DEAR DR. ROACH: My nurse practitioner simply ordered blood assessments, together with blood sugar and ldl cholesterol. He stated I didn’t have to 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 assessments. I requested him if I might have espresso, breakfast, and so forth. No drawback, he stated. I requested him what was completely different, and he responded, “There’s new know-how on the market.” What’s your opinion on his recommendation? — J.S.B.
ANSWER: I’ll begin with the blood sugar take a look at, the primary goal of which is to establish abnormally excessive glucose, both as diabetes or its precursor, prediabetes, additionally known as borderline diabetes or impaired glucose. Each a fasting glucose and a nonfasting glucose can provide your clinician a clue, and an irregular take a look at would often be adopted up with a hemoglobin A1C or glucose tolerance take a look at, that are definitive methods of diagnosing diabetes. A nonfasting glucose is at the very least nearly as good of a screening take a look at as a fasting glucose, since fasting glucose ranges are regular till the situation is fairly superior.
Blood ldl cholesterol is commonly measured as complete ldl cholesterol, HDL ldl cholesterol, and triglycerides. A formulation is used to estimate LDL ldl cholesterol from these, as measuring LDL straight is dear and time-consuming. Complete and HDL ldl cholesterol are usually not 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 choose 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) supplies as a lot details about an individual’s coronary heart illness threat as a fasting, calculated LDL stage.
If the triglycerides themselves are very excessive, most clinicians will then get a fasting panel. In my very own observe, I choose sufferers to quick for 4 hours or so earlier than ldl cholesterol testing (however black espresso/tea and water are all the time advantageous). If a affected person is available in having simply eaten, a complete and HDL ldl cholesterol often provides me all the data I want. Often, I have to get a fasting examine anyway.
DEAR DR. ROACH: Plainly my once-weekly steak shouldn’t be barbecued, as a result of carcinogenic components. A disappointment. How necessary is that this impact? — S.
ANSWER: Grilling meat of any sort 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 cut back your total publicity, and there are steps you’ll be able to take throughout cooking to scale back the technology 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 properly (which don’t type these toxins when grilling).
I’ve all the time beneficial lowering, not eliminating, your less-healthy meals decisions. Should 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 every time doable. Readers might electronic mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.
