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TO YOUR GOOD HEALTH #12345_20211207
FOR RELEASE WEEK OF DEC. 6, 2021 (COL. 2)
BYLINE: By Keith Roach, M.D.
TITLE: Fasting not strictly required for glucose or ldl cholesterol
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DEAR DR. ROACH: My nurse practitioner simply ordered blood checks, together with blood sugar and ldl cholesterol. He stated I did not must quick for both of them, however to tell the lab that I wasn’t fasting. This shocked me, since I have been fasting for years for these checks. I requested him if I may have espresso, breakfast, and so forth. No downside, he stated. I requested him what was totally different, and he responded, “There’s new expertise on the market.” What’s your opinion on his recommendation? — J.S.B.
ANSWER: I will begin with the blood sugar check, the principle goal of which is to establish abnormally excessive glucose, both as diabetes or its precursor, prediabetes, additionally referred to as borderline diabetes or impaired glucose. Each a fasting glucose and a nonfasting glucose can provide your clinician a clue, and an irregular check would often be adopted up with a hemoglobin A1C or glucose tolerance check, that are definitive methods of diagnosing diabetes. A nonfasting glucose is a minimum of pretty much as good of a screening check as a fasting glucose, since fasting glucose ranges are regular till the situation is fairly superior.
Blood ldl cholesterol is usually measured as complete ldl cholesterol, HDL ldl cholesterol, and triglycerides. A formulation is used to estimate LDL ldl cholesterol from these, as measuring LDL immediately is pricey and time-consuming. Complete and HDL ldl cholesterol aren’t a lot affected by current meals, however triglycerides are. Consuming earlier than a ldl cholesterol panel often makes the triglycerides go up, and makes the formulation much less correct. Most clinicians nonetheless want a fasting ldl cholesterol, though there are good information that utilizing non-HDL ldl cholesterol (that is simply the entire ldl cholesterol minus the HDL ldl cholesterol) offers as a lot details about an individual’s coronary heart illness threat as a fasting, calculated LDL degree.
If the triglycerides themselves are very excessive, most clinicians will then get a fasting panel. In my very own apply, I want sufferers to quick for 4 hours or so earlier than ldl cholesterol testing (however black espresso/tea and water are all the time superb). If a affected person is available in having simply eaten, a complete and HDL ldl cholesterol often offers me all the data I want. Often, I must get a fasting research anyway.
DEAR DR. ROACH: It appears that evidently my once-weekly steak shouldn’t be barbecued, because of carcinogenic elements. A disappointment. How essential is that this impact? — S.
ANSWER: Grilling meat of any variety results in the formation of two separate households of cancer-causing chemical compounds (carcinogens): the heterocyclic amines (HCAs) and polycyclic fragrant hydrocarbons. The previous adage stays true that the dose makes the poison. Consuming grilled meat much less typically will scale back your general publicity, and there are steps you may take throughout cooking to scale back the era of those poisonous chemical compounds. These embrace meticulous cleansing of the grill to eliminate the char already there; marinating your protein, which reduces formation of those toxins; utilizing herbs (likewise); cooking at decrease warmth or lowering time on the grill by combining with different cooking strategies; and cooking a lot of grilled greens as nicely (which don’t type these toxins when grilling).
I’ve all the time advisable lowering, not eliminating, your less-healthy meals selections. When you like your grilled steak, make it as safely as attainable and luxuriate in it. The hurt from consuming these often is small.
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Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column at any time when attainable. Readers could e-mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.
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