Triage Theory of Micronutrients

serotonin chemistry

In October 2009, Dr. Bruce Ames and his research team from Children’s Hospital Oakland Research Institute in Oakland, California, published the article Vitamin K, an example of triage theory: is micronutrient inadequacy linked to diseases of aging? in the October 2009 issue of the American Journal of Clinical Nutrition.

While some insiders immediately recognized the importance of this paper, it wasn’t until February 2010, when Dr. Ames was interviewed in the nutritional supplement trade publication, NutraIngredients, that his breakthrough article finally got the attention it deserved.

What Dr. Ames and his colleagues accomplished was nothing short of amazing. First, they were able to prove that Dr. Ames “triage” theory for macronutrients—a theory that suggests the body prioritizes the use of scarce micronutrients in favor of short-term survival at the expense of long-term health—was indeed correct. Secondly, they were able to clearly demonstrate that the current recommendations for vitamin K intake needs to be increased to prevent heart disease, osteoporosis, and ensure optimal human health.

Triage Theory Origin

Dr. Ames first presented his triage theory of aging back in 2006. At that time, it was just a theory and Dr. Ames did not have the clinical data to support it. But to him, the theory made perfect sense and he knew it was just a matter of time before he could prove it.

What his triage theory says is, like Robin Hood, when the body requires nutrients for short-term health and reproduction, it robs them from organs that are nutrient rich and of lesser importance in order to sustain major organs that are nutrient poor.

FDA Vitamin K Recommendations Too Low!

The FDA’s RDI for vitamin K is 90 mcg per day. However, that amount is strictly based on what is required for healthy blood coagulation and does not take into consideration the amounts required by the body to process calcium for proper bone building, osteoporosis prevention, and protect the heart from atherosclerosis.

Some scientists are recommending adult daily vitamin K doses for maintaining optimal health as follows:

  • Vitamin K1 (phylloquinone) 240 mcg
  • Vitamin K2 (menaquinone-7) 45 mcg

In addition, it should be noted that these are still on the low end of the vitamin K spectrum. People who get no  vitamin K from their diets might consider dosages at double or even triple these amounts.

For example, Dr. Ames says, “If you’re short of iron, you take it out of the liver before you take it out of the heart because if you take it out of the heart, you’re dead. But the downside is, doing this causes long-term DNA damage, which doesn’t show up as cancer for 20 years.”1

“If you’re deficient for years your body weakens, DNA becomes damaged and you get sick and eventually die.” Dr. Ames adds, “If you want maximum life span, your micronutrient needs must be met throughout life.”

So Ames and his team set out to prove his theory and they chose vitamin K as the first place to start because they already knew vitamin K deficiency is quite widespread.

What they found was truly frightening. When the supply of vitamin K was limited, as it is in the typical American diet, the body utilizes what little it can find to protect critical metabolic functions in the liver. Unfortunately, that leaves other vitamin K-dependent proteins, the ones associated with bone building, cancer prevention, and protecting the heart from atherosclerosis, without sufficient vitamin K to function properly. The result of this leaves the body at risk for developing age-related diseases like cancer, heart disease, and osteoporosis.

Unfortunately, current FDA recommendations for vitamin K (90 mcg/day for adults) are based on levels to ensure adequate blood coagulation, but fail to ensure long-term optimal levels.

From Ames’ triage perspective, much of the population, and patients who are taking warfarin/Coumadin (blood thinners), are not receiving sufficient vitamin K for optimal long-term health.2

“A triage perspective reinforces recommendations of some experts that much of the population, along with warfarin/Coumadin patients, are not getting sufficient vitamin K for optimal function of vitamin K dependent proteins that are important to maintain long-term health,”wrote Dr. Ames.

What you should know about Vitamin K

Vitamin K is a fat-soluble vitamin, meaning it is stored in fatty tissue in the body. Vitamin K is known as the clotting vitamin because without it blood would not clot.

It is important to note, that while Dr. Ames’ study looked at the body’s vitamin K usage as a whole, there are actually two forms of vitamin K, known as vitamin K1 (phylloquinone) and vitamin K2 (menaquinone).

Is Your Multivitamin Supplement Suffering From Nutrient Deficiencies?

Vitamin K1 is found in green leafy vegetables such as lettuce, broccoli and spinach, and makes up about 90% of the vitamin K consumed in the diet. Vitamin K2 accounts for the other 10% and can be found in meat, and fermented food products like cheese, and natto. However, as stated before, most people do not get enough vitamin K (both K1 and K2) from food sources and most multivitamin supplements contain little if any vitamin K.

