The Effect of Vitamin D Supplementation on Cardiometabolic Risk Factors and Mental Health Symptoms in Obese Children
Abstract
Objective: Decreased 25(OH)-vitamin D concentrations represent a risk factor for the development of cardiometabolic and mental health disorders in adults. We investigated the effect of vitamin D supplementation on cardiometabolic risk factors and mental health symptoms in overweight and obese children, and adolescents with vitamin D deficiency or insufficiency. Patients and Methods: Two hundred and twenty (n=220) overweight and obese children and adolescents [Mean age ± SEM: 10.24±0.17 years; BMI ± SEM: 26.69±0.28 kg/m2; BMI z-score ± SEM: 2.42±0.07; males: 114 (51.8%), females: 106 (48.2%)] with vitamin D deficiency or insufficiency were studied prospectively and randomly assigned into the supplementation (n=109) or the control group (n=111). Participants in the supplementation group received 50,000 IU cholecalciferol once a week for 6 weeks followed by a maintenance dose. Blood samples for determination of 25(OH)-vitamin D, endocrinologic and cardiometabolic parameters were obtained at baseline and 12 months later. Systolic and diastolic blood pressure was determined twice and the mean value was calculated. Mental health was assessed by questionnaires at baseline and 12 months later. Results: Subjects in the supplementation group had significantly lower BMI (p=0.010), hsCRP (p=0.048) and total cholesterol (p=0.015), and higher HDL (p<0.001) concentrations than the control group. In addition, they demonstrated significantly lower scores in anxiety, attention problems, aggressive behavior, externalizing problems, attention deficit hyperactivity problems and oppositional defiant problems than the control group. Conclusions: Vitamin D supplementation may prevent the development of cardiometabolic risk manifestations and may improve anxiety-related, externalizing (behavioral) and internalizing (emotional) problems in overweight and obese children and adolescents with vitamin D deficiency or insufficiency.
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References
Achenbach TM 1991a Manual for the Child Behavior Checklist/4-18 and 1991 profile. University of Vermont, Department of Psychiatry, Burlington, VT
Achenbach TM 1991b Integrative guide to the 1991 CBCL/4-18, YSR and TRF profiles. University of Vermont, Department of Psychiatry, Burlington, VT
Al-Daghri NM, Alkharfy KM, Al-Saleh Y, Al-Attas OS, Alokail MS, Al-Othman A Moharram O, El-Kholie E, Sabico S, Kumar S & Chrousos GP 2012 Modest reversal of metabolic syndrome manifestations with vitamin D status correction: a 12-month prospective study. Metabolism 61 661-666
Al-Daghri NM, Sabico S, Al-Saleh Y, Al-Attas OS, Alnaami AM, AlRehaili MM, Al-Harbi M, Alfawaz H, Chrousos G & Alokail MS 2016 Calculated adiposity and lipid indices in healthy Arab children as influenced by vitamin D status. J Clin Lipidol 10 775-781
Alemzadeh R, Kichler J, Babar G & Calhoun M 2008 Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season. Metabolism 57 183–191
Ashraf AP, Alvarez JA, Gower BA, Saenz KH & McCormick KL 2011 Associations of serum 25-hydroxyvitamin D and components of the metabolic syndrome in obese adolescent females. Obesity (Silver Spring) 19 2214-2221
Aypak C, Türedi O & Yüce A 2014 The association of vitamin D status with cardiometabolic risk factors, obesity and puberty in children. Eur J Pediatr 173 367-373
Belenchia AM, Tosh AK, Hillman LS & Peterson CA 2013 Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial. Am J Clin Nutr 97 774–781
Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S & Baugher M 1999 Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry 38 1230-1236
Bouillon R, Carmeliet G, Verlinden L, van Etten E, Verstuyf A, Luderer HF, Lieben L, Mathieu C & Demay M 2008 Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 29 726-776
Brouwer-Brolsma EM, Feskens EJ, Steegenga WT & De Groot LC 2013 Associations of 25-hydroxyvitamin D with fasting glucose, fasting insulin, dementia and depression in European elderly: the SENECA study. Eur J Nutr 52 917–925
Censani M, Hammad HT, Christos PJ & Schumaker T 2018 Vitamin D deficiency associated with markers of cardiovascular disease in children with obesity. Glob Pediatr Health 5 1–6
Crocker MK & Yanovski JA 2009 Pediatric obesity: etiology and treatment. Endocrinol Metab Clin North Am 38 525-548
Cunningham SA, Kramer MR & Narayan KM 2014 Incidence of childhood obesity in the United States. N Engl J Med 370 403-411
Föcker M, Antel J, Ring S, Hahn D, Kanal Ö, Öztürk D, Hebebrand J & Libuda L 2017 Vitamin D and mental health in children and adolescents. Eur Child Adolesc Psychiatry 26 1043-1066
Forrest KY & Stuhldreher WL 2011 Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res 31 48–54
Grung B, Sandvik AM, Hjelle K, Dahl L, Frøyland L, Nygård I & Hansen AL 2017 Linking vitamin D status, executive functioning and self-perceived mental health in adolescents through multivariate analysis: A randomized double-blind placebo control trial. Scand J Psychol 58 123-130
Högberg G, Gustafsson SA, Hällström T, Gustafsson T, Klawitter B & Petersson M 2012 Depressed adolescents in a case-series were low in vitamin D and depression was ameliorated by vitamin D supplementation. Acta Paediatr 101 779-783
Holick MF 2007 Vitamin D deficiency. N Engl J Med 357 266-281
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney R P & Weaver CM 2011 Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96 1911-1930
Husmann C, Frank M, Schmidt B, Jöckel KH, Antel J, Reissner V, Libuda L, Hebebrand J & Föcker M 2017 Low 25(OH)-vitamin D concentrations are associated with emotional and behavioral problems in German children and adolescents. PLoS One 12 e0183091
Jaddou HY, Batieha AM, Khader YS, Kanaan SH, El-Khateeb MS & Ajlouni KM 2012 Depression is associated with low levels of 25-hydroxyvitamin D among Jordanian adults: results from a national population survey. Eur Arch Psychiatry Clin Neurosci 262 321–327
Javed A, Vella A, Balagopal PB, Fischer PR, Weaver AL, Piccinini F, Dalla Man C, Cobelli C, Giesler PD, Laugen JM & Kumar S 2015 Cholecalciferol supplementation does not influence β-cell function and insulin action in obese adolescents: a prospective double-blind randomized trial. J Nutr 145 284-290
Judd SE, Nanes MS, Ziegler TR, Wilson PW & Tangpricha V 2008 Optimal vitamin D status attenuates the age-associated increase in systolic blood pressure in white Americans: results from the third National Health and Nutrition Examination Survey. Am J Clin Nutr 87 136–141
Kamal M, Bener A & Ehlayel MS 2014 Is high prevalence of vitamin D deficiency a correlate for attention deficit hyperactivity disorder? Atten Defic Hyperact Disord 6 73–78
Kelishadi R, Salek S, Salek M & Hashemipour M 2014 Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. J Pediatr (Rio J) 90 28-34
Kim DH, Sabour S, Sagar UN, Adams S & Whellan DJ 2008 Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol 102 1540-1544
Kovacs M. 1985 The Children’s Depression Inventory (CDI). Psychopharmacol Bull 21 995-998
Lerner PP, Sharony L & Miodownik C 2018 Association between mental disorders, cognitive disturbances and vitamin D serum level: Current state. Clin Nutr ESPEN 23 89-102
