Dear Doctor: I know that processed foods aren’t good for me and should be avoided, but I still have some questions. Could you please explain why they are unhealthy and provide some specific examples of such foods?

Dear Reader: Any food, when it’s changed from its original form, can be considered to be processed. That includes chopped spinach in the frozen food aisle, yogurt in the dairy case or whole-grain bread from your local bakery. To set apart the highly manipulated, salty, fatty and sugary foods we’ve grown to love and crave, they’ve been given a category of their own: “ultra-processed” foods. These include the flavored puffs and chips in the snack aisle, luncheon meats, manufactured ice cream products, processed cheeses, boxed baking mixes, many prepackaged frozen entrees, the majority of fast food menus, candy, sodas and other sugary drinks, instant noodles, energy drinks and even so-called energy bars, to name just a few.

Ultra-processed foods have gone through multiple steps, such as milling, grinding, dehydrating, frying, rolling, rehydrating and extruding. They also include a wide range of additives, which are used to arrive at a product that is markedly different from the original forms of its ingredients. Added salt, fats and sugars amp up flavor. Dyes are used to achieve a specific look. Ingredient lists often end with tongue twisters of chemicals used to create a specific texture or mouthfeel, and to prevent spoilage. Food industry whistleblowers have long claimed that many ultra-processed foods are carefully formulated to spark cravings, encourage overeating and create brand loyalty.

When eaten in moderation as an occasional treat -- heavy emphasis on “moderation” and “occasional” -- these types of foods can be fine. It’s when they become dietary staples that problems arise.

Our bodies are complex mechanisms. It takes a wide range of fresh foods to deliver the vitamins, minerals and other nutrients needed for optimal health. But ultra-processed foods are often low in fiber and nutrients. Many lean so hard on added salt to punch up flavor that a single serving puts a serious dent in your daily sodium budget. The empty calories of ultra-processed foods deliver unhealthful amounts of fat, salt and sugar, and they replace the healthful whole foods that truly feed the body. We now know that eating a diet high in these types of foods is linked to a range of illnesses, including increased risk of Type 2 diabetes, heart disease, stroke, obesity, depression, digestive issues, cancer and early death.

That said, it’s also important to be realistic and find a diet you’re able to follow long-term. Eating is pleasurable, and snack foods can be tasty and fun to eat. With that in mind, we advise our patients to aim for a diet that’s 80 percent good, 20 percent cheat. For those with existing health issues, such as diabetes or hypertension, scale that back to 90 percent good and 10 percent cheat. Focus on healthful eating, but allow yourself the occasional naughty detour. You’ll arrive at a dietary plan you can sustain -- and that sustains you.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Can you please explain what gout is and how it’s treated? Our father is 81 years old and was just told that he has gout. His doctor says it could be because he takes water pills for swelling due to congestive heart failure. Does that make sense?

Dear Reader: Gout is a type of arthritis that can occur due to the presence of high levels of uric acid, a metabolic waste product, within the body. The kidneys eliminate uric acid via the urine, and some is excreted via the gut. But sometimes the accumulation of uric acid in the blood can exceed the amount that is excreted. This can lead to the buildup of tiny needle-shaped deposits, known as urate crystals, in and around the joints.

The condition causes periodic episodes of swelling and pain, which can be intense. Symptoms of someone’s first gout attack typically begin at the base of the big toe. However, in subsequent flare-ups, gout can also affect the other joints of the lower leg, including in the foot, ankle and knee. Although gout can affect either sex, it’s three times more common in men than in women. For men, the onset typically begins in middle age, often around age 40 and onward. Women become more susceptible to developing gout during and after menopause.

Diagnosis begins with a physical exam, and includes tests to measure blood levels of uric acid. The patient is asked about the location and severity of their pain, when the attacks first began and how quickly they arise. This last bit of information is important because one of the hallmarks of gout flares is their sudden onset, usually at night or in the early morning. Many patients report pain so severe that it wakes them from sleep. The affected joints are often swollen, sensitive to pressure and warm to the touch. Gout flares tend to subside over the course of a week or two. Some people have frequent flares, while others can go months, or even several years, between attacks.

A diet high in meat, fish, seafood, alcohol and sugary drinks can contribute to elevated blood levels of uric acid. Having diabetes or taking certain medications, including the diuretics that your dad is taking to manage his edema, or swelling, can impede the removal of uric acid. So can being overweight. A family history of gout is also considered to be a risk factor for developing the condition.

Treatment focuses on managing pain and swelling during an attack, as well as adopting preventive behaviors. These include staying hydrated, avoiding or limiting the use of alcohol, cutting back on meat, poultry and fish and maintaining a healthy body weight. If someone needs to lose weight, it’s important to do so gradually. Crash diets can have the effect of temporarily increasing levels of uric acid. In your father’s case, he should let his cardiologist know he has developed gout. It’s possible that a different type of diuretic may be helpful.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Why are people making a big deal out of the fact that you can lose your sense of smell and taste when you get sick with COVID-19? The same thing happens to me when I’ve got a plain old cold.

Dear Reader: Many of us who have slogged through the unpleasant symptoms of a cold or the flu know that losing your sense of smell, and often a large portion of your sense of taste, is a common part of the experience. The same has proven to be true with COVID-19. However, it turns out that this loss of the sense of smell, known as anosmia, occurs for two very different reasons.

Let’s start with a cold and the flu. Our immune systems fight these infections on multiple fronts, including the one-two punch of mucus production and inflammation. This combination does an excellent job of blocking our sinuses. Since the sense of taste is closely linked to the sense of smell, both take a steep dive during the plugged-up phase of an illness. With specialized nerve endings in the nasal passages unable to send a full range of information to the brain, the subtleties of taste are gone. What we’re left with are the broad strokes of bold flavors. That’s why, when we’re fighting a cold or the flu, the sweetness of hot tea with honey or the saltiness of chicken soup tastes particularly good.

When it comes to COVID-19, researchers have recently uncovered the surprising reason for anosmia as one of the earliest symptoms of infection. Rather than congestion, as with a cold or the flu, the loss of smell in people with COVID-19 occurs due to how the virus affects the nervous system. According to a study published by researchers at Harvard University earlier this summer, SARS-CoV-2, the virus that causes COVID-19, attacks certain cells whose job is to support the olfactory sensory neurons. These are the specialized nerve cells that detect the chemical compounds that make up a scent, known as odorants, and transmit that information to the brain. The brain then decodes the electrical impulses, which allows us to experience them as scent. By damaging the support cells, the virus prevents the olfactory sensory neurons from responding to the molecules that make up different types of scents. The good news is that for most patients, recovery from COVID-19 includes a return of their sense of smell.

As we’ve mentioned here before, researchers are still in the earliest stages of learning about the novel coronavirus and COVID-19. That makes each new bit of information important. As cases began to mount, it became clear that only about half of contagious people presented with a fever as an early symptom. At the same time, it emerged that a loss of the sense of smell was one of the first symptoms of infection. Since early intervention gives people who become ill with COVID-19 a better chance of recovery, this has been a significant finding. Thus, the widespread news stories and discussions that you have noticed.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)