On Nutrition

DEAR DR. BLONZ: I take medications along with several supplements, and they come in various sizes, shapes and forms. To keep things straight between what I take in the morning and evening, I have them in a container with weekday, AM and PM pockets. I have been unable to find an answer to whether there is a problem keeping the different types together like this. Would it be best to store them in the refrigerator? -- M.M., San Jose, California

DEAR M.M.: Similar to most medications, supplements should be kept in a cool, dry place, avoiding moisture and temperature extremes. Unless specifically required, storing in the refrigerator is unnecessary and can expose the supplements to moisture through condensation. Even small amounts of water can facilitate complex compounds' chemical and physical breakdown. This is why bottles typically contain tight seals with a moisture-absorbing packet to help preserve their shelf life.

Supplement organizers usually come as multi-compartment containers, some with 7-day, AM and PM sections. Unless made with this feature, these containers are not moisture-proof or airtight, so assume the environment outside can affect what's inside. That would rule out storing them and their contents in the refrigerator where moisture is present. After being out at room temperature, moving the container to the refrigerator might cause condensation inside the compartments.

Regarding the products themselves, sizes and shapes can vary between companies, making a supplement difficult to distinguish once outside its parent container. Consider creating a photo key using a photo easily taken with your phone. This would be important information for you (and caregivers) to know what's what, especially in an emergency where you are unable to speak for yourself. It is best to keep medications in the containers provided, where they are complete with their prescription information. Also, considering you are taking medications and supplements, read the article about interactions at b.link/bjjv4uy.

The bottom line is that these containers are only a short-term holding convenience, so as long as supplements are stored in the recommended way, a mix of capsules, hard tablets and soft gels should not be a problem. Check all prescription storage instructions for the "discard after" information.

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 an unfortunate tendency to develop hives and was told that a low-histamine diet can help in some cases. I have been having difficulty finding a list of foods showing histamine content. -- S.S., San Diego, California

DEAR S.S.: Hives also goes by "chronic spontaneous urticaria," which relates to annoyingly itchy raised skin of unknown origin that can appear in unpredictable ways and places on the body. Considering whether what you eat plays a role makes sense, but seeking a low-histamine diet is a bit misleading, as pre-formed histamine is not found in foods to any appreciable degree. (Read more about hives at b.link/649b2je.)

Histamine is involved with inflammation, a reaction that can bring about a localized increase in blood flow that the body uses to facilitate tissue repairs and the elimination of foreign materials. The body makes its own histamine from histidine, an essential amino acid in all complete proteins, and it stores its histamine in reservoirs called mast cells, which are distributed throughout the body.

Histamine has its dark side. In addition to doing good things, histamine is responsible for cold and allergy symptoms, such as sneezing, itchy eyes, runny nose and, in your case, hives. When under the throes of such effects, we often turn to antihistamines to provide symptomatic relief. Check the MedlinePlus video on histamine at b.link/gxef5uy. It may not be a case of seeking a diet low in histamine as much as it is identifying foods that cause histamine to release in your body.

As histamine is involved in allergic-type reactions, the first foods to consider would be suspects often associated with allergies or hypersensitivity reactions. That list includes shellfish, eggs, cheese, hard sausage, sauerkraut, chocolate, nuts, tomatoes, berries, wine and beer.

Other lists recommend the elimination of food additives such as sulfites, benzoates, nitrites, salicylates, artificial colors, preservatives and tartrazines, as well as other foods such as milk, citrus, cola, cinnamon, strawberries, peas, beans, eggs, pork and wheat.

The next foods to check would be those with unusually high concentrations of free histidine, an essential amino acid. Free histidine in foods poses a potential problem because enzymes can change histidine into histamine. Foods with high levels of free histidine include fish such as tuna, bonito, mackerel, blue marlin, sardines, herring and anchovies. (Note: This is not an issue with the histidine that's part of complete proteins.)

We all differ in how we react to foods, so it is best to find out what is going on rather than following a bunch of "avoid" lists. Testing is available; be sure to discuss this with the health professional focused on this aspect of your care.

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: There are no Nutrition Facts labels on fresh produce, but one local store provides posters with information I find helpful, and there are also websites. My question is whether this information reflects the picked or the ripest versions. Does a really sweet piece of fruit have more calories than one that is not so ripe or sweet? Is there a theme here? Thank you. -- D.T., Dover, Delaware

DEAR D.T.: Assuming both are no longer on the tree and continuing to develop, there will be no calorie difference between a ripe and a less ripe piece of fruit. Depending on the type of fruit, there can be differences in the types of carbohydrates and the perception of sweetness they provide.

Some foods have enzymes that break down their complex carbohydrates (starches) into more simple sugars, and this process continues the ripening after harvest. Referred to as climacteric fruits, they include bananas, avocados, peaches, pears, plums, nectarines, mangoes, guava and papayas. These fruits produce ethylene gas that triggers ripening (putting them in a paper bag can speed up their ripening). Non-climacteric fruits include grapes, strawberries, cherries, oranges, pineapples, blueberries, raspberries, blackberries, pomegranates and watermelon; these do not ripen in any significant way after harvest, which ideally would be at the peak of ripeness.

Regarding the Nutrition Facts labels, the FDA does not require labels on raw produce, but some stores provide information for their customers. You can find charts of Nutrition Facts for raw produce (this page also has seafood) at b.link/y4f5s4a.

Ripening characteristics help successful plants survive. Seeds remain a part of the plant until they are ready to grow on their own. There is a coordination between the seed’s maturity and the fruit’s ripeness, the completion being signaled by a change in color, flavor and aroma. The mature package is more likely to be grabbed, picked up and carried to a new location.

Many seeds are large, so they are unlikely to be eaten, while others are small with hard protective coats that allow them to pass through the digestive system and get deposited in a new location. The trip through the digestive system helps prime some seeds for germination. Fascinating, the way nature works.

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.