The Difference Between Nonfasting & Fasting Cholesterol Tests
The amount of cholesterol in your blood is directly correlated with your risk of developing heart disease, the leading cause of death in the United States. Cholesterol tests involve drawing a blood sample from your arm to measure the level of cholesterol components in your blood. The American Heart Association recommends that adults over the age of 20 have their cholesterol checked every five years 1.
Fasting Versus Non-fasting
A fasting cholesterol test is one that is performed after a specified period of time during which a person has not eaten or drunk anything with the exception of pure water. A non-fasting cholesterol test, sometimes referred to as a random cholesterol test, measures your cholesterol level without any restrictions on your dietary intake. Some cholesterol tests require you to fast, while others are not affected by food intake.
Types of Cholesterol Tests
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It is not necessary to fast before a total cholesterol test because the value does not change significantly after eating, according to the Harvard Health Publications 2. A lipid profile, which includes values for total cholesterol, as well as individual values for LDL cholesterol, HDL cholesterol and triglycerides, another lipid in the blood, requires you to fast.include:
- A lipid profile
- which includes values for total cholesterol
- as well as individual values for LDL cholesterol
- HDL cholesterol
- triglycerides
- another lipid in the blood
- requires you to fast
Reason to Fast
LDL levels cannot be measured from the blood directly. Instead, a mathematical equation called the Friedewald equation, is used to calculate LDL levels using values for total cholesterol, HDL cholesterol and triglycerides. The equation divides your triglyceride level by 5 and then subtracts this value as well as your HDL value from your total cholesterol. The result is your LDL level. When you eat, your triglyceride levels rise 20 to 30 percent, according to the Harvard Health Publications 2. Because this increase in triglycerides affects the outcome of the Friedewald equation significantly, it is necessary to fast before a lipid profile, individual LDL test or triglyceride screening.
- LDL levels cannot be measured from the blood directly.
- Because this increase in triglycerides affects the outcome of the Friedewald equation significantly, it is necessary to fast before a lipid profile, individual LDL test or triglyceride screening.
Length of Fast
The Effects of Eating Before Cholesterol Test
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According to the Health Services at Columbia, fat and cholesterol components are usually only measurable for approximately 10 hours after a meal 4. Because of this, most physicians recommend fasting for a period of at least 12 hours before a fasting cholesterol test. Alcohol can increase your triglyceride levels significantly, so abstain from alcohol for at least 24 hours before a fasting cholesterol test.
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References
- American Heart Association; How to Get Your Cholesterol Tested; June 14, 2011
- Work Health: WorkHealth Checks General Information
- American Academy of Family Physicians. High cholesterol. Updated December 5, 2019.
- MedlinePlus. High blood cholesterol levels. Updated February 22, 2018.
- Harvard Health Publishing. How it's made: cholesterol production in the body. Updated July 31, 2019.
- MedlinePlus. Cholesterol levels: what you need to know. Updated April 18, 2019.
- Lepor NE, Vogel RE. Summary of the third report of the National Cholesterol Education Program Adult Treatment Panel III. Rev Cardiovasc Med. 2001;2(3):160-5. doi:10.1001/jama.285.19.2486
- Familial Hypercholestrolemia Foundation. Surprising familial hypercholestrolemia statistics. Updated March 6, 2015.
- Cleveland Clinic. LDL cholesterol and heart health. Updated May 24, 2019.
- Harvard Health Publishing. 11 foods that lower cholesterol. Updated February 6, 2019.
- American Heart Association. Cholesterol medications. Updated November 10, 2018.
- American Heart Association. Prevention and treatment of high cholesterol (hyperlipidemia). Updated April 13, 2017.
- Centers for Disease Control and Prevention. Heart disease. National Center for Health Statistics. Updated February 21, 2020.
- National Heart, Lung, and Blood Institute. High blood cholesterol: What you need to know." Updated June 2005.
- Fallon Jr., L. Fleming. "Hypercholesterolemia." Health AtoZ, Gale Encyclopedia of Medicine. 2006. The Gale Group.
Writer Bio
Lindsay Boyers has a Bachelor of Science in nutrition from Framingham State College and a certificate in holistic nutrition from the American College of Healthcare Sciences. She is also a licensed aesthetician with advanced training in skincare and makeup. She plans to continue on with her education, complete a master's degree program in nutrition and, ultimately, become a registered dietitian.