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

Abstract Purpose 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. Conclusion 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.