Diet diversity and blood pressure in women of childbearing age in Guatemala: analysis based on a population nutritional surveillance system 2016–2019

The global burden of arterial hypertension (AHT) continues to increase. Evidence suggests that improving micronutrient intake and diet quality may reduce the risk of AHT. This study aimed to assess the association between dietary diversity and blood pressure in Guatemalan women of reproductive age, using data from the Epidemiological Surveillance System of Health and Nutrition (SIVESNU, in Spanish), 2016–2019. This cross-sectional analysis included non-pregnant, non-lactating women aged 15 to 49 years. AHT was defined using the American College of Cardiology criteria, and dietary diversity was measured with the Minimum Dietary Diversity for Women (MDD-W) indicator. Proportions and 95% confidence intervals (CIs) were estimated. Associations between dietary diversity and blood pressure were assessed using crude and adjusted linear and log-binomial regression models. Variables selected through a Directed Acyclic Graph (DAG) were included in adjusted models. Statistical significance was established at p < 0.05. Survey weights were applied to account for the sampling design. Among 5846 women (mean age: 29.7, SD 10.4 years), 17.8% (95% CI: 16.2–19.4) had inadequate dietary diversity, and 39.7% (95% CI: 35.5–43.9) had AHT. Linear regression analysis revealed non-significant negative associations between dietary diversity and both systolic blood pressure (SBP) and diastolic blood pressure (DBP). In log-binomial regression, the adjusted prevalence ratio for AHT in women with inadequate dietary diversity was 0.82 (95% CI: 0.65–1.03), hence not statistically significant. No significant association was found between dietary diversity, as measured by the MDD-W, and blood pressure among Guatemalan women of reproductive age. Broader or more sensitive dietary assessment tools may be needed to evaluate diet-related risk of hypertension in this population.