HEMOGLOBIN
LEVELS
CHILDREN
OLD
W.
By
W.
AMONG
SEVEN
IN SASKATOON,
M.Sc.,
HAWKINS,
AND
NUTRITIONAL
I
N THE
as
appraisal
an
globin
index
formation
have
provided
Besides
of
factors,
intake
the
in
case
of
recommendation
crease
being
iron
is most
would
be
rats
one
is
mg.
age.
independent
of
it
for
hemoglobin
protein,
some
both
both
daily,
metals
the
at one
and
level
is used
mainly
however,
that
hemo-
and
that
of
certain
are
for
and
and
animal
experiments
of
the
involved
and
findings
of 7 tO
may
children
as
increased
but
from
comments
such
hemoglobin
women,
girls
children
among
by
year
men
boys
figures
part
of age
BA.
KLINE,
remembered,
importance
nutritionally
in
month
adequate
of
For
These
important
supported
blood
be
probable
of iron
male.
with
the
should
amounts
adult
i
K.
DOROTHY
YEAR
in
vitamins.
hemoglobin
but they hardly
constitute
nutritional
problems.
Board
of the National
Research
Council’
recommends
mg.
12.
of the
upon
the
trace
formation
or maintenance,
The Food
and Nutrition
a daily
It
also
evidence
these
status
nutrition.
depends
FOURTEEN
CANADA
CONSIDERATIONS
of nutritional
of iron
TO
14
it
is io
reflect
the
with
2.0
the
iron
the
the
i5,
opinion
inthat
This
and
need
of age
to
women.
of Ellis
the
years
tO
and
that
questions
53
opinion
Bessey’
that
intake,
but
for
became
of age.
Widdowson
and McCance3
have recently
reported
that with
the onset
of sexual
development
the females
of some species
possess
a greater
ability
to accumulate
iron in the liver than do the males,
and they have presented
some evidence
to indicate
a governing
role of sex hormones.
They
found
that pregnancy
rapidly
reduced
has
the
liver
that
stated
males.
He
ence
up
to the
iron
in
in
the
case
to
that
and
of
age
of
of
the
only
during
human
iron
the
Gm.
to be about
per
the
than
amount
of iron
and
is characterized
tional
From
its
small
importance
factors
the
period
Department
since
less
there
slow.
iron
appears
Lapicque4
than
those
to be no
sex
of
differ-
growth.
whatever
as calcium
as that
The
for
iron,
The
requirement
by
upon
but
not
of Biochemistry,
within
by
the
be emphasized
level
the
body
to the
the
in
comparison
order
of
magnesium
body
nature
and
extent
Saskatoon,
Gm.
i
is judged
in much
quantitative
are neglected.
of Saskatchewan,
2.78
in the
the
be explained
small
of
for
is present
between
University
are
requirement
iron
the hemoglobin
is very
which
child’s
difference
can
be,
sodium,
conservation
should
may
it
and
respectively.
of iron
bearing
losses,
of
is magnesium.
which
The
time
such
same
was
considerably
Whether
or not
there
is a sex difference
in the storage
be more factors
operating
to deplete
this
reserve
Probably
the iron
intake
of the
female
is of nutritional
of the menopause,
while
in the
male
it need
be con-
requirement,
day
reaccumulation
would
the
of minerals
that
contain
years.
i
female.
to
and
livers
to menstrual
there
up
rats,
female
this
humans,
importance
The
of female
human
attributes
of
sidered
iron
greaten
importance
of its
very
metabolism,
low
that
The
excretion.
other
child’s
Canada.
nutri-
greater
W.
need for protein
a relationship
the
quality
and
HAWKINS
AND
dietary
casein
been shown,5
of hemoglobin.6’
protein
oven
as has
gluten
Among
also
the
comparatively
those
importance
ranged
to
ards for reference
are the averages
and
from
14.5
those
12. to
is questionable
up to the year
13
years
because
1933
of
358
Florida
Columbia
Saskatchewan
Anderson
i483
,i.8
Pett,
1456
13.3
Pett
-
Britain
500
13.1
Hamilton,
Ont
York,
Saskatoon,
and
i
children
Kracke8
of 5,ooo
Children
cc al.24
& Sandstead”
Hanley
and
Med.
