For most people in Canada, no: the Canadian Cardiovascular Society has accepted non-fasting lipid testing since 2016, because total cholesterol, HDL and non-HDL cholesterol barely change after a meal. Fasting still matters when your provider wants an accurate triglyceride or calculated LDL value, when a previous non-fasting triglyceride was above 4.5 mmol/L, or when the requisition says to fast. If it does, follow it: water only for 9 to 12 hours.
What changes when you eat before a lipid test?
Triglycerides rise for several hours after a meal, and because LDL cholesterol is usually calculated from triglycerides, a high post-meal value can make the LDL estimate less reliable. Total cholesterol, HDL and non-HDL cholesterol are stable enough that guidelines treat non-fasting results as valid for cardiovascular risk assessment. Apolipoprotein B, when ordered, is also unaffected by food.
When your provider will still ask you to fast
- Your requisition says fasting: Ontario requisitions often still do, and the lab follows the requisition.
- A previous non-fasting triglyceride result was above 4.5 mmol/L.
- You are being assessed for a triglyceride disorder or pancreatitis risk.
- Your provider is comparing with earlier fasting results and wants like for like.
If you are unsure, fasting never makes a lipid profile less valid, so when in doubt fast. Our guide to fasting before a blood test covers what counts as fasting and which other tests need it.
How long should you fast?
Nine to twelve hours, water only. Coffee, tea, juice, gum and food all count as breaking the fast. Take your usual medications with water unless told otherwise. Do not fast longer than about 14 hours.
Reading your cholesterol numbers
Canadian reports give results in mmol/L. Your provider looks at LDL or non-HDL cholesterol together with your overall risk, not at a single number in isolation, and decides whether lifestyle changes or medication are needed. The reading your results guide explains the flags on a lab report.
Getting a cholesterol test in Ottawa
Bring your requisition and Ontario health card to any Bio-Test centre; no appointment is needed. If you are fasting, early morning is easiest, and all 11 centres open by 8:00 am on weekdays, the main lab at 7:30. Results reach your provider within 24 to 48 hours and appear in the patient portal. A lipid profile ordered by an authorized provider is covered by OHIP.