The Link Between Bone Health and Cardiovascular Health

Osteoporosis, the weakening of bones caused by mineral bone loss, affects over two million Canadians and many more who have not been diagnosed. The disease is associated with an increased risk of bone fractures and a loss of independence. It primarily affects postmenopausal women. During menopause, women can experience an alarming bone density loss of 2-5% per year.1 When it comes to preventing osteoporosis, no vitamin or mineral is as closely associated with bone health as calcium. Through Health Canada's dietary recommendations, advice from our healthcare professionals, and milk advertisements we see on TV every day, the link between calcium and bones is persuasive. Indeed, it is true that calcium is essential for bone health. Calcium provides the protective "concrete" layer necessary for the collagen framework of our skeletal structure. Our bones act as storage for the body's calcium. However, humans cannot produce calcium; we must obtain it from our diet.Due to the high incidence of osteoporosis and osteopenia in the aging population, it is assumed that calcium intake needs to be increased. Many women take a 1,200 mg calcium supplement daily to prevent or slow down osteoporosis, as recommended by their healthcare professional. However, more recent studies are beginning to question whether taking high amounts of calcium is truly beneficial. Recently, the media published headlines claiming that "Calcium pills taken by hundreds of thousands of women double the risk of heart attack and could do more harm than good" (Daily Mail, May 2012), leading calcium users to question their intake of this mineral.2 A large study conducted by the University of Auckland, looking for people taking calcium supplements in Germany, was behind these headlines and concluded that high-dose calcium supplements could indeed increase the incidence of heart attacks. The study was highly controversial, and some believed that more studies needed to be done before such conclusions could be drawn. The study authors concluded that calcium-only supplements were not as well utilized by the body as calcium from food sources.3 Recently, vitamin D, the sunshine vitamin, has received increased attention for its role in bone health. Vitamin D helps us absorb a higher percentage of our calcium intake. In Canada, vitamin D supplementation is often recommended due to our low vitamin D intake during the winter months when daylight is reduced. However, vitamin D has its limitations. While it promotes calcium absorption, it does not direct calcium to the bones. Another specialized vitamin is needed to increase calcium assimilation into the bones. Vitamin K2 While many people have increased their calcium intake, the incidence of osteoporosis and cardiovascular events has also continued to rise. Emerging, and often overlooked, research reveals that our intake of another much-needed nutrient for our bones has decreased: vitamin K2. Previously, vitamin K2, a fat-soluble vitamin, was abundant in our diet. It is found in animal by-products that we consume every day, particularly in meat, eggs, dairy products, and cheese. Animals consume vitamin K1 from the grass they eat while grazing and convert it into K2 in their own bodies; humans obtain most of their K2 by consuming animal by-products. Unfortunately, times have changed. Through our modern agricultural techniques, most domesticated animals are kept in barns and fed grains rather than grass. By not consuming grass, animals do not get enough vitamin K1, which they would usually use to provide K2-rich by-products. By being housed indoors, animals no longer benefit from vitamin D through exposure to sunlight. While vitamin D is often fortified in animal feed or added to milk for human consumption, vitamin K is not. Research indicates that K2 can prevent some of the negative consequences of high calcium intake. K2 ensures that calcium intake is used for bones rather than accumulating in arteries and soft tissues. Calcium in bones helps increase bone density. Calcium in the blood becomes a primary mineral contained in plaque deposits that harden in the arteries, leading to cardiovascular disease. Cardiovascular disease is linked to one-third of human deaths.4 Vitamin K1 is a bound form of vitamin K found in green leafy vegetables. It is not greatly needed for bone or cardiovascular health. It plays a role in blood clotting. Unlike vitamin K2, vitamin K1 is rarely deficient in humans. People taking anticoagulants should monitor their consumption of foods containing vitamin K1. How does vitamin K2 work? To simplify a very complex process, vitamin K2 is a protein activator. Its presence activates MGP (matrix Gla proteins) and osteocalcin. Calcium adheres to these two proteins when they are activated. Activated matrix Gla proteins remove calcium from soft tissues, organs, and arteries. Activated osteocalcin helps calcium stick to bones. These two actions make