For individuals managing type 2 diabetes, GLP-1 agonist drugs have become valuable allies in the quest for better blood sugar control. Beyond their primary role in glucose regulation, these medications have demonstrated an unexpected benefit in promoting weight loss. However, this weight loss can be a double-edged sword, as it may include not just fat but also valuable lean muscle mass (ref 1). In fact, a 2021 study looking at once-weekly GLP1 agonists reported that ~40% of weight loss was attributed to muscle loss, and just 60% of their weight loss was due to fat loss (ref 1). To counteract this potential side effect, a dietary strategy centered around increased protein intake emerges as a key element in preserving muscle mass for those using GLP-1 agonists.

Understanding GLP-1 Agonists

GLP-1 agonists belong to a class of medications that mimic the action of glucagon-like peptide-1 (GLP-1), a hormone naturally produced in the intestine. These drugs are known for their ability to lower blood sugar levels, enhance insulin sensitivity, and promote weight loss by reducing appetite and slowing down gastric emptying.

The Muscle-Loss Conundrum

While the decrease in appetite supports weight loss, there is a concern that a significant portion of the lost weight could be attributed to muscle mass (ref 1). Muscle plays a crucial role in metabolic health and healthy aging, and its preservation is essential for overall wellbeing. Therefore, individuals using GLP-1 agonists should proactively implement dietary strategies to maximize muscle retention with their limited appetite.

The Protein Solution

Protein is a fundamental nutrient for maintaining and building muscle mass. It provides the essential amino acids required for muscle protein synthesis, the process through which the body repairs and grows muscle tissue. For individuals on GLP-1 agonists, incorporating an adequate amount of protein into their daily diet can help counteract muscle loss and promote a more favorable body composition.

Recommended Protein Intake

The amount of protein needed varies among individuals, but a general guideline is to aim for at least .75 grams of protein per pound of body weight per day. This range ensures that the body has a sufficient supply of essential amino acids to support muscle maintenance and repair. Distributing protein intake evenly throughout the day can also optimize its effectiveness in promoting muscle protein synthesis.

Choosing Protein-Rich Foods

Opting for high-quality protein sources is crucial for achieving the desired muscle-preserving effects. Foods such as lean meats, poultry, fish, eggs, dairy products, legumes, and plant-based protein sources like tofu and quinoa should be staples of the diet. Including a variety of high-quality protein supplements that are enriched with essential amino acids, such as meal replacement shakes that contain at least 20 grams of complete protein and ample fiber per serving, is also beneficial.

Meal Timing Matters

To maximize the benefits of protein for muscle preservation, consider spreading protein intake across multiple meals and snacks throughout the day. This approach helps sustain a steady supply of amino acids, preventing the body from relying solely on muscle breakdown for energy between meals. Ideally, look to get 20 grams of protein in each feeding session per day with 5+ feeding sessions daily.

Conclusion

While GLP-1 agonist drugs offer valuable benefits in managing type 2 diabetes and promoting weight loss, individuals using these medications should be mindful of the potential for muscle loss. Incorporating a protein-rich diet through meals and protein shakes can play a pivotal role in mitigating this concern and supporting overall muscle health. By paying attention to protein intake, individuals can optimize the positive effects of GLP-1 agonists while safeguarding their precious muscle mass for a healthier and more resilient body.

References:

March 18, 2021; N Engl J Med 2021; 384:989-1002 DOI: 10.1056/NEJMoa2032183