Objective To investigate the temporal, geographic, and population distribution characteristics of folate deficiency and its associated factors among elderly individuals with chronic diseases in Rongcheng, Shandong Province. Method This study was based on data from the 2024 Rongcheng City Precision Nutrition Intervention for Chronic Diseases: Real-World Study (R-RWS). A total of 15,604 participants were included. Baseline information, including demographic characteristics, lifestyle factors, and folic acid supplementation status, was collected, and serum folate concentrations were measured. Differences in folate status across temporal, geographic, and population characteristics were assessed using chi-square tests and analysis of variance. Multivariable logistic regression models were applied to identify factors associated with folate deficiency.Result The overall prevalence of folate deficiency was 16.5%. Regarding temporal distribution, the prevalence of folate deficiency was higher in summer than in spring (18.8% vs. 16.0%), with the highest proportion of deficient individuals observed during April and May. In terms of geographic distribution, participants residing in inland townships exhibited a higher prevalence of folate deficiency than those living in coastal townships (17.5% vs. 15.9%). Regarding population distribution, folate deficiency was more prevalent among males than females (23.0% vs. 12.9%), among individuals aged ≥70 years than those aged <70 years (18.1% vs. 14.5%), among participants without folic acid supplementation than those receiving supplementation (24.7% vs. 7.9%), and among current smokers than former smokers and never smokers (26.4% vs. 20.5% vs. 13.9%, respectively) (all P < 0.05). Conclusion Folate deficiency was common among elderly individuals with chronic diseases in Rongcheng, China, and exhibited marked temporal and population-level variations. Males, individuals aged ≥70 years, current smokers, and those not receiving folic acid supplementation were identified as key high-risk groups. Targeted public health strategies, including strengthened nutritional surveillance, health education, promotion of healthy lifestyles, and appropriate folic acid supplementation, should be implemented according to seasonal and population-specific characteristics to reduce the burden of folate deficiency and support comprehensive chronic disease prevention and management.
Key words
Folate deficiency /
Coastal area /
Three-dimensional distribution /
Tumor prevention and control /
Elderly population
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