vitamin K2 effective for bone and cardiovascular health. Sources of vitamin K2 There are two main sources of vitamin K2 commonly available in supplements: MK-4 and MK-7. Both are found in animal by-products. However, MK-4 is only available as a synthetic supplement source. MK-7 is available as a natural source supplement. The fermentation of soybeans with Bacillus Subtilis bacteria to create the traditional Japanese food, natto, produces a rich natural source of the MK-7 form of vitamin K2. Vitamin K2: Clinical data on bone health Although vitamin K2 does not receive the attention it deserves, clinical data on its effectiveness is well documented. A study showed that Japanese women in regions where natto (fermented soybeans) is regularly consumed have a higher concentration of MK-7 (vitamin K2) than women in other regions where natto is rarely consumed. Furthermore, Japanese women in natto-consuming regions had a reduced risk of bone fractures. A similar study also concluded that osteocalcin, a substance that attracts calcium to bones, is found in higher concentrations in people who regularly consume natto.6 A three-year study completed in 2013 evaluated postmenopausal women taking a daily supplement of 180 mcg of the MK7 form of vitamin K2. The study showed that vitamin K2 levels were effectively increased and concluded that MK-7 helped reduce bone density and mineral content loss while increasing bone strength.7 A three-year double-blind study on vitamin K2 supplementation showed that women taking vitamin K2 experienced an increase in bone mineral content. 8 Vitamin K2: Clinical Evidence on Cardiovascular Health A large study conducted in the Netherlands, involving nearly 5,000 patients over a ten-year period, suggested that the consumption of vitamin K2-rich foods could reduce the risk of arterial calcification and cardiovascular disease by as much as 50%.9 Another Dutch study conducted in 2009 concluded that patients consuming a higher dietary level of K2 had a reduced rate of coronary calcification. After 8 years, the incidence of coronary heart disease was reduced by 9% for every 10 mcg of vitamin K2 consumed. Researchers commented that the MK-7 form of vitamin K2 could play an important role in reducing cardiovascular disease.10 MK-7 supplements have been shown to improve arterial stiffness in postmenopausal women in a double-blind, placebo-controlled study. Women with a higher degree of stiffness benefited the most.11 Vitamin K2 Max by Health First® Potent Dose: Vitamin K2 Max meets Health Canada's highest allowable daily dose of vitamin K2 per 120 mcg serving. Superior Fermented Form: It contains the preferred form of K2, MK-7 (menaquinone-7), from fermented soybeans. These beans contain the Bacillus Subtilis bacteria, producing the richest natural source of vitamin K2. This form of K2 is more absorbable and longer-lasting than synthetic forms. References: 1. Osteoporosis Canada. www.osteoporosis.ca 2. Hope, Jenny. Calcium pills taken by hundreds of thousands of women ‘double risk of heart attack and could do more harm than good’. May 22, 2012, Daily Mail. http://www.dailymail.co.uk/news/article-2149031/Calcium-booster-pills-raise-risk-heart-attack-harmgood.html#ixzz21nlFlR5S 3. J. Bolland, A. Grey, A. Avenell, G. D. Gamble, I. R. Reid. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ, 2011; 342 (apr19 1): d2040 DOI 4. Vitamin K2 Shown to Reduce CVD Risk. www.vitamink2.org. International Health and Science Foundation. 5. Sato et al., “Comparison of Menaquinone-4 and Menaquinone-7 bioavailability in healthy women.” Nutritional Journal 2012 6. Kaneki, M. et al. Japanese fermented soybean food as the major determinant of the large geographic difference in circulating levels of vitamin K2: possible implications for hip-fracture risk. Nutrition. 2001 Apr;17(4):315-21. 7. Knapen, MH et al. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporos Int. 2013 Sep;24(9):2499-507. doi: 10.1007/s00198-013-2325-6. Epub 2013 Mar 23. 8. Tsukamoto Y et al. Intake of fermented soybean (natto) increases circulating vitamin K2 (menaquinone-7) and gamma-carboxylated osteocalcin concentration in normal individuals. J Bone Miner Metab. 2000;18(4):216-22. 9. Geleijnse JM et al. Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study. J Nutr. 2004 Nov;134(11):3100-5.] 10. Gast, GC et al. A high menaquinone intake reduces the incidence of coronary heart disease. Nutr Metab Cardiovasc Dis. 2009 Sep;19(7):504-10. doi:10.1016/j.numecd.2008.10.004. Epub 2009 Jan 28. 11. Knapen et al. Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women. A double-blind randomized clinical trial. Thromb Haemost. 2015 May;113(5):1135- 44. doi: 10.1160/TH14-08-0675. Epub 2015 Feb 19. 12. Health Canada. Natural Health Products Directorate. “Multi-Vitamin/Mineral Supplements” monograph.

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The Link Between Bone Health and Cardiovascular Health

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