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  1. 20 Foods That Are High in Vitamin K
  2. Best 40 foods for vitamin K
  3. Other UMHS Sites
  4. Food Sources of Vitamin K

The other plant sources of phylloquinone are certain plant oils including soybean, canola also known as rapeseed , cottonseed, and olive Table 1. Margarine, spreads, and salad dressings derived from these plant oils are important dietary sources of phylloquinone 4 , 5. Plant oils are used for preparation of multiple mixed dishes, hence many commercially prepared foods including baked goods also contain small amounts of phylloquinone. As expected, trans fatty acid concentrations are highly correlated with dihydrophylloquinone concentrations In the US food supply commercial hydrogenation of plant oils was a common practice that prolonged shelf life of the oil-based products.

However, with current controversy regarding the health consequences of trans fatty acid intake 11 , there have been regional trans fat bans in the US food supply.

20 Foods That Are High in Vitamin K

It is anticipated that the decrease in hydrogenation of plant oils will also reduce the presence of dihydrophylloquinone in the US food supply, hence monitoring of this form of vitamin K in the food supply is warranted. Unlike trans fatty acids, dihydrophylloquinone is only present in hydrogenated plant oils, hence monitoring this form of vitamin K in the food supply is a robust approach to monitoring the practice of commercial hydrogenation of plant oils.

Menaquinones are the other category of vitamin K present in the food supply Fig. Menaquinones are often referred to as Vitamin K 2 , which is somewhat misleading given that all menaquinones are not alike in their origin or their function. Menaquinones are primarily of bacterial origin, and differ in structure from phylloquinone in their 3-substituted lipophilic side chain. The major menaquinones contain 4—10 repeating isoprenoid units indicated by MK-4 to MK; forms up to 13 isoprenoid groups have been identified. Menaquinone-4 MK-4 Fig. Instead, MK-4 is formed by a realkylation step from menadione present in animal feeds or is the product of tissue-specific conversion directly from dietary phylloquinone 12 , In the United States, menadione is the synthetic form of vitamin K used in poultry feed.

As such, MK-4 formed from menadione is present in poultry products in the US food supply However, MK-4 formed from phylloquinone is limited to organs not commonly consumed in the diet including kidney. The exceptions are dairy products with MK-4 found in milk, butter, and cheese, albeit in modest amounts. Therefore it is unlikely that MK-4 is an important dietary source of vitamin K in food supplies that do not use menadione for poultry feed nor are rich in dairy products.

There is growing interest in the health benefits of longer-chain menaquinones, which are limited to certain foods in the food supply. Menaquinone-7 MK-7 is primarily the product of fermentation using bacillus subtilis natto and is present in a traditional Japanese soybean-based product called natto.

  • Vitamin K Levels in Common Foods;
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Natto contains approximately 2. Some cheeses also contain MK-8 and MK-9 6 , but these are dependent on cheese production practices, hence the food composition databases are limited in their ability to characterize menaquinone intake across different food supplies. These guidelines are termed adequate intakes AI because the Institute of Medicine concluded in that there were insufficient data available to generate a precise recommendation for vitamin K. In the absence of abnormal bleeding associated with low vitamin K intakes among adults, it was assumed that the current intakes are adequate.

However, the adequacy of intake defined by an absence of bleeding is controversial. Furthermore, the elderly report median intakes below the current AI for adults. As reviewed elsewhere 16 , there is controversy regarding biochemical measures of subclinical vitamin K deficiency and as a consequence, the true dietary requirement of vitamin K is unknown. For the purpose of this review, dietary intakes of vitamin K will be presented relative to the current AI.

Estimates of phylloquinone intake in various populations are probably more accurate than intakes of other forms of vitamin K and there is a substantial difference in the reported intakes from a number of countries, which seems to be related to food consumption practices in different areas 18 — For example, the mean reported vitamin K intake of young Japanese women mean Of note, phylloquinone intakes have been decreasing over the last two decades in the United Kingdom, consistent with a concomitant decline in leafy green vegetable consumption This observation supports the findings of others who have reported very low phylloquinone intakes among those in nursing homes 26 and those with Alzheimer's disease Given emerging association of low vitamin K intakes with risk of certain diseases such as cardiovascular disease and osteoarthritis 16 , the elderly present a potentially vulnerable subgroup of the population with respect to vitamin K.

In one study among adults with acute bacterial overgrowth as induced by omeprazole, menaquinones produced by these bacteria had some contribution to vitamin K status during dietary phylloquinone restriction, but not enough to restore biochemical measures of vitamin back to normal range As previously indicated, there are regional differences in the forms and content of menaquinones in the food supply.

For example, natto is unique to a traditional Japanese diet whereas the cheeses that contain high concentrations of MK-8 and MK-9 appear to be most prevalent in European dairy producing food supplies. Although there are reported menaquinone intakes, these are limited to studies from Japan 18 and the Netherlands 21 , and are low compared to phylloquinone intakes. In the United States, menaquinones are limited in the food supply and have not been systematically assessed. There are surprisingly little data on the relative biological availability of different forms of vitamin K among different food sources.

