"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

Margaret Mead
David  K. Cundiff
Reviewer Rating
0 reviews
Share

David K. Cundiff

Internal Medicine

Internal Medicine, LA County + USC Medical Center (Retired)
SIQ
7.8

This user has not published any posters with Cureus.

How to Rescue American Football

Editorial
Commented on: May 07, 2016

This helps to frame the debate on the issue of football related brain injuries. Medical consultants to NFL teams and other sports medicine physicians should be encouraged to comment on this editorial.


Cardiovascular Disease Death Before Age 65 in 168 Countries Correlated Statistically with Biometrics, Socioeconomic Status, Tobacco, Gender, Exercise, Macronutrients, and Vitamin K

Original Article
Commented on: August 28, 2016

Thanks for your cogent comments. As you allude to, cholesterol and other serum lipid explain little about CVD risk in wealthy nations. Indeed, cholesterol and simulated cholesterol/HDL-C are inversely associated with early CVD death worldwide. Since the primary vehicle for vitamin K2 in the diet is fat and cholesterol laden foods (animal products), the role of vitamin K2 in calcium regulation plausibly accounts in part for fewer CVD deaths in wealthy countries where K2 intake is much higher. The increasingly contentious debates about whether the optimal diet for cardiovascular health is low or high in animal products also needs to be viewed in relationship to the intake and functioning of vitamin K2. I agree that we need more data on the mechanisms involved in the endogenous synthesis and utilization of vitamin K2. To progress in this regard, we need a good assay of vitamin K2 content in the body. Then we could experimentally manipulate gut flora and determine the effects on vitamin K2. We could also look more closely at vitamin K3 (menadione), the enzyme UbiA prenyltransferase domain-containing protein 1 (UBIAD1), and compare the functioning of vitamin K2 derived from animal products, plant product fermentation, and supplements. The effects of different types of drugs on vitamin K2 functioning may also have clinical consequences and should be studied. Amid all the complexity and the unanswered questions about vitamin K2, we should remember that CVD kill about one-third of people in wealthy countries as well as poor countries. Vitamin K2 is not toxic in high doses according to the FDA. So it appears that the FDA should use the data currently available, including this article, to determine “adequate intakes” (AIs) of vitamin K2 for USA residents at all ages of life.


Cardiovascular Disease Death Before Age 65 in 168 Countries Correlated Statistically with Biometrics, Socioeconomic Status, Tobacco, Gender, Exercise, Macronutrients, and Vitamin K

Original Article
Commented on: August 29, 2016

Thanks for the insights about vitamin K2, and kudos on your many contributions over the years to our knowledge about vitamin K. The introduction of refrigeration and freezing in food preservation may have played some role in reducing vitamin K2 intake in some situations, however, it is probably not a dominant role worldwide. Developing countries that lack widespread refrigeration have higher rates of early CVD death than developed countries, and rates of early CVD death in the USA and Western Europe have dramatically fallen over the past 50+ years while refrigeration has been widespread. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767229/). Vitamin K2 intake from animal products may be a bigger factor. Since the Second World War the intake of vitamin K2 containing animal products have increased substantially in wealthy countries and less so in the developing world. The widespread availability of the circulating inactive MGP assay you describe should be useful to determine the bioavailability of ingested vitamin K2 and as the long sought after means of screening people for adequacy of vitamin K2 intake. My recently submitted “Citizen Petition” to the US Food and Drug Administration requesting that they establish an “adequate intake” for vitamin K2 might be more favorably reviewed if a good biomarker of vitamin K2 adequacy is available to affirm the sufficiency of given levels of vitamin K2 intake. Thanks again.


Cardiovascular Disease Death Before Age 65 in 168 Countries Correlated Statistically with Biometrics, Socioeconomic Status, Tobacco, Gender, Exercise, Macronutrients, and Vitamin K

Original Article
Commented on: August 31, 2016

The comment from Micki Jacobs about dihydrophylloquinone as a form of trans fat is well taken. The available data related to dihydrophylloquinone in foods from the USDA and other sources were not sufficient enough to explore this in the paper. When more data are available, i will explore it.