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Vitamin K and Heart Disease

February 12, 2009 Written by JP    [Font too small?]

Did you know that cardiovascular disease is the #1 cause of death in women 25 and up? There’s not even a close second in the mortality race. You’d have to add up all the deaths from every form of cancer and multiply that number by almost two in order to equal the number of heart related deaths. Pretty shocking, isn’t it?

In today’s blog, I’d like to share some information about a little known but very valuable nutrient that may help tip the odds in your favor with regard to heart disease.

Stay Okay with Vitamin K

Natto - A Good Source of K2The new issue of the journal Nutrition, Metabolism and Cardiovascular Diseases focuses on the role of vitamin K in the development of Coronary Heart Disease (CHD). Before I describe this exciting new research, I’d like to briefly discuss the different forms of vitamin K that are found in nature.

  • Vitamin K1 (phylloquinone) This form of K is abundant in green vegetables such as kale, spinach, broccoli and Brussels sprouts. A healthy diet is the leading source for this type of vitamin K, though supplements do exist.
  • Vitamin K2 (menaquinones) Vitamin K2 actually has several family members. The members that are most often studied are MK-4, MK-7, MK-8 and MK-9. These forms of K are usually found in cultured or fermented foods such as natto (fermented soy) and a variety of cheeses. The MK-4 and MK-7 varieties can also be found in certain nutritional supplements.

One of the key differences between MK-4 and MK-7 is that MK-7 is retained in the body for a much longer period of time. It is estimated that MK-7 is active for up to 3 days. MK-4 only remains in the blood stream for approximately one hour. Perhaps because of this difference, much lower dosages of MK-7 are required to produce a positive effect.

Vitamin K Retention

Studying the Studies

Researchers based in the Netherlands poured through previous heart disease research conducted on over 16,000 women. Their analysis focused on women who were free of heart disease ranging in age from 49-70. Over the course of about 8 years, these healthy women were asked to complete food frequency questionnaires which were used to determine their approximate intake of various nutrients.

During the 8 year trial, 480 women were diagnosed with Coronary Heart Disease (CHD). When the researchers carefully assessed a variety of dietary and lifestyle risk factors, they found a strong inverse connection between vitamin K2 and the risk of CHD. A 9% reduction in risk was found for every 10mcg dosage of vitamin K2 obtained through diet. The higher the consumption of vitamin K2, the lower the risk of a CHD diagnosis.  It’s also interesting to note that certain types of K2 were found to be most effective (the MK-7, MK-8 and MK-9 forms). In addition, they did not find any evidence that vitamin K1 provided a protective effect.

According to one of the study’s authors, “This study confirms our findings in the Rotterdam study, showing that increased vitamin K2 intake strongly reduces the risk of coronary heart disease. Also this study showed that the reduction in CHD was tied to the longer chain menaquinones 7, 8, and 9 – the menaquinones found most abundantly in fermented cheese.  As the Western diet is likely deficient in K, supplementation or enrichment of long chain menaquinones is an obvious choice.”

Since the Rotterdam study was mentioned, I want to briefly summarize the results of that research. In the Rotterdam study, nearly 5,000 men and women were analyzed. Analysis of 10 years of data found that those who consumed the highest quantity of vitamin K2 had approximately half the amount of calcium in their arteries and were also about 50% less likely to die from CHD. These results were based on those who consumed the greatest amount of vitamin K2 (about 45 mcg per day) compared to those whose intake was the lowest (roughly 12 mcg per day). Another similar finding in this study was that vitamin K1 did not appear to impart any significant heart protection.

So how is it that a relatively obscure vitamin does so much good for our cardiovascular system? The answer may be found in a vitamin K-dependent protein called “matrix Gla-protein (MGP)”. MGP is known to prevent the build up on calcium in arteries. But as my description implies, it doesn’t work without the presence of adequate vitamin K.

An important factor to remember about the Rotterdam study is that it involved both men and women. We cannot simply assume that what works for women will work equally well for men. There are too many examples that exhibit the folly in that kind of generalization.

