This paper explores the relationship between the big three healthy lifestyle behaviors of physical activity, nutrition and specifically breakfast eating, and sleep with alcohol and marijuana use among US high school students. In addition, published research examining these associations was examined.
Using the Youth Online YRBS data analysis tool (CDC, 2019) for all high school students in the country, cross-tabs were run comparing each of the big-three healthy behaviors (one-hour physical activity, eating breakfast, eight-hours of sleep per day: yes/no) against various measures of alcohol and marijuana use (yes/no): https://nccd.cdc.gov/youthonline/App/Default.aspx
Youth eating a daily breakfast and getting eight or more hours of sleep each night were significantly less likely to drink alcohol before age 13 years old, currently drink, currently binge drink and drink 10 or more drinks in a row, compared to those not regularly eating breakfast and getting adequate sleep (p’s<.0000-.04).
Similar findings were identified with youth eating breakfast and getting eight hours sleep and having less likelihood of ever using marijuana, using before age 13, currently using and using synthetic marijuana compared to adolescents not eating a regular breakfast or getting eight hours of sleep (p’s<.0000-.001).
Youth getting one or more hours of physical activity every day did not differ from less physically activity youth on most alcohol and marijuana measures with two exceptions. One, physically active youth were more likely to drink before age 13 years old (p=.03) and less likely to drink 10 or more alcohol drinks in a row (p=.001).
Published research has shown that skipping breakfast is associated with higher risk of frequent alcohol drinking among college students (https://www.mdpi.com/2072-6643/14/13/2657/htm), frequent alcohol use and smoking among adolescents (https://pubmed.ncbi.nlm.nih.gov/12821884/), and binge drinking and alcohol use among secondary school students (https://academic.oup.com/jpubhealth/article/39/2/321/3002961).
Frequency of family meals is inversely associated with alcohol, marijuana and tobacco use among adolescents (https://jamanetwork.com/journals/jamapediatrics/article-abstract/485781).
In addition, risky behaviors like skipping breakfast, illegal drug use, and current alcohol use and cigarette smoking, among others, have been found to cluster in adolescents (https://onlinelibrary.wiley.com/doi/abs/10.1111/cdoe.12354).
Meanwhile, research has shown that duration and quality of sleep is associated with earlier use, intoxication and repeated use of alcohol and marijuana throughout adolescence (https://www.sciencedirect.com/science/article/abs/pii/S0376871616302460), preference for later sleep and wake times is associated with greater at-risk alcohol use, binging and last year marijuana use among adolescents (https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.13401), and sleep problems are associated with alcohol and cannabis use in late adolescence to emerging adulthood (https://academic.oup.com/sleep/article-abstract/44/10/zsab102/6245112).
Together, the data analyses presented earlier along with these studies suggest that alcohol and marijuana use prevention programs may benefit from promoting sleep quantity and quality and eating regular healthy breakfasts for adolescents.
Regarding regular physical activity and sports participation, research shows that across high school grade levels greater exercise is associated with less alcohol, cigarette and marijuana use while higher levels of athletic team participation is associated with higher levels of smokeless tobacco, alcohol and steroid use (https://www.sciencedirect.com/science/article/abs/pii/S0749379711000377), and being part of a competitive sports team is related to lower probability of marijuana initiation but increased rates of alcohol use over time for youth (https://journals.sagepub.com/doi/abs/10.1177/0022042613491107).
These final studies support the data analyses we showed above and suggest that both physical activity and sports participation may protect youth against certain substance use, including marijuana consumption, but athletic team participation is likely to increase risk for other substances including alcohol use.
In conclusion, teachers, coaches and parents should therefore promote under-practiced health behaviors for all adolescents, including eating breakfast daily, getting eight or more hours sleep each night and participating in an hour of daily physical activity, not only to enhance physical and mental health but also to aid in preventing substance use.
For youth participating in team sports, alcohol use prevention programs should be included to reduce adolescent increased risk for alcohol consumption and depending upon the specific type of sports, other substance use prevention may be required to protect youth (e.g., steroids and smokeless tobacco use prevention).