Vitamin K2 plays important roles in the health of children, including support for coagulation, promoting cardiovascular health (through the inhibition of vascular calcification), and bone mineralization. Unfortunately, research shows that there is a high prevalence of vitamin K deficiency among infants and children.
Low vitamin K status is common in newborn infants. In fact, research shows that as many as 50 percent of all newborns are vitamin K deficient.1 The reasons for this include limited vitamin K transport across the placental barrier, and low vitamin K content of breast milk.2 However, studies indicate that maternal supplementation with vitamin K can help mitigate this problem.3
Although vitamin K deficiency is prevalent in patient and healthy populations of children, research has shown that supplementation with vitamin K, particularly as the MK-7 (menaquinone-7) form of vitamin K2, is an effective strategy for deficiency management. In addition, research has shown the MK-7 form of vitamin K2 has advantages over the MK-4 form or over vitamin K1 for this purpose.4,5 This includes advantages in half-life, bioavailability and history of safe and effective use in children.
Laying the foundation for health
Healthy aging truly begins in infancy and childhood. Optimal nutrient intake is critical during the developmental years.
The skeleton develops most intensively during childhood and adolescence, with up to 90 percent of peak bone mass acquired by age 18 in girls and by age 20 in boys. Without adequate vitamin K2 (specifically, MK-7) to activate osteocalcin, calcium cannot be properly utilized to build healthy, strong bones. The amount of activated osteocalcin (a protein that helps build dense and strong bones) should be high, and correspondingly, circulating amounts of inactive (also called undercarboxylated) osteocalcin should be low; osteocalcin depends on vitamin K2 to activate it. When there is not enough K2, osteocalcin remains inert.
Population-based studies and clinical trials have tightly linked better K2 vitamin status in children (meaning higher levels of K vitamins found in blood serum) to achieving strong, healthy bones. Yet a 2014 study of 42 children and 68 adults showed that levels of the bone-building vitamin-K2-dependent protein osteocalcin are 8 to 10 times higher in children than adults, hence their requirement of vitamin K2 is also higher.6
But recent research has shown that most children are vitamin K2 sub-optimal, which is likely attributable to the consumption of more processed food, and generally less that is naturally rich in K2. With the average dietary vitamin K2 intake dropping significantly over the last 50 years, today’s intake is insufficient for optimal bone development, as evidenced by a population-based Minnesota study showing an increase in forearm fractures in children over a 30-year period.7
What is causing the overall lack of sufficient vitamin K2 in children? In a word—calcium. Children's diets today consist not only of a high amount of chemically laden convenience foods, but are also high in calcium, as many foods are fortified with this mineral. Unfortunately, their diets contain very little K2. Please understand that it is essential for children to get adequate calcium—in no way are we suggesting this is not the case. However, improperly utilized calcium can be deposited into arteries, creating a cement-like plaque over time, instead of being bound to bones, enhancing bone structural integrity. The ability to bind calcium to healthy bone matrix maximizes bone mineral density to maintain bone mass later in life. The ability to ensure that calcium is inhibited from the arteries promotes enduring heart health.
Vitamin K2 is the answer
A 2008 published study showed that improving vitamin-K status in children over a two-year period resulted in stronger and denser bones. One year later, the same researchers demonstrated that in healthy, pre-pubertal children, modest supplementation with vitamin K2 (as MenaQ7®) increased osteocalcin carboxylation (activation).8
In the previously mentioned 2014 study6, researchers tested 896 blood samples collected from 42 children and 68 adults. The researchers measured biomarkers reflecting vitamin K2 status by measuring both circulating inactive MGP and inactive osteocalcin. The researchers found that children and adults had the most pronounced vitamin K2 deficiency, and showed the highest responses to supplementation with vitamin K2. Children (and adults above the age of 40 years) showed the largest vitamin K2 deficiency, and may benefit from K2 supplementation to improve their vitamin K2 status.
This is an important point to consider, as we reach our peak bone mass by our early 30s. Once we reach that peak, that is all we will ever have—it will inevitably begin to diminish, and in women, that decline amps up once they reach menopause. By ensuring adequate intakes of vitamin K2, we are making sure the K-dependent proteins osteocalcin and MGP are activated, ushering calcium away from the arteries (where it doesn’t belong) and to the bones (where we need it).
To say laying the foundation for health begins in childhood is an understatement. We feel that it begins in the womb, and by making vitamin K2 a part of prenatal and children’s multivitamins means we have the best possible chance of creating stronger, healthier generations.
Eric Anderson is the senior vice president of Global Sales and Marketing with NattoPharma USA Inc., Metuchen, NJ.
- Patel P, Mikhail M. “Vitamin K Deficiency." eMedicine. Updated: Feb 13, 2014. Retrieved August 11, 2015 from http://emedicine.medscape.com/article/126354-overview#a9.
- Ferland G. Vitamin K. In: Erdman Jr. JW, Macdonald IA, Zeisel SH, eds. Present Knowledge in Nutrition. 10th ed. Ames: Wiley-Blackwell; 2012:230-247.
- Food and Nutrition Board, Institute of Medicine. Vitamin K. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, D.C.: National Academy Press; 2001:162-196.
- Sato T, Schurgers LJ, Uenishi K. “Comparison of menaquinone-4 and menaquinone-7 bioavailability in healthy women." Nutr J. 2012;11:93.
- Schurgers LJ et al. “Vitamin K-containing dietary supplements: comparison of synthetic vitamin K1 and
- natto-derived menaquinone-7." Blood. 2007;109(8):3279-3283.
- Theuwissen E et al. “Vitamin K status in healthy volunteers." Food Funct. 2014 Feb;5(2):229-34. DOI: 10.1039/c3fo60464k.
- Khosla S et al. “Incidence of childhood distal forearm fractures over 30 years: a population-based study." JAMA. 2003 Sep 17;290(11):1479-85.
- vanSummeren MJ et al. “The effect of menaquinone-7 (vitamin K2) supplementation on osteocalcin carboxylation in healthy prepubertal children." Br J Nutr. 2009 Oct;102(8):1171-8.