Fasting before a cholesterol test is not mandatory: Study

Fasting before a cholesterol test is not mandatory, according to the recent study involving over 300,000 individuals in Denmark, Canada, and the U.S. The research concluded that taking a cholesterol test on an empty stomach is not really necessary. Fasting is required for cholesterol testing in Canada and the U.S. In Denmark, fasting before a cholesterol test has not been practiced since 2009.

Many patients find fasting problematic, and the latest findings demonstrated that cholesterol readings remain the same, regardless of whether the test was taken on an empty stomach or not. Professor Børge Nordestgaard said, “This will improve patients’ compliance to preventive treatment aimed at reducing number of heart attacks and strokes, the main killers in the world.”

In Denmark, non-fasting cholesterol tests have been practiced since 2009. Patients, doctors, and labs alike have benefitted from this change, along with children, employed patients, and seniors, as it meant greater access to and convenience of cholesterol testing. Nordestgaard added, “That more patients will have their cholesterol and triglycerides measured will facilitate advice from their doctors on how best to prevent heart attacks and strokes in the future. We hope that non-fasting cholesterol testing will make more patients together with their doctors implement lifestyle changes and if necessary statin treatment to reduce the global burden of cardiovascular disease and premature death.”

The recommendations represent a joint consensus from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine, involving 21 world medical experts from Europe, Australia, and the U.S.

How to test for cholesterol

Generally, cholesterol screening measures your level of high-density lipoprotein (HDL) cholesterol, which is considered to be the good kind. Low-density lipoprotein (LDL) is the bad kind of cholesterol your doctor might have mentioned as well.

Your doctor might perform a complete cholesterol test to assess your risk for the plaque buildup in the arteries leading to the blockage or narrowing of arteries throughout your body. This condition is known as atherosclerosis.

At first, a small sample of your blood is drawn from your arm. If your primary care doctor orders other tests, all of the samples are usually taken simultaneously. Your blood sample is then carefully examined in a lab.

Typically, your doctor will tell you whether you should fast before the test. When you are asked to fast, you are told to avoid eating, drinking, or taking medications for nine to 12 hours before your blood test. If you don’t fast before the blood sample is taken, only the values for total cholesterol and HDL cholesterol will be usable. That’s because the amount of LDL cholesterol levels and triglycerides can be affected by what you last consumed.

This is where a good cholesterol score can be deceiving. If you don’t fast beforehand, your LDL (bad) cholesterol levels won’t be detected by the test. You could walk away with the rose results, thinking all is well and you needn’t worry about your cholesterol.

If you live in the United States, your test report will reveal your cholesterol levels in milligrams per deciliter of blood (mg/dL). The American Heart Association deems a triglyceride level of 100 mg/dL (1.3 mmol/L) or lower is “optimal”.

After you get back the results, your doctor will then interpret your cholesterol numbers based on other risk factors, such as age, family history, smoking, and high blood pressure, before recommending a treatment plan. Usually, diet, weight loss, and physical activity are all encouraged, because triglycerides tend to respond well to dietary and lifestyle changes.