Dear Doctor: I’m 66 years old, and I seem to be of an age at which the people I know are being diagnosed with COPD. I’ve heard it mentioned in TV ads, but I still don’t really understand what it is. Who gets COPD? Is there a cure?

Dear Reader: Chronic obstructive pulmonary disease, commonly referred to as COPD, is the name for a group of lung diseases in which it becomes difficult to breathe. It is caused by lung damage and chronic lung inflammation, which produce symptoms that include wheezing, persistent coughing, an excess of mucus in the lungs, a sensation of tightness in the chest and shortness of breath, particularly during and after physical exertion.

Because COPD diminishes lung function, the amount of oxygen that is available to the body is reduced. This leads to symptoms like weakness and fatigue, and it can even cause the lips or fingernails to take on a blueish color.

The two most common types of COPD are emphysema and chronic bronchitis. In emphysema, the tissues in the smaller airways and air sacs in the lungs become damaged, which makes breathing increasingly difficult. Chronic bronchitis results in the over-production of mucus in the airways due to inflammation. This causes a persistent cough as the lungs attempt to clear the mucus. It also leaves the individual at increased risk for repeated respiratory infections. The disease is caused by long-term exposure to fine particulates and other irritants that damage the airways and the lungs.

The leading cause of COPD is a history of smoking cigarettes. It can also be caused by environmental exposure, such as air pollution and second-hand smoke, or industrial exposure, such as in coal mining, tunnel work and certain manufacturing and chemical processes. People with a deficiency of alpha-1 antitrypsin, a protein that protects the lungs, also can develop COPD despite having no other risk factors.

To diagnose COPD, your doctor begins with a detailed medical history to assess exposure to pollutants, including cigarettes. Lung function tests are used to measure the amount of air someone can inhale and exhale and whether or not adequate amounts of oxygen are being delivered to the blood. The most common of these is spirometry, in which the person blows through a tube and into a gauge called a spirometer. The spirometer measures two markers of lung function -- the volume of air the lungs can hold and how efficient they are at expelling that air.

Scans such as a chest X-ray or CT scan may be used to detect emphysema, and to rule out cancer or heart failure. A blood test known as an arterial blood gas analysis reveals how efficient the lungs are at delivering oxygen to the blood and removing carbon dioxide, a waste product.

Treatment includes medications known as bronchodilators, which relax and open the airways to make breathing easier. In more severe cases, oxygen therapy and inhaled steroids to reduce inflammation may be recommended.

Lifestyle changes are just as important. These include quitting smoking. Staying active is important, and your doctor can help craft an appropriate exercise plan. Remember, COPD is a progressive disease, and patients who receive consistent medical care have the best outcomes.

(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: Everybody’s suddenly talking about how it’s important to eat some walnuts every day. Who decided that? Why is there always a new food fad?

Dear Reader: It’s a challenge to keep up with the latest superfood that’s going to change your life. Blueberries, broccoli, chia seeds, kale, acai berries, pea flour, fish oil, oatmeal -- and the list goes on -- have all had their day. Health promises include fast and easy weight loss, lower blood pressure, better cholesterol levels, improved mood and even disease prevention.

This wish for a cure-all is as old as time, with a diabetes remedy of okra and wheat germ dating back to ancient Egypt in 1550 B.C. Thousands of years later, we still love the notion of a food with special properties that extend beyond its nutritional profile. It’s that ongoing wish for a magic bullet that fills our newscasts and headlines with an ever-changing list of miracle foods.

As you point out in your letter, one of the newest entries into the superfood pantheon is the walnut. The reason why is recent research that links walnuts to certain health benefits. A study from scientists at Penn State found that people who ate several ounces of walnuts each day saw an increase in the populations of several types of gut bacteria. Among these were gut bacteria associated with blood pressure regulation and with improved heart health. This echoes the findings of previous studies, which have linked a diet that includes walnuts with a reduced risk of heart disease. The subjects in the Penn State study also saw an increase in the numbers of a gut bacterium that may help to protect the lining of the gut. This holds promise for conditions such as leaky gut syndrome and inflammatory bowel disease.

The results of another study, conducted by researchers at Loma Linda University Adventist Health Sciences Center, was published earlier this year in the American Journal of Clinical Nutrition. Those findings suggested that eating walnuts may have a beneficial effect on cognitive decline in older adults who have existing risk factors for the condition. Similar effects on cognitive function were not seen in healthy older adults.

Both of these are small studies. The Penn State research included 42 volunteers. The Loma Linda University study looked at data from 640 “free-living” older adults in California and Spain. In addition, the authors of the Loma Linda University study disclosed that it was completed with funding from the California Walnut Commission.

We’re not complete skeptics when it comes to superfoods. The truth is that many are indeed rich in an array of vitamins, minerals, fiber or micronutrients associated with improved health and well-being. But rather than concentrate on a few unique and important foods, we like to think in terms of what some licensed nutritionists are now calling the “super plate.” That is, a healthful and balanced diet made up of whole, fresh foods from a wide variety of sources. You’ll feel better, you won’t get bored and your body will thank 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: Our mom had half of her face go numb for a few minutes, and she also had trouble speaking. She went to the doctor and was told she had a ministroke. What is that? Is it dangerous?

Dear Reader: Your mother had what is known as a transient ischemic attack, or TIA. This occurs due to a temporary decrease or blockage of blood flow within the brain. The words “mini” and “temporary” sound reassuring, and, in fact, people tend to shrug off a TIA because the symptoms often improve quickly. However, a TIA is a strong warning sign of elevated stroke risk, which makes it a medical emergency. Up to 15% of patients go on to have a more severe stroke in the three months following a TIA, with half of those occurring within the first 48 hours after the initial event. Statistics show that long-term stroke risk is elevated as well.

The symptoms of a TIA are similar to those of a major stroke. They include weakness, numbness or sudden paralysis of the face, arm or leg, which usually involves just one side of the body; slurred or confused speech; difficulty understanding spoken and written language; changes to vision; dizziness; difficulty walking or standing; and the swift onset of a severe headache. Unlike in a stroke, the symptoms associated with a TIA are brief. They can last up to 24 hours, but in many cases they pass within the hour. In some people, as with your mother, the symptoms last for mere minutes.

It’s this short-lived nature of a TIA that causes up to one-third of patients to put off seeking medical care for more than 24 hours. Risk factors include high blood pressure, heart disease, diabetes, being 55 or older, having a family history of stroke, having had a previous stroke or TIA, the use of tobacco products and being overweight. TIAs occur more often in men than in women, but due to their longer life spans, the mortality rate is higher in women. Genetics, race and a poor blood lipid profile also play a role.

If you have the symptoms of a TIA, it’s important to seek medical care immediately. Diagnosis includes a complete medical history, physical exam and one or more of a variety of scans and imaging tests to evaluate the relevant blood vessels. Treatment may include the use of medications to lessen the risk of clotting, to dissolve existing clots, to lower blood cholesterol and to address any blood pressure issues. In some cases, angioplasty to open a clogged artery, or the use of a stent to prop open an artery, may be recommended. When severe blockage is found, surgery to clear the artery may be needed. The treatment approach is determined by the cause, location and severity of the TIA, as well as each patient’s medical status and history.

The reassuring news is that, with prompt and proper medical care, up to 80% of the strokes that occur after a TIA are preventable. That makes early diagnosis and immediate treatment all the more important.

(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.)