Vitamin k levels in common foods pdf

One study found that both phytonadione and MK-7 supplements are well absorbed, but MK-7 has a longer half-life [ 19 ]. Menadione, which is sometimes called "vitamin K3," is another synthetic form of vitamin K. It was shown to damage hepatic cells in laboratory studies conducted during the s and s, so it is no longer used in dietary supplements or fortified foods [ 3 ].

Most U. In adults aged 20 and older, the average daily vitamin K intake from foods is mcg for women and mcg for men. When both foods and supplements are considered, the average daily vitamin K intake increases to mcg for women and mcg for men. The significance of these findings is unclear because the AI is only an estimate of need, especially for vitamins like vitamin K that are also synthesized endogenously.

Moreover, reports of vitamin K deficiency in adults are very rare [ 3 , 7 ]. Finally, food composition databases provide information primarily on phylloquinone; menaquinones—either dietary or from bacterial production in the gut—likely also contribute to vitamin K status [ 1 , 6 , 7 ].

Vitamin K deficiency is only considered clinically relevant when prothrombin time increases significantly due to a decrease in the prothrombin activity of blood [ 3 , 7 ]. Thus, bleeding and hemorrhage are the classic signs of vitamin K deficiency, although these effects occur only in severe cases.

Because vitamin K is required for the carboxylation of osteocalcin in bone, vitamin K deficiency could also reduce bone mineralization and contribute to osteoporosis [ 23 ]. Vitamin K deficiency can occur during the first few weeks of infancy due to low placental transfer of phylloquinone, low clotting factor levels, and low vitamin K content of breast milk [ 7 ].

Clinically significant vitamin K deficiency in adults is very rare and is usually limited to people with malabsorption disorders or those taking drugs that interfere with vitamin K metabolism [ 3 , 7 ]. In healthy people consuming a varied diet, achieving a vitamin K intake low enough to alter standard clinical measures of blood coagulation is almost impossible [ 3 ].

Vitamin K transport across the placenta is poor, increasing the risk of vitamin K deficiency in newborn babies [ 3 ]. During the first few weeks of life, vitamin K deficiency can cause vitamin K deficiency bleeding VKDB , a condition formerly known as "classic hemorrhagic disease of the newborn. People with malabsorption syndromes and other gastrointestinal disorders, such as cystic fibrosis, celiac disease, ulcerative colitis, and short bowel syndrome, might not absorb vitamin K properly [ 3 , 5 , 23 ].

Vitamin K status can also be low in patients who have undergone bariatric surgery, although clinical signs may not be present [ 26 ]. These individuals might need monitoring of vitamin K status and, in some cases, vitamin K supplementation.

This section focuses on two conditions in which vitamin K might play a role: osteoporosis and coronary heart disease. Osteoporosis, a disorder characterized by porous and fragile bones, is a serious public health problem that affects more than 10 million U. Consuming adequate amounts of calcium and vitamin D, especially throughout childhood, adolescence, and early adulthood, is important to maximize bone mass and reduce the risk of osteoporosis [ 27 ].

The effect of vitamin K intakes and status on bone health and osteoporosis has been a focus of scientific research. Vitamin K is a cofactor for the gamma-carboxylation of many proteins, including osteocalcin, one of the main proteins in bone [ 28 ]. Some research indicates that high serum levels of undercarboxylated osteocalcin are associated with lower bone mineral density [ 5 , 28 ]. Although vitamin K is involved in the carboxylation of osteocalcin, it is unclear whether supplementation with any form of vitamin K reduces the risk of osteoporosis.

In , Cockayne and colleagues conducted a systematic review and meta-analysis of randomized controlled trials that examined the effects of vitamin K supplementation on bone mineral density and bone fracture [ 35 ].

Most of the trials were conducted in Japan and involved postmenopausal women; trial duration ranged from 6 to 36 months. Thirteen trials were included in the systematic review, and 12 showed that supplementation with either phytonadione or MK-4 improved bone mineral density.

Seven of the 13 trials also had fracture data that were combined in a meta-analysis. MK-4 supplementation significantly reduced rates of hip fractures, vertebral fractures, and all nonvertebral fractures. Other randomized clinical trials since the review by Cockayne et al. In one of these studies, postmenopausal women received either 1 mg phylloquinone, 45 mg MK-4, or placebo daily for 12 months [ 38 ].

All participants also received daily supplements containing mg calcium and IU vitamin D3. At the end of the study, participants receiving either phylloquinone or MK-4 had significantly lower levels of undercarboxylated osteocalcin compared to those receiving placebo.

However, there were no significant differences in bone mineral density of the lumbar spine or proximal femur among any of the treatment groups. In Japan and other parts of Asia, a pharmacological dose of MK-4 45 mg is used as a treatment for osteoporosis [ 5 ]. The European Food Safety Authority has approved a health claim for vitamin K, noting that "a cause and effect relationship has been established between the dietary intake of vitamin K and the maintenance of normal bone" [ 39 ].

