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A practical approach to minimize the interaction of dietary vitamin K with warfarin

机译：减少饮食中维生素K与华法林相互作用的实用方法

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What is known and objective The many interactions between warfarin and other drugs and foods generate great challenges for clinicians and patients in maintaining stable anitcoagulation. Interactions due to variable vitamin K content of different dietary items influence the therapy of nearly all patients on warfarin. Unfortunately, there is no widely acceptable, patient-friendly strategy for managing such interactions. In this contribution, we propose a practical approach to managing this troublesome interaction, consisting of 'maintaining constant weekly dietary vitamin K intake scores'. Methods Twenty-three vitamin K-rich vegetables commonly seen in Taiwanese meals were identified and classified into seven score grades according to their relative vitamin K content per serving. The scores were based on published vitamin K content of different foods. Results and discussion The vitamin K score was equivalent to 5 points for spinach and garland chrysanthemum per bowel, followed by (baby) bok choy, amaranth, arden lettuce (4 points); leaf mustard, edible rape, sweet potato leaf, bai cai and Chinese leek (3 points); and okra and Chinese celery (0·5 points). This classification can be used to guide patients in recording their weekly vitamin K scores with a view to maintaining it when on warfarin. What is new and conclusion We suggest a novel approach to patient counselling on warfarin to maintain consistent dietary vitamin K intake and achieve a more stable anticoagulation response. A prospective randomized controlled trial to validate this pragmatic approach would be useful. Twenty-three vitamin K-rich vegetables commonly seen in Taiwanese meals were identified and classified into seven score grades according to their relative vitamin K content per serving. The scores were based on published vitamin K content of different foods. The vitamin K score was equivalent to 5 points for spinach and garland chrysanthemum per bowel. We suggest a novel approach to patient counseling on warfarin to maintain consistent dietary vitamin K intake and achieve a more stable anticoagulation response. A prospective randomized controlled trial to validate this pragmatic approach would be useful.
机译：已知和客观的华法林与其他药物和食物之间的许多相互作用给临床医生和患者在维持稳定的抗凝方面提出了巨大的挑战。由于不同饮食中维生素K含量变化而产生的相互作用几乎影响了所有华法林患者的治疗。不幸的是，尚无广泛接受的，对患者友好的策略来管理此类交互。在这项贡献中，我们提出了一种实用的方法来管理这种麻烦的互动，包括“保持恒定的每周饮食中维生素K摄入分数”。方法确定台湾膳食中常见的23种富含维生素K的蔬菜，并根据每份食物中的相对维生素K含量将其分为7个评分等级。分数基于不同食品的公开维生素K含量。结果与讨论每个肠菠菜和花环菊花的维生素K得分等于5分，其次是（婴儿）白菜，a菜，阿登生菜（4分）;芥菜，食用油菜，番薯叶，白菜和韭菜（3分）;黄秋葵和芹菜（0·5分）。此分类可用于指导患者记录其每周维生素K评分，以期在服用华法林时维持该评分。什么是新结论我们建议采用一种新颖的方法为患者提供有关华法令的咨询，以保持饮食中维生素K的摄入量恒定，并实现更稳定的抗凝反应。一项前瞻性随机对照试验来验证这种实用的方法将是有用的。确定了台湾膳食中常见的23种富含维生素K的蔬菜，并根据每份食物中的相对维生素K含量将其分为7个评分等级。分数基于不同食品的公开维生素K含量。每个肠菠菜和花环菊花的维生素K得分等于5分。我们建议在华法林上为患者提供咨询的一种新颖方法，以维持一致的饮食中维生素K摄入量，并实现更稳定的抗凝反应。一项前瞻性随机对照试验来验证这种实用的方法将是有用的。

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