What are the dietary recommendations for a GLP-1 (Glucagon-like peptide-1) diet?

Dietary Recommendations for GLP-1 Medications

For patients on GLP-1 receptor agonists, dietary modifications should focus on moderate carbohydrate portions at each meal, avoiding skipping meals, and gradually introducing the medication to minimize gastrointestinal side effects. 1

Core Dietary Principles for GLP-1 Users

Meal Timing and Structure

• Take daily or twice-daily GLP-1 injections before meals 1
• Once-weekly GLP-1s can be taken at any time regardless of meal times 1
• Do not skip meals, especially if also taking insulin secretagogues, to reduce hypoglycemia risk 1
• Maintain consistent meal timing if also on fixed insulin regimens 1

Carbohydrate Management

• Consume moderate amounts of carbohydrates at each meal and snack 1
• Focus on whole grains rather than refined carbohydrates 2
• Consider carbohydrate counting if also using insulin to match doses appropriately 1

Food Choices to Enhance GLP-1 Effects

• Prioritize foods that naturally stimulate GLP-1 secretion:
  • High-fiber grain products
  • Nuts
  • Avocados
  • Eggs 3
• Include foods rich in monounsaturated and polyunsaturated fatty acids 3
• Choose minimally processed foods over ultra-processed options 2
• Incorporate plenty of fruits and vegetables for fiber and nutrients 2

Managing Common GLP-1-Related Dietary Challenges

Gastrointestinal Side Effects

• Gradually titrate medication dose to minimize gastrointestinal side effects 1, 4
• Take medication with food or 15 minutes after meals if GI symptoms persist 1
• If side effects don't resolve within a few weeks, follow up with healthcare provider 1

Hypoglycemia Prevention

• Always carry a source of quick-acting carbohydrates (15-20g) such as glucose tablets 1
• If hypoglycemia occurs (blood glucose <50-60 mg/dL), treat with 15g of glucose and recheck in 15 minutes 1
• Be especially cautious when combining GLP-1s with insulin or sulfonylureas 4

Physical Activity Considerations

• Engage in at least 150 minutes of moderate-intensity physical activity weekly 1
• If physical activity is performed within 1-2 hours of mealtime insulin injection, consider lowering the insulin dose 1
• Interrupt prolonged sitting at least every 30 minutes for blood glucose benefits 1

Special Considerations

Renal Impairment

• Monitor renal function as some GLP-1 analogues require dose adjustment in renal impairment 4
• Limit sodium intake to 2,300 mg/day 1

Cardiovascular Health

• Use liquid plant oils rather than tropical oils or partially hydrogenated fats 2
• Choose healthy protein sources (mostly plants, fish, seafood, low-fat dairy) 2
• Minimize intake of beverages and foods with added sugars 2

Pitfalls to Avoid

• Do not combine different incretin-based medications (GLP-1 RAs, GIP/GLP-1 RAs, DPP4i) 1
• Use caution when combining insulin with GLP-1 RAs due to hypoglycemia risk 1
• Avoid high-fat meals that may worsen delayed gastric emptying effects of GLP-1 medications 4
• Do not start at full medication dose - gradual titration is essential to minimize side effects 4

By following these dietary recommendations, patients on GLP-1 medications can maximize medication effectiveness while minimizing side effects and optimizing overall health outcomes.