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Vitamin K1 intake and incident diabetes in the Danish Diet Cancer and Health study

Published online by Cambridge University Press:  22 March 2023

P. Pokharel ,
J.W. Bellinge ,
F. Dalgaard ,
K. Murray ,
M. Sim ,
B. Yeap ,
E. Connolly ,
L. Blekkenhorst ,
C. Bondonno  and
J. Lewis
...Show all authors
P. Pokharel
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia Danish Cancer Society Research Center, Copenhagen, Denmark
J.W. Bellinge
Affiliation:
School of Medicine, University of Western Australia, Perth, WA, Australia Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
F. Dalgaard
Affiliation:
Department of Medicine, Nykøbing Falster Sygehus, Nykøbing, Denmark Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
K. Murray
Affiliation:
School of Population and Global Health, University of Western Australia, Perth, WA, Australia
M. Sim
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia School of Medicine, University of Western Australia, Perth, WA, Australia
B. Yeap
Affiliation:
School of Medicine, University of Western Australia, Perth, WA, Australia Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
E. Connolly
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
L. Blekkenhorst
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
C. Bondonno
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia School of Medicine, University of Western Australia, Perth, WA, Australia
J. Lewis
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia School of Medicine, University of Western Australia, Perth, WA, Australia Centre for Kidney Research, Children's Hospital at Westmead, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
G. Gislason
Affiliation:
Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark The National Institute of Public Health, University of Southern Denmark, Odense, Denmark The Danish Heart Foundation, Copenhagen, Denmark Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
A. Tjønneland
Affiliation:
Danish Cancer Society Research Center, Copenhagen, Denmark Department of Public Health, University of Copenhagen, Copenhagen, Denmark
K. Overvad
Affiliation:
Department of Public Health, Aarhus University, Aarhus, Denmark
J. Hodgson
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia School of Medicine, University of Western Australia, Perth, WA, Australia
C. Schultz
Affiliation:
School of Medicine, University of Western Australia, Perth, WA, Australia Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
N. Bondonno
Affiliation:
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia Danish Cancer Society Research Center, Copenhagen, Denmark
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Abstract

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Observational studies have observed lower risks of type 2 diabetes (T2D) with higher vitamin K1 intakes,(Reference Ibarrola-Jurado, Salas-Salvadó and Martínez-González1,Reference Beulens, van der and Grobbee2) but these studies have lacked power to investigate effect modification due to known risk factors for diabetes. Thus, we aimed to examine associations between vitamin K1 intake and incident diabetes overall and in subpopulations at risk of diabetes. In this prospective cohort study, participants from the Danish Diet, Cancer, and Health study who had no history of diabetes and had completed a food-frequency questionnaire (FFQ) at baseline were followed up for diabetes. The association between intakes of vitamin K1 (phylloquinone), estimated from the FFQ, and incident diabetes was determined using multivariable-adjusted Cox proportional hazards models. In 54,787 Danish residents with a median [IQR] age of 56 [52–60] years at baseline, 6700 individuals were diagnosed with diabetes during 20.8 [17.3–21.6] years of follow-up. Intake of vitamin K1 was linearly inversely associated with incident diabetes (p < 0.0001). Compared to participants with the lowest vitamin K1 intakes (Quintile 1; median intake 57 μg/day), participants with the highest intakes (Quintile 5; median intake: 191 μg/day) had a 31% lower risk of diabetes (HR = 0.69, 95% CI [0.64, 0.74]) after multivariable adjustments. The inverse association between vitamin K1 intake and incident diabetes was present in all subgroups; males and females, ever and never smokers, low and high physical activity groups, and in participants who were normal to overweight and obese at baseline. Our findings suggest a beneficial role of vitamin K1 among adults; promoting adequate intake of foods rich in vitamin K1 (e.g., green leafy, cruciferous vegetables and plant oils) may help in preventing diabetes.

References

Ibarrola-Jurado, N, Salas-Salvadó, J, Martínez-González, MA, et al. (2012) Am J Clin Nutr 96, 1113–1118.CrossRefGoogle Scholar
Beulens, JWJ, van der, A DL, Grobbee, DE, et al. (2010) Diabetes Care 33, 1699–1705.CrossRefGoogle Scholar