Why Is Table Salt Iodized?

 Why was iodine added to salt?

Iodine is a trace mineral that the body needs to make thyroid hormones:

T3 (triiodothyronine)

T4 (thyroxine)

These hormones regulate:

Metabolism

Body temperature

Heart rate

Brain development

Growth

The thyroid gland cannot make these hormones without enough iodine.

What happened before iodized salt?

In many inland areas, especially places with iodine-poor soil, people did not get enough iodine from food.

The result was iodine deficiency disorders, including:

1. Goiter

The thyroid gland enlarges because it is trying harder to capture iodine.

Signs:

Enlarged neck

Difficulty swallowing (in severe cases)

Thyroid dysfunction

2. Brain and developmental problems

Severe iodine deficiency during pregnancy and childhood can cause:

Impaired brain development

Learning difficulties

Growth problems

Why use salt as the delivery method?

Scientists chose salt because:

✅ Almost everyone consumes it

✅ People use a fairly predictable amount

✅ Iodine can be added in very small, safe quantities

✅ It is inexpensive and stable

In the 1920s, countries including the United States began large-scale iodization programs.

The result:

Goiter rates dropped dramatically

Childhood development improved

Iodine deficiency became much less common

How much iodine do adults need?

The recommended intake for most adults is about:

150 micrograms (mcg) of iodine per day

Pregnancy:

220 mcg/day

Breastfeeding:

290 mcg/day

(Needs can vary depending on individual health.)

Sources of iodine:

🧂 Iodized salt

🐟 Seafood

🥛 Milk and dairy products

🥚 Eggs

Seaweed (very high, sometimes excessively high)

Important modern point:

Iodine is essential, but more is not always better.

Too much iodine can also affect the thyroid in some people, especially those with thyroid disorders.

Also, many people today consume less iodized salt because they eat more:

Restaurant food

Processed foods made with non-iodized salt

So a person may eat a lot of salt but still not get much iodine.

Simple takeaway:

Iodized salt is a small nutritional change that prevented millions of cases of goiter and protected brain development worldwide. It is an example of how understanding a tiny nutrient deficiency can create a huge public health impact.

7 warning signs of vitamin deficiency

 7 warning signs of vitamin deficiency

There are many cases of vitamin deficiency that start off as asymptomatic, making it particularly difficult for some to become immediately aware of the fact that they've got a nutrition problem; however, there are plenty of case in which the vitamin deficiency is marked by a number of key symptoms.

Because many of the symptoms of vitamin deficiency are shared by several slightly related conditions, it's easy for many people to get their wires crossed about determining exactly when vitamin deficiency is the key culprit.

While it's always advisable to consult your primary care provider to get any potential case of vitamin deficiency figured out with 100 percent certainty, the following are some of the most common recurrent symptoms to keep an eye out for.

Cavities

Vitamin A & D are essential for strengthening tooth enamel, and when they're not being taken in enough, the constitution and durability of the teeth will naturally start to decline.

Mental fog

Vitamin B-12 is one of the most important things that a person should be taking in on a regular basis to ensure that their nervous system is properly regulated. Without enough Vitamin B-12, subtle symptoms of mild confusion and slowed cognitive function can occur.

Skin rashes

Vitamin B-6 is highly helpful for the body's ability to keep the epidermis healthy, but without it, the skin's resilience can suffer by a fair degree. Less defensive capability in the skin cells can quickly lead to a greater susceptibility to rash outbreaks.

Fatigue

It's important to have a sufficient vitamin D intake level to keep the bones tough and capable of bearing the pressure of everyday activities for years on end. Not only does vitamin D deficiency open up the bones to much more damage susceptibility, but it's also oftentimes coupled by a persistent feeling of diminished energy.

Paleness and thinning hair

One of the most vital jobs that iron is responsible for in the body is to properly regulate oxygen transmission. Proper oxygen transmission is necessary for red blood cell synthesis, but without that, the body's skin and hair quality goes down by a huge degree. Thinning hair and paler-than-usual skin can be a subtle but sure sign of inefficient iron levels.

