Researchers at Steno Diabetes Center Copenhagen reported that starting a GLP-1 receptor agonist (GLP-1RA) coincided with slightly healthier supermarket purchases. Grocery purchases from GLP-1RA users in Denmark contained modestly fewer calories and sugars and slightly more protein per 100 g of food after treatment began than before.
Appetite suppression and lower calorie intake are commonly associated with GLP-1RAs, while day-to-day food choices have remained less clear in prior work. Case reports and small observational studies have suggested a shift away from ultra-processed, energy-rich snacks toward more whole, minimally processed foods after GLP-1RA initiation, while real-world purchase records at scale have remained unclear.
In the study, “Consumer Food Purchases After Glucagon-Like Peptide-1 Receptor Agonist Initiation,” published in JAMA Network Open, researchers analyzed supermarket receipt data to assess whether nutritional quality and processing levels changed after initiation of GLP-1RA therapy.
How purchases were measured
Receipt records came from the Danish SMIL cohort, which includes thousands of participants who shared supermarket receipts through a smartphone app. New GLP-1RA patients from 2019 to 2022 were matched 1:3 with nonusers of the same age, sex, and income.
All participants had at least one year of purchases before and after the first prescription date or matched date. Total enrollment included 1,177 adults with a median age of 53 years and 52.5% women, including 293 who started GLP-1RA therapy and 884 matched controls.
Food purchases were categorized by nutrient content and by the NOVA processing system, spanning from unprocessed to ultra-processed items. Comparisons focused on average energy density in kcal per 100 g and nutrients per 100 g of food, including sugar, carbohydrates, saturated fat, and protein, before versus after GLP-1RA initiation.
Small shifts
After GLP-1RA initiation, grocery purchases shifted modestly toward lower energy density and lower sugar and carbohydrate content. Mean energy density was reduced from 209.4 to 207.3 kcal per 100 g, sugar content slid from 15.7 to 15.1 g per 100 g, and total carbohydrates dropped from 19.8 to 19.3 g per 100 g. Saturated fat content decreased slightly from 7.3 to 7.2 g per 100 g, while protein increased from 6.6 to 6.9 g per 100 g of food intake.
Processing categories moved in the same direction, with unprocessed foods rising by about 0.9 percentage points from a baseline of 46.9% and ultra-processed foods falling by about 1.2 points from 39.2%. Little change, or opposite change, appeared in the matched control group.
Authors note that changes for each individual were modest, and observed changes may partly reflect the start of a weight-loss journey.