Caution: People taking certain “blood thinning” medications should consult with their doctors prior to increasing vitamin K consumption through diet or supplementation.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Heart Health, Nutrition, Nutritional Supplements

11 Comments & Updates to “Vitamin K and Heart Disease”

  1. Iggy Dalrymple Says:

    Because of all the literature on K2 as MK7, I now take it, but other than the Japanese, what did the rest of the world do for MK7, all these 1,000s of years? The Japs are long livers but they don’t have a monopoly on longevity, yet they are practically the only large consumers of natto. I think the importance of MK7 may be exaggerated. For that reason, I take LEF Super K, which includes K1, MK4, and MK7.

  2. JP Says:

    I do agree that other forms of vitamin K, besides the MK7 form, are important.

    Be well!


  3. AB Says:

    In the Rotterdam study above MK-7 is from cheese.

    Something to consider. Perhaps co-factors along with the MK-7 in the cheese make it more effective than MK-7 from Natto.

    Vitamin MK-4 is present in cheese, but not in Natto. Also other vitamins like A, D, etc.

    Would be interesting to see cardio results of MK-7 from Natto, not from cheese.

    To say the people that ate the most cheese in Rotterdam had the least cardiovascular disease. And therefore it must be vitamin K-7 —> that is a big leap.

  4. carolyn bowen Says:

    i have a history of blood clots since 1995.all together i have had 26 blood clots since 199do you have menu to go by.i need to get my weigh off. i also have disks 4-10 has spurs. i have alot of health problem.i keep on trusting GOD. i would appreciated it alot. thank you

  5. carolyn bowen Says:

    do you have something about lupus. i was diagnosed in 2003,i have lupus.

  6. JP Says:

    Hi Carolyn,

    I can’t provide a proper consultation here. But, I’d be happy to share a few ideas that you can discuss with your health care team:

    For starters, I would look into the utility of:

    Fish Oil




    Vitamin D


    Be well!


  7. betty s Says:

    Just wanted to say that people in Canada and USA not that long ago would have eaten a lot of fermented foods. I am 73 and I remember my mother making cottage cheese. We had no elecricity. The cheese was delicious, but a completely different taste than the quickly made and refrigerated cottage cheese we buy in the stores now. She also made fermented dill pickles and sauerkraut that also tasted much better and different to our store products now. The store products now have a sharp acidy taste.I think we must have been getting some K2 from those.

  8. JP Says:

    No doubt about it, Betty! Thank you for sharing your experience with us!

    Be well!


  9. JP Says:

    Update: Vitamin K2 (MK-7) improves arterial stiffness in older women …


    Thromb Haemost. 2015 Feb 19;113(5).

    Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women: double-blind randomised clinical trial.

    Observational data suggest a link between menaquinone (MK, vitamin K2) intake and cardiovascular (CV) health. However, MK intervention trials with vascular endpoints are lacking. We investigated long-term effects of MK-7 (180 µg MenaQ7/day) supplementation on arterial stiffness in a double-blind, placebo-controlled trial. Healthy postmenopausal women (n=244) received either placebo (n=124) or MK-7 (n=120) for three years. Indices of local carotid stiffness (intima-media thickness IMT, Diameter end-diastole and Distension) were measured by echotracking. Regional aortic stiffness (carotid-femoral and carotid-radial Pulse Wave Velocity, cfPWV and crPWV, respectively) was measured using mechanotransducers. Circulating desphospho-uncarboxylated matrix Gla-protein (dp-ucMGP) as well as acute phase markers Interleukin-6 (IL-6), high-sensitive C-reactive protein (hsCRP), tumour necrosis factor-α (TNF-α) and markers for endothelial dysfunction Vascular Cell Adhesion Molecule (VCAM), E-selectin, and Advanced Glycation Endproducts (AGEs) were measured. At baseline dp-ucMGP was associated with IMT, Diameter, cfPWV and with the mean z-scores of acute phase markers (APMscore) and of markers for endothelial dysfunction (EDFscore). After three year MK-7 supplementation cfPWV and the Stiffness Index β significantly decreased in the total group, whereas distension, compliance, distensibility, Young’s Modulus, and the local carotid PWV (cPWV) improved in women having a baseline Stiffness Index β above the median of 10.8. MK-7 decreased dp-ucMGP by 50 % compared to placebo, but did not influence the markers for acute phase and endothelial dysfunction. In conclusion, long-term use of MK-7 supplements improves arterial stiffness in healthy postmenopausal women, especially in women having a high arterial stiffness.

