Two-year randomized controlled trial of vitamin K1 (phylloquinone) and vitamin D3 plus calcium on the bone health of older women.

UNLABELLED: Dietary supplementation with vitamin K(1), with vitamin D(3) and calcium or their combination, was examined in healthy older women during a 2-year, double-blind, placebo-controlled trial. Combined vitamin K with vitamin D plus calcium was associated with a modest but significant increase in BMC at the ultradistal radius but not at other sites in the hip or radius. INTRODUCTION: The putative beneficial role of high dietary vitamin K(1) (phylloquinone) on BMD and the possibility of interactive benefits with vitamin D were studied in a 2-year double-blind, placebo-controlled trial in healthy Scottish women > or =60 years of age. MATERIALS AND METHODS: Healthy, nonosteoporotic women (n = 244) were randomized to receive either (1) placebo, (2) 200 microg/day vitamin K(1), (3) 10 microg (400 IU) vitamin D(3) plus 1000 mg calcium/day, or (4) combined vitamins K(1) and D(3) plus calcium. Baseline and 6-month measurements included DXA bone mineral scans of the hip and wrist, markers of bone turnover, and vitamin status. Supplementation effects were tested using multivariate general linear modeling, with full adjustment for baseline and potential confounding variables. RESULTS: Significant bone mineral loss was seen only at the mid-distal radius but with no significant difference between groups. However, women who took combined vitamin K and vitamin D plus calcium showed a significant and sustained increase in both BMD and BMC at the site of the ultradistal radius. Serum status indicators responded significantly to respective supplementation with vitamins K and D. Over 2 years, serum vitamin K(1) increased by 157% (p < 0.001), the percentage of undercarboxylated osteocalcin (%GluOC) decreased by 51% (p < 0.001), serum 25-hydroxyvitamin D [25(OH)D] increased by 17% (p < 0.001), and PTH decreased by 11% (p = 0.049). CONCLUSIONS: These results provide evidence of a modest synergy in healthy older women from nutritionally relevant intakes of vitamin K(1) together with supplements of calcium plus moderate vitamin D(3) to enhance BMC at the ultradistal radius, a site consisting of principally trabecular bone. The substantial increase in gamma-carboxylation of osteocalcin by vitamin K may have long-term benefits and is potentially achievable by increased dietary intakes of vitamin K rather than by supplementation.

Comparative dietary intake and sources of phylloquinone (vitamin K1) among British adults in 1986-7 and 2000-1.

Using data from 7 d weighed dietary records, dietary intake and sources of phylloquinone (vitamin K1) were examined by socio-demographic and lifestyle factors in 1916 participants aged 16-64 years from the 1986-7 Dietary and Nutritional Survey of British Adults, and 1423 participants aged 19-64 years from the 2000-1 National Diet and Nutrition Survey. Using UK-specific food content data, geometric mean phylloquinone intakes were estimated as 72 (95% CI 70, 74) and 67 (95% CI 65, 69) microg/d in 1986-7 and 2000-1 respectively (P<0.001). In 1986-7, 47% of participants had phylloquinone intakes below the UK guideline for adequacy (> or =1 microg/kg body weight per d), compared with 59% in 2000-1 (P<0.001). In both surveys, daily phylloquinone intake was higher among men than women and increased significantly with age. Participants of manual occupational social class, or who were smokers, had lower phylloquinone intake than their counterparts. Participants living in Scotland and northern England had lower phylloquinone intake than those living elsewhere in mainland Britain, particularly in 1986-7 when the contribution from vegetables was also lower than elsewhere. However, by 2000-1 this regional difference was no longer significant. Overall, vegetables contributed 63% of phylloquinone intake in 1986-7 and 60% in 2000-1, with cooked leafy green vegetables (LGV) providing 23 and 19% respectively. In both surveys, the contribution of vegetables (cooked LGV in particular) was directly associated with age. These data show a decrease in phylloquinone intake from 1986-7 to 2000-1, mainly owing to lower consumption of cooked LGV.

A newly constructed and validated isoflavone database for the assessment of total genistein and daidzein intake.

