| Summary: | 碩士 === 輔仁大學 === 營養科學系 === 100 === Up to half of the patients receiving anticoagulants failed to stabilize their status of blood coagulation within target range. Therefore, the risks of thromboembolism and bleeding increased in these patients. Dietary vitamin K has recently been recognized as a key factor that might interfere with long-term oral anticoagulation stability. This study assessed dietary vitamin K and cardiovascular disease (CVD)-protecting nutrients intake of Taiwanese patients receiving anticoagulation therapy. We evaluated whether the INR variability could be reduced and stability of anticoagulation control could be improved following instruction on the management on the daily intake of vitamin K. Patients anticoagulated with warfarin were recruited from the Neurology Clinic and Cardiology Clinic. We first validated a semi-quantitative food frequency questionnaire specifically designed to measure dietary vitamin K intake. Vitamin K FFQ (VK-FFQ) was administered at the beginning (VK-FFQ-1) and at the end (VK-FFQ-2) of one month. Four 24-hour dietary recalls (24hr) were collected between either two VK-FFQs. The average vitamin K intakes calculated from both four 24hr were used as the reference for VK-FFQ-1 and VK-FFQ-2 relative validity respectively. Vitamin K intake measured by the VK-FFQ-1 was significantly higher than that obtained by 24Hr. Secondly, dietary vitamin K intake of the anticoagulation patients in the study were assessed with the questionnaire. We provided patients counseling about green leafy vegetables intake and then evaluated the stability of anticoagulation therapy for unstable patients. The mean daily intake of vitamin K for stable and unstable patients were 738.0 ± 286.2 μg/d and 654.6 ± 580.0 μg/d, respectively. The results indicated the mean intake of vitamin K for patients approaching target INR (International Normalized Ratio) were 500-600 μg/d. The dietary intake of folate, magnesium, potassium and dietary fiber increased with the assistance of dietary counseling. Plasma concentrations of homocysteine and folate did not change during the study. In summary, the mean dietary intake of vitamin K in stable patients was higher than that that of unstable patients. Anticoagulation control and intake of CVD-protecting nutrients were improved in unstable patients receiving counseling on dietary vitamin K management.
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