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Bone Health and Vitamin K2, What is the Connection?
Vitamin K-2 and bone health
Osteoporosis is a common health problem in Western countries, especially among older women. It is characterised by a reduction in bone mass, an increase in bone fragility, and greater vulnerability to fractures.
Just like vitamin D, vitamin C, and calcium, vitamin K plays an important role in maintaining optimal bone health, especially in the elderly.
As a reminder, calcium is a main component of bone structure. Its absorption by the intestine is optimised thanks to vitamin D which plays an important role in calcium balance and bone mineralisation. Vitamin C helps the body make collagen, which is essential for bone formation.
As for vitamin K-2, one of its most important functions is in the regulation of calcium deposits: it promotes the calcification of bones and prevents the deposition of calcium in blood vessel walls. By stimulating osteoblasts and inhibiting osteoclasts, vitamin K2 (especially its MK-7 form) has an anabolic effect on bone calcification.
It acts in synergy with vitamin D to promote the construction and maintenance of healthy bones.
Several studies and meta-analyses highlight the fact that vitamin K2 can improve bone mineral density in people with osteoporosis, as well as reduce the risk of fractures.
A study of 241 patients with osteoporosis who were treated with a vitamin K2, type MK-4, supplement (45 mg/day) combined with a calcium supplement (150 mg/day) showed a stable bone density and 65% less fractures, while those treated with only a calcium supplement lost 2.5% of their lumbar bone density.
In effect, taking high doses (up to 45 mg/day) of vitamin K2, type MK-4, would improve bone health and significantly reduce the risk of hip fractures (77% reduction), vertebral fractures (60% reduction) and all non-vertebral fractures (81% reduction).
Another 3-year study put forth that taking supplements of 180μg per day of vitamin K2, type MK-7, could help postmenopausal women prevent bone loss.
The hypothesis that vitamin K2 plays a role in maintaining and improving bone density and preventing fractures in postmenopausal women with osteoporosis is supported by a meta-analysis.
Given its role in bone health, vitamin K deficiency is associated with low bone mass, osteoporosis and greater risks of fracture.
Conclusion
More and more evidence is accumulating to say that vitamin K2 improves bone health. In effect, it could reduce the risk of fractures and help to counter balance the loss of bone mineral density that occurs with aging and especially for women at the time of menopause.
Although taking a 45mg supplement of vitamin K2 MK-4 is recommended as a standard treatment in Japan, where most studies have taken place, further studies are needed to confirm their applicability to other populations.
For vitamin K2 MK-7, the recommended dose, based on the dosage used in the most recent research studies, would be 150 to 180μg per day. Note that there are no official recommendations yet.
Diet plays a primary role in the prevention and control of osteoporosis and eating healthy helps keep our bones healthy. Our osteoporosis and menopause meal plans are also here to help.
Be careful, people who use anticoagulant drugs, such as Warfarin or Coumadin, should have a stable intake of vitamin K and should not consume a vitamin K supplement without consulting with a doctor.
Sources
1- https://www.healthline.com/nutrition/vitamin-k2#what-it-is
2- Fu, X., Shen, X., Finnan, E. G., Haytowitz, D. B., & Booth, S. L. (2016). Measurement of multiple vitamin K forms in processed and fresh-cut pork products in the US food supply. Journal of agricultural and food chemistry, 64(22), 4531-4535.
3- Schwalfenberg, G. K. (2017). Vitamins K1 and K2: the emerging group of vitamins required for human health. Journal of nutrition and metabolism, 2017.
4- Fusaro, M., Cianciolo, G., Brandi, M. L., Ferrari, S., Nickolas, T. L., Tripepi, G., … & M Cheung, A. (2020). Vitamin K and osteoporosis. Nutrients, 12(12), 3625.
5- Hauschka, P. V. (1986). Osteocalcin: the vitamin K-dependent Ca2+-binding protein of bone matrix. Pathophysiology of Haemostasis and Thrombosis, 16(3-4), 258-272.
6- Theuwissen, E., Smit, E., & Vermeer, C. (2012). The role of vitamin K in soft-tissue calcification. Advances in Nutrition, 3(2), 166-173.
7- Yamaguchi, M. (2006). Regulatory mechanism of food factors in bone metabolism and prevention of osteoporosis. Yakugaku Zasshi, 126(11), 1117-1137
8- Weber, P. (2001). Vitamin K and bone health. Nutrition, 17(10), 880-887.
9- Plaza, S. M., & Lamson, D. W. (2005). Vitamin K2 in bone metabolism and osteoporosis. Alternative Medicine Review, 10(1).
10- Shiraki, M., Shiraki, Y., Aoki, C., & Miura, M. (2000). Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis. Journal of bone and mineral research, 15(3), 515-521.
11- Fusaro, M., Mereu, M. C., Aghi, A., Iervasi, G., & Gallieni, M. (2017). Vitamin K and bone. Clinical Cases in Mineral and Bone Metabolism, 14(2), 200.
12- Cockayne, S., Adamson, J., Lanham-New, S., Shearer, M. J., Gilbody, S., & Torgerson, D. J. (2006). Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Archives of internal medicine, 166(12), 1256-1261.
13- Knapen, M. H. J., Drummen, N. E., Smit, E., Vermeer, C., & Theuwissen, E. (2013). Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporosis International, 24(9), 2499-2507.
14- Huang, Z. B., Wan, S. L., Lu, Y. J., Ning, L., Liu, C., & Fan, S. W. (2015). Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials. Osteoporosis International, 26(3), 1175-1186.
Author
Jennifer is a Registered Dietitian graduated from the University of Montreal in December 2018 and is a member of the Ordre professionnel des diététistes du Québec (OPDQ). She believes that the quality of our food choices has a direct impact on our health and energy level. Her goal? To help people improve the quality of what they put in their plates, for their better well-being and greater pleasure.
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