This deficiency is putting the vast majority of the population at risk for age-related disease like arterial calcification, osteoporosis and bone fracture, and cancer.

  1. Downey, Michael.  The triage theory offers a new look at aging. Natural Foods Merchandiser. Jan. 1, 2007
  2. McCann JC, Ames BN, Vitamin K, an example of triage theory: is micronutrient inadequacy linked to diseases of aging? Am J Clin Nutr. 2009 Aug 19. [Epub ahead of print]

Vitamin K2 is More Important than Calcium for Preventing Osteoporotic Fracture

Bone Density Examples

In human studies, 25 years of research has linked osteoporotic fracture with vitamin K insufficiency. A study published in 1984 found that patients who suffered fractures caused by osteoporosis had vitamin K levels 70% lower than age-matched controls.

This association has been repeatedly confirmed. One recent trial involving almost 900 men and women found those with the lowest blood levels of vitamin K2 had a 65% greater risk of hip fracture compared to those with the highest levels of the nutrient.

In other human research, vitamin K2 has continually shown to be an effective treatment against osteoporosis: A review study of all randomized, controlled human trials of at least 6 months duration that assessed the use of vitamin K1 or K2 to lessen fracture risk identified 13 trials. All but one showed vitamin K reduced bone loss with K2 being most effective, reducing risk of vertebral fracture by 60%, hip fracture by 77%, and all non-vertebral fractures by 81%. And remember, reducing fracture risk is the true measure of bone health.

In a 2-year study of 241 women with osteoporosis, subjects were given either vitamin K2 plus calcium or calcium alone. At the end of the study, women receiving only calcium had lost an average of 3.3% of their lumbar (lower spine) BMD, while those receiving vitamin K2 lost just 0.5%. Women taking K2 plus calcium had one-third the fracture risk of those receiving calcium only.

Continue reading

What is Vitamin K?

Originally identified as a fat-soluble nutrient required for normal blood coagulation, vitamin K is actually a family of similar compounds, which recent research reveals are also necessary for integrating calcium into bone and preventing its deposit within blood vessels. The latest research also indicates vitamin K possesses significant anti-cancer and anti-inflammatory actions.

In nature, vitamin K is found in the forms of vitamin K1 (phylloquinone) and several different types of vitamin K2 (menaquinones):

K1, which is involved in photosynthesis, is produced by plants and algae, its highest concentrations found in green leafy vegetables. Primary dietary sources of K1 are leafy greens, such as broccoli, kale, and Swiss chard, and plant oils, such as canola and soybean oil.

K2 is produced by bacteria and also via the conversion of K1 to K2 by beneficial bacteria in the intestines of animals, including humans. Natto (fermented soybeans) is the richest dietary source of vitamin K2. Dairy products (milk, butter, cottage cheese, cheese) and egg yolk also provide small amounts.

K2 is more potent and has the widest range of activity. Far more active than K1 in both bone formation and reduction of bone loss, K2 is a 15-fold more powerful antioxidant than K1, and is also the form which has been found to protect against arterial calcification and the oxidation (free radical damage) of LDL cholesterol.

Protect Multi
Protect Multi with Vitamin K2

Finally, K2 occurs in numerous forms that vary in their activity. K2 can have a side chain between 4 and 9 units long. This side chain has a great effect on bioavailability. Shorter chain length results in shorter half-life within the body, thus limiting our body’s ability to utilize the vitamin. Both vitamin K1 and vitamin K2 in the form of menaquinone-4 have very short half-lives in the body, while longer chain forms of vitamin K2, such as menaquinone-7, have dramatically longer half-lives and much higher bioactivity. Because recent research has shown that vitamin K2, in the form of menaquinone-7, is the most potent and longest acting form of vitamin K2, many researchers now consider it to be the most important dietary form of vitamin K for protecting the cardiovascular system and promoting bone health.

In a massive European clinical trial following 4,807 subjects aged at least 55 over a 7-10 year period, researchers found that K2, but not K1, significantly reduced risk of cardiovascular disease by 57%, death from all causes by 26%, and severe aortic calcification by 52%. K1 provided no significant cardiovascular protection.

Read more about vitamin K in these following articles:

http://lmreview.com/vitamin-k2-optimal-levels-essential-for-the-prevention-of-age-associated-chronic-disease/

Vitamin K2—Keeps Calcium Out of Your Arteries and In Your Bones

The Heart Bone and Skin Health Benefits of Vitamin K

Vitamin K2 is More Important in the Fight Against Osteoporosis than Calcium