Inexplicable appetite reduction and weight loss

The body's proper weight regulation depends strongly on proper vitamin intake, with potassium and magnesium being two of the most essential for this job of all. Potassium is essential for correcting your metabolic regularity and magnesium plays a big role in creating a healthy appetite; when these two vitamins fall to inefficient levels, weight maintenance can spiral out of balance.

Nausea

Vitamins like niacin are vital for ensuring that the body's gastrointestinal functionality is kept in check. When vitamin deficient, it's common for a creeping sensation of stomach sickness to rise up over time and possibly continue unmitigated if the deficiency isn't corrected.

Summary

The challenge of keeping your body properly nourished today is easier to do than at any point in history, but at the same time, it can be very easy to fall off the wagon if you've got a busy schedule and are oftentimes under pressure to settle for convenience instead of eating full-course meals.

By staying on top of your awareness of the most likely symptoms above, you can at least take the first step towards becoming better: recognition of the issue. Once you've gotten ahold of the earliest signs of the symptoms, you'll be that much better at preventing them from getting much worse.

6 common warning signs of colon cancer that doctors pay attention to:

 1. Iron-deficiency anemia (low iron)

A tumor in the colon can bleed slowly over time. The blood loss may be too small to see, but it can cause:

Low hemoglobin-A blood test (CBC and iron studies) can detect this.

Important: Iron-deficiency anemia does not always mean cancer. It can also come from:

Fatigue

Weakness

Shortness of breath with activity

Pale skin

Menstrual blood loss

Low iron intake

Stomach ulcers

Other bleeding problems

2. Abdominal pain or discomfort

Colon cancer may cause:Cramping

Persistent abdominal discomfort

Bloating

A feeling that something is “not right”

Pain alone is usually not enough to diagnose colon cancer because many common conditions can cause similar symptoms:

Irritable bowel syndrome (IBS)

Gas

Constipation

Infections

3. Change in bowel habits

A new, persistent change such as:

Constipation

Diarrhea

Narrower stools

Feeling that you cannot completely empty your bowel

that lasts more than a few weeks should be evaluated.

4. Blood in stool

Possible signs:

Bright red blood

Dark or black stools

Hidden blood detected by stool tests

Not all colon cancers cause visible bleeding.

5. Unexplained weight loss

Losing weight without trying can happen because cancer may:

Increase the body's energy demands

Affect appetite

Change metabolism

6. Fatigue or weakness

This can result from:

Anemia

Inflammation caused by cancer

Poor nutrition

Sleep disruption

Who should be more alert?

Risk factors include:

Increasing age

Family history of colorectal cancer or polyps

Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

Obesity

Smoking

Heavy alcohol use

Low physical activity

Diet high in processed meats

Screening saves lives

For average-risk adults in the U.S., colorectal cancer screening generally begins at age 45.

Common screening options:

Colonoscopy (detects and can remove polyps)

Stool-based tests (such as FIT)

Screening can prevent cancer by finding and removing precancerous polyps.

Seek medical evaluation if you have:

✅ Blood in stool

✅ Unexplained iron-deficiency anemia

✅ Persistent bowel changes

✅ Unexplained weight loss

✅ Symptoms lasting several weeks

Early colon cancer often has better treatment outcomes, which is why recognizing symptoms and getting appropriate screening are important.

If cancer needs carbs (glucose) to grow, why don't doctors change people’s diets when the cancer is first diagnosed?

 Cancer cells do use glucose — but so do normal cells

Many cancer cells rely heavily on glucose for energy through a process called the Warburg effect.

 They consume glucose at high rates even when oxygen is available.

However, glucose is also essential for:

Brain cells

Red blood cells

Immune cells

Muscles during activity

Healing and recovery

The body tightly regulates blood glucose.

