ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Association between nutrition literacy and hypertension control: chain mediating association of diet-control intention and salt-restriction tools utilization
Provisionally accepted
- Bengbu Medical University, Bengbu, China
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Introduction: 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. Methods: 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. Results: 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 (ꞵ = -0.0026, 95% CI: -0.0046 to -0.0006) and by a sequential pathway through diet-control intention and salt-restriction tool use ( ꞵ = -0.0008, 95% CI: -0.0015 to -0.0001). Conclusion: 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.
Keywords: blood pressure control, chain mediation, Diet-control intention, Hypertension, Nutritional literacy, Salt-restriction tool utilization
Received: 11 Oct 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Zhang, Yin, Liu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huaqing Liu
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