Fasting and cholesterol levels -
For the 6-month period from April 1, , to September 30, , we examined the test results of all individuals with lipid test panels high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol, total cholesterol, and triglycerides performed by CLS.
For patients with multiple measurements, only the first lipid test panel during the 6-month period was included. All testing was performed at CLS using standard laboratory protocols on modular analyzers Roche. High-density lipoprotein cholesterol and triglyceride levels were measured directly; LDL cholesterol levels were estimated using the Friedewald equation.
Time since last meal fasting duration, in hours was obtained by self-report from the patient at the time of testing. For the purpose of analysis, fasting time was stratified into hourly intervals from 1 to 16; fasting times longer than 16 hours were included in the hour category.
The 1-hour category included individuals who had fasted for less than 1 hour. Records with missing data for time since last meal were excluded. Age was categorized into 5-year intervals following the methodology of Langsted et al. Previous work has shown that fasting time varies as a function of age and sex.
For each sex, we constructed linear regression models SPSS general linear models with cholesterol measurements as the dependent variable and fasting time in hours and age in 5-year cohorts as the independent variables.
In these models, both age and fasting time were significant predictors of cholesterol level and also showed significant interactions.
We assessed statistical significance by comparing mean cholesterol subgroup measurements obtained at 9 to 12 hours criteria used in the Adult Treatment Panel III study 1 and at more than 8 hours criteria used in the Copenhagen General Population and Copenhagen Heart Study studies 7 with all other fasting time intervals.
In these comparisons, the Scheffé post hoc test was used to control for the effects of multiple pairwise testing. Statistical analyses were performed using SPSS version The study was approved by the University of Calgary institutional ethics review board.
A total of individuals had at least 1 lipid profile completed during the study period. Their baseline characteristics are shown below to convert cholesterol values to millimoles per liter, multiply by 0.
The estimated mean cholesterol subclass levels by fasting time are shown in Table 1 males and Table 2 females. Statistically significant differences among cholesterol subclass levels were present only for a minority of fasting intervals when compared with either a 9- to hour fasting time or a greater than 8-hour fasting time.
We found that fasting time showed little association with lipid subclass levels in a large community-based cohort. This finding suggests that fasting for routine lipid level determinations is largely unnecessary.
Our study corroborates the findings of previous smaller studies. First, fasting for routine blood work presents an inconvenience for patients and may discourage compliance with routine screening programs. Previous work has shown that peak triglyceride levels measured 4 hours after meals yielded the strongest predictive relationship of cardiovascular events.
These findings suggest that analysis of fasting time and lipid levels could have a role in identifying individuals for further screening with supplementary tests such as oral triglyceride tolerance testing 17 or more rigorous treatment protocol goals and closer monitoring.
The elimination of a fasting requirement for lipid determination could also increase patient compliance with testing, which could have particular benefits for patients with diabetes, many of whom have difficulty with prolonged fasting.
There are several limitations to this study. First, individual meal choices before blood draws were not examined, and we could not control for recall errors for self-reported fasting times. Second, our clinical data were limited to measurements commonly taken as part of screening blood work and did not include apolipoprotein B, apolipoprotein A-1, or apolipoprotein B to apolipoprotein A-1 ratios.
Fourth, we did not have knowledge of pharmacological treatment of individual subjects, although a previous study reported that patients who were taking lipid-lowering drugs did not differ from controls in regard to changes in nonfasting vs fasting lipid subclass levels.
Fifth, because we used secondary data on all individuals presenting for cholesterol testing rather than a random sample of individuals drawn from the general population, our findings should be interpreted as representative of individuals presenting for screening and therefore may represent a biased sample of the general population.
Furthermore, we cannot exclude the possibility that individuals with specific medical conditions for example diabetes or dyslipidemia may have been more or less likely to have been compliant with the recommendation to fast before cholesterol testing.
The results presented herein, combined with those of other recent studies, suggest that nonfasting determination of lipid subclasses is a reasonable alternative to fasting determinations.
A possible future direction will be to address this question more directly by examining repeated measurements with differing fasting times in the same individuals. Correspondence: Christopher Naugler, MSc, MD, CCFP, FCFP, FRCPC, Department of Pathology and Laboratory Medicine, University of Calgary, C, Research Rd NW, Calgary, AB T2L 2K8, Canada Christopher.
naugler cls. Published Online: November 12, Author Contributions: Dr Naugler had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design : Sidhu and Naugler.
Acquisition of data : Sidhu and Naugler. Analysis and interpretation of data : Sidhu and Naugler. Drafting of the manuscript : Sidhu and Naugler. Critical revision of the manuscript for important intellectual content : Sidhu and Naugler. Statistical analysis : Sidhu and Naugler. Administrative, technical, and material support : Sidhu and Naugler.
Study supervision : Naugler. full text icon Full Text. Download PDF Top of Article Abstract Methods Results Comment Article Information References. A cholesterol test is a simple blood test during which a technician will generally seat the person in a chair with a special armrest.
When the tube is full of blood, the technician will remove the needle and hold gauze on the site of the puncture. The technician may ask the person to apply pressure for a few minutes to stop the bleeding, and they might apply a small bandage over the gauze.
At this point, the test is complete, and the person is usually free to go about their normal daily activities. It is possible to break down the results by type of cholesterol. Higher readings tend to be better than lower readings:.
Lower readings tend to be better than higher readings:. Lower triglyceride levels tend to be better than higher readings:. A low total cholesterol level tends to be better than a higher one:.
What happens next will depend largely on the results of the test and other risk factors that a person may or may not have. If the cholesterol levels do not suggest any potential health problems, a doctor is likely to recommend no further action or testing. The doctor may prescribe medications, such as statins, to lower cholesterol.
