Increased serum osteocalcin levels and vitamin K status by daily cheese intake

Abstract

<p class="abstract"><strong>Background:</strong> Cheese is a major source of long-chained vitamin K2 variants. How intake of vitamin K2 rich cheese affects vitamin K and osteocalcin has not been studied. The aim was to establish a maximum efficacy dose (MED) after daily intake of vitamin K2-rich cheese (Jarlsberg<sup>®</sup>) based on increase in ratio between carboxylated and undercarboxylated osteocalcin during a five-week diet.</p><p class="abstract"><strong>Methods:</strong> 20 healthy healthy volunteers (HV) were recruited. The daily intake of Jarlsberg<sup>®</sup> cheese in the study varied from 20 to 152 g. Clinical investigation was performed initially and after three, four and five weeks with measurement of vital signs, hematological and biochemical variables, carboxylated and undercarboxylated osteocalcin and vitamin K. The ratio OR= carboxylated/undercarboxylated osteocalcin was the main variable.</p><p class="abstract"><strong>Results:</strong> The MED decreased with treatment duration and was estimated to 57 g/day (95% CI: 47-67) after five weeks diet, resulting in a mean OR increase of 30% (95% CI: 23.8-36.8). Both OR and serum osteocalcin followed a quadratic dose response curve. For osteocalcin, a maximal increase of 46% was estimated at 59 g/day for five weeks. The serum content of long-chained vitamin K2 increased significantly with increasing cheese dose. The increase were mainly obtained the first three weeks and kept unchanged the following two weeks. The cheese doses close to the MED caused nearly significant reductions in total cholesterol, LDL-cholesterol, the LDL/HDL ratio and significant reduction in the blood pressures after five weeks diet (p≤0.05).</p><p class="abstract"><strong>Conclusions: </strong>MED of Jarlsberg® cheese was estimated to 57 g/day. Daily intake of Jarlsberg<sup>®</sup> cheese increased the osteocalcin level, vitamin K2 and positively affected the lipid patterns and blood pressure.</p>

Determination of maintenance Jarlsberg® cheese dose to keep the obtained serum osteocalcin level; a response surface pathway designed de-escalation dose study with individual starting values

“…The six week run-in periods with daily MED of Jarlsberg® preceding the de-escalation and maintenance studies verified the increases in tOC levels, osteocalcin ratio and serum vitamin K2 as previously reported. 12 The studies verified the increases in vitamin K status, measured as osteocalcin carboxylation, as well as serum vitamin K2. The obtained positive effects are not transient and can be retained by daily intake of Jarlsberg®.…”

“…In addition to the positive effect of daily Jarlsberg® cheese intake on tOC and the vitamin K2 variants, this previous study indicated a positive effect on the lipid patterns and blood pressure. 12 These findings and the known association between osteocalcin and health suggest that daily intake of vitamin K2 rich cheese may have a positive impact on public health. 5,6 In case the previous results can be verified in new clinical studies, a daily addition of cheese such as Jarlsberg® might be used as a prophylactic against several diseases and even as an addition to treatment of diseases like osteoporosis and hyperlipidaemia.…”

“…The HVs in both the de-escalation and the maintenance study were initially included in a six week run-in period, in which they consumed 60 g or 6 slices Jarlsberg® cheese daily. 12 Clinical investigations and blood sampling were performed initially and at the end of the six weeks run-in period. In addition to common laboratory variables, the blood samples were used for measurements of tOC and the vitamin K2 variants MK-7, MK-8, MK-9 and MK-9 (4H).…”

“…[9][10][11] The study was performed on 19 women with daily intake of Jarlsberg® cheese during a period of 5 weeks. 12 This recent study estimated the MED of Jarlsberg® cheese to 57 g/day and resulted in an increase of both the total serum osteocalcin level (tOC) and vitamin K2 levels. To the best of our knowledge, this is the first time medical or dietary intervention has been able to demonstrate a significant increase in the tOC level in humans.…”

“…10,11 RSP design with skewed starting point is previously introduced, but will not be able to correct for the expected individual deviations in osteocalcin increase. 12,13 In order to optimize the study, it is necessary to develop a within-patient RSP design with an individual starting dose, which will depend on the individual tOC increase after 6 weeks on MED.…”