 Even if someone eats almost no carbohydrates, the liver can make glucose from:

Protein (amino acids)

Glycerol from fat

Other metabolic pathways

So a low-carb diet does not mean cancer cells receive zero glucose.

2. Why don’t doctors prescribe a ketogenic diet for everyone with cancer?

A ketogenic diet (very low carbohydrate, high fat) is being researched, but it is not proven to replace standard cancer treatments.

Possible problems during cancer treatment:

Weight loss and muscle loss can worsen outcomes, especially in advanced cancers.

Chemotherapy and radiation require the body to have enough energy and protein to repair tissues.

Some patients develop cachexia (cancer-related muscle wasting), where maintaining weight is a major goal.

For many cancer patients, the priority is:

✅ maintain strength

✅ preserve muscle

✅ tolerate treatment

✅ recover after surgery/chemotherapy

3. Could diet influence cancer risk or outcomes?

Yes, nutrition matters — but in a different way.

Evidence supports:

Maintaining a healthy body weight

Eating plenty of vegetables, fruits, legumes, and whole grains

Getting adequate protein

Limiting processed meats

Limiting excessive alcohol

Regular physical activity

These can reduce cancer risk and improve general health.

But there is currently no strong evidence that eliminating carbohydrates can cure cancer.

4. Are there situations where a ketogenic diet is studied?

Yes. Researchers are studying ketogenic diets in some cancers because lowering insulin and glucose availability may affect certain tumor pathways.

Early research has explored this in cancers such as:

Brain tumors (including glioblastoma)

Some breast cancers

Some metabolic-sensitive tumors

But results are mixed, and it remains an adjunct research approach, not a replacement for chemotherapy, immunotherapy, surgery, radiation, or targeted treatments.

5. Why did the doctors in the story advise against extreme dieting?

Because a newly diagnosed cancer patient often needs more nutritional support, not restriction.

For example:

A patient undergoing chemotherapy may need extra protein to maintain muscle.

A surgical patient needs calories for wound healing.

A person losing weight unintentionally may have a worse prognosis.

A balanced diet designed around the person's cancer type, treatment, symptoms, and nutritional status is usually recommended.

Cancer cells do use glucose, but “starving cancer by removing sugar” is not realistic because the body will still make glucose and cancer cells can adapt. 

The strongest evidence still supports medical cancer treatments plus good nutrition to keep the body strong enough to fight and recover.

For someone with cancer, a good question for the oncology team is not “How do I remove all sugar?” but rather:

“What eating pattern will help me maintain muscle, energy, and tolerate my treatment best?”

Orthopedic and spine patients

 

Congratulations, you passed this test!

Question 1 of 16Correct

Orthopedic and spine patients should receive discharge instructions related to: select all that apply

Your Answer

Diagnosis and we

You did not pass this test.

You scored 12 out of 16, or 75%. To pass, you needed to correctly answer 13 questions, or 80%.

Question 1 of 16Correct

The Orthopedic service line at El Camino Health has programs certified for care of Total Hip, Total Knee, and Total Shoulder Arthroplasty at both campuses, Hip Fracture care at Mountain View campus, and Spine Fusion care at the Los Gatos campus.  

Your Answer

True

Question 2 of 16Correct

Patients and caregivers are encouraged to attend a pre-operative class to learn about:

Your Answer

All of the above

Question 3 of 16Incorrect

Certified programs, including the Orthopedic and Spine Care Programs, must meet core requirements including standards, clinical practice guidelines, and performance measurements every: 

Your Answer

3 years

Correct Answer

2 years

Question 4 of 16Correct

Orthopedic and spine patients should receive discharge instructions related to: select all that apply

Your Answer

Diagnosis and weight bearing status and precautions

Your Answer

Discharge diet, activity, bathing and incision care

Your Answer

Home medications (including “next dose due info”)

Your Answer

Signs and symptoms of possible complications and what to report to your doctor

Your Answer

Discharge therapy plan (home exercises vs. home health PT vs. outpatient PT)

