574 Ascorbic Acid Subnutrition 



fragility test useful though less sensitive than chemical methods in indicating 

 ascorbic acid subnutrition. 



On the other hand, there are many dissenting opinions. Several investiga- 

 tors"'"'' have for various reasons questioned the reliability of the test. Weld* 

 found that vitamin D was even more effective than ascorbic acid in increasing 

 capillary resistance. 



Thus the opinions about the capillary-fragility test are rather contradictory. 

 In view of the frequent use of this test in nutritional surveys, it would, how- 

 ever, seem desirable to have at hand some more definite evidence in regard 

 to its reliability as a means of detecting ascorbic acid subnutrition. The pres- 

 ent paper is a further attempt to evaluate the capillary-fragility test. 



Correlation of Capillary Fragility ivith the Ascorbic Acid Content of the 

 Diet. If ascorbic acid deficiency were a cause of increased capillary fragility, 

 a correlation should exist between the ascorbic acid content of the diet and 

 the capillary resistance. This question has not to my knowledge been studied 

 previously on any considerable scale. Gedda'° and Nordenmark," it is true, 

 demonstrated the existence of a seasonal difference in capillary fragility, which 

 apparently paralleled a corresponding difference in ascorbic acid intake. The 

 same fact is also evident from my data, which indicate a very definite seasonal 

 difference between the capillary resistance values in the spring and those in 

 the late autumn and an equally definite, parallel difference in the amounts 

 of dietary ascorbic acid. Such evidence, however, is of limited value, for it is 

 clear that a multitude of dietary and other environmental factors undergo 

 seasonal variations. Thus there is not enough justification for the conclusion 

 that the seasonal changes observed in capillary resistance were due to changes 

 in ascorbic acid intake. On the other hand, it would constitute decidedly 

 more valuable evidence in favor of the test, if it were possible to demonstrate 

 a fair correlation between these two variables in a sufficiently large body of 

 material. An extensive mass of data collected by the Finnish National Nutri- 

 tion Committee some time ago offered an opportunity for studying this 

 question. 



In the years 1936-1937 the diet of a number of families of the lower income 

 classes in Finland was examined. All food consumed by the families during a 

 lo-day period was carefully weighed, and its contents of the chief nutrients, 

 ascorbic acid among them, were calculated. The amounts of the nutrients 

 found in the diet were compared with the estimated requirements of the 

 family. The requirements for ascorbic acid were taken as 50 mg. per day for 

 persons over ten years of age and 25 mg. per day for children less than ten years 

 old. Capillary-fragility tests were carried out by Gothlin's method® on the 

 members of the families (616 persons in all), the results being expressed as the 

 number of petechiae developing under 50 mm. (Hg) pressure. 



Table 1 shows the distribution of the 616 persons examined in regard to 

 their ascorbic acid intake and the capillary status. This table reveals that the 



