DEAR DR. ROACH: My nurse practitioner simply ordered blood checks, together with blood sugar and ldl cholesterol. He stated I didn’t must quick for both of them, however to tell the lab that I wasn’t fasting. This stunned me, since I’ve been fasting for years for these checks. I requested him if I might have espresso, breakfast, and many others. No drawback, 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’ll begin with the blood sugar check, the principle goal of which is to determine 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 no less than 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 commonly measured as whole ldl cholesterol, HDL ldl cholesterol, and triglycerides. A formulation is used to estimate LDL ldl cholesterol from these, as measuring LDL straight is pricey and time-consuming. Whole and HDL ldl cholesterol will not be a lot affected by latest 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’s simply the full ldl cholesterol minus the HDL ldl cholesterol) gives 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 at all times fantastic). If a affected person is available in having simply eaten, a complete and HDL ldl cholesterol often provides me all the knowledge I want. Sometimes, I must get a fasting examine anyway.
DEAR DR. ROACH: Evidently my once-weekly steak shouldn’t be barbecued, attributable to carcinogenic elements. A disappointment. How essential is that this impact? — S.
ANSWER: Grilling meat of any sort results in the formation of two separate households of cancer-causing chemical substances (carcinogens): the heterocyclic amines (HCAs) and polycyclic fragrant hydrocarbons. The outdated adage stays true that the dose makes the poison. Consuming grilled meat much less usually will cut back your total publicity, and there are steps you’ll be able to take throughout cooking to cut back the era of those poisonous chemical substances. 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 number of grilled greens as effectively (which don’t kind these toxins when grilling).
I’ve at all times beneficial lowering, not eliminating, your less-healthy meals selections. In case you like your grilled steak, make it as safely as doable and luxuriate in it. The hurt from consuming these sometimes is small.
Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column each time doable. Readers might electronic mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.
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