Vitamin D and mental health connection in children: Symptoms of the deficiency

Vitamin D deficiency has become a serious public health issue. 50-90 per cent of children suffer from vitamin D deficiency or insufficiency in India. However, there is also a lack of public awareness of the significance of this crucial vitamin. The deficiency adversely affects a child's growth and development, immunity, and mental health. It is key to seek proper treatment to ensure your child gets enough vitamin D. 

Vitamin D and mental health
Vitamin D could significantly influence the mental health of your child. Latest research suggests that the risk for mental health issues like depression and anxiety is higher in children who suffer from vitamin D deficiency. This vitamin is crucial not only for physical development but also for overall growth, mental stability, and emotional well-being. 

How does vitamin D deficiency affect mental well-being?
1. Role of vitamin D in controlling the happiness hormones
The brain releases serotonin, also known as the feel-good hormone. Vitamin D is essential for transforming tryptophan that you get from food into serotonin. Serotonin levels decrease when the body lacks vitamin D, which then leads to sudden mood swings and depression in children. 

2. Neuroprotection
Vitamin D is not just a vitamin; it's also a neurosteroid. There are lots of vitamin D receptors in the hippocampus and prefrontal cortex, the parts of the brain that control emotions. The neurons in the brain slow down, leading to anxiety and reduced concentration due to a vitamin D deficiency. 

3. Sleeplessness and exhaustion
Good sleep is vital for good mental health. Vitamin D is essential for the proper functioning of melatonin, the hormone that controls sleep. Vitamin D deficiency in children can cause sleeplessness, which in turn can make them irritable. This eventually leads to extreme fear of exams and suicidal thoughts. A study conducted among people who were admitted to hospitals after attempting suicide revealed that vitamin D was significantly low in their bodies. 

While discussing the mental health of children, their physical health too should be focused on. Specific blood tests should be done to check vitamin D levels, thyroid function, and iron levels. 

Symptoms of vitamin D deficiency
1) Children suffer from muscle aches and difficulty in physical movements due to poor calcium absorption. 
2) Weak muscles and bones. 
3) Obesity: Vitamin D deficiency may increase the fat deposits, raising the risk of obesity among children. In children with obesity, vitamin D absorption of excess fat reduces the body's vitamin D availability. 
4) Poor immunity
5) Repeated fractures

Sunlight, the main source
Sunlight is the natural and most abundant source of vitamin D. Children who spend time indoors are more likely to suffer from vitamin D deficiency. They are not exposed to the sun as they prefer staying indoors and do not play outside. The outfits and sunblock creams they wear when they go out will prevent the absorption of ultraviolet rays that produce vitamin D. Getting some sun exposure between 9 am and 3 pm will ensure that the body produces sufficient vitamin D. So, do not prevent children from playing outside or getting exposed to the sun. 

Food sources
You will get only under 10 per cent of the vitamin D that is required for the body from food. Besides, only a handful of food items naturally contain vitamin D. Nevertheless, these are some of the food items that have vitamin D. 
•Tuna (85 grams = 154 IU)
•Liver or beef (85 grams = 42 IU)
•1 big egg (41 IU, from the yolk)
•Fortified breakfast grains (330 grams = 40 IU)
•Sardines, salmon
•Milk, yoghurt, cheese
•Mushrooms
Foods containing vitamin D should be strictly included in your child’s regular menu. Although milk and grains are rich in nutrients, some children may not consume them adequately. 

Daily requirement
The vitamin D requirement for children varies by age group. 
•0 – 12 months: 400 IU daily
•1 – 13 years: 600 IU daily
•14 – 18 years: 600 IU daily
The American Academy of Paediatrics recommends a 400 IU vitamin D supplement for babies who consume only breastmilk from the first day. 

The risk of vitamin D deficiency is higher in kids who:
•Live in cold weather conditions
•Have dark complexion (due to high melanin)
•Live in cities
•Are obese
•Girl children (especially if they are scared of tanning due to sun exposure)
•Spend more time indoors

Tests and diagnosis
The vitamin D level can be checked with a 25–hydroxy vitamin D (25(OH)D) blood test. 
•Deficiency: <12 ng/ml
•Insufficiency: 12 – 20 ng/ml
•Normal: >20 ng/ml

Treatment
If diagnosed with a deficiency or insufficiency of vitamin D, the initial phase of treatment lasts 6 to 8 weeks. Supplements should be included in the diet as directed by the doctor. 

Ways to prevent deficiency
•Try to get sun exposure for at least 15 – 20 minutes daily
•Include food with vitamin D in a regular diet
•Take supplements as per the doctor’s instructions
•Encourage children to engage in outdoor games and physical activities 
•Regular tests for children whose vitamin D levels have dropped dangerously

Vitamin D is essential for the overall growth and well-being of children. The fact that most children in India suffer either from a deficiency or an insufficiency of vitamin D is a serious cause of concern. Parents and health care workers should be aware of its consequences and ensure that their children get enough sun exposure and a nutritious diet or supplements. Proper awareness and timely interventions could ensure your child’s physical health and mental well-being.   
(The writer is a professional social worker, and child, adolescent and relationship counsellor.)