The association of cannabis use with fast-food consumption, overweight, and obesity among adolescents aged 12-15 years from 28 countries

Background: Cannabis legalization and use have risen globally. However, the association between cannabis use, eating behaviors and body weight among adolescents is yet unexplored. Objectives: This study examined the association between cannabis use, fast-food consumption, overweight and obesity in 28 countries using data from the 2010-2016 Global School-Based Student Health Survey. Methods: Multivariable logistic regression and meta-analysis were performed among a sample of 83,726 adolescents (48.7% females) aged 12-15 years, mean (SD) age of 13.8 (0.9) years. Results: The overall prevalence of cannabis use (in past 30 days) and fast-food consumption (in past 7 days) were 2.8% and 57.3% respectively. The overall prevalence of overweight and obesity was 14.7% and 4.2%, respectively. Cannabis use was significantly associated with fast-food consumption (OR = 1.33; 95%CI = 1.13-1.57) but not with overweight (OR = 0.95; 95%CI = 0.80-1.14) or obesity (OR = 1.16; 95%CI = 0.85-1.59). For obesity, there was a moderate level of between-country heterogeneity (I2 = 51.9%) and significant positive associations with cannabis use were observed in Bahamas, Bangladesh, Namibia and Nepal.                Conclusion: The results highlight the association between cannabis use and dietary risks, providing evidence for public health interventions on the interrelated nature of cannabis use and fast-food consumption.