Cardiovascular diseases (CVDs), particularly atherosclerotic vascular diseases (ASVDs) like stroke and ischemic heart disease (IHD), are the leading global cause of death. Although ASVDs are more common in men, older women also experience a higher stroke burden, which is underrepresented in the research studies. Consumption of healthy diets rich in leafy greens and cruciferous vegetables lowers mortality from ASVDs, mainly due to the presence of a common nutrient called vitamin K1. This vitamin may reduce the risk of ASVD by preventing vascular calcification via activation of matrix GLA protein (MGP).
Although some previous studies have shown no association, vitamin K2 may still offer health benefits. Although limited food data precludes current dietary guidelines from focusing on K1, they do emphasize the use of region-specific databases for accuracy. A recent study published in the European Journal of Nutrition aimed to examine the dietary vitamin K1 intake and its association with subclinical atherosclerosis (common carotid intima-media thickness [CCA-IMT]) and long-term ASVD events among Australian older women.
A total of 1,436 (mean age = 75.1 ± 2.7 years, body mass index = 27.2 ± 4.7 kg/m2) community-dwelling women from the Perth Longitudinal Study of Ageing Women (PLSAW) were included in this study. Consumption of vitamin K1 was estimated through a validated semiquantitative food frequency questionnaire (FFQ, n= 74 questions) at baseline (1998). A region-matched vitamin K food database was used for the analysis. CCA-IMT was measured in 2001 (n = 1,090) via ultrasound. ASVD events (hospitalization and mortality) were tracked over 14.5 years using linked hospital and mortality data from the Western Australia data linkage system. All statistical analyses were conducted using Stata MP (Version 18.0), the Statistical Package for the Social Sciences (SPSS, Version 29.0), and R software (Version 3.4.2).
Based on their dietary intake of vitamin K1, all participants were divided into four quartiles: Q1 (< 61.1 µg/d), Q2 (61.1 to < 78.7 µg/d), Q3 (78.7 to < 99.1 µg/d), and Q4 (≥ 99.1 µg/d). A statistically significant inverse associations were found between vitamin K1 intake and both maximum (Spearman’s rank-order correlation [ρ] = –0.089, p = 0.003) and mean (ρ = –0.091, p = 0.003) CCA-IMT. When compared to the lowest intake of vitamin K1 (Q1), mean CCA-IMT was found to be lower by 3.1% (Q2, p = 0.025), 4.1% (Q3, p = 0.004), and 5.6% (Q4, p < 0.001). Also, the maximum CCA-IMT was lower by 3% (Q2, p = 0.028), 4.3% (Q3, p = 0.003), and 5.4% (Q4, p < 0.001).
Over 14.5 years of follow-up, higher vitamin K1 was linked to significantly lower risk of ASVD events (n = 620), hospitalization (n = 497), and mortality (n = 301). Multivariable-adjusted analysis demonstrated that the highest consumption of vitamin K1 (Q4) was correlated with lower relative hazards for ASVD mortality (Hazards ratio [HR] 0.74, 95% confidence interval [CI]:0.57–0.96) ASVD events (HR 0.71, 95% CI:0.55–0.92) and compared to the Q1 group. However, no significant association was observed for ASVD hospitalization (HR 0.83, 95% CI:0.63–1.11).
Moreover, higher vitamin K1 intake was significantly associated with lower mortality of IHD in Q4 group (HR 0.54, 95% CI:0.33–0.87) and Q3 group (HR 0.65, 95% CI:0.45–0.93). This association remained similar across body weight, kidney function, diet quality, and competing risk analysis.
This study was limited by its observational design, older Caucasian female cohort, and dependence on self-reported dietary data. Vitamin K2 intake and biomarkers of vascular calcification were not assessed, limiting generalizability and causality.
In conclusion, this study highlights that consumption of higher vitamin K1 (~ 120 µg/day) was associated with lower ASVD mortality and subclinical atherosclerosis. Increasing the intake of cruciferous and leafy green vegetables daily may support cardiovascular health.
Reference: Dupuy M, Zhong L, Radavelli-Bagatini S, et al. Higher vitamin K1 intakes are associated with lower subclinical atherosclerosis and lower risk for atherosclerotic vascular disease–related outcomes in older women. Eur J Nutr. 2025;64:171. doi:10.1007/s00394-025-03686-x
