The riboflavin requirements of two groups of riboflavin-deficient, but otherwise healthy, Guatemalan elderly persons over the age of 60 y were studied by varying the fat:carbohydrate ratio in two diets. The first group consumed a diet similar in macronutrient content to a Western-type diet with low carbohydrate and high fat; the second group consumed a typical Guatemalan diet with high carbohydrate and low fat. Energy and protein intakes of both groups were similar. Riboflavin status was monitored by weekly measurements of erythrocyte glutathione reductase activity coefficient (EGRAC) and urinary riboflavin excretion. Increasing increments of riboflavin were added to the subjects' diets until their status was normalized, as indicated by EGRAC of < 1.34 and a sharp increase in urinary riboflavin excretion. Using the EGRAC method, the mean value of riboflavin intake at which the subjects' EGRAC reached the limit of normality was 1.37 +/- 0.03 mg/d in the first phase and 1.29 +/- 0.03 mg/d in the second phase. The sharp increase in urinary excretion occurred at riboflavin intakes of 1.13 and 1.03 mg/d for Groups 1 and 2, respectively. Thus, the differences between the two groups suggest that diets with a lower fat:carbohydrate ratio can decrease the dietary need for riboflavin. The dietary requirement of riboflavin, as estimated by the more reliable urinary excretion method, was 1.1-1.3 mg/d for those consuming the Western-type diet, which is similar to values found over 40 y ago in young adults. We conclude that the dietary requirements of riboflavin in the elderly do not differ from those of young adults.

Six groups of elderly subjects from central Guatemala were assessed for riboflavin status by using the erythrocyte glutathione reductase activity coefficient (EGRAC). The prevalence of riboflavin deficiency ranged from 50% to 76% among the free-living rural elderly subjects. Milk intake data that were collected from some of the subjects showed a significant correlation (P < 0.0001) between frequency of milk intake and riboflavin status. In a short-term riboflavin supplementation experiment in which nine riboflavin-deficient subjects were given 10 mg riboflavin/d for 3 d, all the subjects' EGRACs were normalized by the supplementation. However, they returned to a state of deficiency within 2 wk while consuming their usual diets without supplementation. It appears that the high prevalence of riboflavin deficiency in elderly Guatemalan people is caused by inadequate intake of riboflavin-rich foods such as dairy products, and that sufficient amounts of riboflavin need to be ingested regularly to maintain satisfactory riboflavin status.

Although concordance with some of the cancer prevention goals and guidelines can be evaluated from the existing questionnaires, adjustments and additions must be made with respect to salt and supplement use, physical activity, and food handling. Actual weight and height measurements are also needed, particularly in low-income populations.

This study examined the association of self-rated health with physical function and emotional well-being, while controlling for differences in sex, age and anthropometry. Subjects were participants in a multicentre study originated by the International Union of Nutritional Sciences (IUNS). A total of 151 elderly Guatemalan subjects were examined using a questionnaire which included information on self-rated health, activities of daily living, well-being, and a common battery of anthropometric variables. Adjusted odds ratios (OR) obtained with polytomous logistic regression showed that subjects with the highest score on the well-being index compared with those with the lowest were 1.67 times more likely (P-value <0.001, confidence interval (C.I.) = 1.31-2.14) to rate themselves in 'good' health versus 'fair' and 'poor' health. Subjects with the highest score versus those with the lowest on the mobility index were 1.15 times more likely (P-value <0.05, (C.I.) = 1.00-1.32) to rate themselves in 'good' health versus the other health ratings. These are the first results to examine the relationship of self-rated health to physical function and emotional well-being of elderly, free-living Guatemalans.

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