Estimating the association between metabolic risk factors and marijuana use in U.S. adults using data from the continuous National Health and Nutrition Examination Survey.
OBJECTIVE
More research is needed on the health effects of marijuana use. Results of previous studies indicate that marijuana could alleviate certain factors of metabolic syndrome, such as obesity.


METHODS
Data on 6281 persons from National Health and Nutrition Examination Survey from 2005 to 2012 were used to estimate the effect of marijuana use on cardiometabolic risk factors. The reliability of ordinary least squares (OLS) regression models was tested by replacing marijuana use as the risk factor of interest with alcohol and carbohydrate consumption. Instrumental variable methods were used to account for the potential endogeneity of marijuana use.


RESULTS
OLS models show lower fasting insulin, insulin resistance, body mass index, and waist circumference in users compared with nonusers. However, when alcohol and carbohydrate intake substitute for marijuana use in OLS models, similar metabolic benefits are estimated. The Durbin-Wu-Hausman tests provide evidence of endogeneity of marijuana use in OLS models, but instrumental variables models do not yield significant estimates for marijuana use.


CONCLUSIONS
These findings challenge the robustness of OLS estimates of a positive relationship between marijuana use and fasting insulin, insulin resistance, body mass index, and waist circumference.
Department of Clinical Pharmacy, Pharmaceutical Economics, and Policy, University of Southern California, Los Angeles; Leonard Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles.
Christin Ann
CA
Thompson
Department of Clinical Pharmacy, Pharmaceutical Economics, and Policy, University of Southern California, Los Angeles; Leonard Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles. Electronic address: jhay@usc.edu.
Joel W
JW
Hay
D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016018:Least-Squares Analysis; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology; D012044:Regression Analysis; D015203:Reproducibility of Results; D012107:Research Design; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D055105:Waist Circumference
D004040:Dietary Carbohydrates
Instrumental variables; Marijuana use; Metabolic health; Multivariate linear regression