Vitamin K2 Key To Health Special Report VITAMIN K2 Readers, I believe this newsletter contains among the most important new health information that I have ever written for you. In many ways it is the longawaited missing link to The Calcium Story. For my part, I consider it a privilege to tell you about a nutrient that can literally change your health and your life in a significant way. As I often remind you, these vitamins are vitamins for a reason. Siri Khalsa
Table of Contents 1 Introduction Just about everybody knows that we need vitamin K for our blood to coagulate. Anytime that...page 3 2 Bone Up On Vitamin K2! Calcium supplementation is widely believed to be the most effective non-prescription method of...page 5 What Is Vitamin K2? How Is It Linked To Healthy Bones? Why Do We Need K2 For Our Hearts? 2 3 Banking Strong Bones Bone tissue grows and develops most intensively during childhood and adolescence. This is the time 4...Page 7 How Old Are Your Arteries? Heart diseases are the leading cause of death globally. These cardiovascular diseases (CVD) 5...Page 8 Deficiencies & Doses There are two kinds of vitamin K deficiency: acute and chronic. Neither is gender specific...page 10 What Is The Calcium Paradox? Calcium can be dangerous. Read on and find out why...
Introduction Vitamin K2 Just about everybody knows that we need vitamin K for our blood to coagulate. Anytime that we suffer a skin rupture a cut, a wound, or any other injury, even a pin prick vitamin K comes into play. 1 As important as this function is to our survival, recent research shows that vitamin K has other far-reaching implications for our health. The information in this edition of Nutrition News will surprise and amaze you. In fact, it will change forever your ideas about vitamin K. 3 Here s the surprise: Vitamin K is integral to the distribution of calcium in our bodies. What does this mean? Studies are showing that low levels of a certain kind of vitamin K, called K2, correlate with both hardening of the arteries and osteoporosis. In other words, because of a deficiency of vitamin K2, calcium that ought to be drawn from our blood and deposited into our bones is being laid down in our arteries. Incidentally, hardening of the arteries is a complex process of mineralization that actually resembles bone formation. One example is a recent study from The Journal of Clinical Endocrinology & Metabolism. The study involving 228 women showed a connection between calcification of the arteries in the breasts and reduced bone mineral density. To make matters worse, arterial calcification is a marker of atherosclerosis, which in turn is a marker of heart disease risk.
Thus, without sufficient vitamin K2, we find ourselves in the unenviable position of being at risk for both heart disease and osteoporosis. Let s take a closer look... Vitamin K is a complex of fat-soluble vitamins. Two types of molecules found in the complex are now known to be important to our health: vitamin K1 (a phylloquinone) and vitamin K2 (a group called menaquinones). K1, found in green leafy vegetables, is involved in the coagulation process. It is used initially by the liver. However, it is poorly absorbed and is rapidly excreted. Less than 10 percent reaches tissues outside the liver, where it is needed as well. However, vitamin K2 is preferred by the nonliver tissues. K2 works in bone, in cartilage, and in the arteries and veins (together known as vasculature). It is produced in the intestines by bacteria and can also be obtained from fermented foods such as mature cheeses and curd (e.g., cottage cheese). The best food source of K2 is a traditional Japanese fermented soy food called natto. 2 Natto provides an unusually rich source of natural vitamin K2 as long chain menaquinone-7. An especially prepared menaquinone-7 from natto is used in some vitamin K2 supplements. Laboratory experiments, population studies, and clinical trials have tightly linked higher vitamin K status to clean, flexible arteries and strong, healthy bones. All forms of vitamin K activate vitamin K-dependent proteins, which are used in the liver for coagulation and also in the bones and soft tissues for calcium utilization. It is important to note that no amount of K1 can influence excessive calcium accumulation. Clean-up is the job of vitamin K2 from menaquinone-7. 4
Both heart disease and osteoporosis are long term degenerative diseases. It is amazing to learn that they are linked in the body by a misappropriation of calcium. And, further, that the calcium link is related to vitamin K2. Research has revealed that K2 is essential to the activation of the proteins involved in forming bone and inhibiting arterial calcification. 5 Bone Up On Vitamin K2! Calcium supplementation is widely believed to be the most effective non-prescription method of maintaining bone integrity. Although public education has stressed the importance of vitamin D-enhanced calcium, recent studies indicate that this is not enough to give us strong bones. 3 For us to benefit from calcium, vitamin K2 must be present. Most of us have only seen human bone related to Halloween skeletons. Few of us realize that bone is living tissue. Comprised of a hard outer shell and spongy inner tissue matrix, it undergoes a natural process called remodeling. New bone cells are added where needed and old cells are removed. This process is particularly active during growth and following injuries. Our entire skeleton is replaced every seven years. Bone tissues grow and develop most intensively during childhood and adolescence. At this time we build our greatest insurance against bone fragility in old age. (See Banking Strong Bones, p. 7.) By our mid-30s, we have achieved our maximum bone mass. After that, the balance between build-up and breakdown begins to skew toward breakdown. It becomes extremely important to protect our bones with good nutrition, the right supplementation, and weight-bearing exercises. Children and menopausal women have the greatest need to build and preserve bone.
