Hello again, dear readers, and welcome to the monthly letters column. Thank you to everyone who wrote to let us know these columns, and the tips and thoughts from fellow readers, have been helpful. It means a lot to us. And now, onward.

-- We wrote about panic attacks recently, which a reader from Sand Springs, Oklahoma, said he had been experiencing for many years. There turned out to be a connection between his panic attacks and a congenital heart abnormality, and following a valve replacement and treatment with beta blockers, his episodes have stopped. He urges people living with panic attacks to talk to their health care providers, just in case there is a physical cause. “I should have gone to a doctor and discussed this many years earlier, but you know us men, just walk it off,” he wrote. “People with panic attacks should see their doctor.” Agreed.

-- Several of you have written regarding the column about motion sickness. The gist was to let fellow sufferers of seasickness and motion sickness know that you have had good luck with the Sea-Band. It’s the elastic acupressure bracelet we mentioned, which uses a small knob to exert a gentle and constant pressure on the inside of the wrist. The Sea-Band is inexpensive, and it is widely available without a prescription at most major drugstores.

-- In a column about how to ease the confusion some older adults experience after surgery and during hospitalization, we explained that the goal is to help the patient become and remain aware of where he or she is. Making sure they have their eyeglasses, hearing aids and dentures can make a big difference. A reader shared his experience. “My brother had severe paranoia after heart surgery,” he wrote. “A large clock or time display that includes a.m. and p.m., and the day and date, is very helpful. Green potted plants and flowers are also a plus, especially for longer stays.” Another reader said she places family photos in prominent places in a hospital room. Those are all excellent ideas, and we are glad to share them.

-- A reader who contracted COVID-19 wrote to ask about a common symptom that they have developed. “I have COVID-19, and I've lost my taste and smell,” they wrote. “This is my fourth day, and I wonder, what's the average time people lose these senses?” It varies. About half of patients regain their sense of smell and taste within a few weeks. Most patients recover the senses by eight weeks. Only 2% of patients with COVID-19 report a continuing loss of these senses after six months.

We want to remind you that we cannot offer a diagnosis in this column, or comment on specific illnesses, conditions, medications or medical histories. Also, due to the pandemic, letters sent through the U.S. mail are not reaching us on a regular basis. If possible, please send your comments and questions via email. Thank you again for taking the time to write and share your thoughts. We’ll see you here again next month.

(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: In our family, some of us have gained weight in quarantine. I’ve been thinking this might be a good time to try a more plant-based diet. It’s supposed to be better for you physically, and I want to know if that’s true. We are meat-eaters and aren’t interested in going vegan.

Dear Reader: You’re far from alone when it comes to putting on a few pounds during the past year of the pandemic. Often referred to as the “quarantine 15” -- or even the “COVID-19 19” -- weight gain is just one of the side effects a number of us are experiencing as we stay hunkered down close to home, cooking and snacking our way through these strange and challenging days. Not only have shelter-in-place orders closed gyms, pools, ball fields and rec centers, but they have separated millions of people from daily physical activities they didn’t even realize were helping to keep them fit. Those flights of stairs you take at work or school, the walks through corridors or parking lots or out to lunch -- they all add up. And now, idled at home, so have the extra pounds.

There’s a lot of research about the health benefits of a plant-forward diet, which is rich in vitamins, minerals, micronutrients and fiber. Fiber is particularly important, as it helps reduce inflammation, increases the absorption of nutrients and nourishes the billions of microbes in our gut. Fiber also helps reduce cancer risk, particularly colorectal cancers. Plant-based diets have been linked to improved heart health, including a reduced risk of cardiovascular disease. In case that’s not persuasive enough, the results of a new study, published at the start of the year in the journal Nature Medicine, point to a link between the presence of certain bacteria in the gut microbiome and the ability to maintain healthful blood sugar levels after a meal. Other species of bacteria were associated with lower post-meal blood lipid levels and fewer inflammation markers. Each of these species of so-called “good” microbes were found in greater numbers in people with diets high in a wide range of fresh fruit, vegetables and leafy greens.

We think that a more plant-based diet is a great idea for your family’s health. As with all kinds of change, you have the best chance of success if you move incrementally. You don’t have to give up meat, but if you start thinking of it as a condiment, then you’ll automatically cut back on how much you’re eating. Foods like stir fry, kebabs, soups, stews and tacos are as much an opportunity to use a wide variety of greens and vegetables as are salads. It may sound obvious, but find out what your family’s favorite fruits and vegetables are, and start building your plant-based meals around those. Keep a fruit bowl on the counter so it’s easy to grab a healthy snack. If time is an issue, frozen vegetables and bagged salads can be a real life-saver. And, as you make the transition and get adventurous, consider trying one or two meatless days per week.

(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: I heard on the news that if your gut isn’t in good shape, you’ll probably get a worse case of COVID-19. Is that really true?

Dear Reader: A study published earlier this year put forth an intriguing theory about a link between the state of someone’s gut microbiome and the severity of their case of COVID-19.

Research has taught us that the vast colonies of microscopic creatures living in our guts are in constant communication with the brain and have an effect on everything from mood, emotions, sleep and weight to metabolism, blood-sugar control and a range of diseases. Considering this inextricable connection between the human gut microbiome and our health, looking into a potential relationship between the trillions of microbes in our intestinal tracts and COVID-19 seems like a logical step.

The study, published earlier this year in the journal Gut, builds upon previous inquiries into what role the gut may play in patients with COVID-19. Earlier studies have identified a measurable difference between the microbial composition of the guts of those patients and of people who were sick with a cold or the flu.

In this new study, researchers delved into the question in greater detail. They analyzed samples of blood and stool taken from 100 patients with COVID-19 whose disease was severe enough that they were admitted to the hospital and compared the results to samples drawn from 78 healthy control subjects. They discovered that species of certain bacteria that are known to play a role in the immune system were present in much lower numbers in the guts of the patients hospitalized with COVID-19. They also found larger populations of certain bacteria in the patients with COVID-19, including several that are associated with inflammation. The researchers saw this as evidence that an imbalance in certain bacterial colonies within someone’s gut might influence how severe their illness could or would become.

They also found evidence of a potential link between these gut imbalances and the lingering symptoms known as long-haul COVID. For fellow science nerds, the bacterial overgrowth included a species known as Ruminococcus gnavus, which previous studies have shown to produce a simple sugar that causes inflammation. This bacterium has been linked to Crohn’s disease and diverticulitis.

It is important to note that, although results of this study suggest a connection between certain gut microbiome imbalances and a more severe case of COVID-19, they do not offer conclusive proof. There’s no way to know whether the specific array of microbes in these patients’ guts existed before they became infected with the novel coronavirus, or if they arose as a result of the infection and subsequent illness. Still, with the novel coronavirus and COVID-19 so new to the world, every additional bit of data is, at the very least, interesting. With any luck, it may prove important enough to help develop a cure. In that vein, some are holding out hope that this line of research into the gut microbiome of COVID-19 patients may someday lead to microbe-based therapies, each one tailored to a person’s specific gut microbiome.

(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.)