How does fasting affect cholesterol test results. What are the current recommendations for fasting before a cholesterol test. How do different types of cholesterol impact overall health. What should you expect during a cholesterol test procedure. How are cholesterol test results interpreted.

The Evolving Landscape of Cholesterol Testing

Cholesterol testing has long been a cornerstone of preventive healthcare, but recent developments have sparked a shift in traditional practices. While fasting before a cholesterol test was once the standard protocol, new research is challenging this longstanding recommendation. This article delves into the intricacies of cholesterol testing, exploring the latest guidelines, the impact of fasting, and what patients can expect during the procedure.

Understanding Cholesterol and Its Types

Cholesterol, a fat-like substance present in all body cells, plays a crucial role in various physiological processes. It’s essential for the production of vitamin D, hormones, and digestive enzymes. However, not all cholesterol is created equal. A comprehensive cholesterol test, also known as a lipids panel, measures several distinct types of cholesterol:

• High-density lipoprotein (HDL) cholesterol: Often referred to as “good cholesterol”
• Low-density lipoprotein (LDL) cholesterol: Commonly known as “bad cholesterol”
• Triglycerides: The chemical form in which most fats exist in the body

Healthcare professionals calculate a person’s total cholesterol score by adding the HDL and LDL cholesterol levels to 20 percent of the triglyceride level. This comprehensive assessment helps evaluate an individual’s risk of developing heart disease and other cholesterol-related health issues.

The Fasting Debate: To Fast or Not to Fast?

Traditionally, patients were instructed to fast for 9-12 hours before a cholesterol test, consuming only water during this period. However, recent guidelines have introduced more flexibility in this approach. A 2017 paper advocates for nonfasting cholesterol testing, citing several advantages:

• Increased convenience for patients
• Enhanced safety
• Elimination of waiting periods

The study, which involved over 300,000 participants, suggests that nonfasting tests are at least as accurate as fasting tests in predicting future cardiovascular health problems. However, the medical community continues to debate the necessity of fasting for certain high-risk groups.

The Impact of Fasting on Test Results

Research indicates that nonfasting cholesterol tests may yield slightly different results compared to fasting tests:

• Triglyceride levels may be approximately 26 mg/dl higher in nonfasting readings
• Total cholesterol and LDL cholesterol levels may be around 8 mg/dl lower on average

Despite these variations, many experts consider these differences clinically insignificant for most patients.

Fasting Recommendations for High-Risk Groups

While nonfasting tests are becoming more widely accepted, some healthcare professionals still recommend fasting for certain high-risk individuals. An analysis from the American College of Cardiology suggests that fasting may be beneficial for these groups, as the equations used to calculate LDL levels tend to underestimate both LDL and triglyceride levels in nonfasting individuals.

Given these considerations, it’s crucial for patients to follow their doctor’s specific recommendations regarding fasting. In cases where fasting is advised, patients are typically instructed to refrain from all food and drink except water for 9-12 hours before the test.

The Cholesterol Test Procedure: What to Expect

A cholesterol test is a straightforward blood test that can provide valuable insights into an individual’s cardiovascular health. Here’s what patients can typically expect during the procedure:

1. The patient is seated in a chair with a special armrest
2. A technician applies a rubber strip around the arm to locate a suitable vein
3. The chosen area is cleaned with alcohol
4. A needle attached to a tube is inserted into the vein to collect blood
5. Once the tube is filled, the needle is removed, and gauze is applied to the puncture site
6. The patient may be asked to apply pressure for a few minutes to stop bleeding
7. A small bandage is often placed over the gauze

After the test, patients are usually free to resume their normal daily activities. The entire process is generally quick and minimally invasive.

