I have often had clients who had cholesterol tests come back well out of the normal range and blamed it on forgetting to fast, or in the case of a recent client, a nurse that called and said it would be better for her if she came that particular evening instead of the scheduled next morning. This moved his exam from a pre breakfast fast to a blood draw 2 hours after dinner.

We always encourage fasting, as do the insurance companies, as do doctors when they are trying to assess your lipid profile. But, is there really a huge difference between fasting and non fasting results?

One of the most argued results is the cholesterol ratio, total over hdl. Most insurance companies are looking for a ratio under 5, some under 4.5. I had a client recently whose ratio was 7.8 and he blamed it on forgetting to fast. I told him to have it checked independently and this time his fasting ratio was 7.6. He was simply lacking in hdl since in both tests his total cholesterol was in the 190 range.

Another argument that is often thrown out is that “the last time I had it checked” everything was much lower. Well, if the last time was 2 years ago, guess what. If you haven’t maintained the same diet and exercise regimen, big changes can happen.

A blog I read recently made the point that there can be some change between fasting and non fasting lipids, but not to a huge degree. The doctor answering the question made a point that hdl is impacted more by exercise than other factors.

From talking with doctors and life insurance underwriters, there seems to be some agreement that the most volatile of the lipid results is the triglyceride level. This is why I not so jokingly tell clients not to eat a double cheeseburger and fries right before the exam.

Bottom line. Life insurance underwriters look closely at lipid profiles, as they should. The best results will come after properly fasting for at least four hours, preferably eight hours. The likelihood that forgetting to fast is going to blow your entire health picture out of focus is more myth than fact.

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