Is it time to break the fast?—a paradigm shift in clinical lipidology

Cardiovascular risk assessment traditionally includes a fasting blood sample for determination of the lipid panel, including total plasma (or serum) cholesterol, triglycerides (TG), HDL-C and calculated (or directly measured) LDL-C levels. Some laboratories also include plasma apolipoprotein (apo) B and apo A-I. It has been known for centuries that ingestion of a fatty meal will increase the concentrations of circulating TG-rich lipoproteins and more so, in conditions such as obesity, type 2 diabetes mellitus and familial disorders of TG metabolism (1).