The role of dietary nitrate and vitamin K in improving cardiovascular outcomes

Dr Nicola Bondonno

Investigating the relationship between dietary components and cardiometabolic disease

Research Collaboration Award

$29,722

2020 - 2021

School of Health and Medical Sciences, Edith Cowan University, collaborating with The University of Western Australia, Gentofte Hospital (Copenhagen, Denmark)

Dr Nicola Bondonno was awarded a Healy Research Collaboration Award in 2020 to investigatepotential associations between dietary components (namely dietary nitrate and vitamin K) and cardiovascular and cancer outcomes.

Current dietary guidelines recommend a high intake of all fruits and vegetables however, studies have shown that some fruits and vegetables may be more protective against cardiometabolic disease than others. Plants contain a wide variety of health promoting compounds including nitrate and vitamin k. Evidence from clinical trials suggests that dietary nitrate may play a critical role in the prevention and treatment of hypertension and a diet rich in vitamin K may help prevent the development of vascular calcification and diabetes mellitus. Long-term epidemiological studies looking at disease incidence are needed to identify whether certain foods or dietary constituents afford greater protection against specific types of cardiometabolic disease and to provide an estimate of their effects at the population level.

The current project examined associations between dietary nitrate and vitamin K intakes and a wide range of cardiometabolic health outcomes, namely mortality, cardiovascular disease and diabetes in a large cohort of 57,000 Danish men and women.

As a result of this collaboration and funding, Dr Bondonno has published three high impact publications demonstrating that dietary nitrate is inversely associated with incident cardiovascular disease and that dietary vitamin K1, but not vitamin K2, is inversely associated with incident atherosclerotic cardiovascular disease, all-cause mortality, cardiovascular disease mortality and cancer mortality.

Dr Bondonno and her collaborators ran successful media campaigns for two of these publications, including more than 500 media mentions, and have presented findings at national and international conferences. They have secured over $800k in grant funding to continue their research on dietary nitrate and have applied for a further two large grants to continue their research on vitamin K. The collaboration between the two Western Australian Universities (ECU and UWA) and two Danish Institutes has been strengthened with joint PhD students and plans for student exchanges in place.

The findings of the current project, in conjunction with ongoing studies, seek to provide important future direction for ongoing world-wide research the role of dietary nitrate and vitamin k in the development of chronic disease. Additionally, Dr Bondonno and her team aspire to achieve a world-first by addressing the critical knowledge gap regarding the beneficial versus harmful effects of nitrate on human health. If positive findings are confirmed in clinical trials, results from the proposed studies can be translated into nutritional advice, encouraging diets high in nitrate and vitamin K to assist in the prevention of cardiometabolic disease.

"This award has greatly enhanced my research track record. I know that this is just the beginning and foresee that this collaboration will continue to grow and develop well into the future."

- Dr Nicola Bondonno