Vitamin K And Heart Disease Deaths

Written by Dr. Steve Chaney on . Posted in Heart Disease, Vitamin K

Does Vitamin K Reduce Heart Disease Risk?

Author: Dr. Stephen Chaney

 

viatmin k and heart diseaseYou are trying to live a heart healthy lifestyle, but it is so confusing. It seems like there are new heart healthy diets, foods, and nutrients each week. How can you possibly keep up?

Some of those “heart healthy” recommendations contradict each other. They can’t all be true. Which should you believe? I will answer that question in my new books “Slaying the Food Myths” and “Slaying the Supplement Myths.

Today, however, I am going to add to your confusion by adding another nutrient, vitamin K, to your “heart healthy” list. When it comes to heart health, vitamin K is a neglected nutrient. Most people think it is just needed for blood clotting. It doesn’t have the recognition and glamor of omega-3s, antioxidants, and polyphenols for heart health. However, recent research suggests it may play a crucial role in protecting your heart. So, I will explain how vitamin K and heart disease are related.

Before, I go into today’s study, let me give you some background information on vitamin K metabolism and heart health.

Metabolism 101: Vitamin K and Heart Disease

viatmin k and heart disease vegetablesVitamin K is a coenzyme for enzymes that add carboxyl groups to proteins. Without going into a lot of boring detail, carboxylated proteins:

  • Are more water soluble. That makes them more efficient at catalyzing metabolic reactions in our cells.
  • Chelate calcium. That allows them to catalyze calcium-dependent reactions.

For this discussion there are 3 kinds of calcium-dependent reactions catalyzed by carboxylated proteins that are important to know:

  • Reactions involved in blood clotting. Hence, vitamin K is essential for blood clotting.
  • Reactions involved in depositing calcium in our bones. Hence, vitamin K is essential for bone formation.
  • Reactions involved in removing calcium deposits from soft tissues. Hence, vitamin K is essential for keeping our arteries clear of calcium deposits.

If you think about those last two reactions, vitamin K deficiency is the worst of all possible worlds. Calcium in our bloodstream is less likely to be deposited in our bones and more likely to be deposited in our arteries. Vitamin K deficiency is bad for bone health and bad for heart health.

There is only one other factoid you need to know to understand the study I will discuss below. Because vitamin K is essential for the carboxylation of certain proteins, the uncarboxylated level of those proteins in the bloodstream can be used as an indirect assay for vitamin K deficiency. That is the assay that was used in this study.

How Was The Study Performed?

viatmin k and heart disease deathsIn this study (I.J. Riphagen et al, Nutrients, 9, 1334; doi: 10.3390/nu9121334, 2017 ) the investigators studied 4275 subjects enrolled in a clinical trial called PREVEND (Prevention of Renal and Vascular End-Stage Disease). The study population was recruited from the city of Groningen in the Netherlands.

In terms of study population characteristics, the average age was 53, the population was 46% male, 94% Caucasian, and 60% of the population already had renal disease at the time of enrollment (The significance of this will be discussed later).

Study participants were followed for 10 years. By then 279 had died, with 74 deaths attributable to heart disease. Here are the results of the study:

  • 30% of the population was vitamin K deficient.
  • Vitamin K deficiency was close to 50% for the elderly and for subjects with hypertension, diabetes, kidney disease, and cardiovascular disease.
  • Vitamin K deficiency was significantly correlated with all-cause mortality and cardiovascular mortality.

The authors concluded: “Importantly, a low vitamin K status is not only a clinically relevant risk factor for adverse health outcomes, but it may be a modifiable risk factor. Given the availability of vitamin K supplements, vitamin K insufficiency seems an attractive target for preventative intervention. Future prospective clinical trials are needed to investigate whether correction of low vitamin K status can indeed improve health outcomes.”

Pros and Cons of This Study

Cons:

  • This is an association study. It showed that vitamin K deficiency was associated with cardiovascular mortality, but it didn’t show that vitamin K deficiency caused cardiovascular mortality.
  • Kidney disease reduces the efficiency of vitamin K-dependent carboxylation of proteins. This study relied on levels of uncarboxylated protein for determining vitamin K status, and 60% of the subjects had kidney disease. The study might have overestimated the prevalence of vitamin K deficiency.
  • The population of the study were primarily Caucasian from one city in the Netherlands. It is not clear whether these findings would be equally true for other population groups.

Pros:

  • This study is consistent with previous studies. Several other studies have reported a correlation between vitamin K deficiency and either arterial calcification or heart disease risk. At least one study has shown that vitamin K supplementation can reverse arterial calcification.
  • The levels of vitamin K deficiency seen in this study are consistent with previous studies that have measured blood levels of vitamin K directly.

