Nutritional management of hypercalcemia

Question 1

What are the three most commonly identified causes of hypercalcemia

Answer 1

Hypercalcemia of malignancy

Kidney disease

Idiopathic hypercalcemia

Question 2

Which dietary factors exert a beneficial effect in lowering circulating calcium

Answer 2

Increased concentration of fiber, sodium and water

Decreased concentration of calcium, vitamin D, and vitamin A

Question 3

What is the current approach to manage hypercalcemia

Answer 3

The current approach combines 2 nutritional goals:
- feeding a diet with both < 200 mg calcium/100 kcal
- and a Ca:P ratio < 1.4:1

Question 4

Explain how fiber can lower circulating total calcium

Answer 4

Supplemental fiber may lead to increased binding of intestinal calcium, preventing its absorption, and also decreased intestinal transit time through the small intestine, decreasing calcium absorption

Question 5

Why Chia seeds can be used to manage hypercalcemia

Answer 5

Addition of 2 grams of chia seeds per day could normalise ionised hypercalcemia because:
- they are low in calcium
- moderate in phophorus (thus low Ca:P ratio)
- high in fibre