Association between nutrition literacy and hypertension control: chain mediating association of diet-control...

The limited success in controlling hypertension highlights its role as a persistent and critical public health issue in the Chinese population. Nutritional literacy (NL), as a modifiable factor, may influence blood pressure management through diet-control intention and salt-restriction tool utilization.

Date came from a cross-sectional survey conducted in Bengbu in 2023. Using multi-stage stratified random sampling, 866 hypertensive adults were enrolled. Data on demographics, NL, diet-control intention, salt-restriction tool use, and self-rated hypertension control were collected via structured questionnaires. Preacher & Hayes four-path framework were applied to examine chain mediation, with significance assessed by bias-corrected bootstrap.

Higher NL was significantly associated with stronger diet-control intention (OR = 1.11, 95% CI: 1.09-1.14), greater salt-restriction tool utilization (OR = 1.08, 95% CI: 1.05-1.12), and better self-rated hypertension control (OR = 1.04, 95% CI: 1.02-1.06). Mediation analysis showed that the association between NL and hypertension control was partly accounted for by salt-restriction tool use (β = -0.0026, 95% CI: -0.0046 to -0.0006) and by a sequential pathway through diet-control intention and salt-restriction tool use (β = -0.0008, 95% CI: -0.0015 to -0.0001).

NL is positively associated with hypertension control, with chain mediating the associations of diet-control intention and salt-restriction tool utilization. Enhancing NL and strengthening dietary self-regulation behaviors may provide associative strategies for hypertension prevention and management.