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 glucagon-like peptide-1 receptor agonist users with type 2 diabetes, 2007-2020. J Nutr 156(8):101685; doi: 10.1016/j.tjnut.2026.101685. PMID: 42331063.

Abstract

Background: There is increasing use of glucagon-like peptide-1 receptor agonists (GLP1-RAs) for the treatment of obesity and diabetes. Objectives: This study aims to evaluate differences in dietary intake among GLP1-RA users compared with nonusers and determine if length of use was associated with dietary intake in the United States. Methods: National Health and Nutrition Examination Survey data (2007–2020) were used to identify individuals with diabetes aged ≥30 y with complete demographics, anthropometric, dietary intake, and prescription medication use details, and not currently breastfeeding or pregnant. Nutrient intake and adequacy, and intake of United States Department of Agriculture–defined food categories were compared across 3 groups consisting of non-GLP1-RA users (n = 4247), short-term users (GLP1-RA use <1 y; n = 42), and long-term users (GLP1-RA use ≥1 y; n = 85). The likelihood of meeting the dietary reference intake and dietary intake was assessed with multivariable regression models. Results: Compared with nonusers, nonsignificantly lower mean energy intakes were observed among short-term users (1900 vs. 1700 kcal, respectively), and nonsignificantly higher average energy intakes were noted among long-term users (1900 vs. 2100 kcal). Compared with nonusers, 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 B-6 (66% vs. 47%, P = 0.011). Food consumption varied with increased intake of higher-carbohydrate food categories (e.g., rice) in the nonusers and higher-protein food categories (e.g., beef) among users. Long-term users appear to have food consumption patterns that more closely resemble those of nonusers than those of short-term users. Similar results were noted for analyses restricted to obese individuals. Conclusions: Observed findings suggest a lower likelihood of being nutritionally inadequate among 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.