact on your cholesterol levels. Unlike other fats, trans fat — also called trans fatty acids — both raises your "bad" (LDL) cholesterol and lowers your "good" (HDL) cholesterol.
A high LDL cholesterol level in combination with a low HDL cholesterol level significantly increases your risk of heart disease. My uderstanding is that trans fats are converted mostly to LDL cholesterol which binds to your HDL cholesterol and is eliminated though the liver. Unfortunately, in addition to placing more LDL cholesterol into your system it also lowers your good HDL cholesterol, less HDL means less capacity to eliminate LD cholesterol from your blood.
Hope this helps,
Jon
Sorry, forgot to answer the second question, Exercise and diet are normally the first line of treatment depending upon your family history, current cholesterol levels and other risk factors. In some cases, doctors will go directly to statin therapy which can control your levels of LDL and help increase your HDL. In my case, I have done both. I am a 50 year old male and made some lifestyle changes by watching my diet and began to exercise daily and at the same time started statin therapy due to my age, being a male, my current TC which was 234 and my high blood pressure which has been controlled for several years. My numbers dropped from a TC of 234 to 151 in 6 months plus I lost 60 pounds to boot, can't beat that!
Good luck,
Jon