 

Vitamin K1 Versus K2: What Happens Naturally?

 

viatmin k and heart disease vitamin k1 and vitamin k2There are two forms of vitamin K, vitamin K1 and vitamin K2. Vitamin K1 is used for the blood clotting reactions. Vitamin K2 is used for the reactions involving bone formation and removal of calcium from soft tissues. That has led to a vigorous debate about whether vitamin K1 or K2 supplements are better. I won’t get into that debate, because the data aren’t conclusive yet. However, I will point out that there is a natural relationship between vitamin K1 and K2 that has existed for thousands of years.

Vitamin K1 is the primary dietary form of vitamin K. It is found in heart-healthy foods like green leafy vegetables; cruciferous vegetables like broccoli, Brussels sprouts and cabbage; and other healthy foods like carrots, blueberries, and asparagus. It is converted to vitamin K2 by our intestinal bacteria. Small amounts of vitamin K2 can also be found in less heart-healthy foods like cheeses, egg yolks, butter, chicken liver, and salami.

Simply put, if we eat healthy foods and have healthy gut bacteria, we get vitamin K1 from our diet, and our gut bacteria make all the vitamin K2 we need. This is a system that has worked well for humankind since the dawn of time. It’s only when we start messing up our diet and our gut bacteria that we need to start arguing about whether vitamin K1 or K2 supplements are better. It’s not nice to mess with Mother Nature.

 

The Bottom Line

 

A recent study in the Netherlands found that:

  • 30% of the population was vitamin K deficient.
  • Vitamin K deficiency was close to 50% for the elderly and for subjects with hypertension, diabetes, kidney disease, and cardiovascular disease.
  • Vitamin K deficiency was significantly correlated with all-cause mortality and cardiovascular mortality.

The authors concluded: “…a low vitamin K status is not only a clinically relevant risk factor for adverse health outcomes, but it may be a modifiable risk factor. Given the availability of vitamin K supplements, vitamin K insufficiency seems an attractive target for preventative intervention.”

For more details about vitamin K and heart disease and a brief discussion of vitamin K1 and vitamin K2, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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What Is The Planetary Diet?

Posted May 21, 2019 by Dr. Steve Chaney

Is Your Diet Destroying The Planet?

Author: Dr. Stephen Chaney

 

Earth Day has come and gone, but you are still committed to saving the planet. You save energy. You recycle. You drive an electric car. But is your diet destroying the planet?

This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) serves as a dire warning of what will happen if we don’t change our ways. I touched on this report briefly in a previous issue of “Health Tips From The Professor,” What Is The Flexitarian Diet , but this topic is important enough that it deserves an issue all its own.

The commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The commission described the typical American diet as a “lose-lose diet.” It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

How Was The Study Done?

The study (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) was the report of the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. This Commission convened 30 of the top experts from across the globe to prepare a science-based evaluation of the effect of diet on both health and sustainable food production through the year 2050. The Commission included world class experts on healthy diets, agricultural methods, climate change, and earth sciences. The Commission reviewed 356 published studies in preparing their report.

 

Is Your Diet Destroying The Planet?

When they looked at the effect of food production on the environment, the Commission concluded:

  • “Strong evidence indicates that food production is among the largest drivers of global environmental change.” Specifically, the commission reported:
  • Agriculture occupies 40% of global land (58% of that is for pasture use).
  • Food production is responsible for 30% of global greenhouse gas emissions and 70% of freshwater use.
  • Conversion of natural ecosystems to croplands and pastures is the largest factor causing species to be threatened with extinction. Specifically, 80% of extinction threats to mammals and bird species are due to agricultural practices.
  • Overuse and misuse of nitrogen and phosphorous in fertilizers causes eutrophication. In case you are wondering, eutrophication is defined as the process by which a body of water becomes enriched in dissolved nutrients (such as phosphates from commercial fertilizer) that stimulate the growth of algae and other aquatic plant life, usually resulting in the depletion of dissolved oxygen. This creates dead zones in lakes and coastal regions where fish and other marine organisms cannot survive.
  • About 60% of world fish stocks are fully fished and more than 30% are overfished. Because of this, catch by global marine fisheries has been declining since 1996.
  • “Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”
  • The world’s population is expected to increase to 10 billion by 2050. The current system of food production is unsustainable.

