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Original Article
Online Published: 23 Sep 2026
 


Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia

Lama A. Alkhaldi, Shaima S. Alrubie, Renad S. Alharthi, Jana S. Althobaiti, Thikra K. Aloufi, Abdulmajeed M. Algethami.


Abstract
Background: Vitamin D deficiency is common among adolescents and may be associated with cognitive and psychological outcomes. Evidence on its relationship with academic performance, pre-examination anxiety, and hypovitaminosis D symptoms in Saudi students is limited. This study investigated the relationship between vitamin D status, academic performance, pre-examination anxiety, and hypovitaminosis D symptoms among secondary school students in Taif City, Saudi Arabia.
Methodology: A cross-sectional survey was conducted among 557 students aged 15–18 years using convenience sampling. An online questionnaire assessed demographics, vitamin D status, academic performance, pre-examination anxiety, and hypovitaminosis D symptoms. Chi-square, Mann–Whitney U, Kruskal–Wallis, and Spearman tests were used.
Results: Of 557 students, 52.6% reported a previous diagnosis of vitamin D deficiency. Better academic performance was associated with normal vitamin D levels (P = 0.006), no previous diagnosis of deficiency (P < 0.001), and physical activity (P = 0.016). Students with deficiency had higher pre-examination anxiety and hypovitaminosis D symptom scores (both P < 0.001). Anxiety was also associated with vitamin D level (P = 0.003), sleep duration (P < 0.001), supplementation (P = 0.002), and fish intake (P = 0.014). Symptom scores were associated with sex, school grade, vitamin D status, testing interval, sleep duration, and supplementation (P < 0.05). Anxiety and symptom scores were moderately correlated (ρ = 0.493, P < 0.001).
Conclusion: Vitamin D deficiency was associated with poorer academic performance, higher pre-examination anxiety, and hypovitaminosis D symptom burden. Longitudinal studies using laboratory-confirmed vitamin D measurements are needed to clarify causality.

Key words: Academic performance, Hypovitaminosis D, Pre-examination anxiety, Secondary school students, Saudi Arabia, Vitamin D deficiency


 
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Pubmed Style

Alkhaldi LA, Alrubie SS, Alharthi RS, Althobaiti JS, Aloufi TK, Algethami AM. Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia. IJMDC. Online First: 23 Sep, 2026. doi:10.24911/IJMDC.51-1787059107

Web Style

Alkhaldi LA, Alrubie SS, Alharthi RS, Althobaiti JS, Aloufi TK, Algethami AM. Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia. https://www.ijmdc.com/?mno=331790 [Access: September 23, 2026]. doi:10.24911/IJMDC.51-1787059107

AMA (American Medical Association) Style

Alkhaldi LA, Alrubie SS, Alharthi RS, Althobaiti JS, Aloufi TK, Algethami AM. Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia. IJMDC. Online First: 23 Sep, 2026. doi:10.24911/IJMDC.51-1787059107


Vancouver/ICMJE Style

Alkhaldi LA, Alrubie SS, Alharthi RS, Althobaiti JS, Aloufi TK, Algethami AM. Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia. IJMDC, [cited September 23, 2026]; Online First: 23 Sep, 2026. doi:10.24911/IJMDC.51-1787059107


Harvard Style

Alkhaldi, L. A., Alrubie, . S. S., Alharthi, . R. S., Althobaiti, . J. S., Aloufi, . T. K. & Algethami, . A. M. (0) Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia. IJMDC, Online First: 23 Sep, 2026. doi:10.24911/IJMDC.51-1787059107


Turabian Style

Alkhaldi, Lama A., Shaima S. Alrubie, Renad S. Alharthi, Jana S. Althobaiti, Thikra K. Aloufi, and Abdulmajeed M. Algethami. 0. Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia. International Journal of Medicine in Developing Countries, Online First: 23 Sep, 2026. doi:10.24911/IJMDC.51-1787059107


Chicago Style

Alkhaldi, Lama A., Shaima S. Alrubie, Renad S. Alharthi, Jana S. Althobaiti, Thikra K. Aloufi, and Abdulmajeed M. Algethami. "Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia." International Journal of Medicine in Developing Countries Online First: 23 Sep, 2026. doi:10.24911/IJMDC.51-1787059107


MLA (The Modern Language Association) Style

Alkhaldi, Lama A., Shaima S. Alrubie, Renad S. Alharthi, Jana S. Althobaiti, Thikra K. Aloufi, and Abdulmajeed M. Algethami. "Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia." International Journal of Medicine in Developing Countries Online First: 23 Sep, 2026. Web. 23 Sep 2026 doi:10.24911/IJMDC.51-1787059107


APA (American Psychological Association) Style

Alkhaldi, L. A., Alrubie, . S. S., Alharthi, . R. S., Althobaiti, . J. S., Aloufi, . T. K. & Algethami, . A. M. (0) Association of Vitamin D Deficiency with Academic Performance, Pre-Examination Anxiety, and Symptoms of Hypovitaminosis D Among Secondary School Students in Taif City, Saudi Arabia. International Journal of Medicine in Developing Countries, Online First: 23 Sep, 2026. doi:10.24911/IJMDC.51-1787059107




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