The principal phyto-oestrogens (PO) in food are isoflavones, lignans, coumestans and prenylated flavonoids, with isoflavones and lignans being the most commonly found in UK diets. Until recently obtaining accurate data on the PO content of foods was hampered by lack of suitable analytical methods and validation techniques. Furthermore, although PO data exist for some foods, these foods may not be available in the UK. The aim of the present study was to construct a new, comprehensive isoflavone (total genistein + daidzein) database. Using data, mainly from recent GC-MS analysis, for approximately 300 foods available in the UK, and extensive recipe calculations, a new database was constructed containing approximately 6000 foods allocated an isoflavone value. By analysing 7 d weighed food diaries, the database was subsequently used to estimate isoflavone intake in two groups of healthy volunteers, omnivores (n 9) and vegetarians (n 10). Mean isoflavone intake in the vegetarian and omnivorous group was 7.4 (sem 3.05) and 1.2 (sem 0.43) mg/d, respectively. Mean intake for the total group was 4.5 (sem 1.89) mg/d. Main food sources of isoflavones for the vegetarian group were soya milk (plain), meat-substitute foods containing textured vegetable protein and soya protein isolate, soya mince, wholemeal bread and rolls, white bread and rolls, croissants and pitta breads, beans, raisins and soya sauce. Main food sources of isoflavones for the omnivorous group were soya yogurts, wholemeal bread and rolls, white bread and rolls, garlic bread, nan bread and brown bread, sultanas and scones.

Energy intakes of children after preloads: adjustment, not compensation.

BACKGROUND: Young children accurately compensate for energy-dense preloads consumed before test meals. The accuracy of compensation seems to deteriorate as a function of age. OBJECTIVE: The hypothesis that accurate energy compensation varies by age, body mass index, and individual characteristics of children and their mothers was tested. DESIGN: Energy intake (EI) from a test meal was measured in 74 children aged 6-9 y 90 min after the ingestion of no-energy (NE), low-energy (LE), or high-energy (HE) preload snacks. The NE preload consisted of 250 mL water, the LE preload consisted of a 56-g muffin + a 250-mL orange drink (783 kJ), and the HE preload consisted of a 56-g muffin + a 250-mL orange drink (1628 kJ). RESULTS: A significant dose-related reduction in EI was found after the preloads; younger children adjusted more effectively than did older children, although total EI (including preload energy) indicated that the adjustment was not accurate. The compensation index (COMPX) differed by preload and age group; COMPX scores were higher between the NE and LE preloads (younger children: 44.4 +/- 9.3%; older children: 57.0 +/- 11.6%) than between the NE and HE preloads (39.6 +/- 4.9%; 31.3 +/- 6.2%) and the LE and HE preloads (35.2 +/- 7.8%; 7.4 +/- 9.8%). This finding indicates a more consistent response across preloads and a greater sensitivity to energy load by younger than by older children. High interindividual variation and low intraindividual variation in COMPX was found. The tendency to over- or undereat in response to the preloads (deviation from perfect) correlated directly and positively with maternal concerns about child overweight, not with actual BMI. CONCLUSIONS: The children adjusted their EIs in response to different preloads, and the younger children did so more effectively than did the older children. Poor short-term energy compensation may constitute a behavioral marker for positive energy balance.

Beyond deficiency: potential benefits of increased intakes of vitamin K for bone and vascular health.

Vitamin K is well known for its role in the synthesis of a number of blood coagulation factors. During recent years vitamin K-dependent proteins were discovered to be of vital importance for bone and vascular health. Recommendations for dietary vitamin K intake have been made on the basis of the hepatic requirements for the synthesis of blood coagulation factors. Accumulating evidence suggests that the requirements for other functions than blood coagulation may be higher. This paper is the result of a closed workshop (Paris, November 2002) in which a number of European vitamin K experts reviewed the available data and formulated their standpoint with respect to recommended dietary vitamin K intake and the use of vitamin K-containing supplements.

Phylloquinone (vitamin K1) intakes and food sources in 18-64-year-old Irish adults.

