Eating Green leaves & Warfarin
qbuster
Posts: 14 Member
I spotted a popular cookery forum praising kale as a 'wonder' veg and you might be interested in the following comment I placed on their forum:
For all of the acknowledged wonders of kale and other dark green vegetables, there are some of us - and we are in the hundred of thousands, if not millions - that need to avoid these delicious leaves.
The RDA (Recommend Daily Allowance) of vitamin K is around 30 mcg and a typical portion of kale contains over 30 times that (1000 mcg). For most folk, this wouldn't be a problem but for those of us taking the anti-coagulant Warfarin (Coumadin) that high a level of vitamin K can counteract the desired effects of the drug and put us at risk.
As a result the medical profession usually advise their warfarin patients to keep the intake of such foods consistent which, in practice, is not that easy for those of us that enjoy a varied diet.
As someone who has a scientific background, my approach is to use the USDA database (see http://tinyurl.com/86lrg2z) to work how much of a given food will provide roughly the RDA. In the case of kale I am afraid that is not very much. As a cup (say 180g) of cooked kale provides over 30 times the RDA then we would only be allowed about a tablespoonful - barely more than a colourful blob on the plate!
This gets more complicated with salads of mixed leaves because most salad ingredients contain vitamin K, so ideally one should consider the k-impact of each leaf.
As indicated earlier, the medical profession suggests that the way around this is to eat the same amount of the same green veg leaves each day - this would work because warfarin patients regularly have their blood tested to ensure that the clotting potential is neither to low to risk a haemorrhage nor to high to risk a clot forming and causing further complications. These regular tests enable the daily dose to be adjusted as necessary. This process works but in most cases it isn't practical to test blood everyday so as much as I love salads, spinach, broccoli, kale, asparagus etc., I really don't relish the idea of eating the same mix each day.
Instead I revert to the simple - if initially a trifle tedious - practice of using a digital scale (these days most scales are accurate enough to weigh out a few grams) and the USDA database to familiarise myself with how much of each veg provides roughly the RDA daily dose. Personally, I find this quite interesting and I soon remember what I refer to as the 'overdose level' of each veg and so combining mixed leaves into an occasional salad or daily mixed veg turns out to be a rather satisfying creative process.
By the way, I have written to myFitnessPal management making the case that they should include vitamin K in the output of standard nutrients.
For all of the acknowledged wonders of kale and other dark green vegetables, there are some of us - and we are in the hundred of thousands, if not millions - that need to avoid these delicious leaves.
The RDA (Recommend Daily Allowance) of vitamin K is around 30 mcg and a typical portion of kale contains over 30 times that (1000 mcg). For most folk, this wouldn't be a problem but for those of us taking the anti-coagulant Warfarin (Coumadin) that high a level of vitamin K can counteract the desired effects of the drug and put us at risk.
As a result the medical profession usually advise their warfarin patients to keep the intake of such foods consistent which, in practice, is not that easy for those of us that enjoy a varied diet.
As someone who has a scientific background, my approach is to use the USDA database (see http://tinyurl.com/86lrg2z) to work how much of a given food will provide roughly the RDA. In the case of kale I am afraid that is not very much. As a cup (say 180g) of cooked kale provides over 30 times the RDA then we would only be allowed about a tablespoonful - barely more than a colourful blob on the plate!
This gets more complicated with salads of mixed leaves because most salad ingredients contain vitamin K, so ideally one should consider the k-impact of each leaf.
As indicated earlier, the medical profession suggests that the way around this is to eat the same amount of the same green veg leaves each day - this would work because warfarin patients regularly have their blood tested to ensure that the clotting potential is neither to low to risk a haemorrhage nor to high to risk a clot forming and causing further complications. These regular tests enable the daily dose to be adjusted as necessary. This process works but in most cases it isn't practical to test blood everyday so as much as I love salads, spinach, broccoli, kale, asparagus etc., I really don't relish the idea of eating the same mix each day.
Instead I revert to the simple - if initially a trifle tedious - practice of using a digital scale (these days most scales are accurate enough to weigh out a few grams) and the USDA database to familiarise myself with how much of each veg provides roughly the RDA daily dose. Personally, I find this quite interesting and I soon remember what I refer to as the 'overdose level' of each veg and so combining mixed leaves into an occasional salad or daily mixed veg turns out to be a rather satisfying creative process.
By the way, I have written to myFitnessPal management making the case that they should include vitamin K in the output of standard nutrients.
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Replies
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I greatly understand what you are saying. I too am on coumadin, and are very limited on what vegs I am allowed to eat. I have a autoimmune desease that causes me to form clots for no reason. and I will be on coumadin the rest of my life! But GOD has truly Blessed me, For I have just recently had surgery for A-Fib, and I am recovering well. But was amazed that while I have been in the hospital 4 times in the last 2 months, that they serve food that is very rich in vit k to all their patients. My INR was 1.3 2 days after my surgery and they brought me turnips and salad and squash casserole in the same meal. I was very dissapointed that in a hospital on the cardiac floor that no caution was taken to adjust my diet for my coumadin. They have no such diet for those of us that need it. At Home I can carefully watch what I eat, But in the Hospitals you are not so lucky. I too wish they would add the vit k list to this site, I have beeen using this site for a couple of months now and love it! But would also like to see the vit k list added. It would be a great help to the many many of us who have to keep track of it. Anyway just wanted to add my opinion. Thank you for this wonderful site and May God Bless you all!!
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Wouldn't you have to re-log all the food to include Vit |K content - the databases seem to be accrued by "members" rather than any central reference - and some are way, way off.
For the 6 months that I was on Warfarin the main rule seemed to be to keep green vegetables intake as it had been rather than making any gross fluctuations.
If it is for life then it is different. I was more fortunate in my hospital's meals.
I am delighted to hear that you are recovering well.0 -
Yes the general idea is to keep your vitamin k about the same each day! however, The problem with this is, so many foods have vitamin k that you don't even realize so it makes it very hard to regulate it. I am A lifer as they call it, I will be on Blood thinners for life, and have to be very careful what I eat, I am suppose to have around 81 mg of vit k a day! and when you do some research, you find that it is very hard to stay in that range. It is not just Greens that are full of vitamin K. there are foods you would never think of, So it is very hard to stay in the range that is recommmened for coumadin users! And since so many of us are on coumadin, I am so agitated at the Hospitals for not being more up to date as to what the patients needs are concerning thier diets!! It is sad when you are admittted to the Hospital with a low INR and then you are served meals very High in vitamin K and that of course drops your Inr even lower. Makes no since to me.0
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Does your hospital have a Patient Liasion Officer? They are usually a waste of space but you could plague him or her into some sort of submission. Would your GMP cooperate by writing to ask why the hospital caterers are trying to assassinate his/her patients?0
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Good Point, I think I will talk to the administator of the hospital first and see where this leads me, I Think in my opinion the Dr should care more about what thier patients are given when in the hospital, But the hospital diatary staff should know better!! And Thank you for your Reply, May God Bless you!!0
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I am on Warfarin and eat greens (love Kale) every day. I just stay consistent as to how much vegetable Vit K I have every day and the nurse matches my warfarin dosage to keep my range steady. It's easy. As long as I have the same amount each day, that amount does NOT need to be zero.
She said the idea that you had to stay away from Vitamin K is what they used to tell patients. But nowadays they just increase your warfarin to accommodate it.0 -
Consistency is the key - don't change what you are used to and monitor INR until you know what you can get away with.0
