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Post by on Thursday, August 5, 2021

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Many heart patients especially those with valve replacements or those having atrial fibrillation due to valve diseases are on oral anti-coagulants like warfarin. In these patients an increased intake of dietary vitamin K can reduce the anticoagulant response which can especially occur in patients consuming dark green vegetables or vitamin K-containing supplements (as a part of weight-reduction diets). Thus those on oral anti-coagulants should not partake more than three servings of dark green vegetables per week.  If Vitamin K is absolutely necessary it may be recommended to keep vitamin K intake consistent on a daily basis. Avoid sudden changes in the intake of foods and vitamins containing vitamin K. 
1. Green leafy vegetables – Kale (Gobhi), Cabbage, Spinach (Palak), Brussels sprouts, Parsley, Collard greens, Mustard greens (Sarson), Endive, Red cabbage.
2. Fruits – Mango, Avocado
3. Drinks – Green tea, soy milk 
4. Fruit juice like cranberry juice ( can raise INR), grape fruit juice
5. Alcohol can raise INR level; especially avoid binge drinking 
6. Cooking oils with high vitamin K content; rapeseed (canola), soybean, and olive oil
7. Cheese, Livers
8. Vitamin K supplements
9. Vitamin E supplements can affect INR 
10. Calcium supplements taken 2-3 times / day can reduce the absorption of oral anticoagulation
11. Fish oils; Cod liver oil & omega 3 can impact INR
12. Unknown herbal remedies
13. Sudden change in fat content of diet should be avoided
14. Tobacco and marijuana use
Prof of Cardiology, AIIMS Delhi 

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