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Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study

Mito

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Dec 10, 2016
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Background​

Dietary vitamin K (K1 and K2) may reduce atherosclerotic cardiovascular disease (ASCVD) risk via several mechanisms. However, studies linking vitamin K intake with incident ASCVD are limited. We aimed to determine the relationship between dietary vitamin K intake and ASCVD hospitalizations.

Methods and Results​

In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study, with no prior ASCVD, completed a food‐frequency questionnaire at baseline and were followed up for hospital admissions of ASCVD; ischemic heart disease, ischemic stroke, or peripheral artery disease. Intakes of vitamin K1 and vitamin K2 were estimated from the food‐frequency questionnaire, and their relationship with ASCVD hospitalizations was determined using Cox proportional hazards models. Among 53 372 Danish citizens with a median (interquartile range) age of 56 (52–60) years, 8726 individuals were hospitalized for any ASCVD during 21 (17–22) years of follow‐up. Compared with participants with the lowest vitamin K1 intakes, participants with the highest intakes had a 21% lower risk of an ASCVD‐related hospitalization (hazard ratio, 0.79; 95% CI: 0.74–0.84), after multivariable adjustments for relevant demographic covariates. Likewise for vitamin K2, the risk of an ASCVD‐related hospitalization for participants with the highest intakes was 14% lower than participants with the lowest vitamin K2 intake (hazard ratio, 0.86; 95% CI, 0.81–0.91).

Conclusions​

Risk of ASCVD was inversely associated with diets high in vitamin K1 or K2. The similar inverse associations with both vitamin K1 and K2, despite very different dietary sources, highlight the potential importance of vitamin K for ASCVD prevention.

 

Soren

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Thanks for sharing. Any conclusions in the study as to why vitamin K causes lower cardiovascular issues?
 

Aladdin

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Feb 8, 2018
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Background​

Dietary vitamin K (K1 and K2) may reduce atherosclerotic cardiovascular disease (ASCVD) risk via several mechanisms. However, studies linking vitamin K intake with incident ASCVD are limited. We aimed to determine the relationship between dietary vitamin K intake and ASCVD hospitalizations.

Methods and Results​

In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study, with no prior ASCVD, completed a food‐frequency questionnaire at baseline and were followed up for hospital admissions of ASCVD; ischemic heart disease, ischemic stroke, or peripheral artery disease. Intakes of vitamin K1 and vitamin K2 were estimated from the food‐frequency questionnaire, and their relationship with ASCVD hospitalizations was determined using Cox proportional hazards models. Among 53 372 Danish citizens with a median (interquartile range) age of 56 (52–60) years, 8726 individuals were hospitalized for any ASCVD during 21 (17–22) years of follow‐up. Compared with participants with the lowest vitamin K1 intakes, participants with the highest intakes had a 21% lower risk of an ASCVD‐related hospitalization (hazard ratio, 0.79; 95% CI: 0.74–0.84), after multivariable adjustments for relevant demographic covariates. Likewise for vitamin K2, the risk of an ASCVD‐related hospitalization for participants with the highest intakes was 14% lower than participants with the lowest vitamin K2 intake (hazard ratio, 0.86; 95% CI, 0.81–0.91).

Conclusions​

Risk of ASCVD was inversely associated with diets high in vitamin K1 or K2. The similar inverse associations with both vitamin K1 and K2, despite very different dietary sources, highlight the potential importance of vitamin K for ASCVD prevention.

If you look at the figures though, there is a U shaped curve for Vitamin K2, with 60-75uG being the optimum for atherosclerosis and Ischemic heart disease, which seems to worsen with rising intake beyond this dosage (see two graphics on left below). Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study. This would imply that most people who take K2 could be overdosing since most supplements provide much higher dosages than this.

1634181193024.png
 

Soren

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If you look at the figures though, there is a U shaped curve for Vitamin K2, with 60-75uG being the optimum for atherosclerosis and Ischemic heart disease, which seems to worsen with rising intake beyond this dosage (see two graphics on left below). Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study. This would imply that most people who take K2 could be overdosing since most supplements provide much higher dosages than this.

View attachment 28932

I highly doubt that the increase in Vitamin K is what resulted in the increase of heart disease. Given that the study was looking into vitamin K intake based on dairy consumption rather than supplementation it could be the case that the reason that the risk increases is because of a large amount of excess calories being consumed in order to get that level of vitamin K. If you are not supplementing it you have to eat/drink a large amount of dairy. That's a lot of calories and fat.

"Intakes of vitamin K1 and vitamin K2 were estimated from the food‐frequency questionnaire, and their relationship with ASCVD hospitalizations was determined using Cox proportional hazards models."
 

Aladdin

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I highly doubt that the increase in Vitamin K is what resulted in the increase of heart disease. Given that the study was looking into vitamin K intake based on dairy consumption rather than supplementation it could be the case that the reason that the risk increases is because of a large amount of excess calories being consumed in order to get that level of vitamin K. If you are not supplementing it you have to eat/drink a large amount of dairy. That's a lot of calories and fat.

"Intakes of vitamin K1 and vitamin K2 were estimated from the food‐frequency questionnaire, and their relationship with ASCVD hospitalizations was determined using Cox proportional hazards models."
Soren you could be right as they do state this as a confounder: "However, the relatively higher vitamin K2 intake in our cohort permitted the discovery of a nonlinear, and in fact more “U‐shaped” association between vitamin K2 intake and ASCVD risk, which, to the best of our knowledge, has not previously been described. This may reflect a competing increase in ASCVD risk associated with overconsumption of vitamin K2‐rich foods (ie, cheese, eggs, butter)."
 
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Does anyone know how long did the Japanese study [of 45mg K2-mk4] lasted before it showed good results?
 
Last edited:

David PS

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In the most recent KMUD interview, Ray talks about vitamin K and aspirin for about 5 minutes beginning around 41 minute. He does not talk about ASCVD. However, his recommendations are on the low side of the graphs above.

 

Jam

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In the most recent KMUD interview, Ray talks about vitamin K and aspirin for about 5 minutes beginning around 41 minute. He does not talk about ASCVD. However, his recommendations are on the low side of the graphs above.

Around the 45 minute mark he says a good dose is 1mg per week but up to 20-30mg is fine as the only "bad" side effects are decalcification and lowering blood pressure.
 

Jam

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