Association of Glucagon-Like Peptide Agonist Therapy With Dietary Patterns in a Cross-Sectional Cohort

Mechanisms by which glucagon-like peptide receptor agonists (GLPRAs) improve cardiovascular outcomes remain incompletely understood. Whether taking GLPRAs are associated with differential dietary patterns remains unknown.

Data from the National Health and Nutrition Examination Survey (2009-2020) were used to match GLPRA users to non-users with exact matching. Dietary patterns were identified using principal component analysis.

The four dietary patterns were "Standard American", "Legume-Heavy", "Animal Protein and Vegetable", and "Whole Food Carbohydrate". In a multinomial logit model among matched cases (n = 127) and comparisons (n = 1264), taking a GLPRA (vs. not) was associated with lower alignment with the Legume-Heavy pattern (0.15 vs. 0.24, p = 0.01), but no difference for Standard American (0.29 vs. 0.29, p = 0.97), Animal Protein and Vegetable (0.30 vs. 0.22, p = 0.07), or Whole Food Carbohydrate patterns (0.26 vs. 0.25, p = 0.87). There was no difference in dietary quality based on taking or not taking GLPRAs (mean Healthy Eating Index 53.7 (12.1) versus 52.6 (12.3), p = 0.09).

GLPRAs were associated with lower likelihood of legume-focused dietary pattern and no difference in dietary healthfulness. Without simultaneous improvement in dietary healthfulness, there is a risk of a missed opportunity to promote healthy dietary habits among those taking GLPRAs.