A person can have too much cholesterol in their body. Often, people with high cholesterol have no symptoms. Cholesterol can combine with other substances in the blood and make a substance called plaque that clogs the arteries.
As high cholesterol often does not cause symptoms, doctors routinely order a cholesterol test for adults. The American Heart Association recommend that people aged 20 years and older should consider having a cholesterol level check once every 4—6 years. Doctors may recommend that some people get more frequent cholesterol tests.
Those who may need these additional tests include the following groups:. High cholesterol levels can warn doctors of other potential health problems that a person may develop during their lifetime. As high cholesterol often has no symptoms, doctors recommend checking cholesterol levels with a simple blood test.
Fasting before a cholesterol test used to be standard practice. Now, however, the medical community is starting to change its recommendations on fasting before cholesterol testing. Drinking a cup of black coffee before a cholesterol test might not significantly affect the test results.
If the doctor suggests fasting before a cholesterol test, then the person should fast. Gerhard Whitworth, RN Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
What a person can eat the night before a cholesterol blood test depends on what a healthcare professional suggests. Learn more here. Table 2 summarize the changes in parameters at baseline and post 6 weeks study.
Furthermore, body fat, triglycerides and blood glucose did not show any significant interaction effects. Table 3 shows the mean changes in body measurements, lipids, and blood glucose levels from baseline to post-treatment for the control and intervention groups and the results of post-hoc analyses of within-group change.
There were no significant changes for any of the parameters for the control group. However, it should be noted that the between-group difference in change did not reach statistical significance for triglycerides. Figures 2 , 3 represent the comparison of changes in body measurements, lipid and blood glucose levels of control and intervention groups at baseline and post intervention with significance level of interaction effect.
Figure 2. Multiplot figure of body measurements and blood glucose level of control and intervention group at baseline and post study. Figure 3. Multiplot figure of lipid levels of control and intervention group at baseline and post study. The study suggests that IF has the potential of improving the lipid profile and reducing body weight and waist circumference.
These results are in line with other studies showing that different types of IF, including Ramadan fasting and alternative day fasting, reduce body weight and lipid levels 17 , Studies combining IF with physical activity 11 and comparing different types of IF 12 also suggest that IF can be an effective lifestyle modification for reducing the risks of cardiovascular diseases.
However, most of the IF clinical trials in the literature were conducted for short periods of time and large scale randomized controlled trials with longer duration and follow-ups are not available. Long term studies should be conducted to validate their effectiveness and safety. Santos et al.
As compared to the other types of IF, our method appears safe, effective and can be adopted in daily life, without any additional financial or physical burden. Individuals can incorporate IF into their lifestyles without worrying about any extra efforts to prepare low calorie meals.
The h fast might be maintained by an early breakfast and having dinner at an appropriate time, which works for weekdays and weekends. However, it might be difficult for people working late nights or having an active social life with frequent dining out routines. Previously conducted trials have mentioned that intermittent fasting of 12—36 h results in a metabolic switch 20 leading to a break down of triglycerides into fatty acids and glycerol and conversion of fatty acids to ketone bodies in the liver During fasting, fatty acids and ketone bodies provide energy to cells and tissues Studies suggested that molecule modulation in the liver leads to expression of PPARa and PGC-1a that increases fatty acid oxidation and apoA production leading to increased HDL levels, whereas apoB decreases which causes decreased hepatic triglycerides and LDL levels 23 , Shibata and colleagues worked on SREPB-2, Sterol regulatory element-binding protein in mice, and suggested that intermittent fasting can lead to reduction in cholesterol by regulating SREPB-2 The main limitations of this study included non-randomization of the study population.
Moderate to severe dyslipidemic patients were not included in the study. Other major limitation was the drop out of five participants from the intervention group of the study which may have inflated the size of the results.
It was a single centered and small-scale study lacking data on food intake and record of caloric intake. Future studies including randomized controlled trials with more diet control, longer follow ups and individuals with cardiovascular diseases and type 2 diabetes mellitus are warranted to validate these findings.
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. The studies involving human participants were reviewed and approved by Ethical Review Committee of Aga Khan University.
NA conceived the idea, designed and conducted the trial, provided the funding support, and supervised the study. JF conducted the study, managed the project and participants, and drafted the manuscript. HS, BK, and AHL helped in conducting the clinical trial, data interpretation, and manuscript review.
HJ reviewed and revised the draft of the manuscript. FP performed the statistical analysis. SAM provided intellectual input and resources for performing some analysis.
All authors contributed to the article and approved the submitted version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
We are also thankful to Prof. Anwar-ul Hassan Gilani and Prof. Perwaiz Iqbal for their intellectual input, mentorship and constant support and guidance, and Mr. Andersson C, Lyass A, Vasan RS, Massaro JM, D'Agostino RB Sr. Long-term risk of cardiovascular events across a spectrum of adverse major plasma lipid combinations in the Framingham heart study.
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A complete cholesterol Fat intake and omega- Energy balance calculator also called a lipid panel choolesterol lipid Fasting and cholesterol levels — is a blood Fasting and cholesterol levels that can measure chlesterol amount cholfsterol cholesterol cholestterol triglycerides in your blood. AFsting cholesterol test can help Fasging your risk of the buildup of fatty deposits plaques in your arteries that can lead to narrowed or blocked arteries throughout your body atherosclerosis. A cholesterol test is an important tool. High cholesterol levels often are a significant risk factor for coronary artery disease. High cholesterol usually causes no signs or symptoms. A complete cholesterol test is done to determine whether your cholesterol is high and to estimate your risk of heart attacks and other forms of heart disease and diseases of the blood vessels.
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