Your Answer

Follow-up appointments

Question 5 of 16Incorrect

Knee precautions after surgery include avoiding: select all that apply

Your Answer

Pillows under the knee

Your Answer

Kneeling on the surgical leg

Your Answer

Exercises with high impact

Your Answer

Prolonged sitting without elevation

You Missed

Ambulation without an assistive device

Question 6 of 16Correct

Performance Measures for Total Hip and Total Knee Arthroplasty include:

Your Answer

All of the above

Question 7 of 16Correct

Post-operative treatment goals for total joint arthroplasty include: select all that apply

Your Answer

Reducing postoperative pain and discomfort

Your Answer

Reducing the risk of venous thromboembolism and infection

Your Answer

Preventing constipation

Your Answer

Promoting return to patient’s functional goal

Your Answer

Providing appropriate nutrition and emotional support

Question 8 of 16Correct

Neutral spine principles following lumbar spine fusion include all of the following except:

Your Answer

No log rolling (rolling in bed side-to-side with your shoulders, hips, and knees together as one unit)

Question 9 of 16Incorrect

Delirium is a common complication in hospitalized older adults, occurring in as much as 61% of patients with hip fracture. Nursing interventions to reduce delirium risk include the following: select all that apply

Your Answer

Using restraints to manage behaviors

Your Answer

Providing additional auditory stimulation in a darkened environment

You Missed

Considering opioid alternatives, such as, acetaminophen, anti-inflammatories and ice

You Missed

Having patient wear glasses or hearing aids

You Missed

Ensuring adequate rest

Question 10 of 16Incorrect

Performance Measures for Hip Fracture include: select all that apply

Your Answer

Early mobilization by POD 1

Your Answer

Early mobilization within 4 hours after surgery 

You Missed

Avoiding Readmissions

You Missed

Scheduled multimodal analgesic

You Missed

Nutrition Education

Question 11 of 16Correct

Performance Measures for Spine Fusion include all except:

Your Answer

Eat a Regular diet

Question 12 of 16Correct

12. A good ____________________________ assessment can alert caregivers to the development of potential complications and prevent permanent damage to the function of the limb. Assessments include pulse strength, motor strength, color, temperature, and capillary refill.

Your Answer

Neurovascular

Question 13 of 16Correct

Post surgical Total Shoulder Precautions include all except:

Your Answer

Active Range of Motion (AROM)

Question 14 of 16Correct

A potential complication after lumbar fusion is ___________________. If this complication occurs, your patient will “look sick” and have feelings of impending doom, as well as, be diaphoretic and tachycardic with decreased oxygen saturations.

Your Answer

Pulmonary embolus

Question 15 of 16Correct

An early postoperative complication of total knee arthroplasty is arthrofibrosis, which: select all that apply

Your Answer

Is the formation of excessive scar tissue after surgery or injury

Your Answer

Limits range of motion

Question 16 of 16Correct

Hip precautions after posterolateral approach surgery include avoiding:  select all that apply 

Your Answer

Hip flexion greater than 90 degrees

Your Answer

Adduction/internal rotation

Your Answer

Crossing legs

Your Answer

Pivoting or turning toes inwards on the operative leg

Your Answer

Low, soft chairs

 

Question 3 of 16Correct

Neutral spine principles following lumbar spine fusion include all of the following except:

Your Answer

No log rolling (rolling in bed side-to-side with your shoulders, hips

Burkholderia gladioli

Burkholderia gladioli is a type of bacterium found naturally in soil, water, and on plants. It is best known for causing disease in certain plants, but it can occasionally infect humans.

