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Association of dietary vitamin K and risk of coronary heart disease in middle-age adults: the Hordaland Health Study Cohort
  1. Teresa R Haugsgjerd1,
  2. Grace M Egeland1,2,
  3. Ottar K Nygård3,4,
  4. Kathrine J Vinknes5,
  5. Gerhard Sulo6,7,
  6. Vegard Lysne4,
  7. Jannicke Igland1,
  8. Grethe S Tell1,8
  1. 1Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  2. 2Health Registries, Research and Development, Norwegian Institute of Public Health, Bergen, Norway
  3. 3Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
  4. 4Centre for nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway
  5. 5Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
  6. 6Oral Health Centre of Expertise in Western Norway, Bergen, Norway
  7. 7Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
  8. 8Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
  1. Correspondence to Teresa R Haugsgjerd; Teresa.Haugsgjerd{at}


Objective The role of vitamin K in the regulation of vascular calcification is established. However, the association of dietary vitamins K1 and K2 with risk of coronary heart disease (CHD) is inconclusive.

Design Prospective cohort study.

Setting We followed participants in the community-based Hordaland Health Study from 1997 - 1999 through 2009 to evaluate associations between intake of vitamin K and incident (new onset) CHD. Baseline diet was assessed by a past-year food frequency questionnaire. Energy-adjusted residuals of vitamin K1 and vitamin K2 intakes were categorised into quartiles.

Participants 2987 Norwegian men and women, age 46–49 years.

Methods Information on incident CHD events was obtained from the nationwide Cardiovascular Disease in Norway (CVDNOR) Project. Multivariable Cox regression estimated HRs and 95% CIs with test for linear trends across quartiles. Analyses were adjusted for age, sex, total energy intake, physical activity, smoking and education. A third model further adjusted K1 intake for energy-adjusted fibre and folate, while K2 intake was adjusted for energy-adjusted saturated fatty acids and calcium.

Results During a median follow-up time of 11 years, we documented 112 incident CHD cases. In the adjusted analyses, there was no association between intake of vitamin K1 and CHD (HRQ4vsQ1 = 0.92 (95% CI 0.54 to 1.57), p for trend 0.64), while there was a lower risk of CHD associated with higher intake of energy-adjusted vitamin K2 (HRQ4vsQ1 = 0.52 (0.29 to 0.94), p for trend 0.03). Further adjustment for potential dietary confounders did not materially change the association for K1, while the association for K2 was slightly attenuated (HRQ4vsQ1 = 0.58 (0.28 to 1.19)).

Conclusions A higher intake of vitamin K2 was associated with lower risk of CHD, while there was no association between intake of vitamin K1 and CHD.

Trial registration number NCT03013725

  • coronary heart disease
  • cardiac epidemiology
  • nutrition & dietetics

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  • Contributors GST and OKN designed the study and collected the data. TRH and JI undertook the statistical analyses. TRH wrote the first draft of the manuscript and was responsible for the full submission process. All authors refined the various versions of the full paper and approved the final manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer This study used data from the Norwegian Cause of Death Registry. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the registry is intended nor should be inferred.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was in accordance with principles of the Declaration of Helsinki and the study was approved by the Regional Committee for Medical and Health Research Ethics.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data available.