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Folate has emerged as a key nutrient for optimising health. Impaired folate status has been identified as a risk factor for cardiovascular disease, various types of cancers, and neurocognitive disorders. The study was aimed at examining the distribution and determinants of serum folate concentrations in a healthy adult population in Crete, Greece.
A cross-sectional sample of 486 healthy adults were involved in the study. Inadequate folate levels were present in 6.8% of men and 2.1% of women. Approximately 76% of men and 87% of women did not meet the reference dietary intake for folate.
Crete, once known for the low cardiovascular mortality among adult men in early 1950's, has now increasing rates of cardiovascular disease, a trend that appears to be related to dietary and lifestyle changes that have been taking place during the last decades. The traditional Cretan diet – a variant of the Mediterranean diet – has been gradually abandoned, and current Cretans consume higher amounts of saturated fat, meat, and cheese, and lower amounts of bread, fruits, vegetables, legumes, and fibre. Among other consequences, such dietary changes are expected to result in decreased intake of dietary folate and thus, impaired folate status. To date, however, no data are available with regard to the folate status of the adult population in Crete.
In the study it was found that individuals with higher intakes of potatoes, legumes, fruits and/or vegetables – all these foods considered major sources of folate – had significantly decreased risk for low serum folate (below the 1st quartile), compared to those with no consumption. Conversely, higher intakes of cereals and meat products were related to decreased serum folate concentrations. These findings are in accordance with those reported by both cross-sectional and diet-intervention studies, which suggest a positive association between folate status and a dietary pattern characterized by high consumption of fruits, vegetables, legumes and low consumption of refined cereals and meat.