RT Journal Article SR Electronic T1 Effect on bone anabolic markers of daily cheese intake with and without vitamin K2: a randomised clinical trial JF BMJ Nutrition, Prevention & Health JO BMJ Nutrition FD BMJ Publishing Group Ltd SP e000424 DO 10.1136/bmjnph-2022-000424 A1 Helge Einar Lundberg A1 Morten Glasø A1 Rahul Chhura A1 Arjun Andre Shukla A1 Torunn Austlid A1 Zohaib Sarwar A1 Kathrine Hovland A1 Sapna Iqbal A1 Hans Erik Fagertun A1 Helge Holo A1 Stig Einride Larsen YR 2022 UL http://nutrition.bmj.com/content/early/2022/06/29/bmjnph-2022-000424.abstract AB 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 cross-linked 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 CTX-changes detected in neither of the groups.Serum lipids increased slightly in both groups. Switching to Jarlsberg, total cholesterol and low-density lipoprotein-cholesterol 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.Trial registration number NCT04189796.Data are available upon reasonable request. All data is saved in a SAS database at Meddoc Research.