    Be well!


  10. JP Says:

    Update: Supplemental Vitamin K1 improves insulin sensitivity …


    Eur J Clin Nutr. 2015 Mar 18.

    The effect of vitamin K1 supplementation on sensitivity and insulin resistance via osteocalcin in prediabetic women: a double-blind randomized controlled clinical trial.

    BACKGROUND/OBJECTIVES: A relationship between osteocalcin (OC) levels and factors associated with energy metabolism and insulin resistance has been reported recently. The aim of this study was to investigate whether modulation of ostecalcin isoforms via vitamin K1 supplementation would affect glucose metabolism or insulin sensitivity in prediabetic and premenopause women.

    SUBJECTS/METHODS: Eighty-two prediabetic women were randomized to consume vitamin K1 supplement (n=39) or placebo (n=43) for 4 weeks. Participants in the vitamin K1 supplement group received one pearl softgel capsule containing 1000 μm of phylloquinone, and the placebo group received one placebo capsule daily for 4 weeks. Blood samples were collected at baseline and after the 4-week intervention period to quantify carboxylated OC (cOC), undercarboxylated OC (ucOC) and relevant variables.

    RESULTS: Phylloquinone supplementation increased the serum levels of cOC and decreased ucOC, compared with placebo (12.53±5.95 compared with 7.43±4.85 ng/ml and 2.47±1.91 compared with 4.79±2.43 ng/ml, respectively; P<0.001). Furthermore, intake of phylloquinone supplement led to significant decreases in %ucOC (17.97±12.24 compared with 43.80±19.86) and 2-h post-oral glucose tolerance test (OGTT) glucose (7.32±1.50 compared with 8.62±1.45 mmol/l), and 2- h post-OGTT insulin level (80.34±42.24 compared with 112.43±53.19 μIU/ml) and increased insulin sensitivity index (2.46±0.71 compared with 1.75±0.61) compared with placebo. Overall, a significant association was found between changes in %ucOC and changes in 2-h post-OGTT glucose (r=0.308, P=0.028).

    CONCLUSIONS: The results of this study demonstrated that vitamin K1 supplementation for 4 weeks did not affect insulin resistance in premenopausal and prediabetic women but had beneficial effects on glycemic status and insulin sensitivity.

    Be well!


  11. JP Says:

    Updated 06/15/16:


    Am Heart J. 2016 Jul;177:17-24.

    Sugar-sweetened carbonated beverage consumption and coronary artery calcification in asymptomatic men and women.

    BACKGROUND: Sugar-sweetened carbonated beverage consumption has been linked to obesity, metabolic syndrome, type 2 diabetes, and clinically manifest coronary heart disease, but its association with subclinical coronary heart disease remains unclear. We investigated the relationship between sugar-sweetened carbonated beverage consumption and coronary artery calcium (CAC) in a large study of asymptomatic men and women.

    METHODS: This was a cross-sectional study of 22,210 adult men and women who underwent a comprehensive health screening examination between 2011 and 2013 (median age 40 years). Sugar-sweetened carbonated beverage consumption was assessed using a validated food frequency questionnaire, and CAC was measured by cardiac computed tomography. Multivariable-adjusted CAC score ratios and 95% CIs were estimated from robust Tobit regression models for the natural logarithm (CAC score +1).

    RESULTS: The prevalence of detectable CAC (CAC score >0) was 11.7% (n = 2,604). After adjustment for age; sex; center; year of screening examination; education level; physical activity; smoking; alcohol intake; family history of cardiovascular disease; history of hypertension; history of hypercholesterolemia; and intake of total energy, fruits, vegetables, and red and processed meats, only the highest category of sugar-sweetened carbonated beverage consumption was associated with an increased CAC score compared with the lowest consumption category. The multivariable-adjusted CAC ratio comparing participants who consumed ≥5 sugar-sweetened carbonated beverages per week with nondrinkers was 1.70 (95% CI, 1.03-2.81). This association did not differ by clinical subgroup, including participants at low cardiovascular risk.

    CONCLUSION: Our findings suggest that high levels of sugar-sweetened carbonated beverage consumption are associated with a higher prevalence and degree of CAC in asymptomatic adults without a history of cardiovascular disease, cancer, or diabetes.

    Be well!


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