DEAR DR. BLONZ: What is the story with having a "sluggish liver"? An article I recently read said that symptoms of a sluggish liver can include having a hard time losing weight, experiencing various abdominal pains or even having cellulite. This piqued my interest, and I found more on the topic, with some articles making specific recommendations for herbs and other dietary supplements. Should I try these treatments? -- F.S., Madison, Wisconsin

DEAR F.S.: The entire concept of a "sluggish liver" has no real medical meaning. I have seen the term used to explain everything from hemorrhoids to migraine headaches. It is difficult to answer the specifics of your question, because to do so would justify your conclusion that a "sluggish liver" was the source of your problems. I cannot help but doubt that this is so.

Our liver is very complex: perhaps the hardest-working and most diverse organ in our body. Its responsibilities include: making our blood; manufacturing proteins; detoxifying chemicals, including alcohol and all matter of drugs and contaminants, whether eaten, injected, absorbed through the skin or present in the air we breathe; making and storing glycogen, a form of stored glucose (blood sugar); turning excess calories into fat for storage; burning fats when necessary; creating ketones when there is insufficient glucose in the blood; producing bile, a substance that helps digest food; storing iron and some other vitamins and minerals; and making the factors that help clot the blood.

The obvious implications of this impressive list is that there can be serious consequences if the liver is not functioning up to par. But what does it mean to have a "sluggish liver"? This nonspecific term is unhelpful. It would be similar to proclaiming "something is wrong," and then expecting this singular confession to give rise to specific advice that will make it right.

With problems involving the liver, the first step should be to determine what's going on. To do this, you'll need to see a health professional, who will take a careful history, do a physical examination and order the appropriate laboratory tests.

Depending on what is at play, it is possible that there might be some treatment that can help, but what works for one individual might be counterindicated for another. The bottom line is that you risk making things worse by trying treatments on your own without knowing the source of the problem, and whether the liver is even involved. I encourage you to take the time to get the needed information before you proceed.

Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 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: Coffee is a part of my morning routine, but I have read that there might be an association between coffee and rheumatoid arthritis. The thought of this is giving me a real headache. I usually have a cup in the morning and another with lunch. My parents both have osteoarthritis, and I certainly don't want to take steps down any road that might lead to that. -- K.D., San Diego

DEAR K.D.: Don't toss your coffee beans yet. There has been research reporting a potential connection between decaf coffee-drinking and the risk of rheumatoid arthritis -- a form of arthritis involving the immune system. This is not the same as osteoarthritis (see tinyurl.com/jga42vh for more on the different forms). The type of research you reacted to was epidemiological, often referred to as a "population study." Such research reports coincidences between the factors it measures, but not causation: It doesn't tell you what, if anything, is causing what.

In this case, the study, in the January 2002 issue of the journal Arthritis and Rheumatism, reported an increased risk of rheumatoid arthritis in women drinking more than four cups of decaffeinated coffee per day. It did not conclude that drinking decaf causes rheumatoid arthritis.

My favorite example of the limits of epidemiological research was a finding that physicians who eat meat and drink alcohol have a significantly lower risk of being killed in a plane crash. So, should all docs have a burger and a beer before every flight? Of course not. But if there is nothing going on, why would this relationship be found? It turns out to be one of the quirks of research involving large amounts of data, and it is the reason we need more than a mere statistical relationship before giving full credence to results.

With the coffee study, for example, there might be other factors that have yet to be considered. Next steps might be replication with other populations to see if the relationship held. If so, there could then be an examination of other variables, such as method of coffee preparation or other dietary and lifestyle factors, that might be at play.

That 2002 study was countered by a subsequent study in the November 2003 issue of the same journal. This one failed to support the relationship between coffee, tea and rheumatoid arthritis. A November 2014 study in the journal Clinical Rheumatology performed a meta-analysis on the relationship between coffee (or tea) consumption and the risk of rheumatoid arthritis. A meta-analysis is one in which multiple studies, all meeting specific criteria, are combined and their data viewed collectively. This study reported there was a relationship between a high coffee consumption (four or more cups per day), and the risk of rheumatoid arthritis -- but only with individuals having a positive blood test for rheumatoid arthritis. For those with a negative test, no relationship was found.

The bottom line is that there is no evidence that drinking coffee raises risk of osteoarthritis (the type your parents have). Coffee has also not been shown to cause rheumatoid arthritis, but for those who already have this condition, there may be a reason to limit consumption. It is certainly something best discussed with your physician or rheumatologist.

Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 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: How long can a body go without food? A friend who just suffered a devastating loss has been unable to eat anything. She says she has no appetite, and when she tries to eat anything, her body rejects the food and she throws up. Of course she is losing weight, and has this pale, unhealthy complexion. -- S.F., Santa Clara, California

DEAR S.F.: Deprived of nourishment, the body undergoes a series of adaptations designed to extend life and scale back unnecessary usages of energy. Normally there is constant action in our digestive system: enzymes to be made, cells maturing or being replaced, digestive muscles primed to go. But with no food coming in, the digestive system goes "lights out." When foods are then reintroduced, it can bring about queasiness or nausea until the system is again firing with all cylinders.

Without incoming calories, the body slows down its metabolic rate and lowers its temperature. This means that there will be less circulation near the skin surface, which is one of the reasons why people who go without food feel chilled and tend to have a sallow look about them.

As a friend, you represent an essential source of support. The fact that she is not able to eat indicates that professional assistance may be needed to help her through this rough time. Don't wait.

In the meantime, the body requires more water than any other thing we ingest, so encourage your friend to consume water -- perhaps even sport drinks, as they provide some electrolytes and calories.

If pressed, the human body can survive for many weeks without food, but we would last only a few days without water. The outcome depends on one's state of health, the amount of excess energy (translation: body fat) present at the start of the fast, and whether the body received essential hydration and electrolyte support during the deprivation. I would hope that your friend finds the solace she seeks before testing the limits of her endurance.

DEAR DR. BLONZ: I have read that chromium can alter DNA. I have been taking 200 micrograms a day of chromium picolinate for approximately eight years. Should I be concerned? -- R.S., Glendale, Arizona

DEAR R.S.: Many individuals take supplements that contain chromium. There was some preliminary research reporting that chromium picolinate might have an ability to damage DNA. The research did not really apply to chromium naturally present in foods, or to chromium picolinate taken as a supplement.

At present, dietary chromium has a relatively good safety record, but I will keep you informed if that changes due to more recent studies. The level you are taking is in the National Academy of Science's safe and adequate range, which is set at 50-200 micrograms per day. The "No Observed Adverse Effect Level" (the level at which there are no credibly substantiated adverse reactions) for chromium is 1,000 micrograms per day. Read more on chromium at tinyurl.com/jf8mjgx.

Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 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.