Background: Vitamin K mediates the gamma-carboxylation of glutamyl residues
on several bone proteins, notably osteocalcin. High serum concentrations o
f undercarboxylated osteocalcin and low serum concentrations of vitamin K a
re associated with lower bone mineral density and increased risk of hip fra
cture. However, data are limited on the effects of dietary vitamin K.
Objective: We investigated the hypothesis that high intakes of vitamin K ar
e associated with a lower risk of hip fracture in women.
Design: We conducted a prospective analysis within the Nurses' Health Study
cohort. Diet was assessed in 72 327 women aged 38-63 y with a food-frequen
cy questionnaire in 1984 (baseline). During the subsequent 10 y of follow-u
p, 270 hip fractures resulting from low or moderate trauma were reported.
Results: Women in quintiles 2-5 of vitamin K intake had a significantly low
er age-adjusted relative risk (RR: 0.70; 95% CI: 0.53, 0.93) of hip fractur
e than women in the lowest quintile (<109 mu g/d). Risk did not decrease be
tween quintiles 2 and 5 and risk estimates were not altered when other risk
factors for osteoporosis, including calcium and vitamin D intakes, were ad
ded to the models. Risk of hip fracture was also inversely associated with
lettuce consumption (RR: 0.55; 95% CI: 0.40, 0.78) for one or more servings
per day compared with one or fewer servings per week), the food that contr
ibuted the most to dietary vitamin K intakes.
Conclusions: Low intakes of vitamin K may increase the risk of hip fracture
in women. The data support the suggestion for a reassessment of the Vitami
n K requirements that are based on bone health and blood coagulation.