In 1984, Hart, et al, made the initial association between low vitamin K levels and impaired bone health. In the years since, many scientific papers have been published validating this discovery. Bone is formed by cells called osteoblasts and broken down by osteoclasts. (Think of iconoclast.) Osteoblasts secrete the vitamin K-dependent protein osteocalcin. Osteocalcin helps remove calcium from the blood and bind it into bone matrix as mineral content, making the bones stronger and less susceptible to breaking. However the key to osteocalcin activity is K2. When osteocalcin is not actuated, the bonding process does not occur. In fact, measuring blood levels of unactivated osteocalcin gives a strong indicator of bone health. Vitamin K2 can completely prevent bone loss. Researchers involved in the 3-year Osteo Study followed two groups of patients. The test group received vitamin K2 while the control group was not given supplementation. Results demonstrated unquestionably that taking K2 curtailed loss of bone strength for the entire supplementation period. This process does not happen with vitamin K1 the form needed for coagulation. As mentioned, the richest known food source of vitamin K2 is natto. A groundbreaking study by Kaneki showed that higher levels of K2 from natto resulted in better levels of activated osteocalcin and a reduced risk of bone fracture. In a 3-year study, involving 944 women (aged 20-79), Ikeda found that eating natto appears to prevent the development of osteoporosis. 6
Most recently, in the European Journal of Epidemiology, Yaegashi showed that better vitamin K status resulted in a reduction of hip fracture risk. While calcium, magnesium, zinc, and vitamin D were related to bone health, K2 from natto was identified as the key source. This high correlation extended to a lower risk of hip fracture. Together, these studies reinforce the importance of vitamin K2 (as menaquinone-7) in the prevention of bone disorders. 7 Banking Strong Bones Bone tissue grows and develops most intensively during childhood and adolescence. This is the time when individuals have the greatest need for vitamin K to activate osteocalcin. The higher peak mass of bone built during this time, the lower the risk of osteoporosis during the later years of life. Laboratory experiments, population-based studies, and clinical trials have shown a high correlation between vitamin K status in children and strong, healthy bones. In a study in the British Journal of Nutrition, researchers showed that improving the level of K vitamins in children over a 2-year period resulted in stronger, more dense bones. (Summeren, et al, February 2008) Another study involved 223 healthy girls (aged 11-12) and found better vitamin K status related to higher bone density. (O Connor, et al) Sadly, there is reason to believe that the majority of children and adolescents have too little vitamin K in their systems. In a number of studies, high levels of unactivated
osteocalcin have indicated a general deficiency of K vitamins among youth. We get an idea of the consequences of this situation from studies involving children on anticoagulant drugs. These children have significantly reduced bone mass. A lack of vitamin K in childhood may have a multi-aspect effect on health in adulthood. It is a good idea to furnish young people with supplements containing vitamin K2 (as menaquinone-7) at a level of 45 mcg daily. Science supports this recommendation as a means of improving their bone health. 8 How Old Are Your Arteries? Heart diseases are the leading cause of death globally. These cardiovascular diseases (CVD) involve impairment of the heart and blood vessels. They often develop without any signs and by the time symptoms are detected, the underlying cause is advanced and difficult to treat. Hardening of the arteries, atherosclerosis, is frequently the first stage of CVD. This is a process in which the arteries clog and harden from plaque deposits over many years. Calcium is the main mineral component of plaque. The calcification increases the stiffness and fragility of the vessels, impeding blood flow to and from the heart. Recent studies have shown that the amount of calcium stored in the arteries is an indicator of cardiovascular health. Simply, you are only as old as your arteries. Significant hardening pushes back your birth date while supple vessels with little or no plaque can result in your biological age being up to 10 years less than your chronological age.
