TOPLINE:

An analysis of supermarket receipts revealed that after initiating GLP-1 receptor agonist (RA) therapy, participants purchased items with fewer calories; less sugar, saturated fat, and carbohydrates; and slightly more protein, as well as a smaller proportion of ultraprocessed foods.

METHODOLOGY:

• GLP-1 RAs, increasingly used for managing type 2 diabetes and obesity, have well-established effects on appetite and satiety, but their impact on food preferences remains unclear.
• Researchers analyzed supermarket receipts, collected via a smartphone app, from a Danish cohort to assess whether the initiation of GLP-1 RAs was associated with changes in the nutritional quality and processing level of supermarket purchases.
• They identified new GLP-1 RA users (n = 293) between 2019 and 2022, and matched them 1:3 to non-initiators (n = 884) by sex, age, and income. The sample was restricted to individuals who spent kr 100 ($15.75) or more on food during the 365 days both before and after initiation or a matched date.
• Researchers categorized individual items into nutrition-related groups using a published algorithm and compared mean energy density, nutrient composition, and processing level in the year before vs the year after initiation of GLP-1 RAs or the matched date. There were 807,275 purchases in the before period and 1.17 million in the after period.

TAKEAWAY:

• Among GLP-1 RA initiators, the mean energy density decreased from 209.4 kcal/100 g to 207.3 kcal/100 g, mean sugar content from 15.7 g/100 g to 15.1 g/100 g, mean carbohydrate from 19.8 g/100 g to 19.3 g/100 g, and mean saturated fat content from 7.3 g/100 g to 7.2 g/100 g, while mean protein content increased from 6.6 g/100 g to 6.9 g/100 g (P < .001 for all).
• The proportion of items that were ultraprocessed foods decreased from 39.2% to 38%, and the proportion that were unprocessed foods increased from 46.9% to 47.8% among initiators (P < .001 for both).
• The matched individuals showed opposite patterns, with small increases in the mean energy density, mean sugar and carbohydrate content, and purchases of ultraprocessed foods.

IN PRACTICE:

“Although modest at the individual level, these changes may accumulate at the population level, particularly given [the] increasing GLP-1 RA use,” the authors wrote.

SOURCE:

The study, led by Kathrine Kold Sørensen, PhD, Department for Clinical and Translational Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen in Herlev, Denmark, was published online as a research letter in JAMA Network Open.

LIMITATIONS:

Participants likely reflect a self-selected group willing to share receipts, potentially introducing selection bias. The absence of BMI data was a limitation, and observed changes in purchasing patterns may partly reflect the beginning of a weight-loss journey. Potential misclassification during item matching could not be ruled out. 

DISCLOSURES:

One author received grants from the Novo Nordisk Foundation as part of a transitional medicine fellowship program. Another received grants from Bayer and Novo Nordisk outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.