On Nutrition by Ed Blonz

Which Is Better: Grazing or Three-a-Day?

DEAR DR. BLONZ: From the standpoint of nutrition and energy level, is it best to stick with three meals per day, or spread those same foods into smaller meals throughout the day? -- S.T., Dallas, Texas

DEAR T.X.: The overall nutrition status is not significantly different, because the same foods will be eaten. That said, several studies have shown that midmorning and midafternoon meal breaks can enhance work performance -- but the explanation may be more psychological than nutritional.

Interestingly enough, the subjects in those studies who had not eaten a nutritious breakfast showed the greatest improvement. Their typical “coffee and a quick bite” morning meal gave them a jump-start for the day, but only enough dietary energy to last a couple of hours. The caffeine effect was responsible for much of that. For them, having a midmorning break resulted in a needed energy boost.

A complete breakfast, in the studies, included a source of protein, complex carbohydrates and some fat. Those who ate that at one sitting did not report any significant change if they broke that food into two smaller meals. Multiple meals may help break up the tedium of the workday, but the nutrients absorbed by the body are comparable.

Having several meals throughout the day, often dubbed “grazing,” may have potential benefits for dieters. But grazing also has drawbacks, one of which is that it becomes more difficult to keep a handle on total food intake. Besides, when any time can be mealtime, one might be susceptible to errant snacking -- a pitfall of the unsuccessful dieter.

DEAR DR. BLONZ: As a physician, I am always questioning the description of over-the-counter drugs and herbal supplements as nothing more than “harmless placebos” if they do not work as intended.

The American Society of Anesthesiologists and other medical organizations have put out alerts and printed brochures concerning the potentially undesirable effects of these substances, and the ways they can complicate health conditions and affect other medications. When patients do not consider supplements and OTC meds as drugs, they may not mention them when asked about their drug histories. This could be serious: For example, some supplements might affect the way the blood clots, which would be especially risky during surgery. Unfortunately, the FDA and other government agencies probably don’t get much publicity to warn about such things.

Always be upfront with your health care team about all that you take. An essential ally in this is your pharmacist, as they have records of your prescribed medications. If using multiple pharmacists, be sure they are aware of all you are taking. -- R.B., Phoenix, Arizona

DEAR R.B.: Thanks much for your important note. There is no question that OTC drugs, and herbal or other dietary supplements, can raise the risk of health complications, especially during surgery. Patients need to be forthcoming about everything they are taking, and anesthesiologists and surgeons, or their nurses, need to ask the right questions prior to any procedure. In the same way, medical doctors need to inquire about such substances before writing new prescriptions. Pharmacists must also be given this information so that they have the ability to check for interactions. There are online drug-interaction sites, including drugs.com and rxlist.com, where you can enter all the things you are taking or considering, and see whether there are issues to consider.

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.