Nutritional strategies for skeletal and cardiovascular health: hard bones, soft arteries, rather than vice versa (O’Keefe JH et al.)

A new review paper published in Open Heart focuses on nutritional strategies that can significantly improve skeletal health and decrease the risk of cardiovascular disease.

Poor bone strength is a serious problem of majority of Americans. According to the US Surgeon General’s Report, 1 in 2 Americans over age of 50 is expected to have or to be at risk of developing osteoporosis. Osteoporosis causes 8.9 million fractures annually, with an estimated cumulative cost of incident fractures predicted at $474 billion over the next 20 years in the US. Public health approaches are crucial to prevent symptomatic bone disease, but widespread pharmacological prophylaxis is prohibitively expensive and carries potential serious adverse effects.

The researchers pointed out that dietary changes, including insufficient calcium and excess phosphate, are the key reasons of increased fractures. Strong epidemiological associations exist between decreased bone mineral density (BMD) and increased risk of both cardiovascular (CV) disease and CV death. For example, individuals with osteoporosis have a higher risk of coronary artery disease, and vice versa. This problem will be magnified if the therapies for osteoporosis (e.g., calcium supplements) independently increase risk of MI. The recently updated US Preventive Services Task Force (USPSTF) has stated that there is insufficient evidence that calcium and vitamin D prevent fractures in premenopausal women or in men who have not experienced a prior fracture. Indeed, the USPSTF now recommends against daily calcium supplementation for primary prevention of fragility fractures; stating, ‘the balance of benefits and harms cannot be determined’.

The authors comprehensively and systematically reviewed the scientific literature in order to determine the optimal dietary strategies and nutritional supplements for long-term skeletal health and cardiovascular health. They summarized what is helpful for building strong bones while maintaining soft and supple arteries. The recommendation was to obtain calcium from dietary sources (the best choice is calcium-hydroxyapatite, particularly effective for building bone) with the adequate intake of animal protein, fruits and vegetables. A concomitant increase of potassium consumption while reducing sodium intake should be taken into account.

The authors emphasized that two fat-soluble vitamins such as vitamin D and vitamin K are crucial for healthy bones and arteries. They mentioned a large observational study that showed that while supplementation with phytonadione (Vitamin K1) improved bone health, Vitamin K2 was even more effective in this regard. This large and statistically rigorous meta-analysis concluded that high Vitamin K2 levels were associated with reduced vertebral fractures by approximately 60%, hip fractures by 77% and all non-vertebral fractures by approximately 81%.  Further, supplementation with Vitamin K2 as MK-7 increased bone strength in postmenopausal women in a 3-year clinical study.

“While Vitamin K2 has been shown clinically to contribute to helping one maintain their bone health, it has also been demonstrated to improve cardiovascular health,” says Dr. Katarzyna Maresz, president of the International Science and Health Foundation. “A 3-year study published in Thrombosis and Haemostasis showed that supplementation with just 180 mcg of Vitamin K2 as MK-7 daily actually increased arterial elasticity.

“This evidence makes Vitamin K2 an irrefutable tool in the fight for improved bone and cardiovascular health,” Dr. Maresz concludes.


O’Keefe JH, Bergman N, Carrera-Bastos P, et al. Nutritional strategies for skeletal and cardiovascular health: hard bones, soft arteries, rather than vice versa. Open Heart 2016;3:e000325. doi:10.1136/openhrt-2015-000325

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