Calorie labels on menus could make eating disorders worse

King's College London

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Calorie labels on restaurant menus are negatively impacting people with eating disorders, according to a new study published today in the BMJ Public Health.

The review, which is the first of its kind, is led by researchers at King’s College London. It found that individuals who have been diagnosed with an eating disorder changed their behaviours if presented with a menu featuring calorie labels.

This included avoiding restaurants, triggering eating disorder thoughts and paying more attention to calorie labels as identified by eye tracking research.

The research found that some people with eating disorders reported that seeing menu labels reinforced their eating disorder beliefs.

The study evaluated existing research to help build a picture of how nutritional labels on menus impact people with a lived experience of eating disorders or disordered eating. It reviewed 16 studies from the UK, US, Canada and Saudi Arabia which included 8,074 participants in total.

The study highlights that people with eating disorders can feel that eating disorders are perceived as less important in the light of obesity prevention policies.

However, physical health cannot be measured by a single indicator such as weight. Some argue that calorie labels can be seen as a blunt instrument to fix a complicated problem and that people with eating disorders could be losing out.

Food labelling came into force in England in 2022. Restaurants, take-aways and cafes with 250 employees or more must display the calories of the food and drink they sell on menus, online menus and take-away platforms. The measure was an attempt to curb rising obesity levels. The United States and Canada have also made calorie displays mandatory, however, few policies targeting obesity have considered the potential impact on eating disorders.

The eating disorder charity Beat estimates that at least 1.25 million people in the UK have an eating disorder. The number of people admitted to hospital with an eating disorder has risen approximately 7% each year since 2005 – 2006. 

Senior author Dr Tom Jewell, Lecturer in Mental Health Nursing at King’s College London, said: “Our study highlights that people with lived experience of eating disorders are frustrated at being left out of the conversation around calorie labels.

“Striking a balance between the positive and harmful impacts of calorie labels on menus is vital in any public health policies. Policymakers should consider the impact on both obesity and eating disorders when making decisions about nutrition labelling. A recent review found that calorie labelling has a modest effect on people’s behaviour but this needs to be counterbalanced with the potential harm it does for people with eating disorders.”

Co-author Dr Nora Trompeter, Research Fellow University College London, said: “Our study provides an important addition to the evidence base around calorie labels. Typically, there is a lot of focus on whether policies are effective in reducing obesity, but it is also critical to investigate whether these policies inadvertently harm people with eating disorders. Our review also shows that more research is needed to fully understand the impact of calorie labels on individuals with eating disorders. For example, none of the studies included young people.”

The paper, titled ‘Impact of out-of-home nutrition labelling on people with eating disorders: a systematic review and meta synthesis”, is published in British Medical Journal Public Health.

The paper, titled ‘Impact of out-of-home nutrition labelling on people with eating disorders: a systematic review and meta synthesis”, is published in British Medical Journal Public Health.

ENDS

For more information, please contact Jo Dungate at the King’s College London press office at Joanna.dungate@kcl.ac.uk.

Notes to editor:

Paper reference: Trompeter, N., Duffy, F., Peebles, I., Wadhera, E., Chambers, E., Sharpe, H., Maloney, E., Nicholls, D., Serpell, L., Schmidt, U., & Jewell, T. (2025). Impact of out-of-home nutrition labelling on people with eating disorders: A systematic review and meta-synthesis. BMJ Public Health. http://dx.doi.org/10.1136/bmjph-2023-000862

About King’s College London 

King’s College London is amongst the top 40 universities in the world and top 10 in Europe (THE World University Rankings 2024), and one of England’s oldest and most prestigious universities.  With an outstanding reputation for world-class teaching and cutting-edge research, King’s maintained its sixth position for ‘research power’ in the UK (2021 Research Excellence Framework). 

King's has more than 33,000 students (including more than 12,800 postgraduates) from some 150 countries worldwide, and 8,500 staff.

For nearly 200 years, King’s students and staff have used their knowledge and insight to make a positive impact on people, society and the planet. Focused on delivering positive change at home in London, across the UK and around the world, King’s is building on its history of addressing the world’s most urgent challenges head on to accelerate progress, make discoveries and pioneer innovation. Visit the website to find out more about Vision 2029, which sets out bold ambitions for the future of King’s as we look towards our 200th anniversary.

World-changing ideas. Life-changing impact: kcl.ac.uk/news  

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UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

Since 1826, we have championed independent thought by attracting and nurturing the world's best minds. Our community of more than 50,000 students from 150 countries and over 16,000 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

The Times and Sunday Times University of the Year 2024, we are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.  

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

www.ucl.ac.uk | Read news at www.ucl.ac.uk/news/ | Listen to UCL podcasts on SoundCloud | View images on Flickr | Find out what’s on at UCL Minds

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Journal

BMJ Public Health

DOI

10.1136/bmjph-2023-000862 

Method of Research

Literature review

Subject of Research

People

Article Title

‘Impact of out-of-home nutrition labelling on people with eating disorders: a systematic review and meta synthesis

Article Publication Date

29-Jan-2025

 

If at first you don’t succeed: Virginia Tech researchers ask how many attempts it takes to quit substance abuse

A Fralin Biomedical Research Institute analysis found that people trying to quit opioids and pain medication experience more relapses

Virginia Tech

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The number of quit attempts represent adjusted, estimated marginal means for each substance, averaged across levels of substance use disorder severity. 

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Credit: Fralin Biomedical Research Institute Addiction Recovery Research Center

Relapse is common when someone is trying to quit, regardless of whether they’re giving up opioids or alcohol or cigarettes.

