Vitamin K2 to Build Stronger Bones in Children

The relationship between K2 and fractures in children was recently investigated with a new study showing the increased risk of fracture in children with low vitamin K2 status.

Vitamin K2 plays important roles in the health of children, including support for coagulation, promoting cardiovascular health (through the inhibition of vascular calcification), and bone mineralisation. Unfortunately, research shows there is a high prevalence of vitamin K deficiency among children, a group in need of this essential vitamin to aid in their development. A key epidemiological study comparing vitamin K2 in children in 1950 to those in in the 1990s showed a significant decline in K2 status in children from an average of 39 mcg per day down to 24 mcg per day.1 This finding was confirmed by a population-based study showing an increase in forearm fractures in children in 30 years, correlated to insufficient K2.2

The relationship between K2 and fractures in children was recently investigated with a new study showing the increased risk of fracture in children with low vitamin K2 status. Examining healthy children with low-energy fractures (i.e. the result of falling from standing height or lower) and in the control group without fractures, researchers found children with bone fractures had a vitamin K status two times lower (based on ratio of inactive osteocalcin to active oscteocalcin: UCR) than healthy controls. In fact, an increase of UCR by just 0.1 increases the risk of fracture by almost 10 times.3

Vitamin K2 has been shown in multiple studies to activate inert proteins already present in the body, specifically osteocalcin and matrix Gla protein (MGP). With adequate Vitamin K2, activated osteocalcin binds calcium to the bone mineral matrix, resulting in stronger bones, while activated MGP inhibits calcium from depositing in arteries and soft tissues, protecting cardiovascular health. But these proteins only fulfil their respective roles when we obtain enough Vitamin K2, either from diet or supplementation.

During childhood and adolescence, bones develop at a rapid rate; peak bone mass and strength is typically attained by age 18 in females and 20 in males, and remains so until approximately the mid-30s when it begins to slowly decline (most rapidly in women). It is during childhood and adolescence when osteocalcin is needed to optimally facilitate the development of healthy, durable bones. Although epidemiological research has shown a correlation between higher K2 status in children and better bone quality, a 2014 study of 42 children and 68 adults showed levels of osteocalcin are up to 10 times higher in children than adults, confirming kids are in greater need of K2 than previously thought.4

Yet there is hope. One study of healthy prepubertal children showed 45 to 50 mcg of Vitamin K2 as MK-7 supplementation (as MenaQ7® from NattoPharma) for two years showed improved vitamin K status as well as stronger, denser bones.5 It’s also worth noting children, especially young ones, are not keen on swallowing pills. Product development with MK-7 for this age group should focus on what they will enjoy eating, such as fortified yoghurts. Two recently published studies (2015 and 2016) demonstrated MenaQ7® Vitamin K2 as MK-7 was effectively delivered in yoghurt products as shown by improved K2 status.6,7 No matter the form, it makes perfect sense to include Vitamin K2 as MK-7 in multivitamins and other functional foods for children, giving kids every opportunity to grow strong and healthy.


1  Prynne CJ, et al. Public Health Nutr. 2005;8(2):171-80.

2  Khosla S, et al. JAMA. 2003 Sep 17;290(11):1479-85.

3 KarpiƄski M, et al. J Amer College of Nutr 2017, 36:5, 399-412.

4 Theuwissen E, et al. Food & Function, 2014;5(2):229-34.

5 van Summeren M, et al. Br J Nutr. 2009 Oct;102(8):1171.

6 Knapen MHJ, et al. J Nutr Sci. 2015; 4:e35.

7 Knapen MHJ et al. Euro J Clin Nutr 2016, 1–6.

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