When they looked at the effect of the foods we eat on the environment, the Commission concluded:

  • Beef and lamb are the biggest contributors to greenhouse gas emissions and land use.
  • The concern about land use is obvious because of the large amount of pasture land required to raise cattle and sheep.
  • The concern about greenhouse gas emissions is because cattle and sheep are ruminants. They not only breathe out CO2, but they also release methane into the atmosphere from fermentation in their rumens of the food they eat. Methane is a potent greenhouse gas, and it persists in the atmosphere 25 times longer than CO2. The single most important thing we can do as individuals to reduce greenhouse gas emissions is to eat less beef and lamb. [Note: grass fed cattle produce more greenhouse gas emissions than cattle raised on corn because they require 3 years to bring to market rather than 2 years.]
  • In terms of energy use beef, lamb, pork, chicken, dairy and eggs all require much more energy to produce than any of the plant foods.
  • In terms of eutrophication, beef, lamb, and pork, all cause much more eutrophication than any plant food. Dairy and eggs cause more eutrophication than any plant food except fruits.
  • In contrast, plant crops reduce greenhouse gas emissions by removing CO2 from the atmosphere.

 

What Is The Planetary Diet?

In the words of the Commission: “[The Planetary Diet] largely consists of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, poultry, and eggs. It includes no or a very low amount of red meat, processed meat, sugar, refined grains, and starchy vegetables.”

When described in that fashion it sounds very much like other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable. Here is a more detailed description of the diet:

  • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
  • It allows the option of adding one serving of dairy a day (It turns out that cows produce much less greenhouse emissions per serving of dairy than per serving of beef. That’s because cows take several years to mature before they can be converted to meat, and they are emitting greenhouse gases the entire time).
  • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
  • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

This is obviously very different from the way most Americans currently eat. According to the Commission:

  • “This would require greater than 50% reduction in consumption of unhealthy foods, such as red meat and sugar, and greater than 100% increase in the consumption of healthy foods, such as nuts, fruits, vegetables, and legumes.”
  • “In addition to the benefits for the environment, “dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10.8-11.6 million deaths per year globally.”

What Else Did The Commission Recommend?

In addition to changes in our diets, the Commission also recommended several changes in the way food is produced. Here are a few of them.

  • Reduce greenhouse gas emissions from the fuel used to transport food to market.
  • Reduce food losses and waste by at least 50%.
  • Make radical improvements in the efficiency of fertilizer and water use. In terms of fertilizer, the change would be two-fold:
    • In developed countries, reduce fertilizer use and put in place systems to capture runoff and recycle the phosphorous.
    • In third world countries, make fertilizer more available so that crop yields can be increased, something the Commission refer to as eliminating the “yield gap” between third world and developed countries.
  • Stop the expansion of new agricultural land use into natural ecosystems and put in place policies aimed at restoring and re-foresting degraded land.
  • Manage the world’s oceans effectively to ensure that fish stocks are used responsibly and global aquaculture (fish farm) production is expanded sustainability.

What we can do: While most of these are government level policies, we can contribute to the first three by reducing personal food waste and purchasing organic produce locally whenever possible.

What Does This Mean For You?

If you are a vegan, you are probably asking why the Commission did not recommend a completely plant-based diet. The answer is that a vegan diet is perfect for the health of our planet. However, the Commission wanted to make a diet that was as consumer-friendly as possible and still meet their goals of a healthy, environmentally friendly, and sustainable diet.

If you are eating a typical American diet or one of the fad diets that encourage meat consumption, you are probably wondering how you can ever make such drastic changes to your diet. The answer is “one step at a time.”  If you have read my books “Slaying The Food Myths” or “Slaying the Supplement Myths,”  you know that my wife and I did not change our diet overnight. Our diet evolved to something very close to the Planetary Diet over a period of years.

The Commission also purposely designed the Planetary Diet so that you “never have to say never” to your favorite foods. Three ounces of red meat a week does not sound like much, but it allows you a juicy steak once a month.

Sometimes you just need to develop a new mindset. As I shared in my books, my father prided himself on grilling the perfect steak. I love steaks, but I decided to set a few parameters. I don’t waste my red meat calories on anything besides filet mignon at a fine restaurant. It must be a special occasion, and someone else must be buying. That limits it to 2-3 times a year. I still get to enjoy good steak, and I stay well within the parameters of the Planetary diet.

Develop your strategy for enjoying some of your favorite foods within the parameters of the Planetary Diet and have fun with it.

The Bottom Line

 

Is your diet destroying the planet? This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report serves as a dire warning of what will happen to us and our planet if we don’t change our ways.

The Commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The Commission described the typical American diet as a “lose-lose diet.”  It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

The Planetary Diet is similar to other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable (for details, read the article above).

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

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