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Effect on bone anabolic markers of daily cheese intake with and without vitamin K2 : a randomised clinical trial

BMJ Nutrition, Prevention & Health – 2022


Helge Einar Lundberg, Morten Glasø, Rahul Chhura, Arjun Andre Shukla, Torunn Austlid, Zohaib Sarwar, Kathrine Hovland, Sapna Iqbal, Hans Erik Fagertun, Helge Holo, Stig Einride Larsen


BMJ Nutrition, Prevention & Health




Background Daily intake of 57 g Jarlsberg cheese has been shown to increase the total serum osteocalcin (tOC). Is this a general cheese effect or specific for Jarlsberg containing vitamin K2 and 1,4-dihydroxy-2naphtoic acid (DHNA)? Methods 66 healthy female volunteers (HV) were recruited. By skewed randomisation (3:2), 41 HV were allocated to daily intake of 57 g Jarlsberg (J-group) and 25–50 g Camembert (C-group) in 6 weeks. After 6 weeks the C-group was switched to Jarlsberg. The study duration was 12 weeks with clinical investigations every 6 weeks. The main variables were procollagen type 1 N-terminal propeptide (PINP), tOC, carboxylated osteocalcin (cOC) and the osteocalcin ratio (RO ) defined as the ratio between cOC and undercarboxylated osteocalcin (ucOC). Serum crosslinked C-telopeptide type I collagen (CTX), vitamin K2 , lipids and clinical chemistry were used as secondary variables. Results PINP, tOC, cOC, RO and vitamin K2 increased significantly (p<0.01) after 6 weeks in the J-group. PINP remained unchanged in the C-group. The other variables decreased slightly in the C-group but increased significantly (p≤0.05) after switching to Jarlsberg. No CTXchanges detected in neither of the groups. Serum lipids increased slightly in both groups. Switching to Jarlsberg, total cholesterol and low-density lipoproteincholesterol were significantly reduced (p≤0.05). Glycated haemoglobin (HbA1c), Ca++ and Mg++ were significantly reduced in the J-group, but unchanged in the C-group. Switching to Jarlsberg, HbA1c and Ca++ decreased significantly. Conclusion The effect of daily Jarlsberg intake on increased s-osteocalcin level is not a general cheese effect. Jarlsberg contain vitamin K2 and DHNA which increases PINP, tOC, cOC and RO and decreases Ca++, Mg++ and HbA1c. These effects reflect increased bone anabolism and a possible reduced risk of adverse metabolic outcomes.