News

May 18, 2023

Higher Vitamin D Dose in Childhood Linked to Lower Mental Health Risk

Summary: A recent study suggests higher doses of Vitamin D3 supplementation

Summary: A recent study suggests higher doses of Vitamin D3 supplementation during early childhood may reduce the risk of internalizing psychiatric symptoms in later years.

The study, a part of the VIDI trial, observed the impact of the standard 10 µg and a tripled 30 µg dose of Vitamin D on children from the age of two weeks to two years.

The results demonstrated that children who received the higher dose had fewer reported cases of depressed mood, anxiety, and withdrawn behavior. Further research is required to solidify these findings.

Key Facts:

Source: Tampere University

It is estimated that every eighth child suffers from a mental health disorder. Several predictors of children's mental problems have been identified, but much remains uncharted. Previous research suggests that low vitamin D levels in early childhood may be one factor increasing the risk of mental health problems in later life.

A recent Finnish study, now published in JAMA Network Open, presents new information on the association between vitamin D intake and mental health.

A new study by a team of Finnish researchers has investigated whether a daily vitamin D3 supplement higher than the recommended dose in early childhood reduces the risk of psychiatric symptoms at school age.

The study is part of the Vitamin D Intervention in Infants (VIDI) clinical trial, which investigates how early vitamin D3 intervention affects children's growth and development.

In the research, children were randomized as two groups, one receiving the daily standard dose of 10 micrograms and the other triple the amount—30 µg—of vitamin D. The children received the supplementation daily from 2 weeks to 2 years of age.

The children were followed up and the latest monitoring point occurred when they were 6- to 8-year-olds. In the latest follow-up phase, the parents of 346 children assessed their child's psychiatric symptoms using a questionnaire.

The study found that daily vitamin D3 supplementation above the standard dose reduced the risk of internalizing problems at school age. In other words, children who received the higher dose had less parent-reported depressed mood, anxiety, and withdrawn behavior than children who received the standard dose.

According to the research results, parents reported clinically significant internalizing problems in 11.8% of the children who had received the standard dose of daily vitamin D supplement of 10 µg until the age of 2 years. Of the children who received the triple vitamin D supplement, 5.6% were reported to have similar problems.

"Our results suggest that a higher dose of vitamin D3 supplementation during the first years of life may reduce the risk of internalizing psychiatric symptoms in late preschool and early school age," says Samuel Sandboge, Postdoctoral Research Fellow at Tampere University.

"The results and their potential implications are interesting, but further research is needed to confirm the results. In the interpretation of the results, we must note, among other things, that we studied the psychiatric symptoms only as parent-reported. Furthermore, the participants of the study were children with Nordic ancestry living in Finland who had good levels of vitamin D," Sandboge says.

The researchers did not detect differences in externalizing problems, such as aggressive behavior and rule-breaking. Moreover, no differences in the overall extent of psychiatric symptoms were found in the children.

Author: Samuel SandbogeSource: Tampere UniversityContact: Samuel Sandboge – Tampere UniversityImage: The image is credited to Neuroscience News

Original Research: Open access."Effect of Vitamin D3 Supplementation in the First 2 Years of Life on Psychiatric Symptoms at Ages 6 to 8 Years" by Samuel Sandboge et al. JAMA Network Open

Abstract

Effect of Vitamin D3 Supplementation in the First 2 Years of Life on Psychiatric Symptoms at Ages 6 to 8 Years

Importance

Vitamin D is associated with neurodevelopment, but causality, critical windows, and potentials for modification remain unknown.

Objective

To determine the impact of high-dose (1200 IU) vs standard-dose (400 IU) vitamin D3 supplementation during the first 2 years on psychiatric symptoms at ages 6 to 8 years and whether the impact is different in children with lower vs higher maternal vitamin D3 levels; lower vs higher levels were defined as 25-hydroxyvitamin D (25[OH]D) less than 30 ng/mL vs 30 ng/mL or greater.

Design, Setting, and Participants

This study was a long-term follow-up of the double-blind randomized clinical trial (RCT) Vitamin D Intervention in Infants (VIDI) conducted at a single center in Helsinki, Finland, at 60 degrees north latitude. Recruitment for VIDI took place in 2013 to 2014. Follow-up data for secondary data analysis were collected 2020 to 2021. VIDI originally included 987 term-born infants; 546 of these individuals participated in the follow-up at ages 6 to 8 years, among whom 346 individuals had data on parent-reported psychiatric symptoms. Data were analyzed from June 2022 to March 2023.

Interventions

There were 169 infants randomized to receive 400-IU and 177 infants randomized to receive 1200-IU oral vitamin D3 supplementation daily from ages 2 weeks to 24 months.

Main Outcomes and Measures

Primary outcomes were internalizing, externalizing, and total problems scores, with clinically significant problems defined as T scores of 64 or greater in the Child Behavior Checklist questionnaire.

Results

Among 346 participants (164 females [47.4%]; mean [SD] age, 7.1 [0.4] years), the vitamin D3 dose was 400 IU for 169 participants and 1200 IU for 177 participants. Clinically significant internalizing problems occurred in 10 participants in the 1200-IU group (5.6% prevalence) compared with 20 participants (11.8%) in the 400-IU group (odds ratio, 0.40; 95% CI, 0.17-0.94; P = .04) after adjustment for sex, birth season, maternal depressive symptoms at birth, and parental single status at follow-up. In a post hoc subgroup analysis, 48 children in the 400-IU group with maternal 25(OH)D concentrations less than 30 ng/mL had higher internalizing problems scores compared with children in the 1200-IU group, including 44 children with maternal 25(OH)D concentrations below 30 ng/mL (adjusted mean difference, 0.49; 95% CI, 0.09-0.89; P = .02) and 91 children with maternal concentrations above 30 ng/mL (adjusted mean difference, 0.37; 95% CI, 0.03-0.72; P = .04). Groups did not differ in externalizing or total problems.

Conclusions and Relevance

This randomized clinical trial found that higher-than-standard vitamin D3 supplementation in the first 2 years decreased risk of internalizing problems at ages 6 to 8 years.

The spectrum of mental health in children is vast and can never based on one single study. Mental health assessment of every child cannot achieved unless a long list of clinical factors are fully studied. Taken into account, the clinical status of each child, which include abnormalities in visual-motor integration, visual –spatial judgment and visual-perceptual skills and so forth. Comprehensive clinical assessment of mental health in children is not just an observational study through the laboratory evaluation of vitamin D3. Clinical assessment is a sensitive topic which is strongly connected with the neuro- and the musculo-skeletal development, which represents a real challenge and requires appropriate knowledge in clinical phenotypic characterization of every single child. Clinical assessment of mental health starts from the antenatal, prenatal, postnatal and so on. The knowledge should stem from appropriate understanding of the clinical phenotype of every child. Throwing all children in one basket is a false strategy carries a high risk of mismanagement. Authors totally overlooked the phenotype/genotype, which are the key factors of normal development. Vitamin D is not the basic element for proper neurodevelopment. In fact vitamin B complex, specifically cyanocobalamin (vitamin B12). This vitamin is essential for brain development, neural myelination, and cognitive function. Mothers during gestation require normal level of cyanocobalamin, as well as for children in their early years of life. Inadequate status of vitamin B12 has been strongly linked with adverse child health outcomes, including impaired cognitive and neurological development. In short, vitamin D is not a true vitamin because it can be synthesized endogenously through ultraviolet exposure of the skin (vitamin D is a fat soluble steroid hormone). Unfortunately, the current report is based on a short-sighted strategy, simply because the diversity of the underlying pathologies of mental health development in children are enormous.

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