13.3-13.6
I
and
PcrkinsH
Hanley’8
Res.
Council,
MacKay,
Wills
Gt.
and
Britain”
Binghan’8
2.00
11.5
Hawkins,
Leeson
and
McHenry”
Ont
i8
11.4
Hawkins,
Leeson
and
McHenry2’
Sask
1669
13.6
Hawkins
Scandinavian
year-old
for children,
at an altitude
#{182}
Kaucher
Britain
children,
children.
within
the
These
7
tO
14
which
are
are
in good
year
age
has
formation
Authors
,i.8
Great
in the
of Denver.
More
useful
for American,
English,
Hgb
Great
East
among
13.5
I
of egg
animals
per ioo ml. of blood
in 6 to 7 yearThe value
of these figures
as stand-
Values
Gm.
Michigan
values
of the altitude
by Wintrobe9
given
Av.
Children
acids
Colorado,
Gm.
old.
i-Hemoglobin
No.
Locality
hemoglobin
13.3
superiority
in anemic
CHILDREN
at Denver,
of
With
regard
to
is evidence
that
The
amino
AMONG
recorded
an average
in
important.
of certain
Andresen
TABLE
British
2.79
KLINE
regeneration
LEVELS
early
of Mugrage
feet. They
old children
K.
is particularly
in hemoglobin
HEMOGLOBIN
gives
DOROTHY
over that of the adult should
always
be considered.
between
hemoglobin
and protein
nutrition,
there
of the
albumin
W.
I2..9
for
6 to io
agreement
which
group,
and
Kline
year-old,
and
with
more
are presented
13.4
for
to
ii
recent
figures
in table
i.
for
The British
figures
shown
in the table have been calculated
from the Haldane
standard
of 14.8 as ioo per cent. This is the figure
recently
given
by King et al.’#{176}
in place
of the previously
accepted
13.8.
King
et al. calculated
the hemoglobin
content
of blood
from its iron content,
using
H#{252}fner’s (1894)
figure
of 0.334
for
the percentage
of iron in hemoglobin.
Later
and probably
more reliable
figures
are
at variance
with
that of H#{252}fnen:Bernhant
and Skeggs”
found 0.340,
and Drabkin,”
0.33
If the figure 0.340
are thus reduced
8.
figures
bloods
gave about
than on the basis
this
by
cent.
Gibson
calculated
culated
its
the
iron
oxygen
the Haldane
standard
becomes
14.5,
and the British
extent
of about
2. per
cent. King
et al. found
that
higher
hemoglobin
capacity.
Figures
Harrison’3
distinction
from
from
used,
to the
3 pen cent
of oxygen
and
A valid
S
between
showed
these
content
of blood
capacity
represents
values
published
on the basis of iron content
about
a year previous
to
a corresponding
two
values
represents
functional
difference
probably
total
of about
is that
pigment,
pigment.
2.
pen
hemoglobin
and
It illustrates
that
calthat
HEMOGLOBIN
2.80
differences
in methods
ences among
The object
among
7
when
the
CHILDREN
of standardization
tO
THE
In May and June
toon public-school
TABLE
AMONG
may
IN
be one
SASKATOON
factor
responsible
hemoglobin
values
reported
by various
workers.
of the present
survey
was to establish
in this area
healthy
reference
LEVELS
14
year
old
question
of anemia
SASKATOON
of 1948,
children.
i-Variation
children,
which
of Hemoglobin
Values
hemoglobin
be used
values
as standards
for
arises.
SURVEY,
hemoglobin
This was
could
for differ-
METHODS
AND
determinations
about
a third
with
Age
and
RESULTS
were
of the
Sex
among
7
done
to
Year
7-14
on
1669
age
14
Old
Saskagroup
in
Saskatoon
Children
Range
Age
No.
Av.
of Children
S. D.
Gm.
7
98
11.1-14.9
13.1
0.91
8
22.3
11.8-15.4
23.3
0.84
9
89
ii.6-i.8
13.5
0.93
10
101
22.5-15.5
13.6
II
105
11.0-16.7
13.7
,i.o-,6.x
13.9
0.92.
Boys
98
Ii
,,.8-,6.i
14.1
0.91
14
207
11.0-16.4
14.4
1.03
7
115
10915.4
13.0
o.86
8
105
zi.-i.6
13.2.