Interpreting Cholesterol Test Results

Cholesterol test results provide a comprehensive overview of an individual’s cholesterol levels, measured in milligrams per deciliter (mg/dl). Understanding these results is crucial for assessing cardiovascular health and identifying potential risks. Let’s break down the interpretation of each cholesterol type:

HDL Cholesterol: The “Good” Cholesterol

Higher levels of HDL cholesterol are generally considered beneficial:

• 60 mg/dl or higher: Optimal
• 40-59 mg/dl: Less desirable
• Under 40 mg/dl: Poor

LDL Cholesterol: The “Bad” Cholesterol

Lower levels of LDL cholesterol are typically preferred, but recommended levels may vary based on individual health factors:

• Below 70 mg/dl: Optimal for people with diabetes or heart disease
• Below 100 mg/dl: Optimal for people without heart disease or increased risk
• 130-159 mg/dl: Borderline high
• 160-189 mg/dl: High
• Above 190 mg/dl: Very high

Triglycerides

Lower triglyceride levels are generally associated with better health outcomes:

• Under 150 mg/dl: Optimal
• 150-199 mg/dl: Borderline high
• 200-499 mg/dl: High
• Above 500 mg/dl: Very high

The Importance of Regular Cholesterol Monitoring

Regular cholesterol testing plays a vital role in maintaining cardiovascular health and preventing potential complications. By monitoring cholesterol levels over time, healthcare providers can:

• Identify trends and patterns in cholesterol levels
• Assess the effectiveness of lifestyle changes or medications
• Detect early signs of cardiovascular risk
• Tailor preventive strategies to individual needs

The frequency of cholesterol testing may vary depending on an individual’s age, risk factors, and overall health status. It’s essential to consult with a healthcare provider to determine the most appropriate testing schedule.

Lifestyle Factors Influencing Cholesterol Levels

While genetics play a role in determining cholesterol levels, lifestyle factors can significantly impact these values. Understanding and modifying these factors can help individuals maintain healthy cholesterol levels:

Diet

Dietary choices can have a profound effect on cholesterol levels. Consider the following dietary recommendations:

• Limit saturated and trans fats
• Increase intake of fiber-rich foods
• Choose lean proteins
• Incorporate omega-3 fatty acids
• Moderate alcohol consumption

Physical Activity

Regular exercise can help improve cholesterol profiles by:

• Increasing HDL cholesterol levels
• Reducing LDL cholesterol and triglycerides
• Promoting weight management
• Improving overall cardiovascular health

Weight Management

Maintaining a healthy weight is crucial for cholesterol management. Even modest weight loss can lead to significant improvements in cholesterol levels.

Smoking Cessation

Quitting smoking can have a positive impact on cholesterol levels, particularly by increasing HDL cholesterol.

Beyond Cholesterol: Comprehensive Cardiovascular Risk Assessment

While cholesterol testing provides valuable insights into cardiovascular health, it’s important to consider it as part of a more comprehensive risk assessment. Other factors that contribute to overall cardiovascular risk include:

• Blood pressure
• Blood glucose levels
• Family history of heart disease
• Age and gender
• Presence of other medical conditions

Healthcare providers often use risk calculators that incorporate these factors along with cholesterol levels to provide a more accurate assessment of an individual’s cardiovascular risk profile.

Emerging Trends in Cholesterol Management

The field of cholesterol management is continually evolving, with new research and technologies emerging. Some notable trends include:

Advanced Lipid Testing

Beyond standard lipid panels, advanced tests can provide more detailed information about cholesterol particle size and number, offering a more nuanced understanding of cardiovascular risk.

Personalized Medicine

Genetic testing and biomarker analysis are enabling more personalized approaches to cholesterol management, tailoring interventions to an individual’s unique genetic profile.

Novel Therapeutic Approaches

New classes of medications, such as PCSK9 inhibitors, are offering additional options for managing cholesterol in high-risk individuals or those who don’t respond adequately to traditional treatments.

As research in this field continues to advance, it’s likely that cholesterol testing and management strategies will become even more refined and personalized, further improving our ability to prevent and manage cardiovascular disease.

What to do and what to expect

A doctor may instruct a person to fast before taking a cholesterol test. This was once standard practice, but new studies are changing this recommendation.

