Do I need to fast before a cholesterol test?

Q: Does it make much difference if you fast before a cholesterol test? My wife and I have both joined a new practice and were offered a health check with the practice nurse when we registered. I was told to not have any breakfast, while my wife, seen by a different nurse, was advised to eat normally.

A: It used to be standard practice to ask people to avoid all food and drink (except water) for ten hours before checking their cholesterol and other blood fats, but this has changed in recent years. I suspect this is where the confusion has arisen.

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The National Institute for Health and Care Excellence (NICE) now advises that there is no need to fast – indeed, there is some suggestion that a non-fasted test gives a better snapshot of your metabolism than a fasted one. However, there are still situations where your doctor may request a fasting one for a more detailed profile (if you have an abnormal mix of fats, for instance). But if this is not the case, then just eat what you normally would, although I generally advise avoiding strong unfiltered coffee (cafetière, espressos and the like) as it can significantly raise cholesterol levels. This applies to decaffeinated versions of coffee, too. Tea, however, is fine.

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