多吃維生素K可以幫助患者服用華法林 Eating more vitamin K found to help, not harm, patients on warfarin

新聞稿11-Jun-2019

多吃維生素K可以幫助患者服用華法林，而不是傷害患者

與常識相反，增加維生素K的攝入有助於穩定抗凝

美國營養學會

巴爾的摩（2019年6月11日） – 當處方抗凝藥物華法林時，許多患者被告知限制富含維生素K的食物，如綠色蔬菜。一項新的臨床試驗的結果稱該建議存在疑問，並建議華法林患者實際上可以從增加維生素K攝入量中獲益 – 只要他們保持攝入水平一致即可。

華法林廣泛用於預防導致心髒病發作和中風的危險血栓。必須仔細校準藥物的劑量，以平衡凝塊風險和不受控制的出血風險。因為華法林抵消了血液中維生素K的活性，維生素K攝入量的大幅波動會破壞這種平衡。

目前維持每日維生素K攝入量一致的建議通常轉化為限制維生素K攝入量的患者。根據新的試驗，最好建議患者增加飲食中維生素K的含量。

主要研究報告的作者，蒙特利爾大學營養學教授，蒙特利爾心臟研究所研究中心的科學家說，我認為所有接受過華法林治療的患者都可以從增加每日維生素K攝入量中獲益。這說，直接相互作用飲食中維生素K與藥物作用之間的關係，重要的是（每日攝入的維生素K攝入量越高越好）。

Ferland將於2019年6月8日至11日在巴爾的摩舉行的營養學2019年美國營養學會年會上展示該研究。

“我們希望醫療保健專業人員不再向華法林治療患者提供建議，以避免使用綠色蔬菜，”Ferland說。她解釋說，多吃綠色蔬菜和其他營養豐富的富含維生素K的食物可以幫助穩定抗凝治療，並提供許多其他健康益處。

這項研究是第一項測試華法林患者如何應對旨在系統性增加維生素K攝入量的飲食干預的隨機對照試驗。研究人員招募了46名有抗凝不穩定史的患者。一半參加了提供一般營養信息的飲食諮詢和烹飪課程，另一半參加了諮詢會和烹飪課程，重點是增加綠色蔬菜和富含維生素K的油和草藥的攝入量。

六個月後，50％被勸告增加維生素K攝入量的人保持穩定的抗凝血水平，而接受一般營養諮詢的人只有20％，這是一個顯著的改善。 Ferland說，研究結果表明服用華法林的患者可以從食用女性每天至少90微克維生素K和男性每天120微克維生素K的食物中受益。

Guylaine Ferland將於6月11日星期二上午11點15分至11點30分在巴爾的摩會議中心319/320室（摘要）介紹這項研究。有關更多信息，請聯繫媒體團隊或獲取免費的新聞通行證以參加會議。

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請注意，營養2019年提交的摘要由專家委員會評估和選擇，但通常不會在科學期刊上進行相同的同行評審過程。因此，在獲得同行評審的出版物之前，所提出的研究結果應視為初步。

關於營養2019

營養2019年是美國營養學會於2019年6月8日至11日在巴爾的摩會議中心舉行的年會。它是超過3,600名頂級研究人員，從業人員和其他專業人士的國家場所，宣布令人興奮的研究成果，並探討其對實踐和政策的影響。科學專題討論會討論細胞和生理營養與代謝，臨床和轉化營養，全球和公共衛生，人口科學以及食品科學和系統的最新進展。 http://www.nutrition.org/N19#Nutrition2019

關於美國營養學會（ASN）

ASN是全球營養研究科學家和臨床醫生的傑出專業組織。該協會成立於1928年，匯集了頂級營養研究人員，醫療從業人員，決策者和行業領導者，以促進我們對營養的認識和應用。 ASN出版了四份經同行評審的期刊，並提供教育和專業發展機會，以推動營養研究，實踐和教育。 http://www.nutrition.org

News Release 11-Jun-2019
Eating more vitamin K found to help, not harm, patients on warfarin

Contrary to common wisdom, increasing vitamin K intake helps stabilize anticoagulation

American Society for Nutrition

Baltimore (June 11, 2019) – When prescribed the anticoagulant drug warfarin, many patients are told to limit foods rich in vitamin K, such as green vegetables. The results of a new clinical trial call that advice into question and suggest patients on warfarin actually benefit from increasing their vitamin K intake–as long as they keep their intake levels consistent.