A cholesterol test measures the amount of cholesterol and triglycerides in a person’s blood. Cholesterol is a fat-like material that is present in all of the body’s cells.

The body needs some cholesterol to help produce vitamin D, hormones, and enzymes that aid digestion.

A cholesterol test, also known as a lipids panel, measures several different types of cholesterol, including:

• high-density lipoprotein (HDL) cholesterol, or “good cholesterol”
• low-density lipoprotein (LDL) cholesterol, or “bad cholesterol”
• triglycerides, the chemical form in which most fats exist

To work out a person’s total cholesterol score, a healthcare professional adds the HDL and LDL cholesterol levels to 20 percent of the triglyceride level.

A doctor will use these results to assess a person’s risk of developing heart disease and other health problems relating to high cholesterol.

Read on to find out more about fasting before a cholesterol test.

Standard practice used to require a person to fast for 9–12 hours before taking a cholesterol test, meaning that they should have no food or drink other than water during that time.

However, recent guidelines have changed. They now allow doctors to recommend nonfasting cholesterol testing to certain groups of individuals.

One 2017 paper recommends nonfasting cholesterol testing, citing the following advantages of nonfasting cholesterol testing:

• convenient
• safe
• no waiting required

The author also states that research involving over 300,000 people suggests that nonfasting tests are at least as accurate as fasting tests at predicting future cardiovascular health problems.

This paper suggests that the triglyceride level will rise by an average of 26 milligrams per deciliter (mg/dl) for a nonfasting reading in comparison with the fasting level. The total cholesterol and LDL cholesterol levels will be 8 mg/dl lower, on average. The authors believe that this difference is clinically insignificant.

However, the medical community continues to debate the need for some higher-risk groups to fast before testing.

According to another analysis from the American College of Cardiology, higher-risk groups may benefit from fasting. This is because the equation that doctors use to find the LDL level tends to underestimate the levels of LDL and triglycerides in people who do not fast.

Due to this, a doctor may recommend that some people fast before a cholesterol test but suggest that other individuals do not need to. A person should follow their doctor’s recommendation regarding fasting.

In cases where a doctor does recommend fasting before a cholesterol test, this often means that the person must refrain from all food and drink except water for 9–12 hours before the test.

A person who undergoes a fasting cholesterol test is likely to go for the test first thing in the morning so that they may eat after the test and do most of the fasting while they sleep.

A cholesterol test is a simple blood test during which a technician will generally seat the person in a chair with a special armrest. The technician will then tie a rubber strip around the person’s arm to try to find a suitable vein from which to draw blood.

After finding a vein, the technician will clean the area with alcohol, insert a needle attached to a tube into the person’s vein, and allow the tube to fill.

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.

The results will tell a doctor if the levels of cholesterol in a person’s blood are healthy.

The test measures several types of cholesterol in a person’s blood in mg/dl. It is possible to break down the results by type of cholesterol.

HDL cholesterol

HDL results measure the amount of “good” cholesterol in a person’s blood. Higher readings tend to be better than lower readings:

LDL cholesterol

Recommended LDL, or “bad,” cholesterol levels will vary based on the health of the individual. Lower readings tend to be better than higher readings:

Triglycerides

Lower triglyceride levels tend to be better than higher readings:

Total cholesterol

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.

If a person’s cholesterol levels are high, a doctor may recommend that the person makes lifestyle changes, such as losing weight or changing their diet. The doctor may prescribe medications, such as statins, to lower cholesterol.

Additionally, a doctor may recommend more frequent cholesterol testing.

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.

The higher a person’s cholesterol levels, the more likely they are to have health problems related to high cholesterol, including:

• coronary artery disease
• blood clots
• angina
• heart attack
• stroke
• peripheral artery disease
• carotid artery disease

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:

• people who are overweight or obese
• people with a family or personal history of heart attack
• people with a family history of high cholesterol
• people whose initial cholesterol test was high
• people who smoke

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.

