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VITAMIN K AND BONE HEALTH IN THE ELDERLY

INTRODUCTION

INTRODUCTION

Vitamin K is a name given to a group of fat-soluble vitamins. They are essential co-factors in humans for the production of multiple proteins that are involved in multitudinous essential processes within the body and a deficiency of vitamin K has been linked to age-related diseases (Schwalfenberg, 2017).

The health benefits of this micronutrient have been shown to extend beyond its traditional role of coagulation and to have an extra-hepatic role ensuring the correct function of several extra-hepatic VKDPs. These have been described as playing different roles in both physiological and pathological processes including; tissue mineralization, neuroprotection, energy metabolism, inflammation and cellular growth and survival.

VITAMIN K FORMS

Vitamin K1

https://www.researchgate.net/figure/Chemical-structure-of-Vitamin-K1_fig1_280490162

There are two natural forms of Vitamin K: Vitamin K1, which is also known as phylloquinone and vitamin K2, also known as menaquinone.

Recently, the potential use of vitamin K2 in the prevention and clinical treatment of cancer was recently reviewed (Xv et al., 2018) and this multifunctional vitamin has been implicated in chronic age-related diseases such as cardiovascular diseases, osteoporosis and osteoarthritis (Harshman & Shea, 2016). In addition, a role has also been disclosed for vitamin K as an antioxidant and anti-inflammatory (Fujii et al., 2015).

Vitamin K2

https://www.researchgate.net/figure/Chemical-structures-of-vitamin-K-and-metabolites_fig1_317147059

AGE RELATED BONE LOSS

AGE RELATED BONE LOSS

Age-related bone loss involves a gradual and progressive decline (Demontiero et al., 2011). Markedly increased bone resorption leads to the initial fall in bone mineral density. With increasing age, there is also a significant reduction in bone formation. This is mostly due to a shift from osteoblastogenesis to predominant adipogenesis in the bone marrow, which also has a lipotoxic effect that affects matrix formation and mineralization. There is some evidence, utilizing rats, that indicates vitamin K2 prevents bone resorption, slows the increase in bone turnover, ameliorates the increase in bone resorption,and prevents the decrease in bone formation (Iwamoto, 2014).

This evidence suggests that vitamin K could offer same benefits could be possible in humans and offers another option in improving and managing osteoporosis and other bone health issues in the elderly - potentially improving quality of life in this.

What are the effects

of vitamin K on bone health in the elderly?

RESEARCH QUESTION

https://www.dailymail.co.uk/health/article-2124073/Popular-osteoporosis-drug-raises-risk-sight-problems-elderly.html

Several studies support the efficacy of vitamin K supplementation on bone health in the elderly, particularly for those presenting with deficiency. Many of these studies were conducted utilizing postmenopausal women with osteoporosis, and most concluded that both vitamin K1 and K2 had a protective effect on bone health - increasing bone strength and reducing bone turnover, while decreasing the risk of fractures (Iwamoto, 2014; Price et al., 2012).

RESEARCH AND

RESULTS

Vitamin K2, Osteoporosis

and Menopausal Women

A meta-analysis including 19 randomized controlled trials, and encompassing 6759 participants, was conducted to estimate the effect of vitamin K2 in the prevention and treatment of osteoporosis in postmenopausal women (Huang et al., 2014). The authors concluded that K2 treatment was able to improve vertebral bone mineral density and reduce fracture risk in osteoporotic postmenopausal women, although no effect was seen in postmenopausal women without osteoporosis (Simes et al., 2019).

https://www.inmo.ie/article/printarticle/493

In a cross-sectional and longitudinal analysis enrolling 1089 community-dwelling older adults from the Health ABC Study, a lower vitamin K status measured by plasma K1 levels and dp-ucMGP, was associated with worse lower-extremity function over 4–5 years of follow-up (Shea et al., 2016) and results suggest the involvement of vitamin K in the disabling process associated with aging.

Vitamin K status and lower extremity function

https://www.sciencephoto.com/media/115804/view/osteoporosis-in-an-elderly-female-semfor

In a prospective study involving 13 years of follow-up of 644 community-dwelling adults from the Longitudinal Aging Study Amsterdam cohort, low baseline vitamin K status (high levels of circulating dp-ucMGP) was associated with a higher frailty index score in older aging people (Machado-Fragua et al., 2020).

Vitamin K status and frailty

https://www.nia.nih.gov/health/heart-health-and-aging

Yes or No?

These results all provide evidence on the widely accepted idea that vitamin K supplementation has bone health enhancing properties on aging subjects.

There is a consensus that vitamin K can be involved in the prevention and treatment of bone debilitation through the aging process (Simes et al., 2019).

SO.......YES!

WHY VITAMIN K?

Vitamin K is involved in multiple processes in the body and it seems that recent research supports the differing roles K1 and K2 can play in the body. Consuming adequate amounts of calcium and vitamin D, especially throughout childhood, adolescence, and early adulthood,has always been promoted to maximize bone mass and reduce the risk of osteoporosis. More recently however, the effect of vitamin K intakes and status on bone health and osteoporosis has been a focus of scientific research (NIH, 2017).

TOPIC RATIONALE AND IMPACT

https://now.tufts.edu/articles/vitamin-k-secret-key-bone-strength

CAREER

IMPACT

As I age, and my friends around me age, I hope to promote lifestyle practices for peri-menopausal, menopausal and post-menopausal women including nutritional support, hormonal guidance, exercise that caters to changing bodies and a social support network. Part of that support is identifying non-invasive and accessible tools women can use to regain control over their well-being - vitamins and minerals that have the potential to alleviate and minimize physiological changes that occur due to the aging process are an important part of that toolkit.

