Relationship between dietary live microbial consumption and hypertension risk in children and adolescents: results from the NHANES 2009–2023

Objective This analysis aimed to evaluate the association between dietary live microbial consumption and hypertension risk in children and adolescents. Methods This cross-sectional analysis comprised data on children and adolescents (aged 8–17 years) from the NHANES database 2009–2023. The association between dietary live microbial consumption and hypertension risk was analyzed using logistic regression analyses. The combined effect of dietary live microbial consumption and overweight/obesity on hypertension risk was examined using interaction analysis. Results Of these 9342 enrolled children and adolescents, 433 had hypertension, and 8909 did not. Individuals in the high-MedHi (foods containing medium and high live microbes) consumption group (vs. low-MedHi) [OR = 0.70 (0.50–0.98), P = 0.039] were associated with lower odds of hypertension, and this association persisted after further adjustment for overweight/obesity [OR = 0.71 (0.51–0.99), P = 0.046]. In the joint effect analysis of live microbial consumption (low, high) and overweight/obesity (no, yes), individuals in the high-MedHi and overweight/obesity group [OR = 0.60 (0.39–0.92)], the low-MedHi and non-overweight/obesity group [OR = 0.29 (0.20–0.42)], and the high-MedHi and non-overweight/obesity group [OR = 0.28 (0.16–0.49)] were linked to lower odds of hypertension versus the low-MedHi and overweight/obesity group, and there was a significant trend in these joint effect terms (P trend = 0.019). Conclusion High live microbial consumption was associated with reduced odds of hypertension among children and adolescents, and live microbial intake and overweight/obesity exerted a joint effect on the odds of hypertension.