Youth Substance Use and Body Composition: Does Risk in One Area Predict Risk in the Other?

Keryn E. Pasch, Cayley E. Velazquez, Jessica Duncan Cance, Stacey G. Moe, Leslie A. Lytle

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Both substance use and obesity are prevalent among youth. As youth age, substance use rates increase and over the past three decades, obesity rates among youth have tripled. While these two factors have both short- and long-term health impacts, little research has explored how substance use and obesity among youth may be related. This study explores the bi-directional longitudinal relationships between substance use and body composition. Participants (N = 704; 50.7% female) were mostly white (86.4%) with a baseline mean age of 14.7 years. Objectively measured body composition was used to calculate body mass index z-scores (BMI z-score) and percent body fat. Cross-lagged structural equation models, accounting for clustering at the school level, were run to determine the longitudinal association between body composition and self-reported substance use (alcohol, cigarette, and marijuana), adjusting for socio-demographic characteristics, pubertal status, and weight satisfaction. Baseline alcohol use predicted decreased BMI z-score at follow-up and a similar association with percent body fat approached significance. Baseline cigarette use predicted increased percent body fat. No longitudinal associations were seen between baseline body composition and future substance use. Our results suggest that substance use contributes to subsequent body composition; however, body composition does not contribute to subsequent substance use. Continued research that explores these relationships longitudinally is greatly needed.

Original languageEnglish (US)
Pages (from-to)14-26
Number of pages13
JournalJournal of Youth and Adolescence
Issue number1
StatePublished - Jan 2012

Bibliographical note

Funding Information:
Acknowledgment This research was funded through a grant from the National Cancer Institute as part of their Transdisciplinary Research in Energetics and Cancer (TREC) Initiative. Grant # 1U54CA116849 and through a grant supported by the Etiology of Childhood Obesity (ECHO) with funding from the National Heart, Lung and Blood Institute, Grant #R01HL085978. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, National Heart, Lung and Blood Institute, or the National Institutes of Health.


  • Adolescents
  • Body composition
  • Obesity
  • Substance use


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