Bone strength is a hugely influential factor in quality of life and the ability to continue to use your body to do the things you love, hence the focus on vitamin K.

It is well known that the range of vitamin K action is far beyond the scope of blood coagulation (Booth et al., 2008). Although several available studies support a protective role for vitamin K in aging and age-related conditions such as cardiovascular disease, osteoarthritis and osteoporosis, the real evidence of the benefit of vitamin K supplementation is still controversial, since most of the available studies are observational and only a few randomized trials are currently available (Simes et al., 2019).

However, the available evidence clearly supports a beneficial health effect of vitamin K and this is particularly relevant in age-related diseases and in aging conditions such as functional decline, bone degradation, sarcopenia and frailty, affecting the elderly in an aging society.

CONCLUSION

https://hvmn.com/blogs/blog/supplements-vitamin-k-complete-supplement-guide

Aging societies represent a major economic challenge for health care systems throughout the world, and diet supplements promoting healthy aging and improving the prognosis of age-related diseases are urgently needed to be implemented in clinical practice as part of a holistic approach to health and well-being for our elderly.

Aging Societies

http://www.personalcaregiving.com/tips-for-helping-your-elderly-loved-one-to-prevent-osteoporosis/

REFERENCES

Booth, S. L., Dallal, G., Shea, M. K., Gundberg, C., Peterson, J. W., & Dawson-Hughes, B. (2008). Effect of vitamin K supplementation on bone loss in elderly men and women. The Journal of Clinical Endocrinology & Metabolism, 93(4), 1217–1223. https://doi.org/10.1210/jc.2007-2490

Demontiero, O., Vidal, C., & Duque, G. (2011). Aging and bone loss: New insights for the clinician. Therapeutic Advances in Musculoskeletal Disease, 4(2), 61–76. https://doi.org/10.1177/1759720x11430858

Fujii, S., Shimizu, A., Takeda, N., Oguchi, K., Katsurai, T., Shirakawa, H., Komai, M., & Kagechika, H. (2015). Systematic synthesis and anti-inflammatory activity of ω-carboxylated menaquinone derivatives--Investigations on identified and putative vitamin K₂ metabolites. Bioorganic & Medicinal Chemistry, 23(10), 2344–2352. https://doi.org/10.1016/j.bmc.2015.03.070

Harshman, S. G., & Shea, M. K. (2016). The role of vitamin K in chronic aging diseases: Inflammation, cardiovascular disease, and osteoarthritis. Current Nutrition Reports, 5(2), 90–98. https://doi.org/10.1007/s13668-016-0162-x

Huang, Z.-B., Wan, S.-L., Lu, Y.-J., Ning, L., Liu, C., & Fan, S.-W. (2014). 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. https://doi.org/10.1007/s00198-014-2989-6

References

Iwamoto, J. (2014). Vitamin K2 therapy for postmenopausal osteoporosis. Nutrients, 6(5), 1971–1980. https://doi.org/10.3390/nu6051971

Machado-Fragua, M. D., Hoogendijk, E. O., Struijk, E. A., Rodriguez-Artalejo, F., Lopez-Garcia, E., Beulens, J. W., & van Ballegooijen, A. J. (2020). High dephospho-uncarboxylated matrix GLA protein concentrations, a plasma biomarker of vitamin K, in relation to frailty: The longitudinal aging study Amsterdam. European Journal of Nutrition, 59(3), 1243–1251. https://doi.org/10.1007/s00394-019-01984-9

Mott, A., Bradley, T., Wright, K., Cockayne, E. S., Shearer, M. J., Adamson, J., Lanham-New, S. A., & Torgerson, D. J. (2019). Effect of vitamin K on bone mineral density and fractures in adults: An updated systematic review and meta-analysis of randomised controlled trials. Osteoporosis International, 30(8), 1543–1559. https://doi.org/10.1007/s00198-019-04949-0

NIH. (2017). Office of dietary supplements - vitamin K. Nih.Gov. https://ods.od.nih.gov/factsheets/vitaminK-HealthProfessional/

Nowicka, B., & Kruk, J. (2010). Occurrence, biosynthesis and function of isoprenoid quinones. Biochimica Et Biophysica Acta, 1797(9), 1587–1605. https://doi.org/10.1016/j.bbabio.2010.06.007

Price, C. T., Langford, J. R., & Liporace, F. A. (2012). Essential nutrients for bone health and a review of their availability in the average north american diet. The Open Orthopaedics Journal, 6(1), 143–149. https://doi.org/10.2174/1874325001206010143

Schwalfenberg, G. K. (2017). Vitamins K1 and K2: The emerging group of vitamins required for human health. Journal of Nutrition and Metabolism, 2017, 1–6. https://doi.org/10.1155/2017/6254836

Simes, D. C., Viegas, C. S. B., Araújo, N., & Marreiros, C. (2019). Vitamin K as a powerful micronutrient in aging and age-related diseases: Pros and cons from clinical studies. International Journal of Molecular Sciences, 20(17). https://doi.org/10.3390/ijms20174150

Shea, M. K., Loeser, R. F., Hsu, F.-C., Booth, S. L., Nevitt, M., Simonsick, E. M., Strotmeyer, E. S., Vermeer, C., Kritchevsky, S. B., & Health ABC Study. (2016). Vitamin K status and lower extremity function in older adults: The health aging and body composition study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 71(10), 1348–1355. https://doi.org/10.1093/gerona/glv209

References

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