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Bone Health After Menopause
By Jessica Patella, ND abstracted from “Changes in Parameters of Bone Metabolism in Postmenopausal Women Following a 12-Month Intervention Period Using Dairy Products Enriched with Calcium, Vitamin D, and Phylloquinone (Vitamin K1) or Menaquinone-7 (Vitamin K2): The Postmenopausal Health Study II.” from Calcified Tissue International.
 
Key Words: Osteoporosis, Bone Health, Menopause, Vitamin K
 
Women have an increased rate of bone loss during and after menopause (2). With an estimated 37.5 million women reaching or currently menopausal, there is an increased concern with bone loss and menopause (3). Recent research suggests vitamin K, in addition to calcium and vitamin D, has a favorable role in bone health (1). 
 
Recent research included 173 postmenopausal women (aged 54-73 years) that were divided into four groups. Group 1 received 800 mg of calcium and 10 mircograms of vitamin D3 (n=38). Group 2 received 800 mg of calcium, 10 mircograms of vitamin D3, and 100 micrograms of vitamin K1 (phylloquinone) (n=38). Group 3 received 800 mg of calcium, 10 mircograms of vitamin D3, and 100 micrograms of vitamin K2 (menaquinone-7) (n=39). All nutrients in groups 1-3 were obtained through fortified milk and yogurt. Group 4, the control group, did not receive any dietary intervention for the 12-month period (n=58) (1).
 
Participants in the three intervention groups also attended biweekly lifestyle counseling sessions at the local university. The goal was to increase awareness on osteoporosis and motivate lifestyle and dietary changes for health improvement (1). They were also encouraged to increase their walking measured by pedometer (1). All intervention groups increased their walking by approximately 3,000 steps per day or an average of 1.5 miles by the 12-month follow-up (1). 
 
Significant increases in total body bone mineral density, were observed in all intervention groups compared to the control group (P<0.05).   Although increased bone density in the lower spine (L2-L4) was only observed in the vitamin K groups compared to baseline. 
 
Markers of bone breakdown were significantly decreased in the intervention groups taking vitamin K 1 and K2, Indicating vitamin K1 and K2 decreased bone breakdown. 
 
Markers of Bone Breakdown
 
Baseline
12-month change
Significant
Urine D-Pyd
 
 
 
Control
14.0 +/- 4.4
12.6 +/- 5.4
No
Calcium & vitamin D
12.6 +/- 4.1
11.1 +/- 2.8
No
Calcium & vitamin D & vtitamin K1
12.7 +/- 4.1
9.9 +/- 3.4
Yes
P<0.05
Calcium & vitamin D & vtiamin K2
12.5 +/- 3.9
9.8 +/- 2.7
Yes. P<0.05
 
 
 
 
Serum % ucOC
 
 
 
Control
65.1 +/- 93.1
93.8 +/- 167.7
No
Calcium & vitamin D
64.5 +/- 84.6
77.3 +/- 20.8
No
Calcium & vitamin D & vitamin K1
40.8 +/- 44.4
27.5 +/- 35.4
Yes
P<0.05
Calcium & vitamin D & vitamina K2
47.0 +/- 56.1
23.4 +/- 36.5
Yes  P<0.05
 
In conclusion, dietary intake of Vitamin K1 and K2 with calcium and vitamin D is likely to lead to suppression of bone breakdown, which is associated with a lower risk of bone fracture (1). Changes in bone metabolism should be attributed to both the diet and increase in walking (1). Further research with higher doses of Vitamin K should be considered in the future (1). 
 
Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health.  She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians.  Visit her website at  www.awarenesswellness.com
 
REFERENCES:
 
1.       Kanellakis S, et al. Changes in Parameters of Bone Metabolism in Postmenopausal Women Following a 12-Month Intervention Period Using Dairy Products Enriched with Calcium, Vitamin D, and Phylloquinone (Vitamin K1) or Menaquinone-7 (Vitamin K2): The Postmenopausal Health Study II. Calcif Tissue Int. 2012. Doi: 10.1007/s00223-012-9571-Z
2.       Ahlborg HG, et al. Bone loss and bone size after menopause. 2003. N England J Med 349: 327-334.
3.       Menopause. CDC. http://www.cdc.gov/reproductivehealth/womensrh/menopause.htm