Dietary vitamin K1 (phylloquinone) levels that are sufficient to maintain normal blood coagulation may be sub-optimal for bone, and habitual low dietary intakes of vitamin K may have an adverse effect on bone health. The objective of the present study was to measure the intake and adequacy of phylloquinone intake and the contribution of foods to phylloquinone intake in a nationally representative sample of Irish adults. The North/South Ireland Food Consumption Survey database was used, which contains data collected using a 7 d food diary in a randomly selected sample of Irish adults aged 18-64 years (n 1379; 662 men and 717 women). Phylloquinone intakes were estimated using recently compiled food composition data for phylloquinone. The mean daily intake of phylloquinone from food sources was 79 (SD 44) microg. Intakes were significantly higher (P<0.001) in men than in women at levels of 84 and 75 microg/d. The main contributors to phylloquinone intakes were vegetables (48 %), particularly green vegetables (26 %). Potatoes (including chipped and fried potatoes), dairy products and fat spreads contributed 10 % each and meat contributed 8 %. In men, social class and smoking status influenced phylloquinone intakes. Of the population, 52 % had phylloquinone intakes below 1 microg/kg body weight and only 17 % of men and 27 % of women met the US adequate intakes of 120 and 90 microg/d, respectively. The present study shows that habitual phylloquinone intakes in Irish adults are low, which may have implications for bone health.

The effects of dietary fatty acid supplementation on endothelial function and vascular tone in healthy subjects.

OBJECTIVE: Evaluation of the effects of supplementation of n-3 and n-6 fatty acids on vascular tone and endothelial function in healthy men and women aged 40 to 65 years. METHODS: In a double-blind, randomised, placebo controlled study, 173 healthy volunteers took one of six oil supplements for 8 months. Supplements were placebo, oleic acid rich sunflower oil, evening primrose oil, soya bean oil, tuna fish oil, and tuna/evening primrose oil mix. Endothelium-dependent and independent vascular responses were measured in the forearm skin using laser Doppler imaging following iontophoretic applications of acetylcholine and sodium nitroprusside, respectively. RESULTS: Acetylcholine, but not sodium nitroprusside responses were significantly improved after tuna oil supplementation (P=0.02). Additionally, there were significant positive correlations between acetylcholine responses and n-3 fatty acid levels in the plasma and erythrocyte membrane phospholipids after tuna oil supplementation. No significant changes in vascular response were seen after supplementation with any of the other oils. CONCLUSIONS: Fish oil supplementation has a beneficial effect on endothelial function, even in normal healthy subjects. Modification of the diet by an increase of 6% in eicosapentaenoic acid and 27% in docosahexaenoic acid (equivalent to eating oily fish 2-3 times/week) might have significant beneficial effects on cardiovascular function and health.

Consumption of whole-grain foods by British adults: findings from further analysis of two national dietary surveys.

OBJECTIVE: To assess the consumption of whole-grain foods in different age and sociodemographic groups in Great Britain, using data from two national surveys. DESIGN: Cross-sectional analysis of the consumption of whole-grain foods. SETTING: The 1986-87 Dietary and Nutritional Survey of British Adults and the 1994-95 National Diet and Nutrition Survey of people aged 65 years and over. SUBJECTS: In 1986-87, 2086 British adults aged 16-64 years; 1189 British adults aged 65 years and over in 1994-95. RESULTS: In the 1986-87 survey population, consumption of whole-grain foods increased with age. Median consumption of whole-grain foods was 1 serving per week in 16-24-year-olds and 3 servings per week in the 35-64-year-olds In 1994-95, median consumption was 5 servings per week in adults aged 65 years and over. Overall, one-third of British adults ate no whole-grain foods on a daily basis, and less than 5% ate 3 or more servings per day. Manual occupation and smoking were consistently associated with a higher proportion of non-consumers and fewer servings per week of whole-grain foods, independent of age, sex, region and season (each ). The main sources of whole-grain foods were wholemeal bread and breakfast cereals, which accounted for more than three-quarters of all servings. CONCLUSIONS: Consumption of whole-grain foods in the adult UK populations is more prevalent in the non-smoking, higher socio-economic groups. Amongst consumers of whole-grain foods, the frequency is similar to that reported in the USA and Norway.

UK Food Standards Agency Optimal Nutrition Status Workshop: environmental factors that affect bone health throughout life.

The UK Food Standards Agency (FSA) convened a group of expert scientists to discuss and review UK FSA- and Department of Health-funded research on diet and bone health. This research focused on the lifestyle factors that are amenable to change and may significantly affect bone health and the risk of osteoporotic fracture. The potential benefits of fruits and vegetables, meat, Ca, vitamins D and K and phyto-oestrogens were presented and discussed. Other lifestyle factors were also discussed, particularly the effect of physical activity and possible gene-nutrient interactions affecting bone health.