9
109
I1.515.4
13.4
o.8i
0.83
10
113
,o.o-,6.,
13.5
0.94
ii
,o8
11.1-16.,
13.5
o.8i
ii.-i6.z
23.9
0.95
i,.8-i6.i
14.0
0.97
II.8I6.3
13.9
1.01
13
98
109
24
city.
o.88
105
12.
the
o.86
.
13
Girls
Entire
% Hc-b
8
Boys
7-14
82.7
11.1-16.7
13.7
o.86
Girls
7-14
842.
10.0-16.3
13.5
i.i6
10.0-16.7
13.6
o.8i
the
Saskatoon
Group
In
7-14
1938,
Dr.
Griffith
1669
Binning,’4’
‘
Medical
Officer
of
School
Board,
had studied
the incidence
of goiter
in these schools,
and had concluded
that factors
of age, sex, race,
and social
condition
were involved.
Under
Dr. Binning’s
direction
the schools
for our study
were chosen
so as to provide
a
sample
as representative
as possible
of the various
ponents
of this population
group.
Determination
of hemoglobin
was done
on
finger tip into
globin
method
and the figure
calculation.
socio-economic
capillary
a calibrated
pipet,
and measurement
was made
of Collier.16
This was standardized
by blood
0.340
as the percentage
of iron in hemoglobin
and
blood
taken
racial
from
comthe
by the cyanmethemoiron determinations,
was utilized
in the
W.
At the
foot
of table
the
distribution
is shown
TABLE
W.
2.
HAWKiNS
are shown
for
3.-Distribution
AND
the
boys
K.
hemoglobin
and
of Hemoglobin
DOROTHY
girls
Values
values
7-14
Boys
Class
obtained,
separately,
among
2.81
KLINE
Year
and
for
Old
Saskatoon
in table
entire
group.
Children
Entire
Group
Number
%
the
Girls
Interval
Gm.
and
%
--
Number
Number
11gb
10.0-10.9
0
11.0-11.9
3
0
4
31
12..0-12..9
163
2.0
13.0-13.9
318
14.0-14.9
2.2.2.
3
0
35
4
0
66
4
197
2.4
360
ii
38
336
40
654
39
2.7
2.21
2.5
433
i6
53
6
15.0-15.9
78
9
16.0-16.9
15
2.
7
8
131
I
2.2.
I
700
39
600
500
26
400
22
U)
0
0
300
U)
2)
04
‘4
0
200
22
0
C
54
8
U
Li
2)
04
100
4
1
9
10
11
12
13
14
Hemoglobin
in
FiG.
Figure
i is
group,
which
figures
Our
a graphic
representation
of
the
15
Cm.
16
17
18
%
i.
distribution
of values
indicates
the shape
of the distribution
curve.
may be regarded
as maximum
to the extent
that
among
total
blood
the
entire
pigment
3
2.82.
HEMOGLOBIN
was
measured.
as is also
by Drabkin
LEVELS
AMONG
Standardization
measurement
and Austin’7
by
CHILDREN
iron
IN
content
SASKATOON
of blood
of pigment
as cyanmethemoglobin,
to be an ideal
pigment
for
is responsible
for
which
has
determination
the
this,
been said
of total
concentration.
DISCUSSIoN
Our
average
Wintrobe,
of 13.6
and
for children
as the
ages.
values
be made
consideration
of
is not
is of the
others
of these
of hemoglobin
groups
should
practiced
worked
of the
slightly
figures
sidered.
3 per
cent,
the
and
dental
greater
thinness,
14
a wider
age
province.
and
British
ii.8.
British
group
than
Their
range
comparisons
comparable
population
can be made only after
by various
did
we,
and
workers,
Columbia,
the
and
range
and
this
survey
in
included.
about
values,
also
with
serum
where
the
children
pen cent
i
10.3
regard
did
tO
and
evidence
consume
16.3,
iS
in the
that this did not necessarily
health
among
Saskatchewan
be
past
much
better
rickets,
milk,
and
incidence
was said
Saskatchewan
correspond
children
conlower,
to
of
as
also
both
acid levels.