Once again we find vitamin K as a gatekeeper to our health. The K vitamins deliver calcium to bone matrix by actuating osteocalcin. In CVD, the Ks activate a protein that inhibits calcification of the blood vessels. The protein is known as MGP (Matrix Gla Protein). The highest levels are found in the heart, lungs, kidneys, and cartilage. MGP circulates in the blood, attracting calcium and preventing it from binding to the vessel walls. This keeps the arteries clean and flexible. On the other hand, when the body lacks vitamin K, MGP cannot do its job. Under these circumstances, it is highly unlikely that one will escape the development of atherosclerosis. This increases our risk of dying from heart disease. Given this knowledge, a measurement of unactivated MGP has the potential of becoming a primary biomarker for identifying a predisposition for developing atherosclerosis. Findings of The Rotterdam Study (2004) showed that a high dietary intake of vitamin K2 (but not K1) has a strong protective effect on heart health. 4 A group of 4807 men and women aged 55 and older took 45 mcg per day of vitamin K2 over several years. A follow-up reported in 2004 showed that the supplement reduced the risk of both arterial calcification and death from heart disease by as much as 50 percent with absolutely no undesirable side effects! Not only is vitamin K2 protective against CVD, new research indicates that the supplement might actually be able to reverse the disease. Although it has long been believed that calcification was an inevitable and irreversible result of aging, researchers have noted that a high intake of vitamin K2 may restore the arterial wall as well as lowering circulating cholesterol levels. 9
Millions of people take anticoagulant medications such as warfarin and coumarin. These medications are vitamin K antagonists, keeping the blood thin by interfering with clotting. 5 Individuals taking these meds have been found to have 200 percent more soft tissue calcification than patients not taking them. The good news is that 45 mcg daily of vitamin K2 as menaquinone-7 has no additional stimulating effect on clotting. Instead, it does its job of protecting the heart by activating MGP (and the bones by activating osteocalcin). If you are using anticoagulants, ask your physician about the possibility of taking vitamin K2. 10 Deficiencies & Doses There are two kinds of vitamin K deficiency: acute and chronic. Neither is gender specific and they can happen at any stage of life. An acute deficiency is what you would expect: unusual bleeding from gums, nose, or the intestinal tract. Consequences include internal clogging, strokes, lung damage, and death by hemorrhage. Newborns are especially susceptible to acute deficiency because sufficient vitamin K may not be transported across the placenta. Further, the intestinal tract of the newborn is sterile at birth, thus there are no bacteria to produce the necessary amount of vitamin K1. Lack of vitamin K may also be caused by the use of anticoagulant drugs, prolonged use of antibiotics, gallbladder disease, and Crohn s disease. Chronic vitamin K deficiency is the focus of this newsletter. It is less obvious, and actually more
dangerous because of the lack of alarming symptoms. Here, the end result is increased risk of both heart disease and osteoporosis. Chronic deficiency can be partly explained by changes over time in eating habits and in food composition. People eat far fewer leafy greens, rich in K1, than in the past. For example, in 1950, children got about 15 percent of their K from fats and oils and 55 percent from vegetables (excluding potatoes). Today, they get 35 percent from fats and oils and only 30 percent from veggies. Sources are also less rich because sterile packaging conditions impede microorganisms (including the good ones) from penetrating our systems. Thus, we are making less K in our intestines than previously. Vitamin K1 is simple: If your blood is coagulating efficiently, you are taking in and/or making enough. On the other hand, it is unlikely that any of us are getting sufficient vitamin K2. The widespread The Calcium Paradox A 5-year study of healthy postmenopausal women measured the bone-building effects of 1000 mg of calcium taken daily. The study revealed that calcium intake was beneficial for the bones; however, it was also associated with increased heart disease problems. Hence, The Calcium Paradox. CVD and osteoporosis are highly correlated. Where one is found, the other is highly likely to be present. They are the leading causes of death and disability for men and women among all racial and ethnic groups. They both develop over decades often with no