Furthermore, there is a growing body of literature to suggest that our understanding of vitamin K is still rudimentary in light of new developments regarding different forms. As previously stated, phylloquinone is of plant origin, with absolute intakes being predominantly from green leafy vegetables. However there appear to be differences in absorption compared to the plant species, with phylloquinone obtained from broccoli and collards having greater absorption compared to spinach 31 , Similarly, and not unexpected because vitamin K is lipophilic, addition of a fat source to the meal results in higher absorption.

For a more comprehensive review of vitamin K absorption, the readers are referred elsewhere Surprisingly this single substitution results in a lower absorption of dihydophylloquinone compared to an equimolar amount of phylloquinone There is also indirect evidence of lower activity of dihydrophylloquinone as an enzyme cofactor, which currently is the only known function of vitamin K.

The implications of this poor bioavailability and activity are currently unknown, although at least one study suggests a detrimental effect on bone mineral density among older adults in a community-based cohort The potential impact of poor utilization of dihydrophylloquinone on bone health will be of little importance in the future should hydrogenated oils be removed from the food supply.

The menaquinones are poorly understood in terms of vitamin K absorption and utilization.

Best 40 foods for vitamin K

MK-7, when administered in the form of natto in equimolar amounts to phylloquinone administered in the form of spinach, has a peak height difference of more than fold compared to phylloquinone, with a half-life of 56 hours, compared to 7. Whereas all forms of vitamin K appear to be initially associated with triglyceride-rich lipoproteins TRL , the longer chain menaquinones including MK-7 and MK-9 are also associated with low-density lipoprotein LDL. These preliminary data suggest that the menaquinones have different transport pathways and distribution, which has implications for transport to extra-hepatic tissue such as bone Emerging studies on MK-4 challenge our current understanding of vitamin K.

As demonstrated using stable isotopes, MK-4 is a conversion product of phylloquinone via the intermediate, menadione It is important to try and keep the same amount of vitamin K in your diet. All foods are okay, but do not make big changes to how much or what you eat. It is important to check with your health-care provider before making any big changes to your diet. Use of Health Topics. What do I need to know about my diet? Certain foods and dietary supplements have vitamin K.

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Vitamin K works against warfarin. If you eat more vitamin K, it can decrease your INR. Because vitamin K is required for the carboxylation of osteocalcin in bone, vitamin K deficiency could also reduce bone mineralization and contribute to osteoporosis [ 25 ]. Vitamin K deficiency can occur during the first few weeks of infancy due to low placental transfer of phylloquinone, low clotting factor levels, and low vitamin K content of breast milk [ 7 ]. Clinically significant vitamin K deficiency in adults is very rare and is usually limited to people with malabsorption disorders or those taking drugs that interfere with vitamin K metabolism [ 3 , 7 ].

In healthy people consuming a varied diet, achieving a vitamin K intake low enough to alter standard clinical measures of blood coagulation is almost impossible [ 3 ]. Vitamin K transport across the placenta is poor, increasing the risk of vitamin K deficiency in newborn babies [ 3 ]. During the first few weeks of life, vitamin K deficiency can cause vitamin K deficiency bleeding VKDB , a condition formerly known as "classic hemorrhagic disease of the newborn. People with malabsorption syndromes and other gastrointestinal disorders, such as cystic fibrosis, celiac disease, ulcerative colitis, and short bowel syndrome, might not absorb vitamin K properly [ 3 , 5 , 25 ].

Vitamin K status can also be low in patients who have undergone bariatric surgery, although clinical signs may not be present [ 28 ]. These individuals might need monitoring of vitamin K status and, in some cases, vitamin K supplementation. This section focuses on two conditions in which vitamin K might play a role: osteoporosis and coronary heart disease.

Osteoporosis, a disorder characterized by porous and fragile bones, is a serious public health problem that affects more than 10 million U. Consuming adequate amounts of calcium and vitamin D, especially throughout childhood, adolescence, and early adulthood, is important to maximize bone mass and reduce the risk of osteoporosis [ 29 ].

The effect of vitamin K intakes and status on bone health and osteoporosis has been a focus of scientific research. Vitamin K is a cofactor for the gamma-carboxylation of many proteins, including osteocalcin, one of the main proteins in bone [ 30 ]. Some research indicates that high serum levels of undercarboxylated osteocalcin are associated with lower bone mineral density [ 5 , 30 ].

Although vitamin K is involved in the carboxylation of osteocalcin, it is unclear whether supplementation with any form of vitamin K reduces the risk of osteoporosis. In , Cockayne and colleagues conducted a systematic review and meta-analysis of randomized controlled trials that examined the effects of vitamin K supplementation on bone mineral density and bone fracture [ 37 ]. Most of the trials were conducted in Japan and involved postmenopausal women; trial duration ranged from 6 to 36 months. Thirteen trials were included in the systematic review, and 12 showed that supplementation with either phytonadione or MK-4 improved bone mineral density.

