DEAR DR. BLONZ: With the holidays here, I was wondering whether calories from alcoholic beverages such as beer, wine and liquor cause weight gain at about the same rate as calories from carbs and fats. -- F.S., Hayward, California

DEAR F.S.: Calories from alcohol tend to have a more complicated agenda than those from other food components. Much depends on your diet, your overall health and your drinking habits. Regarding strict calorie content, one gram of alcohol contains about seven calories. Compare this with carbohydrates and proteins, which contain four calories per gram, and fat, which contains nine calories per gram.

While there can be brew-to-brew variances, the alcoholic content of beer is about 5 percent by volume, except in states or counties having regulations that limit alcohol content to 3.2 percent. There will be additional carbohydrates in beer, and there can also be an additional amount in other alcoholic beverages, such as liqueurs and finished wines.

Unlike packaged foods, there is no requirement for a Nutrition Facts label on alcoholic beverages. To get a caloric breakdown for a specific beverage, check with the manufacturer. The National Institutes of Health provides a generic calculator at tinyurl.com/ybh4cynr. If you’re only interested in good ballpark figures, you can stop here.

It should be kept in mind that alcohol can become toxic in excessive amounts, so the body has specific enzymes designed to break it down. When we consume alcohol more rapidly than it can be broken down, interim metabolites remain in queue, and this is what brings on the various feelings of inebriation. (Larger people tolerate more because their “queue” is bigger.) An interesting side note to this is that calories from alcohol count more in those who don’t drink on a daily basis. This comes from the fact that when alcohol is consumed on a regular basis, such as a glass of wine a day, the body has some of the needed enzymes at the ready.

There are complexities in alcohol’s metabolic rate that have to do with its ability to proceed down different pathways according to the situation at hand, each having a different impact on the net caloric yield. It’s known, for example, that the metabolites of alcohol can slow down the burning of the body’s own fat for energy; this happens because the alcohol gets preferential treatment. The net effect can be more of a positive fat balance, and alcohol-related fat tends to be deposited in the abdominal area.

Another issue with alcohol is its effect on the heat produced by the body (thermogenesis). Metabolic processes such as digestion are not 100 percent energy-efficient, so it is normal for some dietary energy (i.e., calories) to be lost as heat. (This also explains why we get warm when we exercise.) Alcohol is known to increase thermogenesis more than other foods, but this effect is less robust in overweight individuals, or when paired with a high-fat diet.

A bottom caloric line is that there are about seven calories per gram of alcohol, a number greater than carbohydrates, but lower than fat calories. It is no mystery that the more you drink, the more calories you consume. Excess calories from any source will be stored as body fat, but the alcohol-related excess tends to find a home around the midsection.

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: My doctor determined that I have osteoporosis in my back and hips. (I am 67.) She now wants me to take a prescription bisphosphonate drug. I do not take any medications, and would prefer not to begin. I do take many vitamins and supplements, including calcium and magnesium. Is there anything I can use instead of a drug? -- J.B., Oakland, California

DEAR J.B.: I am not a medical doctor; my training is in biochemistry and nutrition, and my focus is on food, nutrition and health. I cannot therefore give you any medical advice.

I respect your preference for not relying on medication, but it is important to understand that osteoporosis is a nasty ailment. It involves a reduced bone-mineral density that takes decades to develop. Ironically, it develops at a time in life when the body’s ability to build and fortify its bones is on the wane. The class of medications known as bisphosphonates have a demonstrated ability to help the body in this regard.

Our bones are being made and disassembled (resorbed) throughout our lives. From infancy toward adulthood, the process favors the net building of bone, but from midlife toward our senior years, the balance shifts and our total bone mass begins to wane. Osteoblasts are the cells that help build bone, and osteoclasts are the cells that help resorb existing bone, releasing its calcium and other components back into the bloodstream.

The bisphosphonate compounds slow bone resorption by inhibiting the action of the osteoclasts. They have an extremely long half-life, which is science-talk for saying that they are slowly broken down by the body. Depending on the particular bisphosphonate compound selected, they may only need to be taken weekly or monthly. Newer bisphosphonates may only need to be given once a year.

These are medications, and while there is research-based evidence to support their efficacy, there are potential side effects. I advise you to do some research and bring all your issues to your physician so that you can make the right decision for your case. Check out the review by Berkeley Wellness at tinyurl.com/y93l7oz9.

In addition, you need to be eating well and possibly take additional supplements to provide the nutrients needed to build and maintain bones. Aside from calcium, the body relies on magnesium, phosphorous, fluoride and vitamins A, B-6 and D for calcium absorption and healthy bones. “Food first” is an essential philosophy: Eating healthful foods provides benefits far beyond the named nutrients in a supplement bottle.

Finally, our bodies get conservative with resources as we age, lowering the priority of things that aren’t used on a regular basis. The “use it or lose it” theme applies to our bones, and weight-bearing exercise sends a message that you expect your bones to remain strong and on the job. Exercises such as walking, stretching and weight training can help strengthen the body, no matter what age they are begun. However, activities need to be appropriate for your particular situation. Don’t overdo it; seek the guidance of a professional before you begin.

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: Soon after eating something sweet or starchy, I become a bit groggy with an urge to doze off. When out, I can fight it, but sometimes I get nervous and shaky. A friend said that I might have “reactive hypoglycemia,” but I thought those theories were discounted decades ago. -- S.T., Oakland, California

DEAR S.T.: Sugars and other carbohydrates are a source of energy for the body, but they can also be associated with drowsiness, and even, ironically, with the shakiness you describe. One possible explanation is the way simple sugars affect the body and the brain, coupled with inadvertent miscues we give the body through the way we eat.

The body needs to maintain its blood glucose level within narrow limits to keep metabolism on an even keel. Multiple systems kick into gear if glucose gets too high or too low. All the digestible carbohydrates we eat are broken down to simpler sugars, and most end up as glucose in the blood. If it’s from a balanced meal, glucose will rise at a moderate level, but the rise can be rapid if the glucose comes from sweets or a can of soda -- especially if consumed on an empty stomach.

Rising blood glucose is the “I am fed” signal; this then causes insulin to be released by the pancreas. Insulin is the hormone that facilitates the exit of glucose from the blood into the cells, where it provides energy to perform work, build new tissue or create needed substances. A potential connection with drowsiness is the fact that elevating blood glucose and insulin release is paired with the production of relaxation-inducing substances in the brain. (This helps explain the urge to “veg” after a big meal.) The situation becomes more complex in those with Type 2 diabetes, as there can be “insulin resistance” where normal levels of insulin are unable to produce the needed blood-glucose-lowering effect.

You mentioned reactive hypoglycemia, which, although not as common as it was once thought, can develop in some individuals. Reactive hypoglycemia occurs when the body releases too much insulin for a given amount of glucose in the bloodstream.

When blood glucose drops too low, a defense mechanism gets triggered. A hormone involved in this process is adrenaline: the body’s “fight or flight” hormone. Aside from helping provide a small amount of glucose (stored in the liver), adrenaline also revs up the body’s muscles and gets them ready for action. Under the influence of adrenaline, you can feel your heart -- a muscle -- pounding in your chest as it pushes blood into the working muscles to prepare them for action. It is not a pleasant sensation, and the nervousness and shakes you mention could be connected to this phenomenon.

You don’t say much about your general health. I have tried to outline some basic issues, but one certainty is that you need to contact a medical doctor to find out what is going on in your body. There are tests that can provide answers, and it is in your best interest to find out ASAP.

In the meantime, try to stay off the sweet stuff -- especially on an empty stomach.

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.