Standardization of the Fat Tolerance Test - Studies
To standardize the Fat Tolerance Test, specific questions should be answered:
1. How long after the consumption of a standardized meal, the sample for the determination of the triglyceride levels should be taken
2. What should be the composition of the standardized meal and
3. Which value of the triglyceride levels is considered as abnormal?
The sample time of postprandial triglycerides level has not yet been clearly defined. Some researchers used to take blood samples hourly after the consumption of the standardized meal while others every 2 or 3 hours for a total period of 8-10 hours.
This forces patients to remain in the lab for several hours and be subjected to multiple blood samplings, leading to resentment and increased cost of the study.
In the Copenhagen City Heart Study, the greatest increase of postprandial triglyceride levels occurred 4 hours after the last meal.
Similar results were observed in the Women's Health Study, where the 4 hours after the meal measurement were the most representative.
Postprandial lipemia was studied over the last 20 years.
The meta-analysis of 113 studies that has been done in this area over the last twenty years and was published in September 2011 defines the Fat Tolerance Test.
A team of experts, after a meta-analysis of these 113 studies, published the following way of determining and evaluating the postprandial triglyceride levels:
1. The most appropriate time to measure postprandial triglycerides is 4 hours after the consumption of the standardized meal.
2. The Fat Tolerance Test meal should contain 75g saturated fat, 25g carbohydrate and 10g protein.
3. The fat Tolerance Test is positive when triglyceride levels are above 220 mg/dl.
So, the Fat Tolerance Test is the determination of the triglyceride levels 4hours after the consumption of a standardized meal, containing 75g saturated fat, 25g carbohydrate and 10g protein.
*Mihas C, Kolovou GD, Mikhailidis DP, Kovar J, Lairon D, Nordestgaard BG, Ooi TC, Perez-Martinez P, Bilianou H, Anagnostopoulou K, Panotopoulos G. Diagnostic value of postprandial triglyceride testing in healthy subjects: a meta-analysis. Curr Vasc Pharmacol. 2011 May;9(3):271-80