Final answer:
Factors contributing to hyperlipidemia include obesity, cigarette smoking, and intake of refined carbohydrates. Increased intake of fiber is generally beneficial and not a contributing factor.
Step-by-step explanation:
The question asks which factors can contribute to a patient's hyperlipidemia. The factors that can contribute to the development of hyperlipidemia include: A. obesity, B. cigarette smoking, and D. intake of refined carbohydrates. Counterintuitively, C. increased intake of fiber is generally considered beneficial for reducing hyperlipidemia, by aiding in the elimination of cholesterol from the body. Therefore, it would not contribute to hyperlipidemia. Lastly, without the full context of option E, it cannot be accurately assessed, but typically, certain diets high in saturated fats can contribute to hyperlipidemia as well.