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Getting my cholesterol levels checked has always been a source of stress for me, primarily because it traditionally required fasting for eight hours beforehand. For someone like me, this often leads to being irritable during the test. Fortunately, updated international guidelines now indicate that fasting may no longer be needed.
The advice to use non-fasted blood samples is based on extensive research involving over 300,000 participants, including diverse groups such as children, adults, and individuals with diabetes. According to a joint consensus statement by the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine, the variations between fasted and non-fasted results were minimal. In many cases, non-fasted results were adequate—and occasionally superior—for assessing cardiovascular risk.
Another reason behind this recommendation is that most people spend the majority of their day in a fed state. Therefore, measuring cholesterol and triglyceride levels while fasting doesn’t accurately reflect typical daily levels. (That said, it’s still advisable to avoid consuming a high-fat meal, such as a cheeseburger combo, before your test.)
When I reached out to Dr. Yoni Freedhoff, a family physician and assistant professor at the University of Ottawa, for his perspective on these guidelines, he shared the following:
From a practical standpoint, this is excellent news. Many patients skip fasting blood tests due to the inconvenience they cause. Fasting can be unpleasant, unsuitable for certain medical conditions, or clash with morning responsibilities. Additionally, long queues at testing centers can add to the frustration.
The study also highlighted that this change benefits not just patients but also general practitioners, lab technicians, and hospital staff. It’s a win-win situation for everyone involved.
Denmark has been using non-fasted testing as the standard since 2009, and the National Institute for Health and Care Excellence in the UK has also updated its guidelines to state that non-fasted samples aren’t necessary. However, in other regions, these recommendations are still gaining acceptance.
That said, standardized procedures—such as defining “abnormal” test results and determining when retesting is required—will need to be carefully established and may vary by country. If your doctor still recommends fasting, it’s best to comply to avoid complications. However, Dr. Freedhoff suggests you can “politely encourage your doctor to review the latest research on non-fasting lipid profiles and recommendations.”
Image by DoD News Photos.