In humans

I

vitamin daily requirement

 

Vitamin	Daily Requirement
Vitamin A	700 mcg RAE
Vitamin C	75 mg
Vitamin D	600 IU (15 mcg) (800 IU after age 70)
Vitamin E	15 mg
Vitamin K	90 mcg
Thiamin (B1)	1.1 mg
Riboflavin (B2)	1.1 mg
Niacin (B3)	14 mg
Vitamin B6	1.3 mg
Folate (B9)	400 mcg DFE
Vitamin B12	2.4 mcg
Pantothenic Acid (B5)	5 mg
Biotin (B7)	30 mcg
Choline	425 mg

Important minerals

Mineral	Daily Requirement
Calcium	1,000 mg (1,200 mg after age 50)
Iron	18 mg (before menopause)
Magnesium	320 mg
Potassium	2,600 mg
Zinc	8 mg

Based on the foods you mentioned

• 500 mL milk: good source of calcium, vitamin D (if fortified), B12, riboflavin, and protein.
• 2 eggs: provide vitamins A, D, B12, choline, and protein.
• 2 apples: provide vitamin C and fiber.
• 2 potatoes: provide vitamin C, potassium, and B6.
• 2 servings of nuts: provide vitamin E, magnesium, and healthy fats.

This diet gives many nutrients, but it may still be low in:

• Vitamin D
• Vitamin K
• Folate
• Iron
• Some vitamin C (depending on apple size)
• Omega-3 fats

Adding 1–2 cups of vegetables daily (especially spinach, broccoli, kale, carrots, bell peppers, or mixed salad) and a source of lean protein or fish would help cover most vitamin and mineral needs naturally.

Breakfast (350 calories)

• 2 large eggs
• 1 cup (240 mL) whole milk
• 1 medium apple
• 1 slice whole-grain toast

Provides:

• Protein: ~20 g
• Vitamin A, D, B12, choline
• Calcium ~400 mg
• Fiber and vitamin C

---

Morning Snack (170 calories)

• Plain Greek yogurt (170 g)
• ½ cup blueberries

Provides:

• Protein: ~17 g
• Calcium ~200 mg
• Vitamin C and antioxidants

---

Lunch (400 calories)

• 4 oz grilled chicken breast
• Large spinach salad (2 cups spinach)
• ½ cup chickpeas
• Tomatoes, cucumber, bell peppers
• 1 teaspoon olive oil

Provides:

• Protein: ~40 g
• Folate
• Vitamin K
• Iron
• Vitamin A
• Vitamin C
• Magnesium

---

Afternoon Snack (180 calories)

• 1 oz mixed nuts (almonds and walnuts)

Provides:

• Protein: ~6 g
• Vitamin E
• Magnesium
• Healthy fats
• Zinc

---

Dinner (300 calories)

• 1 baked golden potato
• 4 oz salmon
• 1 cup steamed broccoli

Provides:

• Protein: ~28 g
• Vitamin D
• Vitamin B6
• Potassium
• Vitamin C
• Omega-3 fats

---

Daily Total (Approximate)

Nutrient	Amount
Calories	~1,400 kcal
Protein	~95–100 g
Calcium	~1,100 mg
Iron	~15–18 mg
Magnesium	~330 mg
Potassium	~3,000 mg
Zinc	~8–10 mg
Vitamin A	Above 700 mcg
Vitamin C	Above 100 mg
Vitamin D	About 600–800 IU
Vitamin E	About 15 mg
Vitamin K	Above 90 mcg
Thiamin (B1)	Meets goal
Riboflavin (B2)	Meets goal
Niacin (B3)	Meets goal
Vitamin B6	Meets goal
Folate	Meets goal
Vitamin B12	Meets goal
Pantothenic Acid	Meets goal
Biotin	Meets goal
Choline	Above 425 mg

Simple Grocery List

Protein

• Eggs
• Chicken breast
• Salmon
• Greek yogurt

Fruits

• Apples
• Blueberries

Vegetables

• Spinach
• Broccoli
• Bell peppers
• Tomatoes
• Cucumbers

Healthy Carbs

• Whole-grain bread
• Potatoes
• Chickpeas

Healthy Fats

• Almonds
• Walnuts
• Olive oil