A person should follow their doctor’s instructions regarding fasting before a cholesterol test.

Q:

Can drinking coffee before a cholesterol test affect the results?

A:

Drinking a cup of black coffee before a cholesterol test might not significantly affect the test results. However, it is best to follow a doctor’s orders. If the doctor suggests fasting before a cholesterol test, then the person should fast.

Gerhard Whitworth, RNAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Acute coffee ingestion does not affect LDL cholesterol level

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Clinical Trial

. 2005 Jul-Aug;39(7-8):1209-13.

doi: 10.1345/aph.1G005.

Epub 2005 May 31.

Rebecca J Cheung 
¹
, Eric K Gupta, Matthew K Ito

Affiliations

Affiliation

• ¹ Thomas J Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA, USA.

• PMID:

  15928258

• DOI:

  10.1345/aph.1G005

Clinical Trial

Rebecca J Cheung et al.

Ann Pharmacother.

2005 Jul-Aug.

. 2005 Jul-Aug;39(7-8):1209-13.

doi: 10. 1345/aph.1G005.

Epub 2005 May 31.

Authors

Rebecca J Cheung 
¹
, Eric K Gupta, Matthew K Ito

Affiliation

• ¹ Thomas J Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA, USA.

• PMID:

  15928258

• DOI:

  10.1345/aph.1G005

Abstract

Background:

Although patients are instructed to abstain from food before having blood drawn for lipid analysis, many still drink coffee in the morning. It is unknown whether coffee consumed prior to drawing blood samples will impact fasting serum lipids.

Objective:

To determine whether a single 6-oz cup of coffee with or without the addition of nondairy creamer and sugar will significantly affect fasting plasma lipid profiles.

Methods:

This was a prospective, open-label, randomized crossover study. At the first of 2 visits, blood was drawn to measure initial fasting lipid panels, and participants were randomized to drink 6 oz of black coffee or coffee with nondairy creamer and sugar. Within 30-60 minutes of coffee consumption, blood was drawn for follow-up lipid panels. The procedure was repeated at the second visit, except the participants were crossed over to receive the alternate coffee preparation.

Results:

Forty participants (26 men; age [mean +/- SD] 45 +/- 15 y) were enrolled. Total cholesterol (TC) increased from 188.2 +/- 38.1 to 191.3 +/- 39.9 mg/dL (p = 0.019) and high-density lipoprotein cholesterol (HDL-C) increased from 43.2 +/- 12.3 to 44.8 +/- 12.9 mg/dL (p < 0.001) after consumption of black coffee. Triglycerides decreased from 145.6 +/- 123.7 to 136.3 +/- 107.1 mg/dL (p = 0.014) after consumption of coffee with nondairy creamer and sugar. Changes in other lipid parameters, such as low-density lipoprotein cholesterol in either group, were not statistically significant.

Conclusions:

A single cup of coffee consumed within one hour before drawing blood resulted in statistically, but not clinically, significant differences in TC and HDL-C (black coffee) and triglycerides (coffee with creamer and sugar).

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Coffee and cholesterol

Translation of an article about coffee oils, cafestol and cholesterol levels

Ekaterina Lapina

Recently in the coffee magazine Perfect Daily Grind published an article “Exploring the relationship between oils in coffee and cholesterol. ” Why am I interested in this topic? I have long heard that coffee can be the culprit of high cholesterol. I rarely write about health and coffee: I try to avoid medical topics, as research findings often contradict each other, and I’m not strong in medical terms.

But here I have a personal interest: I switched my mother from coffee made in moka to filter coffee a year ago when I found out that she had high cholesterol. Coincidentally, I recently had a marketing research interview with an ER doctor who is a huge coffee fanatic. He mentioned that he switched from turkish to pourover precisely because the paper filter traps most of the coffee oils, and this, he deducted, has a beneficial effect on blood cholesterol levels. Such private stories.
The following is my author’s translation of the publication
Exploring the relationship between oils in coffee and cholesterol (with slight cuts).

