Sello, Mamakase G.Hlephole, Lieketseng V.Monyane, Boitumelo2026-08-132026-08-132026Sello, M.G., Hlephole, L.V., Monyane, B., Pitso, L.S. and Lekatsa, T.K., 2026. Barriers and determinants of low lifestyle and dietary adherence among adults with hypertension in resource-limited settings: A cross-sectional survey from Mokhotlong and Butha-Buthe districts, Lesotho. Nutrition and Health, p.02601060261466082.https://doi.org/10.1177/02601060261466082https://hdl.handle.net/10566/25155Background: Adherence to lifestyle and dietary modifications is crucial for effective hypertension management, yet non-adherence remains a significant challenge. Aim: This study aimed to identify determinants and perceived barriers of low lifestyle and dietary adherence among adults with hypertension attending chronic care units in Butha-Buthe and Mokhotlong districts, Lesotho. Methods: A quantitative cross-sectional survey of 200 adults with hypertension attending chronic care units in the Butha-Buthe and Mokhotlong districts of Lesotho was conducted. Logistic and linear regression were used to identify determinants of dietary and lifestyle adherence, respectively, with statistical significance set at p < 0.05. Summary: The mean age of participants was (48 ± 11.87 years). Only 8.0% of participants adhered to WHO dietary recommendations, while 36.5% adhered to lifestyle recommendations. Patients with low education were substantially less likely to adhere to dietary guidelines (OR = 0.18, 95% CI: 0.03–0.82, p < 0.05), and those reporting specific food preferences were likewise less likely to adhere (OR = 0.18, 95% CI: 0.03–0.88, p < 0.05). Low educational level was also a significant predictor of lifestyle adherence (β = −0.275, p < 0.05), as were food preferences (β = −0.205, p < 0.05). These findings highlight the need for patient education, nutritionist support, and context-appropriate dietary counseling to improve hypertension management in resource-limited settings.enAfricabarriersdietary adherenceHypertensionLesothoArticle