visible symptoms. They may not be diagnosed until an unexpected stroke or hip fracture occurs. As we have stressed throughout this newsletter, improper calcium utilization is an underlying cause of both diseases. A study conducted in the US involved 1000 postmenopausal women. Hardened arteries were more common among women who also had osteoporosis or osteopenia. This was also found in Japanese clinical research. A large Norwegian study (5000+) and another investigation conducted in Denmark showed respectively that low bone density was associated with atherosclerosis while calcification of the aorta was associated with the development of osteoporosis. Researchers in the Danish study declared that a measure of aorta calcification was a site-specific predictor of bone loss and hip fracture risk. It bears repeating that taking natural vitamin K2 as menaquinone-7 is associated with improved strength, density, and structure of bone. Secondly, studies link K2 with the inhibition of hardening of the arteries. Only K2 has been shown to stop and even regress arterial calcium accumulation. 11
deficiency of this important vitamin could easily account at least in part for the nearly epidemic number of cases of cardiovascular disease, osteopenia, and osteoporosis. 6 Like K1, K2 is also produced in our intestines. However, one needs only to look at the state of our hearts and bones to know that we simply are not getting enough of this vitamin. The best sources are fermented foods, such as mature cheeses and curd. A Japanese food called natto, which contains very high amounts of K2 as menaquinone-7, is currently the most effective form known. However, the smell, taste, and texture of this food make it unpalatable to Westerners. Fortunately, vitamin K2 supplements contain menaquinone-7 from natto. These supplements are widely available at natural products stores. As reported, numerous studies demonstrate the usefulness of this vitamin in preventing and restoring the health of our heart and skeletal systems. Although the current recommended dose of vitamin K is 120 mcg per day, these levels are based on K1 and the factors involved in coagulation. They don t take into consideration the factors needed to activate the proteins we need to inhibit hardening of the arteries or uptake of calcium for the bones. Although some researchers have used up to 150 mcg to obtain their results, these same people also want more investigation into an optimal general recommendation. Our look at the research indicates that a dose of 45 mcg per day of vitamin K2 as menaquinone-7 is sufficient. Most supplements provide 90 mcg. This is not harmful. 12
Footnotes: 1 FYI: Hemophilia, the inability of the blood to clot, has nothing to do with vitamin K. It is the result of a hereditary genetic disorder or, far more rare, of a spontaneous gene mutation. Persons with hemophilia do not bleed more intensely than normal people, but bleed for a much longer time. In severe cases, even a minor injury can result in blood loss lasting days, weeks, or never healing completely. 2 Paradoxically, natto is the same source as the enzyme nattokinase, the clot inhibitor and blood thinner. 3 For over 10 years, Siri Khalsa, editor in chief and senior author for Nutrition News, has been advising newsletter readers of the importance of nutrients besides calcium that are necessary to building bone. Vitamin K, vitamin D, and magnesium are among these. 4 The Rotterdam Study began in 1990 and consists of three distinct groups of participants (cohorts) each of whom have entered the study at different times. If you want to know more about the findings of this very informative health study, I recommend going to the web. 5 Read Nutrition News, Supplement Your Prescription, featuring an interview with Hyla Cass, MD. A major message of the interview is that there is no pharmaceutical without health consequences. 6 Osteopenia means thin bones and is a precursor to osteoporosis. 13 Related Resources With each Special Report, Nutrition News features two additional titles to support our main topic. With Vitamin K2, we recommend perusing A Woman s Heart and Osteoporosis. A Woman s Heart Special Report HEART DISEASE & WOMEN Press your ear against the breast of a woman and hear her heartbeat: Rhythmic, strong, warm. That heart never rests, except between pulses. It pumps more than thirty times its own weight in blood each day, more than 1,800 gallons, and over 1.3 million gallons a year. From A Woman s Guide to a Healthy Heart, Carol Simontacchi, CCN, MS, and Frances Fitzgerald A Woman s Heart Osteoporosis For more healthy opportunities, see next page.
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