Global cardiovascular and bone health has been negatively impacted by widespread vitamin K2 deficiency. Yet there is no established RDI (Recommended Daily Intake) for vitamin K2. To that end, as a leader in vitamin K2, NattoPharma has enlisted its research partners to start a program to establish a much-needed RDI for vitamin K2. 
 
The program will begin with a team of researchers at Maastricht University, the Netherlands, the group that has led the way discovering and validating the health benefits of vitamin K2, guided by Dr. Leon Schurgers, professor of biochemistry of vascular calcification at Cardiovascular Research Institute at Maastricht University(CARIM). NattoPharma has worked closely with the Maastricht University in documenting benefits of the company’s exclusive branded MenaQ7 vitamin K2 as MK-7, since 2004—work that has been recognized with many peer-reviewed scientific papers and with recently awarded research grants. 
 
“The RDI for vitamin K is established based on coagulation factors only, but research continues to emerge that vitamin K and vitamin K-dependent proteins have physiological roles beyond coagulation,” said Dr. Schurgers, noting that the AI (Adequate Intake) for vitamin K was established at 90 μg/d for women and 120 μg/d for men for the U.S. and Canada, and in Europe it is 1 μg/Kg/d. This was based on median phylloquinone (vitamin K1) intakes estimated from national surveys back in 2001. Next to vitamin K1 our food also provides us with vitamin K2. “More recent research has confirmed different bioavailability / activity between K1 and K2, and additional biological functions of K2 due to different side chains. Further, all epidemiological and interventional studies showed that only K2 was cardio-protective or has a beneficial effect on the arteries. This has not been considered in the forming of dietary recommendations.”
 
Dr. Schurgers’ team will be joined by the International Science and Health Foundation (ISHF), a research consortium responsible for the educational portal VitaminK2.org.  According to Dr. Katarzyna Maresz, ISHF president, VitaminK2.org was specifically created to educate consumers and practitioners about the proven benefits of vitamin K2, recognizing the impact of widespread K2 deficiency. 
 
“We have seen in comprehensive studies—in adults as well as children – that correcting Vitamin K2 deficiency can greatly improve bone health, and studies in adults have delivered unprecedented improvement in cardiovascular health,” she saod. “Yet studies also show that 97% of the Western population remains deficient. Establishing an RDI is an important step in educating the public about their absolute dietary need, providing them much-needed direction.”  
 
According to Dr. Maresz, one of the first hurdles to overcome establishing an RDI is to have a biomarker or clinical endpoint that reflects the consequences of inadequate K2 consumption. 
 
“Scientific knowledge has changed a lot recently, yet there is still a lack of suitable biomarkers or clinical endpoints that can be used to determine vitamin K2 requirements among adults,” she explained, offering that inactive Matrix Gla Protein (dpucMGP) or the ratio of inactive to inactive Osteocalcin (ucOC/cOC) could be used as markers of vitamin K status. “Given that some vitamin K deficiency or insufficiency has been seen in 97% of older subjects in a mixed population as reflected by their measures of dpucMGP, this could be a good starting marker. However, the ‘normal’ range should be established. Further, K1 influences these markers, too, and we have to consider the metabolic events such the inter-conversion of phylloquinone to MK-4.” 
 
Both NattoPharma and the researchers recognize the scope of this undertaking, but also that it is time to begin. 
 
“Convincing the government to recognize how essential specific nutrients are is an arduous process,” said Eric Anderson, senior vice president of global marketing and business development with NattoPharma. “We have been working with Maastricht University for almost two decades validating the health benefits of vitamin K2, creating this category. Our work, in addition to others’, is building that body of evidence. Now it is time to lead the way ensuring that a global recommendation exists so we can ensure vitamin K2 is adequately attained for the betterment of the world population—men and women, adults and children.”
 
To that end, through the Horizon 2020 grants awarded in which the CARIM is the beneficiary, in partnership with NattoPharma, the company will host PhD students (ESRs) to teach them about the food and supplement industry and foster a further understanding of the RDI values set by FDA/EFSA. These ESRs will utilize this knowledge as they conduct a comprehensive literature review elucidating the data for K2’s bone and cardiovascular benefits. This cogent argument will work towards the efforts of petitioning for RDIs.