Abstract

Background: Vitamin K has been associated with various health outcomes, including non-fatal cardiovascular diseases and cancer. However, little is known about the association between vitamin K intake and all-cause and cause specific mortality. Objective: To investigate the association between vitamin K intake and all-cause and cause specific mortality. Methods: This prospective cohort study included 33,289 participants, aged 21-70 years from the EPIC-NL cohort. Participants were recruited between 1993 and 1997 and the follow-up is complete until December 2012. Dietary intake was assessed at baseline with a 178-item validated food frequency questionnaire and intakes of total vitamin K intake and its sub forms, phylloquinone, menaquinones (MK), short-chain menaquinones (SMK) and long-chain menaquinones (LMK) were calculated. Information on vital status and causes of death was obtained through linkage to several registries. The association between the different forms of vitamin K intake and mortality was assessed with Cox proportional hazard regression, adjusted for risk factors for chronic diseases (gender, age, BMI, physical activity, smoking status, education level) and nutrient intake. Results: During a median follow-up of 16.8 years, 2,863 deaths occurred, including 625 from CVD (256 CHD specific), 1,346 from cancer and 894 from other causes. After multivariable adjustment, vitamin K intake was not associated with all-cause mortality with hazard ratios for the upper vs. the lowest quartile of phylloquinone and menaquinone intake of 1.04 (0.93-1.17) and 0.94 (0.82-1.07) respectively. Phylloquinone intake nor menaquinone intake was associated with risk of CVD mortality. Higher intake of LMK was borderline significantly associated (p trend = 0.06) with lower CHD mortality with a HR per 10 μg of 0.87 (0.75-1.01). None of the forms of vitamin K intake were associated with cancer mortality or mortality from other causes. Conclusions: Vitamin K intake was not associated with all-cause mortality, cancer mortality and mortality from other causes. A higher intake of LMK tended to be associated with a lower risk of CHD mortality.

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