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J Nutr. 2019 Aug 20. pii: nxz185. doi: 10.1093/jn/nxz185. [Epub ahead of print]

Vitamin D Deficiency in Middle Childhood Is Related to Behavior Problems in Adolescence.

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Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Department of Medicine, University of La Sabana, Chia, Colombia.
Foundation for Research in Nutrition and Health, FINUSAD, Bogota, Colombia.
Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.
Department of Pediatrics and Communicable Diseases, Medical School, University of Michigan, Ann Arbor, MI, USA.



Vitamin D deficiency (VDD) is associated with depression and schizophrenia in adults. The effect of VDD in childhood on behavioral development is unknown.


We aimed to study the associations of VDD and vitamin D binding protein (DBP) in middle childhood with behavior problems in adolescence.


We quantified plasma total 25-hydroxyvitamin D [25(OH)D] and DBP in 273 schoolchildren aged 5-12 y at recruitment into a cohort study in Bogota, Colombia. Externalizing and internalizing behavior problems were assessed after a median 6-y follow-up by parental report [Child Behavior Checklist (CBCL)] and self-report [Youth Self-Report (YSR)]. We estimated mean problem score differences with 95% CIs between exposure categories using multivariable linear regression. We also compared the prevalence of clinical behavior problems (score >63) between exposure groups. We assessed whether the associations between DBP and behavior problems were mediated through VDD.


Mean ± SD CBCL and YSR externalizing problems scores were 56.5 ± 9.3 and 53.2 ± 9.5, respectively. Internalizing problems scores averaged 57.1 ± 9.8 and 53.7 ± 9.8, respectively. VDD [25(OH)D <50 nmol/L] prevalence was 10.3%. VDD was associated with an adjusted 6.0 (95% CI: 3.0, 9.0) and 3.4 (95% CI: 0.1, 6.6) units higher CBCL and YSR externalizing problems scores, respectively, and an adjusted 3.6 (95% CI: 0.3, 6.9) units higher CBCL internalizing problems scores. The prevalence of clinical total externalizing problems was 1.8 (95% CI: 1.1, 3.1) times higher in children with VDD than that in children without VDD. DBP concentration below the population median was related to higher YSR aggressive behavior and anxious/depressed subscale scores and to higher prevalence of clinical total externalizing problems. The associations between DBP and behavior problems were not mediated through VDD.


VDD and low DBP in middle childhood are related to behavior problems in adolescence.


Bogota School Children Cohort; adolescence; behavior problems; middle childhood; vitamin D binding protein; vitamin D deficiency


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