Marshall WA & Tanner JM 1969 Variations in pattern of pubertal changes in girls. Arch Dis Child 44 291-303
Marshall WA & Tanner JM 1970 Variations in the pattern of pubertal changes in boys. Arch Dis Child 45 13-23
Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, Felsenfeld A, Levine B, Mehrotra R & Norris K 2007 Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Internal Med 167 1159–1165
Milaneschi Y, Hoogendijk W, Lips P, Heijboer AC, Schoevers R, van Hemert AM, Beekman AT & Smit JH 2014 The association between low vitamin D and depressive disorders. Mol Psychiatry 19 444–451
Mossin MH, Aaby JB, Dalgård C, Lykkedegn S, Christesen HT & Bilenberg N 2017 Inverse associations between cord vitamin D and attention deficit hyperactivity disorder symptoms: A child cohort study. Aust N Z J Psychiatry 51 703-710
Nader NS, Aguirre Castaneda R, Wallace J, Singh R, Weaver A & Kumar S 2014 Effect of vitamin D3 supplementation on serum 25(OH)D, lipids and markers of insulin resistance in obese adolescents: a prospective, randomized, placebo-controlled pilot trial. Horm Res Paediatr 82 107-112
Parikh SJ, Edelman M, Uwaifo GI, Freedman RJ, Semega-Janneh M, Reynolds J & Yanovski JA 2004 The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 89 1196–1199
Petersen RA, Dalskov SM, Sørensen LB, Hjorth MF, Andersen R, Tetens I, Krarup H, Ritz C, Astrup A, Michaelsen KF, Mølgaard C & Damsgaard CT 2015 Vitamin D status is associated with cardiometabolic markers in 8-11-year-old children, independently of body fat and physical activity. Br J Nutr 114 1647-1655
Peterson CA, Tosh AK & Belenchia AM 2014 Vitamin D insufficiency and insulin resistance in obese adolescents. Ther Adv Endocrinol Metab 5 166-189
Pilz S, Tomaschitz A, März W, Drechsler C, Ritz E, Zittermann A, Cavalier E, Pieber TR, Lappe JM, Grant WB, Holick MF & Dekker JM 2001 Vitamin D, cardiovascular disease and mortality. Clin Endocrinol (Oxf) 75 575-584
Pilz S, Verheyen N, Grübler MR, Tomaschitz A & März W 2016 Vitamin D and cardiovascular disease prevention. Nat Rev Cardiol 13 404-417
Roussos A, Karantanos G, Richardson C, Hartman C, Karajiannis D, Kyprianos S, Lazaratou H, Mahaira O, Tassi M & Zoubou V 1999 Achenbach's Child Behavior Checklist and Teachers' Report Form in a normative sample of Greek children 6-12 years old. Eur Child Adolesc Psychiatry 8 165-172
Roussos A, Francis K, Zoubou V, Kiprianos S, Prokopiou A & Richardson C 2001 The standardization of Achenbach's Youth Self-Report in Greece in a national sample of high school students. Eur Child Adolesc Psychiatry 10 47-53
Saad K, Abdel-Rahman AA, Elserogy YM, Al-Atram AA, Cannell JJ, Bjørklund G, Abdel-Reheim MK, Othman HA, El-Houfey AA, Abd El-Aziz NH, Abd El-Baseer KA, Ahmed AE & Ali AM 2016 Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children. Nutr Neurosci 19 346-351
Schäfer TK, Herrmann-Lingen C & Meyer T 2016 Association of circulating 25-hydroxyvitamin D with mental well-being in a population-based, nationally representative sample of German adolescents. Qual Life Res 25 3077-3086
Scragg R, Sowers M & Bell C 2007 Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 20 713–719
Tolppanen AM, Sayers A, Fraser WD, Lewis G, Zammit S & Lawlor DA 2012 The association of serum 25-hydroxyvitamin D3 and D2 with depressive symptoms in childhood -a prospective cohort study. J Child Psychol Psychiatry 53 757-766
Turer CB, Lin H & Flores G 2013 Prevalence of vitamin D deficiency among overweight and obese US children. Pediatrics 131 e152-161
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