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

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.