Evidence Level
Moderate
Vitamin K2 has a growing evidence base particularly for bone and cardiovascular health. The 3-year RCT by Knapen et al. (2013, n=244) demonstrated that MK-7 at 180 mcg/day prevented age-related bone mineral density loss and improved bone strength in postmenopausal women. The landmark Rotterdam Study (Geleijnse et al., 2004, n=4,807) found that high dietary K2 (but not K1) intake was associated with significantly lower aortic calcification and cardiovascular mortality. Mechanistically, K2 activates both osteocalcin (bone formation) and MGP (calcification inhibition), providing a biological rationale for its dual bone and cardiovascular benefits. However, more large-scale RCTs are needed to confirm cardiovascular endpoint reduction.