# Association between nutrition literacy and hypertension control: chain mediating association of diet-control intention and salt-restriction tools utilization

## TL;DR

Higher nutrition literacy helps control hypertension by improving diet intentions and salt-restriction tool use in Chinese adults.

## Contribution

Identifies a chain mediation mechanism linking nutrition literacy to hypertension control through diet-control intention and salt-restriction tool use.

## Key findings

- Higher nutrition literacy is associated with stronger diet-control intention and better hypertension control.
- Salt-restriction tool utilization partially mediates the relationship between nutrition literacy and hypertension control.
- A sequential pathway through diet-control intention and salt-restriction tool use also contributes to hypertension control.

## Abstract

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.