More vitamin K linked to fewer fractures in children: Pilot study

14-Jun-2018 - Last updated on 14-Jun-2018 at 16:07 GMT

Increased levels of vitamin K are associated with lower rates of low-energy fracture incidence in children and adolescents, according to a new study that supports the bone health benefits of the vitamin.

Researchers from Poland, the USA, and The Netherlands assessed vitamin K status as the ratio of uncarboxylated osteocalcin to carboxylated osteocalcin (ucOC:cOC). Osteocalcin is a vitamin K-dependent protein and is essential for the body to utilize calcium in bone tissue. Without adequate vitamin K, the osteocalcin remains inactive, and thus not effective.

“The present study is the first to show a significantly lower fraction of carboxylated osteocalcin in children with low-energy fractures (20.87 ng/mL) as compared to the control group without fractures (42.76 ng/mL),” wrote the authors in the journal Nutrients.

“This suggests that dietary vitamin K intake in children with low-energy fractures may be insufficient to maintain a healthy and resilient skeleton in this population of children.”

K forms

There are two main forms of vitamin K: phylloquinone, also known as phytonadione, (vitamin K1) which is found in green leafy vegetables such as lettuce, broccoli and spinach, and makes up about 90% of the vitamin K in a typical Western diet; and menaquinones (vitamins K2), which make up about 10% of Western vitamin K consumption and can be synthesized in the gut by microflora.

Menaquinones (MK-n: with the n determined by the number of prenyl side chains) can also be found in the diet; MK-4 can be found in animal meat, MK-7, MK-8, and MK-9 are found in fermented food products like cheese, and natto is a rich source of MK-7.

The new study’s findings were welcomed by Dr Hogne Vik, Chief Medical Officer for NattoPharma, which supplies the MenaQ7 branded vitamin K2. “This trial reaffirms the real health benefits improving K2 status delivers,” said Dr Vik. “More importantly, it shines a light on the true impact improving K2 status has on children, our most precious resource.

“The findings are so very significant, as they provide supporting evidence to the clinical research NattoPharma has already spearheaded,” added Dr Vik. “Not only has our research identified children as a group most deficient in Vitamin K2, but that just 45mcg of K2 (as NattoPharma’s MenaQ7) daily improves K status and increases the activation of osteocalcin, the K-dependent protein responsible for binding calcium to the bone mineral matrix, therefore improving bone health.”

Study details

The researchers compared data from 20 children with radiologically confirmed low-energy fractures with data from 19 healthy children without fractures.

The results indicated that there were no statistically significant differences between the groups when they focused on total vitamin D levels or calcium, or other markers of bone health such as bone alkaline phosphatase (BALP) or N-terminal telopeptide (NTx).

However, a statistically significant difference between the groups was observed for the ratio of uncarboxylated osteocalcin to carboxylated osteocalcin.

“The [ratio] is highly sensitive for assessing bone vitamin K status and in clinical practice it may serve to monitor treatment of patients with vitamin K deficit and detect a preventable adverse lifestyle factors,” explained the researchers.

“Based on our pilot study, we hypothesize that besides vitamin D, vitamin K plays an important role in bone health in children. This indicates potential benefits of using supplementation of vitamin D and vitamin K in children to prevent low-energy bone fractures.”

“A growing health concern”

“The epidemiological evidence indicates a disturbing growth in the number of cases of low-energy fractures in healthy children and adolescents,” said Dr Vladimir Badmaev, co-author of the paper and principal and founder of American Medical Holdings, Inc.

“There are multiple risk factors that may contribute to this growing health concern, and among the leading consideration are deficient or insufficient nutrition and nutrients, including calcium, vitamin D and vitamin K.”

The study adds to a review by the same research team published last year in the Journal of the American College of Nutrition. The researchers argued that there is a new nutritional paradigm for efficient and safe delivery of calcium, which is “cosupplementation with both fat-soluble vitamins D and K.”

Source: Nutrients
2018, 10(6), 734. doi: 10.3390/nu10060734
“Decreased Levels of Circulating Carboxylated Osteocalcin in Children with Low Energy Fractures: A Pilot Study”
Author: J. Popko et al.