Publications : 2026

Frankenfeld CL, Movva N, Hooda N, Gauthier J, Reichert H, Doepker C. 2026. Analysis of National Health and Nutrition Survey (NHANES): Nutrient, food, and beverage intake of GLP-1-RA users with type 2 diabetes, 2007-2020. J Nutr 101685; doi: 10.1016/j.tjnut.2026.101685. Online ahead of print June 22. PMID: 42331063.

Abstract

Background: There is increasing use of glucagon-like peptide-1 receptor agonists (GLP1-RAs) for treatment of obesity and diabetes. Objective: To evaluate differences in dietary intake among GLP1-RA users compared to non-users and determine if length of use was associated with dietary intake in the United States (US). Methods: National Health and Nutrition Examination Survey (NHANES) data (2007-2020) were utilized to identify individuals with diabetes aged ≥30 years with complete demographics, anthropometric, dietary intake, and prescription medication use details, and not currently breastfeeding or pregnant. Nutrient intake and adequacy, and intake of US Department of Agriculture (USDA)-defined food categories were compared across three groups consisting of non-GLP1-RA users (n=4247), short-term users (GLP1-RA use <1 year; n=42), and long-term users (GLP1-RA use ≥1 year; n=85). Likelihood of meeting the dietary reference intake (DRI) and intake were assessed with multivariable regression models. Results: Compared to non-users, non-significant lower average energy intakes were observed among short-term users (1900 vs 1700 kcal, respectively) and non-significant higher average energy intakes were noted among long-term users (1900 vs 2100 kcal). Compared to non-users, short-term users displayed nutritional inadequacies for folate (69% vs. 49%, p=0.042), iron (63% vs. 27%, p=0.001), niacin (57% vs 26%, p<0.001), potassium (95% vs. 71%, p=0.001), and vitamin B6 (66% vs. 47%, p=0.011). Food consumption varied with increased intake of higher carbohydrate food categories (e.g., rice) in the non-users and higher protein food categories (e.g., beef) among users. Long-term users appear to have food consumption patterns that more closely resemble non-users than short-term users. Similar results were noted for analyses restricted to obese individuals. Conclusions: Observed findings suggest a lower likelihood of being nutritionally inadequate for short-term GLP1-RA users. Additional investigations are warranted to understand the dynamic nutritional needs of individuals using GLP1-RAs based on the duration of treatment.