Vascular calcification is one of the risk factors for coronary heart disease because it reduces aortic and arterial elasticity [ 40 ]. Matrix Gla-protein MGP is a vitamin K-dependent protein that may play a role in the prevention of vascular calcification [ 5 , 41 ].

Although the full biological function of MGP is unclear, a hypothesis based on animal data suggests that inadequate vitamin K status leads to undercarboxylated MGP, which could increase vascular calcification and the risk of coronary heart disease. These findings might be particularly relevant for patients with chronic kidney disease because their rates of vascular calcification are much higher than those of the general population [ 9 ].

In an observational study conducted in the Netherlands in postmenopausal women, dietary menaquinone but not phylloquinone intake was inversely associated with coronary calcification [ 42 ].

Menaquinone intake was also inversely associated with severe aortic calcification in a prospective, population-based cohort study involving 4, men and women aged 55 years and older from the Netherlands [ 41 ]. Participants in this study who had dietary menaquinone intakes in the mid tertile Phylloquinone intake had no effect on any outcome.

Despite these data, few trials have investigated the effects of vitamin K supplementation on arterial calcification or coronary heart disease risk. One randomized, double-blind clinical trial examined the effect of phylloquinone supplementation in healthy men and postmenopausal women aged 60—80 years [ 43 ]. Participants received either a multivitamin containing B-vitamins, vitamin C, and vitamin E plus IU vitamin D3, mg calcium, and mcg phylloquinone daily treatment or a multivitamin plus calcium and vitamin D3 only control for 3 years.

There was no significant difference in coronary artery calcification between the treatment and control groups.

However, among the participants who adhered to the supplementation protocol, those in the treatment group had significantly less coronary artery calcification progression than those in the control group. Based on these findings, the authors did not make any clinical recommendations, and they called for larger studies in other populations. At this time, the role of the different forms of vitamin K on arterial calcification and the risk of coronary heart disease is unclear, but it continues to be an active area of research in the general population and in patients with chronic kidney disease [ 5 , 9 , 44 ].

In its report, the FNB stated that "no adverse effects associated with vitamin K consumption from food or supplements have been reported in humans or animals. Vitamin K interacts with a few medications. In addition, certain medications can have an adverse effect on vitamin K levels. Some examples are provided below. Individuals taking these and other medications on a regular basis should discuss their vitamin K status with their healthcare providers.

These drugs antagonize the activity of vitamin K, leading to the depletion of vitamin K-dependent clotting factors. People taking warfarin and similar anticoagulants need to maintain a consistent intake of vitamin K from food and supplements because sudden changes in vitamin K intakes can increase or decrease the anticoagulant effect [ 45 ]. Antibiotics can destroy vitamin K-producing bacteria in the gut, potentially decreasing vitamin K status. Vitamin K supplements are usually not needed unless antibiotic use is prolonged beyond several weeks and accompanied by poor vitamin K intake [ 46 ].

They can also reduce the absorption of vitamin K and other fat-soluble vitamins, although the clinical significance of this effect is not clear [ 46 , 47 ]. Vitamin K status should be monitored in people taking these medications, especially when the drugs are used for many years [ 47 ]. It reduces the body's absorption of dietary fat and in doing so, it can also reduce the absorption of fat-soluble vitamins, such as vitamin K.

Combining orlistat with warfarin therapy might cause a significant increase in prothrombin time [ 48 ]. Otherwise, orlistat does not usually have a clinically significant effect on vitamin K status, although clinicians usually recommend that patients taking orlistat take a multivitamin supplement containing vitamin K [ ]. The federal government's — Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods.

In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients e. For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U. Department of Agriculture's MyPlate. We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc.

Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. Updated: March 29, History of changes to this fact sheet. Is it the green apples? How much Vitamin K is in cucumbers? How much Vitamin K is in quinoa?

Will drinking aloe vera juice interact with Coumadin warfarin? Read all of readers' questions about Coumadin warfarin ». Coumadin-Safe Side Dish Recipes The Coumadin safe vegetable side dish recipes listed on this page are under about mcg of Vitamin K per serving, so that they fit into a diet that aims for a stable total intake of about 80mcg of Vitamin K per day.

Coumadin-Safe Vegetarian Main Course Recipes The Coumadin safe vegetarian main course recipes on this page are under mcg of Vitamin K per serving more if they are a complete meal in themselves in order to fit into a diet that aims for a stable total intake of about 80mcg of Vitamin K per day. Vitamin K Levels in Common Foods Your quick guide to eating vegetables while taking Coumadin warfarin Here is a handy list of the amounts of Vitamin K in the indicated servings of common vegetables.

Here are some of the most common questions people have about Coumadin and vegetables: Should Coumadin users peel zucchini? Read all of readers' questions about Coumadin warfarin » Coumadin-Safe Vegetable Recipes Coumadin-Safe Side Dish Recipes The Coumadin safe vegetable side dish recipes listed on this page are under about mcg of Vitamin K per serving, so that they fit into a diet that aims for a stable total intake of about 80mcg of Vitamin K per day.

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