What is cholesterol?

Cholesterol is a lipid (fatty substance) that occurs naturally in both humans and animals. About 80% of cholesterol in humans is made by the liver, but we also get cholesterol from food – mostly animal products.

The liver combines cholesterol with triglyceride fats to form lipoproteins, which then circulate in our blood. Although cholesterol often has negative connotations in the context of nutrition, it actually plays an important role in maintaining the normal functioning of organs, especially the brain, nerves, and skin. But too much of a certain type of cholesterol can lead to a number of health problems, including an increased risk of heart disease.

Chahan Yeretzian

Supervisor
Coffee Excellence Center of the University of Applied Sciences in Zurich (quotes from PDG article)

“Cholesterol is not inherently ‘bad’ — our body needs it to build cells, produce vitamins and other hormones. Coffee does not contain cholesterol, but it does affect how our body makes cholesterol, so it affects our body’s cholesterol levels.
This is because of the oils present in coffee.
Studies have shown that two compounds found in coffee oils – cafestol and kahweol – can raise cholesterol levels.
Cafestol and kahweol are two special compounds that belong to the coffee oil family. They are also known as diterpenes.”

“Caphestol, in particular, affects on blood cholesterol levels. It is the most powerful cholesterol-raising compound found in the human diet.”

However, there are some benefits to consuming these compounds. A 2002 study in the Food and Chemical Toxicology Journal found that both cafestol and kahweol have anti-carcinogenic properties in animals, meaning they can prevent or slow down the development of cancer.

Which coffee has more oils?

“The lipid (or oil) content of coffee varies between Arabica and Robusta, as well as between coffee varieties and origins. As a rule, Arabica contains about 60% more lipids than Robusta, but this may depend on the variety.”

This was told by Anja Rahn, a senior researcher at the Wageningen Food Safety Research Institute in the Netherlands.

Naturally, when coffee is made, some of these oils will be extracted from the coffee beans and end up in our cup. But in many ways the level of coffee oils in the drink will depend on how the coffee is prepared.

• Espresso has the highest yield of lipids (oils) per unit volume. This is a more concentrated drink compared to filtered coffee. Finer grinds and higher brew temperatures also extract more compounds from the coffee.
• Turkish coffee (turk or cezva) – in second place in terms of oils (lipids), about half the yield of espresso. Turkish coffee requires a finer grind and higher brewing temperature, but uses more water in brewing, so it’s less concentrated.

Conclusion from the article: the highest content of coffee oils in espresso; drinking espresso has an effect on cholesterol levels.

Some studies have shown that immersion brewing methods – cezve, french press, moka – extract more oils and are associated with higher cholesterol levels in coffee. This is most likely due to the fact that these brewing methods generally extract more oils (including cafestol and kahweol) compared to pour over.

The good news is that scientists have not found a direct link between coffee consumption and an increased risk of heart disease, since there are many other unaccounted for variables that can also increase the risk.

“Coffee consumption does not directly increase the risk of heart attacks and strokes. There are indications that moderate coffee consumption may reduce the risk of heart attacks and strokes. This may be because coffee is more than just cafestol. Other compounds in coffee may neutralize or even reverse the negative health effects of consuming more lipids in coffee.” (quote from Chahan Yeretzian from the University of Applied Sciences in Zurich)

How to reduce the amount of oils in a cup of coffee?

Although cafestol makes up only 0.4% to 0.7% of the total weight of Arabica coffee, some consumers may still want to reduce their consumption. But is it possible?

“Caphestol doesn’t dissolve in water because it’s an oil,” says scientist Chahan Yeretzian. – If coffee is brewed at very high temperatures (for example, in a geyser coffee maker) or if ground coffee is brewed for a long time in a French press or cup, cafestol consumption may increase.

“Studies have shown that drinking Turkish coffee can lead to higher cholesterol levels as more lipids are extracted. However, when drinking filtered coffee , cholesterol levels usually do not increase, because there are very few of these oils in the finished drink.”

