On Nutrition

DEAR DR. BLONZ: I want your help in settling a cholesterol discussion involving chicken. Does removing the skin from chicken before you eat it get rid of the cholesterol? Also, I grill chicken with the skin on to keep it from drying out, giving people the option of removing it before the meal. How does this compare with removing the skin before cooking? And to reduce cholesterol in other types of meat, does it help if I purchase leaner cuts? -- C.L., Phoenix

DEAR C.L.: There is a small amount of cholesterol in the skin and fat, but most is in the meat -- both light and dark. This holds true for beef, pork and lamb, as well. Buying leaner cuts does little to reduce the cholesterol in the meal.

While the various types of blood cholesterol continue to be monitored, concern about the cholesterol in our foods has shifted a bit. Research evidence points to the level of fat in the diet -- especially partially hydrogenated fat and saturated fat -- as having more of an effect on our blood cholesterol than the amount of actual cholesterol in the foods we eat.

Also key is the need to avoid the excessive intake of simple sugars. Those naturally present in fresh fruits are fine, but we need to avoid added sugars as much as possible. The combination of an active lifestyle with a balanced diet -- focused on fruits, vegetables, grains, nuts and seeds -- is the best move.

Personally, I use my grill for many types of foods. Regarding chicken, I favor keeping the skin on during grilling for flavor and to prevent dryness. Care, of course, must be taken to avoid flare-ups when grilling skin-side down. Once the chicken is cooked, the skin can be removed, if desired. And it should definitely be removed if the skin has been blackened. So, while you need to cook foods completely, avoid overcooking and keep in mind that food does continue to cook for several minutes after it has been removed from the grill.

DEAR DR. BLONZ: I have some orange trees, and I freeze the juice since there are too many oranges to eat while fresh. Does freezing take away any of the good nutrition of the orange? -- J.F., Chula Vista, California

DEAR J.F.: Fresh oranges, or their juice, are a wholesome food. The orange contains vitamin C, folic acid, vitamin B6 and potassium, in addition to a variety of phytochemicals designed to help it thrive in the sun. There is no problem with fresh-frozen orange juice; the goodness in the fresh juice will be waiting to jump into your glass after it defrosts.

Freezing is an interesting method of food preservation. Cold slows down reactions associated with spoilage. The bonus with freezing is that water forms crystals when frozen, making it unavailable to bacteria and other microorganisms that need water to thrive.

You want to be sure to keep any food well covered, with a minimum of dead space around it. When freezing, allow for expansion. Frozen water crystals take up about 9 percent more space than the same quantity of water as a liquid.

Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

DEAR DR. BLONZ: I have a question about calories in carbohydrates, protein and fat. After a meal, do we gain weight or fat immediately, or does this happen overnight? I’ve never seen a good answer to this question. -- P.E., Walnut Creek, California

DEAR P.E.: We weigh the most right after we eat and drink. Assuming you don’t chow down right before you nod off, or wake up in the middle of the night to raid the refrigerator, you actually lose weight as you sleep.

Calories are a measure of potential energy. They can come in the form of fat (9 calories per gram), carbohydrate and/or protein (4 calories per gram), and even alcohol (7 calories per gram). The calories in any particular food represent its potential energy to fuel work and other metabolic processes, much in the same way that money in its different forms can be thought of as financial “energy” that can be used to buy objects or pay for services.

Once consumed and absorbed, dietary energy becomes a part of the body’s general energy pool, a resource that goes wherever it’s needed. There are certain functions that carbohydrates can perform that fats cannot, and there are those unique to certain types of dietary fats and the amino acids found in protein. Focusing solely on energy, we can say that non-fat calories get turned into glucose, and a small amount gets stored in the liver and muscles as glycogen. The body needs to keep blood glucose within specific limits, so extra glucose quickly gets converted to fatty acids and packaged for transport to storage under the skin and in our hips, thighs, and all those other places. This can take place in a matter of hours after a meal.

The blood is the great highway that carries these energy substances in every direction. Blood is water-based, so there are upper limits to how much fat (lipid) can be tolerated. Much gets packaged into substances known as lipoproteins. For those in good health, as the blood fats/lipids rise, more will get pulled out of the blood and put into storage on your waistline (or wherever else you don’t want it). If you have ever had your blood drawn soon after a big meal, you may have noticed that the blood takes on a milky appearance. This type of blood is described as lipemic, reflecting all those lipids from the meal that are still in the blood.

In the hours after we eat, the net flow of energy compounds is from the digestive system to the blood, with the excess finding its way into storage as fat. The ongoing energy dynamic will always be based on demands at the moment. If, for example, you go out for a walk after a meal, fats/lipids originally destined for storage can get pulled out of the blood to fuel muscular work rather than completing their original journey.

What about gaining fat overnight? After you eat, all the fat from the meal is there, but additional fat can be formed from excess carbohydrates, protein and alcohol calories. If the fat synthesized while you snooze is greater than that needed to keep your body running, you can wake with more fat in your body than when you went to sleep.

Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

DEAR DR. BLONZ: Is there an issue with taking a fish oil supplement while on Coumadin? I require that medication to adjust the way my blood clots, and have been on it for many years. Will fish oil interfere with my regular blood monitoring tests? My doctor explained that I should continue to eat my typical diet, and then after the blood test, my dose would be adjusted as necessary. -- R.R.

DEAR R.R.: The key is to make consistent decisions when it comes to dietary components that can affect how your blood clots; that includes supplements and other medications you might be taking. Once your dose of Coumadin, often referred to as a “blood thinner,” is set, you need to maintain the habits that you had at the establishment of that dose. If a new prescription medication is being considered for any reason, your physician should be aware that you are on a medication involved with blood clotting.

As regards dietary supplements, including fish oil, touch base with your physician or the clinic professionals involved with the setting/adjusting of your dose before starting anything new. You are in a situation where a specific blood-clotting ability is the goal, and various foods, medications and supplements can have opposing effects on the clotting process.

You specifically asked about fish oil supplements, also referred to as omega-3 fatty acids, EPA and/or DHA. Studies looking at their effects on blood clotting have reported differing results, depending on the dose and the patient’s particular situation. This is why it’s important to work with the physician involved with your Coumadin therapy to determine whether this supplement is right for you, and if so, at what dosage. The periodic monitoring of how your blood is clotting is designed to detect when there is a need for adjustment in your Coumadin. If an adjustment is made in your dose, follow their advice as to whether the new dietary/supplement habits you had begun should now be considered your new norm. Read more on this at tinyurl.com/yad65rms.

DEAR DR. BLONZ: I had a reaction of muscle pain when I started taking Crestor last spring. I had to stop taking it. Now I learn that Lipitor has similar side effects, including liver issues. My question: Is there a homeopathic way to lower one’s cholesterol? -- J.M.

DEAR J.M.: Crestor (rosuvastatin) is one of a number of statin medications that can be taken to treat high blood cholesterol. Most of these medications will list muscle pain as a possible side effect, but this does not mean that experiencing this with one type of statin means that you will have a similar reaction to any statin. Check with your physician to see what alternatives might be appropriate. As for homeopathy, I am unaware of any evidence for effective treatments in this area.

Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.