Seven of the 13 trials also had fracture data that were combined in a meta-analysis. MK-4 supplementation significantly reduced rates of hip fractures, vertebral fractures, and all nonvertebral fractures. Other randomized clinical trials since the review by Cockayne et al. In one of these studies, postmenopausal women received either 1 mg phylloquinone, 45 mg MK-4, or placebo daily for 12 months [ 40 ].

All participants also received daily supplements containing mg calcium and IU vitamin D3. At the end of the study, participants receiving either phylloquinone or MK-4 had significantly lower levels of undercarboxylated osteocalcin compared to those receiving placebo. However, there were no significant differences in bone mineral density of the lumbar spine or proximal femur among any of the treatment groups.

In Japan and other parts of Asia, a pharmacological dose of MK-4 45 mg is used as a treatment for osteoporosis [ 5 ]. The European Food Safety Authority has approved a health claim for vitamin K, noting that "a cause and effect relationship has been established between the dietary intake of vitamin K and the maintenance of normal bone" [ 41 ].

Vascular calcification is one of the risk factors for coronary heart disease because it reduces aortic and arterial elasticity [ 42 ]. Matrix Gla-protein MGP is a vitamin K-dependent protein that may play a role in the prevention of vascular calcification [ 5 , 43 ]. Although the full biological function of MGP is unclear, a hypothesis based on animal data suggests that inadequate vitamin K status leads to undercarboxylated MGP, which could increase vascular calcification and the risk of coronary heart disease.

These findings might be particularly relevant for patients with chronic kidney disease because their rates of vascular calcification are much higher than those of the general population [ 9 ]. In an observational study conducted in the Netherlands in postmenopausal women, dietary menaquinone but not phylloquinone intake was inversely associated with coronary calcification [ 44 ].

Menaquinone intake was also inversely associated with severe aortic calcification in a prospective, population-based cohort study involving 4, men and women aged 55 years and older from the Netherlands [ 43 ].

Food Sources of Vitamin K

Participants in this study who had dietary menaquinone intakes in the mid tertile Phylloquinone intake had no effect on any outcome. Despite these data, few trials have investigated the effects of vitamin K supplementation on arterial calcification or coronary heart disease risk. One randomized, double-blind clinical trial examined the effect of phylloquinone supplementation in healthy men and postmenopausal women aged 60—80 years [ 45 ].

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Participants received either a multivitamin containing B-vitamins, vitamin C, and vitamin E plus IU vitamin D3, mg calcium, and mcg phylloquinone daily treatment or a multivitamin plus calcium and vitamin D3 only control for 3 years. There was no significant difference in coronary artery calcification between the treatment and control groups. However, among the participants who adhered to the supplementation protocol, those in the treatment group had significantly less coronary artery calcification progression than those in the control group. Based on these findings, the authors did not make any clinical recommendations, and they called for larger studies in other populations.

At this time, the role of the different forms of vitamin K on arterial calcification and the risk of coronary heart disease is unclear, but it continues to be an active area of research in the general population and in patients with chronic kidney disease [ 5 , 9 , 46 ]. In its report, the FNB stated that "no adverse effects associated with vitamin K consumption from food or supplements have been reported in humans or animals. Vitamin K interacts with a few medications. In addition, certain medications can have an adverse effect on vitamin K levels.

Some examples are provided below. Individuals taking these and other medications on a regular basis should discuss their vitamin K status with their healthcare providers. These drugs antagonize the activity of vitamin K, leading to the depletion of vitamin K-dependent clotting factors.

People taking warfarin and similar anticoagulants need to maintain a consistent intake of vitamin K from food and supplements because sudden changes in vitamin K intakes can increase or decrease the anticoagulant effect [ 47 ]. Additional information on the interaction between warfarin and vitamin K is available from the National Institutes of Health Clinical Center.

Antibiotics can destroy vitamin K-producing bacteria in the gut, potentially decreasing vitamin K status. Vitamin K supplements are usually not needed unless antibiotic use is prolonged beyond several weeks and accompanied by poor vitamin K intake [ 48 ]. They can also reduce the absorption of vitamin K and other fat-soluble vitamins, although the clinical significance of this effect is not clear [ 48 , 49 ].

Vitamin K status should be monitored in people taking these medications, especially when the drugs are used for many years [ 49 ]. It reduces the body's absorption of dietary fat and in doing so, it can also reduce the absorption of fat-soluble vitamins, such as vitamin K. Combining orlistat with warfarin therapy might cause a significant increase in prothrombin time [ 50 ].

Otherwise, orlistat does not usually have a clinically significant effect on vitamin K status, although clinicians usually recommend that patients taking orlistat take a multivitamin supplement containing vitamin K [ ]. The federal government's Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.

For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U. Department of Agriculture's MyPlate. This fact sheet by the Office of Dietary Supplements ODS provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

Updated: September 26, History of changes to this fact sheet. Find ODS on:. Strengthening Knowledge and Understanding of Dietary Supplements. Health Information Health Information. For Researchers For Researchers. References Booth SL. Vitamin K: food composition and dietary intakes. Food Nutr Res ; Vitamin K. Present Knowledge in Nutrition.