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Published online by Cambridge University Press: 10 February 2026
Iron deficiency (ID) represents the most prevalent nutritional disorder and a major public health concern. As part of the HYDRIA 2013-2014 National Health and Nutrition study, a cross-sectional survey of a nationally representative sample of adults in Greece, serum ferritin levels (SFL) were measured in participants aged ≥55 years and dietary intake was assessed using two nonconsecutive 24h dietary recalls per participant. The study aimed to evaluate SFL, determine the prevalence of ID among older adults and explore associations with dietary iron intake and adherence to Mediterranean diet(MD). Among individuals over 55 years, ID prevalence was 6.5% for SFL<15 ng/ml and 12.7% for SFL<30 ng/ml. SFL were significantly associated with sex and age (p<0.001), with men showing higher SFL than women. Advancing age, particularly among individuals over 74 years, increased the risk of ID. Dietary iron intake declined with age, and women had significantly lower intake than men (p<0.001). Overall, 57.2% of participants had inadequate daily iron intake. SFL were not associated with total or heme iron intake. High adherence to MD was associated with higher energy-adjusted total iron intake but lower heme-iron intake. Weighted logistic regression for SFL<15 ng/mL showed that MD adherence was significantly associated with reduced odds of ID (p=0.007), likely due to the protective effect of intermediate adherence (OR=0.10, p=0.002). Conclusively, while ID prevalence among older adults in Greece is low, over half of the population present inadequate daily iron intake, especially women. High adherence to MD may have a protective effect against ID.
Shared first authorship (equal contributions of the authors)