Warfarin is widely used to prevent the dangerous blood clots that cause heart attacks and strokes. The drug’s dosage must be carefully calibrated to balance the risk of clots against the risk of uncontrolled bleeding. Because warfarin counteracts the activity of vitamin K in the blood, large swings in vitamin K intake can disrupt this balance.

The current recommendation to keep daily vitamin K intakes consistent often translates into patients limiting vitamin K intake. According to the new trial, patients would be better advised to increase the amount of vitamin K in their diet.

“I think all warfarin-treated patients would benefit from increasing their daily vitamin K intake, said lead study author Guylaine Ferland, professor of nutrition at Université de Montréal and scientist at the Montreal Heart Institute Research Centre. “That said, given the direct interaction between dietary vitamin K and the action of the drug, it is important that (higher) daily vitamin K intakes be as consistent as possible.”

Ferland will present the research at Nutrition 2019, the American Society for Nutrition annual meeting, held June 8-11, 2019 in Baltimore.

“Our hope is that healthcare professionals will stop advising warfarin-treated patients to avoid green vegetables,” said Ferland. She explained that eating plenty of green vegetables and other nutritious vitamin-K rich foods can help stabilize anticoagulation therapy and offers many other health benefits.

The study is the first randomized controlled trial to test how patients on warfarin respond to a dietary intervention aimed at systematically increasing vitamin K intake. Researchers enrolled 46 patients with a history of anticoagulation instability. Half attended dietary counseling sessions and cooking lessons that provided general nutrition information, while half attended counseling sessions and cooking lessons focused on increasing intake of green vegetables and vitamin-K rich oils and herbs.

After six months, 50 percent of those counseled to increase their vitamin K intake were maintaining stable anticoagulation levels, compared with just 20 percent of those who received the general nutritional counseling, a significant improvement. The results suggest patients taking warfarin would benefit from consuming foods that provide a minimum of 90 micrograms of vitamin K per day for women and 120 micrograms per day for men, Ferland said.

Guylaine Ferland will present this research on Tuesday, June 11, from 11:15 – 11:30 a.m. in the Baltimore Convention Center, Room 319/320 (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.

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This release may include updated numbers or data that differ from those in the abstract submitted to Nutrition 2019.

Please note that abstracts presented at Nutrition 2019 were evaluated and selected by a committee of experts but have not generally undergone the same peer review process required for publication in a scientific journal. As such, the findings presented should be considered preliminary until a peer-reviewed publication is available.

About Nutrition 2019

Nutrition 2019 is the annual meeting of the American Society for Nutrition held June 8-11, 2019 at the Baltimore Convention Center. It is the national venue for more than 3,600 top researchers, practitioners and other professionals to announce exciting research findings and explore their implications for practice and policy. Scientific symposia address the latest advances in cellular and physiological nutrition and metabolism, clinical and translational nutrition, global and public health, population science, and food science and systems. http://www.nutrition.org/N19 #Nutrition2019

About the American Society for Nutrition (ASN)

ASN is the preeminent professional organization for nutrition research scientists and clinicians around the world. Founded in 1928, the society brings together the top nutrition researchers, medical practitioners, policy makers and industry leaders to advance our knowledge and application of nutrition. ASN publishes four peer-reviewed journals and provides education and professional development opportunities to advance nutrition research, practice and education. http://www.nutrition.org