When the skeptical cardiologist trained in medicine and cardiology in the 1980s the standard protocol for obtaining a lipid profile (LDL and HDL cholesterol plus triglycerides) involved having the patient fast for >8 hours before the blood was drawn.
Beginning in 2009, however, various national organizations began recommending the use of nonfasting lipid profiles. In 2011 the American Heart Association endorsed the fasting lipid profile and shortly thereafter I began telling my patients they did not need to fast for these tests.
Old habits and ideas are hard to kill and to this day most of my patients think that fasting is a requirement. Lab personnel seem to be stuck in the past as well and I typically instruct my patients to lie if they are asked if they have eaten.
A recent JACC article makes powerful arguments for using non fasting lipid profiles.
Rather than go through it in detail I’m going to post the “central illustration” which summarizes the authors points in graphic form.
The nonfasting profile is “evidence-driven” and also is time-efficient, patient, laboratory and physician-friendly.
So to my patients I say “you don’t need to fast before seeing me or prior to any blood work I order on you.”
To other patients whose physicians are still requiring fasting before a lipid profile I recommend challenging your doctor’s rationale.
If that doesn’t work, print out a copy of the above infographic and politely ask them to read the associated paper.