Cholesterol Testing: Do I really need to be fasting?

Non fasting Cholesterol is Preferred  

In case you or your doctor or your lab technicians are not aware, it may be better not to fast before getting your cholesterol tested. New International Guidelines released 2016 support this notion. These recommendations comes from studies of over 300,000 patients who had tests without fasting. Here's the study in the prestigious European Heart Journal for you to download:

NON-FASTING CHOLESTEROL TESTS ARE PREFERRED

You may have long assumed that fasting overnight before getting your cholesterol testing would give a more accurate assessment of total cholesterol, harmful LDL cholesterol, protective HDL cholesterol, and triglycerides.  New very interesting research now show you are wrong.

Non fasting Cholesterol May be More Accurate

The new research suggests that eating regularly before your test may be preferred because this gives a clearer and 'truer' picture of what an individual's cholesterol levels actual do through throughout the day. We as humans, spent most of our day in a so called 'non-fasting' state (we eat every few hours) - and so our cholesterol tests should reflect this.

Can I really eat normally before my test?

These are important studies and the data needs to be respected. This is not just someone's opinion. This is well conducted science. The data teaches us that even eating your favourite decadent foods or beverages does not affect cholesterol levels and has little effect on lipids, even triglycerides. 

Conclusions and Recommendations

These new study information is important and tells us that most of us have been wrong for a very long time. New accumulating information shows that fasting is not necessarily and we are wrong to assume that eating significant skews results for the majority of us. In fact, these new studies are teaching us that we SHOULD in fact be eating before our cholesterol tests as the numbers we get back STRENGTHENS our ability to predict our health.  We as humans spend most of our life in a 'fed' state rather than a fasting state and our labs had better reflect that. The only time that it really appears fasting might be helpful is if someones triglycerides come back high - repeating these in a fasting state would then be recommended. For example, a fasting test would be recommended if the non-fasting test shows triglyceride levels above 5 mmol/L (440 mg/dL). Patients with known hypertriglyceridemia may also require fasting tests. But these are exceptions - and not common scenarios.

REFERENCE

Børge G. Nordestgaard et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points—a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. European Heart Journal, Volume 37, Issue 25, 1 July 2016, Pages 1944–1958, https://doi.org/10.1093/eurheartj/ehw152