If just thinking about a day without food makes you hangry, you’re not alone — what is life without breakfast, lunch, or that 4 p.m. clutch snack to look forward to?
But when you have a cholesterol test scheduled, you may have to fast for 9 to 12 hours beforehand.
What is cholesterol, anyway?
Cholesterol is a fatty compound your liver produces that’s also found in some foods, like eggs, meat, and milk. It might get a bad rap, but it’s vital to your health. When cholesterol levels get too high, it can increase the risk of stroke, heart attack, and heart disease.
Most people with high cholesterol show no symptoms. That’s why the American Heart Association recommends getting your cholesterol tested every 4 to 6 years starting at age 20. The test, also called a lipid panel, involves drawing a small amount of blood from a vein to measure cholesterol levels.
So can you enjoy breakfast as usual, or will you have to side-eye anyone nomming before your test?
Since guidelines have changed in recent years, it depends. Here’s the lowdown:
If you’re not taking statins, you might not have to fast.
For years, doctors ordered fasts before cholesterol tests. The logic? Scientists thought chowing down affected lipid levels (aka fat). They also thought eating distorted low-density lipoprotein (LDL) cholesterol levels.
Recently, scientists have found that fasting has minimal impact on test results for total cholesterol level, LDL cholesterol, and high-density lipoprotein (HDL) cholesterol.
In fact, testing after eating may help better predict cardiovascular risk, according to Harvard Health Publishing. Since most people chow down throughout the day, post-meal tests may best reflect “normal” lipid levels.
Recent guidelines from the American College of Cardiology advise that as long as you’re not taking statins, you might not have to fast.
Hold that acai bowl — does that mean you’re in the clear? Not necessarily. Many doctors say to fast anyway, so always listen up.
Though eating doesn’t significantly impact three measures of the test, it can affect the fourth. Eating can raise your triglyceride levels for several hours — especially if you enjoy a high fat meal (hi, burger and fries). The effect is usually small, though.
If the reading seems too high, your doctor may order another test post-fast.
Statins like Lipitor, Lipostat, and Zocor are drugs that help lower cholesterol.
If you take cholesterol meds, you’ll likely have to fast for 9 to 12 hours before the test to avoid skewed results. Check with your doctor to be sure.
If you have to fast, don’t stress. Doctors usually schedule tests in the morning, since patients tend to prefer nighttime fasting.
Go ahead and hydrate with H2O beforehand, but avoid juice, soda, and other drinks. And skip the adult beverages for at least 24 hours, since alcohol can raise your triglyceride levels.
A lipid test involves taking a blood sample from a vein, typically in the arm.
Afterward, you’ll need to press down on the site with gauze or a bandage for 2 minutes or so. Then you can go about your day as usual. You should feel little to no pain or discomfort. (Phew.)
Your doctor will send over your lab results in about 24 hours.
If you don’t have to fast, doctors still advise steering clear of fatty foods the night before the test. Both fasters and nonfasters should skip alcohol for at least 24 hours beforehand. (Until next time, beer and pizza.)
Research suggests that heavy exercise can affect the results, so some doctors recommend skipping the gym on the day of your test. You may also need to avoid certain medications.
After the test, you’ll take a look at your total lipid profile. Your doctor will explain whether your results appear normal, at-risk, or high.
These are the adult recommendations, according to the American Heart Association’s 2018 guidelines. All values are in mg/dL (milligrams per deciliter):
Total cholesterol: All the cholesterol found in your blood
- Good: below 200
- Borderline: 200 to 239
- High: 240+
LDL cholesterol (the “bad guy”): Raises heart disease risk
- Good: below 100 (below 70 if you have coronary artery disease)
- Borderline: 130 to 159
- High: 160+
- Very high: 190+
HDL cholesterol (the real MVP): Helps protect against heart disease
- Good: 60+
- Acceptable: 50+ for women, 40+ for men
- Low: below 40
Triglycerides: A major type of fat in the body
- Good: below 149 (ideally below 100)
- Borderline: 150 to 199
- High: 200+
- Very high: 500
Folks with conditions like diabetes might need to shoot for lower numbers, so chat with your doctor to know what’s right for you. Cholesterol guidelines also vary by age: Kids should have lower levels than adults.
If your numbers are in the at-risk zone, your doctor may recommend lifestyle changes to lower them.
If your results come back borderline or a little high, don’t sweat it just yet. It’s not just you: Almost one-third of American adults have high cholesterol. And you can totally bring down your levels and boost your health.
Here’s what your doctor might recommend:
- Load up on fresh fruits and veggies and cut back on saturated fats in foods like cheese, bacon, egg yolks, whole milk, and dairy-based desserts.
- Eat high fiber foods like oatmeal, beans, and healthy fats (avocado and nut butters FTW).
- If you smoke, work on quitting.
- Exercise more often.
- Limit alcohol to one drink per day for women and two drinks per day for men.
- In some cases, your doctor might prescribe cholesterol medication.
Your doctor will likely advise more regular tests until you get back on track. You may also need to get checked more often if you have a family history of high cholesterol.
- Cholesterol tests are important to help maintain a healthy heart.
- If you’re taking cholesterol medication, you’ll probably have to fast before the test. Otherwise, you might be able to nosh beforehand.
- Always listen to your doctor’s advice on fasting, since it varies from person to person.
- If your numbers are high, lifestyle changes or medication can help you bring them down.