For consumers who are concerned about this issue, scientists recommend drinking coffee made with a paper filter, like a filter coffee maker, V60, Kalita Wave, Chemex. The paper filter acts as a physical barrier, the paper absorbs some of the oils. These methods also use a coarser grind and lower water temperature (than a cezve or moka), which ultimately means that less oils will be extracted from the coffee.

The roast profile can also affect the level of cafestol in coffee. Conclusion from the article: Coffee drinkers who care about cafestol content can benefit from choosing a medium to dark roast.

“Longer roast profiles can reduce cafestol levels in coffee,” says researcher Anja Rahn. Thus, coffee roasted with espresso will have a lower cafestol level. But this can be offset by the fact that for espresso we take a finer grind, which will contribute to a better extraction of oils.

Health benefits of coffee

Although cafestol and kahweol are known to affect cholesterol levels, these oils also have a number of benefits for human health in general. True, most of the research in this area is focused on the oils in green coffee that are used in the pharmaceutical industry.

But it’s not just coffee oils – coffee has many compounds that have a positive effect on health. A study in the scientific journal Nature found that caffeine is one of 24 compounds that can help regulate enzyme production in the brain.

Based on long-term research, the article concludes that drinking coffee can be part of a healthy lifestyle. Coffee drinkers are advised to be sensible in their consumption of the drink in order to reduce the chances of high cholesterol levels.

“Your body naturally produces cholesterol, so the main thing for consumers to do is to live a healthy lifestyle and avoid drinking very large amounts of coffee. Coffee is not a necessity, but many people around the world enjoy it.”

Pexels photos used:
Igor Haritanovich ;
Juan Pablo Serrano Arenas ;
samer daboul ,
Janko Ferlic .

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How to monitor cholesterol

Cholesterol is a substance that is vital for a person. But the amount of cholesterol in the blood must be within certain limits. When the concentration of cholesterol exceeds these limits, especially when it comes to low-density cholesterol, this can lead to adverse consequences, first of all, it begins to be deposited in those areas of the vascular wall where there is damage to its integrity.

If we take into account that the length of all vessels of the human body is approximately 80-90 thousand kilometers, which is twice as large as the circumference of the globe, then cholesterol, with its high level, will sooner or later find a place where it can attach itself. There, an inflammatory reaction begins and the so-called atherosclerotic plaque grows, which reduces the permeability of blood through the vessel.

Different foods in our diet affect blood cholesterol levels in different ways. We figured out which food is harmful in terms of cholesterol levels, and which is healthy.

Sausage . Perhaps the most harmful of the popular products. It contains animal fat, which in the process of cooking sausage is modified and becomes even more harmful.

Big Mac and fries . They are considered harmful for the same reason, in addition, they contain a lot of salt, as well as quickly digestible carbohydrates, which disrupt not only carbohydrate, but also fat metabolism and, as a result, can also lead to atherosclerosis.

Tomato is very useful, this vegetable contains a lot of substances necessary for the body.

“All vegetables generally have a good effect on the body, and the tomato is the most useful vegetable. Garlic is in second place, red wine is in third,” says Simon Matskeplishvili, MD, professor, cardiologist.

Bran . A very useful product. Fiber can be taken in both granular and powder form.

Coffee . Many people believe that coffee is bad for the heart, but doctors are convinced that coffee does not have a negative effect on this organ, if you do not abuse it and do not drink 20-30 cups of espresso a day. Coffee and tea contain a large number of substances that improve cholesterol metabolism. For this reason, patients with high cholesterol are not prohibited from drinking coffee. The main thing here is to monitor the amount of sugar that is added to coffee. It is advisable to drink coffee and tea without sugar.

With a critical increase in cholesterol levels, a person begins to feel a lack of blood flow. If the atherosclerotic plaque bursts, then a blood clot forms in this place. This means a serious risk to life and health.