New guidelines on fasting before cholesterol testing

The usual drill for checking blood cholesterol levels is to schedule this test typically in the morning with the patient given instructions to not eat breakfast or to have fasted overnight before the blood draw.  By scheduling early in the day, a person doesn’t have to spend a whole day hungry while waiting to have their blood drawn for the test. The prevailing belief has always been that fasting at the time of obtaining a sample of blood, would provide the most accurate result. The reasoning behind this belief was that your triglycerides (a type of fat in your blood) and low-density lipoproteins (LDL) or “bad” cholesterol – could be affected by food you had eaten recently.

Now, that may not be the case for everyone anymore. New guidelines, published in the Journal of the American College of Cardiology, and from the American Heart Association, state that most people who don’t take statins or other cholesterol-lowering medications can skip fasting, even though it is still okay to do so.

Testing for cholesterol is a simple, relatively painless procedure of having a healthcare provider draw blood using a needle and collecting it in a vial. Usually this test is performed in a doctor’s office or at a lab where the blood is then analyzed. This test provides a baseline reading of cholesterol numbers.  However, if you have eaten an extremely high-fat meal in the past eight hours, your results may be inaccurate. 

The new guidelines state that you may be able to skip fasting, but always heed your doctor’s advice on what they recommend for you. There are still certain situations or individuals who do still need to fast before the blood test in order to get an accurate reading.  This includes the following individuals:

·      Anyone already taking statins or another cholesterol-lowering drug

·      Anyone with an initial nonfasting test that reveals high triglyceride levels, in which case they will need to undergo a second test that does include fasting.

·      Anyone with a family history of premature cardiovascular disease – this includes a male relative younger than age 55 or a female relative younger than age 65.

·      Anyone with a personal or family history of familial hyperlipidemia, a genetic condition that predisposes people to abnormally high cholesterol.

Best advice for anyone getting their blood cholesterol checked, is to inquire with their healthcare provider what they recommend for them on whether to fast or not before the testing.