title: Dietary intake of vitamin K is inversely associated with mortality risk.
abstract: Vitamin K has been related to cardiovascular disease and cancer risk. However, data on total mortality are scarce. The aim of the present study was to assess the association between the dietary intake of different types of vitamin K and mortality in a Mediterranean population at high cardiovascular disease risk. A prospective cohort analysis was conducted in 7216 participants from the PREDIMED (Prevención con Dieta Mediterránea) study (median follow-up of 4.8 y). Energy and nutrient intakes were evaluated using a validated 137-item food frequency questionnaire. Dietary vitamin K intake was calculated annually using the USDA food composition database and other published sources. Deaths were ascertained by an end-point adjudication committee unaware of the dietary habits of participants after they had reviewed medical records and linked up to the National Death Index. Cox proportional hazard models were fitted to assess the RR of mortality. Energy-adjusted baseline dietary phylloquinone intake was inversely associated with a significantly reduced risk of cancer and all-cause mortality after controlling for potential confounders (HR: 0.54; 95% CI: 0.30, 0.96; and HR: 0.64; 95% CI: 0.45, 0.90, respectively). In longitudinal assessments, individuals who increased their intake of phylloquinone or menaquinone during follow-up had a lower risk of cancer (HR: 0.64; 95% CI: 0.43, 0.95; and HR: 0.41; 95% CI: 0.26, 0.64, respectively) and all-cause mortality (HR: 0.57; 95% CI: 0.44, 0.73; and HR: 0.55; 95% CI: 0.42, 0.73, respectively) than individuals who decreased or did not change their intake. Also, individuals who increased their intake of dietary phylloquinone had a lower risk of cardiovascular mortality risk (HR: 0.52; 95% CI: 0.31, 0.86). However, no association between changes in menaquinone intake and cardiovascular mortality was observed (HR: 0.76; 95% CI: 0.44, 1.29). An increase in dietary intake of vitamin K is associated with a reduced risk of cardiovascular, cancer, or all-cause mortality in a Mediterranean population at high cardiovascular disease risk. This trial was registered at http://www.controlled-trials.com as ISRCTN35739639.
authors.affiliation: Human Nutrition Unit, Department of Biochemistry and Biotechnology, Sant Joan de Reus University Hospital, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research.
authors.forename: Martí
authors.initials: M
authors.lastname: Juanola-Falgarona
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Martínez-González
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.forename: Ramón
authors.initials: R
authors.lastname: Estruch
authors.forename: Emili
authors.initials: E
authors.lastname: Ros
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fitó
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.forename: Enrique
authors.initials: E
authors.lastname: Gómez-Gracia
authors.forename: Miquel
authors.initials: M
authors.lastname: Fiol
authors.forename: José
authors.initials: J
authors.lastname: Lapetra
authors.forename: Josep
authors.initials: J
authors.lastname: Basora
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Lamuela-Raventós
authors.forename: Lluis
authors.initials: L
authors.lastname: Serra-Majem
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Muñoz
authors.forename: Valentina
authors.initials: V
authors.lastname: Ruiz-Gutiérrez
authors.forename: Joan
authors.initials: J
authors.lastname: Fernández-Ballart
authors.forename: Mònica
authors.initials: M
authors.lastname: Bulló
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000378:metabolism / Q000401:mortality* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000517:prevention & control; D010938:Plant Oils / Q000737:chemistry; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014675:Vegetables / Q000737:chemistry; D014812:Vitamin K / Q000008:administration & dosage*; D010837:Vitamin K 1 / Q000008:administration & dosage; D024482:Vitamin K 2 / Q000008:administration & dosage
chemical_list: D010938:Plant Oils; D024482:Vitamin K 2; D014812:Vitamin K; D010837:Vitamin K 1