The
fat by pinching,
percent
ii
had
were
considered
to
not
they
average
were
ascorbic
of subcutaneous
Columbia,
examined
of hemoglobin
in British
of them
had low
by the estimation
British
however,
by
reported
a
of
to
group,
to underweight.
appears
to be quite
estimated
the proportion
of Saskatoon
public-school
children
below
the Baldwin-Wood
standard
to be between
4.7 and 6
per cent on routine
measurings
during
the school
year 1947-48.
The high
hemoglobin
levels
which
we found
may also be a reflection
of good
general
health.
Hemoglobin
levels
reported
by Pett and Ogilvie’9
among
children
examined
by
10
per
Dr.
cent
they
the
in
given
of any
average
of 13 .3 slightly
lower,
but the
when
differences
in method
are conof anemia
among
these
children
to be
but
was pointed
out
The degree
of general
used
average
highest
in methods,
workers
on
comparisons
Saskatchewan
defects;
the
and Hanley’8
carried
out a nutrition
which
the city of Saskatoon
was not
children
postural
porportion
as judged
cent
The
as the
is among
it
standards
Columbia
Columbia
and
per
to 8 pen
In
it
high.
Pett
among
1946,
VALUES
of magnitude
but
different
Accurate
the
among
hematologists.
as compared
15.7,
than
but
order
i,
of differences
among
in the
a survey.
tO
be
Because
HEMOGLOBIN
narrower
than
ours,
and their
are quite
comparable,
particularly
The authors
judged
the incidence
ducted
10.0
same
in table
differences
with
children
THE
reported
by
with
caution.
In May
and June of
five areas of Saskatchewan,
They
OF
Binning
cent
or
more
them in various
parts of Canada
average
age groups
are compared.
Two groups
1946’#{176}
had among
the lowest
hemoglobin
one of the chief
35 per cent.”
Saskatoon
laboratory”
is about
we have
great
to affect
able
to suppose,
found
defects
the
by Mugrage
was
i ,6oo
average
and
underweight,
feet
expressed
however,
about
pen cent lower
than ours when
the
of children
studied
in Ontario
in 1945 and
levels of any reported,
and among
them
the
above
the
sea
that
Andresen
level.
opinion
hemoglobin
in Denver.
of which
In a previous
that
level
altitude
incidence
this
A recent
is not
group.
determining
study
group
was
from
this
publication
altitude
of a population
is a factor
in one
of
It seems
the
2.00
sufficiently
normal
high
reasonvalues
adults
in
W.
Mexico
City’3
for men, and
portant
The
we
has revealed
of 15.2. for
factor
question
established
are
aware
influence
the
TABLE
W.
HAWKINS
values
whether
for limited
areas.
of no
that
women.
here.
arises
values
Outside
DOROTHY
K,
unusually
the altitude
to serve
as standards
of factors
geographic
directly
factors
2.83
KLINE
appear
likely
Very
particular
hemoglobin
AND
high:
an average
of
of 7,457 feet is an
for
reference
influencing
other
than
4.-Variation
of
Hemoglobin
Values
altitude
with
Boys
No.
that
might
Age
and
Sex
Selected
among
Year
7I4
Old
Av.
of Children
7
91
8
9
114
S. D.
11gb
11.1-14.9
13.1
0.9!
1I.815.4
13.4
0.83
74
ii.6-i.8
13.6
0.95
io
87
11.5-15.2.
13.6
0.85
II
91
11.9-16.7
13.6
0.84
Ii
84
xi.o-x6.i
13.8
1.01
13
92.
11.3-16.2.
14.1
o.88
12.0-16.4
14.4
1.11
14
Girls
103
7
99
10.9-15.0
13.0
0.84
8
98
ix.-x.6
13.2.
0.84
9
99
11.5-15.4
13.4
0.83
io.o-,6.z
13.6
0.92.
o.8i
100
10
II
92.
xi.i-i6.,
13.6
Ii
8i
ii.-i6.z
13.9
0.90
,,.8-,6.i
14.0
0.97
12.1-16.3
13.9
0.97
101
13
77
14
Boys
7-14
736
11.1-16.7
13.7
0.89
Girls
7-14
748
10.0-16.3
13.6
0.87
10.0-16.7
13.6
0.77
Entire
Group
both
boys
in
hemoglobin
cent
Saskatoon
group,
of
the
ported
similar
It has been
1484
7-14
THE
girls
be
health,
children
Gm.
and
should
general
Range
Age
Among
im-
level.
