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.

DEAR DR. BLONZ: Are some calcium supplements better than others? I had been using oyster shell calcium, but read there are risks of a contaminant. Is this form safe? -- B.B., Milwaukee, Wisconsin

DEAR B.B.: Calcium supplements from natural sources are the ones at higher risk for lead contamination, mainly because they tend to form in areas where lead is also hanging around. These sources include oyster shell, dolomite and bone meal.

Oyster shell calcium can become a problem when the oysters developed in lead-contaminated waters. Dolomite, also called dolomitic limestone, is a mined mineral that’s composed primarily of calcium carbonate and magnesium carbonate, plus some other elements. If the mineral happens to be in areas that contain elevated amounts of lead, this natural source would also have its share of this unwanted mineral.

Bone meal makes sense as a calcium supplement because, in addition to the calcium, it contains the other trace elements used to make bones. The problem is that an animal’s bones often serve as storage tissue for heavy metal contaminants in the diet. Animals allowed to graze near sources of industrial pollution can become sources of higher-than-normal levels of these contaminants in their bones and other tissues.

This doesn’t mean that all natural sources are contaminated; it is just to let you know that when you choose a calcium supplement made from any of these compounds, you need to check the source. That means verifying that the company providing the supplement has tested their product and can provide assurances of its purity. Opt only for those brands that state their product is low-lead or lead-free. In general, only purchase supplements that provide you with the quality assurances that you, as a customer, need in order to be comfortable.

DEAR DR. BLONZ: I appreciate your science-based, respectfully written column, and never miss it. But I have a small correction to a recent answer about chelation therapy. You stated that the EDTA in lavender blood-collection tubes prevents blood from clotting by chelating the iron. Actually, it chelates the calcium in the plasma; the iron in cells is not accessible to the EDTA because the cells remain intact. -- E.B., retired clinical lab scientist, via email

DEAR E.B.: Thanks much for this correction.

DEAR DR. BLONZ: I was surprised when I read that the pH of lemon juice was actually lower than that of vinegar, making it more acidic. I can drink lemon juice straight, but vinegar takes my breath away. I have always been under the impression that if I substituted lemon juice for vinegar in a dressing or recipe, I should use slightly more lemon juice, which now seems unnecessary. -- B.G., San Diego, California

DEAR B.G.: pH is a measure of acidity, and it does not necessarily equate with taste. The vinegar used in foods comes from acetic acid, a substance that is produced during spoilage. It is pure acetic acid, so your taste buds get a real shot of that one component. In lemon juice, we have citric acid with a few other organic acids, but there are other flavor qualities to balance out the sensation. Vinegar acidities can vary, but most are about 5 percent. Lemon juice is in the same range. Your reactions make more sense when you consider the larger flavor context.

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.