Blackmores Institute

Researchers from the Department of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine conducted a systematic review to analyse the combined effect of vitamin K and calcium. Although there were many study differences, the results showed overall that this nutritional combination led to higher lumbar spine BMD. <table> <tr><td> Key Points - Systematic review of combined vitamin K and calcium on BMD and UcOC levels - ­Results showed higher lumbar spine BMD and decreased UcOC levels - ­May be most beneficial in females when taking ≤ 1000 mg/d of calcium combined with ≤100 µg vitamin K - ­Combining vitamin K with calcium may be the key to higher BMD </td></tr> </table><h3>Systematic review analysis and results</h3> This 2021 systematic review involved 10 randomised trials and 1346 participants. Reviewers included trials that measured lumbar BMD, femoral BMD and undercarboxylated osteocalcin (UcOC) levels. The subjects were over 18 years and had taken Vitamin K and calcium supplements for at least six months. UcOC is a marker of bone turnover, with higher percentages linked to increased fracture risk. Osteocalcin is a protein within the bone matrix, that is carboxylated within the osteoblasts (bone-building cells). This process needs Vitamin K. The analysis showed that Vitamin K combined with calcium was associated with higher lumbar spine BMD with a decrease in UcOC levels.<h3>Subgroup analysis provides dosing guidance</h3>When reviewing subgroups, researchers found that there was specific gender and dose information associated with the results. They stated that, ‘When the participant was female, calcium dosage was ≤ 1000 mg/d, and the vitamin K dosage ≤100 µg, the combination with calcium was associated with a higher lumbar spine BMD…’ Although there were dosage and timing differences between the studies, they stated that these subgroup results were not necessarily the contributing factors. <h3>Vitamin K and calcium combination for BMD</h3>Peak bone mass occurs around the ages of 30-35. Therefore, it is important that adolescents and older adults have a good nutritional intake with bone nutrients. This review provides support for the use of combining vitamin K with calcium to support bone mass density, and potentially reducing the risk and consequences of osteoporosis. Sources:Hu L, et al.: The combined effect of vitamin k and calcium on bone mineral density in humans: A meta-analysis of randomized controlled trials. J Orthop Surg Res. 2021;16(1):592. DOI: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515712/" target="_blank">10.1186/s13018-021-02728-4</a>Lin X, et al.: Undercarboxylated osteocalcin: Experimental and human evidence for a role in glucose homeostasis and muscle regulation of insulin sensitivity. Nutrients. 2018;10(7). rel="noopener noreferrer" DOI: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073619/" target="_blank">10.3390/nu10070847</a>Australian Institute of Health and Welfare 2020. Osteoporosis. Cat. rel="noopener noreferrer" no. PHE 233. Canberra: AIHW. Available from: <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoporosis" target="_blank">https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoporosis</a>

Bone-related diseases are a major public health issue, with around 924,000 of Australians (or 3.8% of the population) suffering from osteoporosis. As life expectancy increases, so does this disease, with over 1 in 4 women affected. Nutrition is key in the prevention of osteoporosis, and research has focused on nutrients such as calcium and vitamin K for bone health. However, studies using vitamin K combined with calcium supplementation in bone mass density (BMD) have been inconclusive, with no available systematic review to provide clarity.

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