LB016 - BEYOND CALORIES: AN AI-POWERED REAL-WORLD STUDY OF MACRO- AND MICRONUTRIENT INTAKE IN GLP-1 RECEPTOR AGONIST USERS COMPARED TO NON-USERS

LB016

BEYOND CALORIES: AN AI-POWERED REAL-WORLD STUDY OF MACRO- AND MICRONUTRIENT INTAKE IN GLP-1 RECEPTOR AGONIST USERS COMPARED TO NON-USERS

V. Vinelli^1,*, M. Giannotta², F. Zanoli², L. De Morais², R. De Lorenzo³, C. Francione², D. Ceccarelli², N. Parini², G. De Lorenzo², P. Rovere-Querini³

¹San Raffaele Hospital, ²Robin Health, ³Center Of Metabolic Health, San Raffaele Hospital, Milan, Italy

Rationale: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce caloric intake, raising concerns about overall nutritional adequacy. Real-world dietary data in this population are scarce.

Methods:  Retrospective cohort of Robin Health app users with body mass index (BMI) ≥27 kg/m², ≥3 consecutive food-logging days and 200–5,000 kcal/day. GLP-1 RAs use was self-reported. Intake was captured by an AI-powered multimodal logging system (photo, text, voice, barcode, food database). Adequacy was assessed against LARN 2024 (Italian reference intakes) and EFSA references. Between-group comparisons: Mann-Whitney U and chi-squared.

Results: 332 users (116 GLP-1 RAs, 216 non-users; 5,741 patient-days), comparable for BMI (31.3 vs 30.6 kg/m²; p=0.243) and sex (72.4% vs 63.0% female; p=0.106); age slightly higher in GLP-1 RAs users (52.5 vs 50.0 years; p=0.026). GLP-1 RA users had lower energy (1,102 [875–1,338] vs 1,281 [935–1,692] kcal/day; p=0.001) and weight-adjusted protein (0.6 vs 0.7 g/kg/day; p=0.002); 87.9% fell below the LARN Population Reference Intake. Macronutrient energy distribution was nearly identical. Meal skipping was more frequent in GLP-1 RAs users (breakfast 31.3% vs 16.1%; lunch 30.5% vs 18.2%; dinner 40.4% vs 29.6%; all p<0.001). Micronutrient inadequacy was pervasive in both groups but worse in GLP-1 RA users for iron (100.0% vs 96.8% below LARN; p=0.037), magnesium (94.0% vs 87.0%; p=0.018), niacin (90.5% vs 82.9%; p=0.009), and for copper, riboflavin and B6.

Conclusion: GLP-1 RAs use is associated with widespread nutritional inadequacy, encompassing protein deficit, micronutrient shortfalls and meal skipping, despite proportional macronutrient distribution. Routine nutritional monitoring and targeted dietary guidance are warranted in pharmacological obesity treatment.

Disclosure of Interest: V. Vinelli Consultant for: First author is Scientifc Advisor at Robin Health, M. Giannotta: None declared, F. Zanoli: None declared, L. De Morais: None declared, R. De Lorenzo: None declared, C. Francione: None declared, D. Ceccarelli: None declared, N. Parini: None declared, G. De Lorenzo: None declared, P. Rovere-Querini: None declared