This Danish study in the Journal of the American Heart Association explored the link between vitamin K intake and heart disease risk. Over 53,000 adults with no initial heart disease were followed for two decades. Those consuming the most vitamin K (K1 or K2) had a lower risk of hospitalization for heart disease or stroke compared to those with the least intake This study investigated the potential link between dietary vitamin K intake and the risk of atherosclerotic cardiovascular disease (ASCVD). ASCVD is a major health concern, and understanding ways to prevent it is crucial.

Key Findings

• Researchers looked at data from a large group of Danish adults (over 53,000) who participated in the Danish Diet, Cancer, and Health Study.

• All participants were free of ASCVD at the beginning of the study.

• Researchers collected dietary information through questionnaires, focusing on vitamin K intake (both K1 and K2).

• They then followed the participants for over two decades, monitoring hospital admissions for ASCVD events like heart disease, stroke, and peripheral artery disease.

• the study found an inverse association between vitamin K intake and ASCVD risk. This means people with a higher dietary intake of vitamin K (either K1 or K2) had a lower risk of being hospitalized for ASCVD events.

• Compared to those with the lowest intake, participants with the highest vitamin K1 intake had a 21% lower risk of ASCVD hospitalization.

• Similarly, those with the highest vitamin K2 intake had a 14% lower risk compared to the lowest intake group.

The importance of the findings:

• This study adds to the growing body of evidence suggesting vitamin K may play a role in preventing ASCVD.

• Interestingly, the protective effect was seen for both vitamin K1 (mainly found in leafy green vegetables) and K2 (found in fermented foods and some animal products). This suggests that consuming a variety of vitamin K sources might be beneficial.

• The findings warrant further investigation to confirm the cause-and-effect relationship and explore the underlying mechanisms by which vitamin K might influence ASCVD risk.

Cardiovascular diseases (CVDs) continue to be a significant global health concern, contributing to a substantial number of deaths annually. Among the various factors influencing CVD risk, dietary habits play a crucial role. In recent years, research has shed light on the potential impact of vitamin K intake on cardiovascular health, particularly in relation to atherosclerotic cardiovascular disease (ASCVD) events. This article aims to explore the relationship between dietary vitamin K1 and vitamin K2 intake and the risk of ASCVD, including ischemic heart disease (IHD), ischemic stroke, and peripheral artery disease (PAD), based on recent findings and clinical implications.

The Role of Vitamin K in Cardiovascular Health

Vitamin K is a fat-soluble vitamin known for its role in blood clotting and bone metabolism. However, emerging evidence suggests that vitamin K may also play a significant role in cardiovascular health. There are two primary forms of vitamin K: vitamin K1 (phylloquinone) and vitamin K2 (menaquinones K4-K10). Vitamin K1 is abundant in green leafy vegetables, while vitamin K2 is primarily found in fermented foods such as cheese.

Observational Studies and Clinical Evidence

Observational studies have provided valuable insights into the relationship between dietary vitamin K intake and ASCVD risk. Multiple studies have demonstrated an inverse association between biomarkers of dietary vitamin K intake and the incidence of ASCVD events. Moreover, supplementing with vitamin K has been shown to increase circulating concentrations of these biomarkers in a dose-dependent manner.

Population Characteristics and Follow-up

This study followed over 53,000 Danish adults for an average of 21 years.

• Participants were middle-aged (median age 56) with a long follow-up period, allowing researchers to track who developed heart disease.

• Over 8,700 people were hospitalized for heart disease during the study.

• Nearly 9,500 participants died from other causes before a heart disease hospitalization.

Baseline characteristics showed interesting patterns:

• People who ate more vitamin K1 tended to have healthier lifestyles - they were more active, didn't smoke, were well-educated, and ate a balanced diet rich in fruits, vegetables, and fish.

• In contrast, those with higher vitamin K2 intake were more likely to be men, and active, but also smoked more and consumed an unhealthier diet higher in red meat and saturated fat.

• Interestingly, the two forms of vitamin K (K1 and K2) weren't closely linked in people's diets.

Association between Vitamin K Intake and ASCVD Risk

This study found a complex relationship between vitamin K1 intake and heart disease risk. While higher intake generally lowered the risk, the benefit seemed to level off after a certain point (around 100 micrograms per day). People with the highest K1 intake had a 21% lower risk of heart-related hospitalization compared to those with the lowest intake. This pattern held true for different types of heart disease as well. Importantly, the positive effect of K1 seemed independent of other dietary factors and vitamin K2 intake.

Implications for Clinical Practice

The findings from observational studies underscore the potential clinical implications of adequate vitamin K intake in reducing the risk of ASCVD events. Incorporating sufficient vitamin K into one's diet may be considered part of a comprehensive approach to evaluating and managing cardiovascular risk. However, further research is needed to identify specific at-risk populations who may benefit from increased dietary vitamin K intake or supplementation.

Insights into ASCVD Subtypes

Beyond the overarching ASCVD risk, the study delves deeper into the impact of vitamin K intake on specific ASCVD subtypes, including ischemic heart disease, stroke, and peripheral artery disease. The intricate analysis unveils significant reductions in the risk of subtype-specific hospitalizations among individuals with higher vitamin K1 and vitamin K2 intake, further underscoring the multifaceted protective role of vitamin K in cardiovascular health.

Mechanisms Underlying the Protective Effects

The study elucidates potential mechanisms underlying the protective effects of vitamin K against ASCVD events. From modulating systemic inflammation to regulating insulin resistance and hemostasis, vitamin K emerges as a multifunctional nutrient with far-reaching implications for cardiovascular health. Moreover, the inhibition of pathological arterial calcification emerges as a critical mechanism through which vitamin K exerts its cardioprotective effects.

Conclusion

In conclusion, our study offers compelling evidence of the inverse association between dietary vitamin K intake and ASCVD hospitalizations. By unraveling the intricate relationship between vitamin K1 and vitamin K2 intake and ASCVD risk, we pave the way for future research endeavors aimed at optimizing cardiovascular health strategies.

Journal Reference

Bellinge, J. W., Dalgaard, F., Bondonno, N. P., Torp-Pedersen, K., Overvad, K., Murray, H., ... & Gislason, G. H. (2021). Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study. Journal of the American Heart Association, 10(16), e020551. https://doi.org/10.1161/JAHA.120.020551

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