Saskatoon
8 per
17.7
EFFECT
and
OF
girls
from
over
and also
same age.
surveys.
previously
AGE,
the
the
shows
These
stated
SEX,
age
AND
of 7
seven-year
the
SELECTION
14
there
period.
the similarity
findings
agree
that
tO
OF
in hemoglobin
with
those
object
of
this
hemoglobin
values
among
provide
a range
of values
apparently
healthy
public-school
which
could
be used for reference
anemia
in mind,
arises.
made,
and their
If an individual
With
this
hemoglobin
is ostensibly
a selection
values
were
healthy,
is an increase
Table
values
(table
reasonable
who
was
boys
have
healthy
re-
to discover
children,
and thus
when
the question
of obviously
tabulated
it seems
in the
between
of others
survey
of about
this
2. shows
subjects
to
of
was
4).
to conclude
that
the
2.84
HEMOGLOBIN
hemoglobin
level
more
reliable
cause
of
89 per
group,
which
of
such
of the
not
is evident
good
opinion
state
we
differ
general
proportion
hematologic
had
subject
the
table
4 are
values
to more
selected
however,
are
compared.
the
that
those
for
This
might
be-
found
than
group,
from
any
pigment
regarding
been
called
data
of respiratory
knowledge
have
and
2.
SASKATOON
no other
essentially,
if table
IN
adequacy
of
studied
for what
did
CHILDREN
of the
children
Values
cent,
a large
In our
evaluation
the unimportance
with.
On the other
flection
AMONG
unsatisfactory
of illness.
other
dealt
same
individuals.
pen cent
degree
generally
is adequate.
in assisting
the
healthy
Eleven
LEVELS
in
usual
is,
the
the
entire
indicate
of such selection
when
a large
number
of subjects
is
hand,
it may
be evident
particularly
in this case as a rehealth
among
these children,
since the selected
group
was
of the
whole.
SUMMARY
In May
and June
of
a survey
1948
of hemoglobin
values
was
carried
out
on
842.
girls and 82.7 boys,
ages 7 tO 14 inclusive,
in Saskatoon
public
schools,
who repnesented
about
a third
of this population
group
in the city.
Values
for girls ranged
from
10.0
to 16.3 Gm.
per ioo ml. of blood,
with
an
average
The
of
ported
The corresponding
the whole
group
13.5.
average
for
for
children
age groups
were
parts of Canada.
Values
from near
ity
for
of these
slightly
ages.
higher
in hemoglobin
values
7
tO
average
those
values
for
reported
.2.
and i
even re-
16.7,
tO
the
highest
children
in the
different
groups
in other
for comparable
same age were similar.
to near 14 in the 14 year
There
was an increase
old group.
The similar-
for both
boys
ages,
of age,
are
years
14
for boys were
i
which
is among
13.6,
The
than
boys and girls of the
in the 7 year old group
13
crease
from
workers.
values
was
Eleven
per cent of the children
illness.
No significant
differences
removing
this group.
and
in
girls
of these
agreement
with
had been subject
to more
appear
when
the above
and
the
small
observations
in-
of other
than the usual degree
figures
are corrected
of
by
ACKNOWLEDGEMENTS
We arc
survey
but
could
in the
sincere
To
and
indebted
not
have
been
preparation
to Dr.
Griffith
carried
out.
of this
paper,
Binning
His
were
for
interest
very
his
and
much
help
advice,
and
not
appreciated,
cop:ration,
only
and
during
without
which
course
of the
the
we should
like
this
work,
to render
him
our
for their
courtesy
thanks.
the
principals
and
staffs
of the
schools
included
in the
survey
extend
we
thanks
help.
Dr.
the
greatly
H. B. Collier,
course
Head
of the survey,
of the
and
Department
in the
of Biochemistry,
preparation
of this
rendered
paper.
We
valuable
wish
help
and
to acknowledge
advice
this
during
with
our
thanks.
Helpful
suggestions
Saskatchewan,
Toronto.
were
and
\Ve
extend
received
Dr.
from
to
them
E. W.
from
Dr.
McHcnry,
our
L. B. Jaqucs,
Professor
Professor
of Public
of Physiology
at the
University
of
Nutrition
at the
University
of
Recommended
dietary
Health
thanks.
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