To better inform treatment, researchers with the Fralin Biomedical Research Institute at VTC’s Addiction Recovery Research Center wanted to better understand how the experience of quitting differed across substances. 

“When we talk about intervention for addiction, we know that we are far from the ideal model of treatment,” said Rafaela Fontes, a research scientist at the Fralin Biomedical Research Institute and first author on the study, “Beyond the first try: How many quit attempts are necessary to achieve substance use cessation?”

For the study, “quitting” was based on a yes or no response to a survey question that asked whether participants still used a specific substance. Researchers noted that because substance use is a chronically relapsing disorder, the number of quit attempts reported might not be final, although for all participants across all substances, the average time in abstinence was more than seven years.

The work, scheduled for publication in the Feb. 1 issue of Drug and Alcohol Dependence, found that:

• Substance use disorder is a chronically relapsing condition that often requires multiple quit attempts before successful abstinence.
• The number of quit attempts varies by substance, with opioids and pain medication requiring significantly more attempts than all other substances.
• Hallucinogens are less challenging to quit, requiring fewer attempts.
• People who meet the criteria of having a more severe or longer history of substance use disorder might need more attempts before achieving abstinence.

“We treat addiction as an acute disorder, even though we know that it is a chronically relapsing condition,” Fontes said. “When we’re talking about addiction, we need to understand that it’s not one size fits all. There are some substances that are harder to quit than others, and it’s not equally easy or equally hard for everyone. We cannot use the same strategy for everything, because it might not work.”

The findings suggest that early intervention improves success and reduces relapses, according to Allison Tegge, corresponding author on the study and a research associate professor at the Fralin Biomedical Research Institute at VTC.

“What makes this research stand out is that, not only did we consider the substance, but we asked additional questions to look at the individual experience in context,” Tegge said.

What they did

Researchers recruited study participants from the International Quit & Recovery Registry, a tool created to advance scientific understanding of success in overcoming addiction. Sponsored by the Fralin Biomedical Research Institute, it was developed by Professor Warren Bickel, an addiction expert who died in September. Bickel was an author and principal investigator on the substance use cessation research.

“These findings highlight the relevance of the registry and the work started by Dr. Bickel to understand addiction recovery,” Fontes said. “He was a visionary, and his registry continues to help us gain a deeper and better understanding of recovery trajectories.”

The study ultimately drew its findings from 344 registry participants who completed surveys on the substances they had used, the age of first use, the number of quit attempts, and current substance use. Only participants who reported successful abstinence from at least one substance were included.

Participants were asked which they had used 10 or more times: nicotine, alcohol, cannabis, cocaine, opioids, stimulants, prescription pain relievers, hallucinogens, anesthetics, tranquilizers, inhalants, or “other.” They were also asked about length and severity of use, based on criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

What they found

Participants reported more difficulty quitting pain medication and opioids, substances with high relapse rates and for which short-term treatment effectiveness is low. Both alcohol and stimulants had more quit attempts than cannabis, cocaine, hallucinogens, and nicotine.

Hallucinogens, which have a different clinical profile than other commonly misused substances, required fewer quit attempts. Researchers also found that tranquilizers had a substantially higher number of quit attempts than hallucinogens.

Notably, substances with a higher number of quit attempts were also those that can bring on severe physical symptoms of withdrawal, such as pain, nausea, and anxiety.

The researchers hope their work informs treatment, with a goal of avoiding high rates of relapse and readmission. 

“This information can help provide the necessary support for someone moving through recovery,” Tegge said.

Why it matters

The research corroborates the chronic nature of substance use disorder and expands on previous research by showing that the number of quit attempts varies depending on the substance.

Additionally, recognizing that it takes multiple attempts, and understanding how some substances may be more challenging to quit than others, is the first step. “If people in recovery knew the average number of attempts it might take to quit a particular drug, rather than see relapse as a failure they might view it as a step on the journey,” Tegge said. “Understanding that relapse is part of recovery can help people stay engaged.”

The challenges of substances’ physiological effects combined with individual circumstances allows treatment providers to create personalized plans. Knowing different factors that affect relapse can help inform interventions. 

In addition to helping inform providers, Fontes also hopes it helps people who are trying to quit. “Maybe they can see that failure is part of the process,” she said, “and think: ‘I just need to keep trying, and eventually I'm going to get there.’”

Authors:

• Rafaela Fontes, research scientist, Fralin Biomedical Research Institute at VTC
• Allison Tegge, research associate professor, Fralin Biomedical Research Institute at VTC and Department of Basic Science Education, Virginia Tech Carilion School of Medicine
• Roberta Freitas-Lemos, assistant professor, Fralin Biomedical Research Institute at VTC and Department of Psychology, College of Science
• Daniel Cabral, postdoctoral associate, Fralin Biomedical Research Institute at VTC
• Warren Bickel, professor, Fralin Biomedical Research Institute at VTC; Department of Psychology, College of Science; and psychiatry and behavioral medicine, Virginia Tech Carilion School of Medicine

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Journal

Drug and Alcohol Dependence

DOI

10.1016/j.drugalcdep.2024.112525 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Beyond the first try: How many quit attempts are necessary to achieve substance use cessation?

Article Publication Date

1-Feb-2025

COI Statement

Although the following activities/relationships do not create a conflict of interest pertaining to this manuscript, in the interest of full disclosure, Dr. Bickel would like to report the following: W. K. Bickel is a principal of HealthSim, LLC; BEAM Diagnostics, Inc.; and Red 5 Group, LLC. In addition, he serves on the scientific advisory board for Ria Health and as a consultant for Lumanity and AlphaSights. Dr. Tegge would like to report the following: A. N. Tegge works on a project supported by Indivior, Inc.

 FACTORY FARMING

University of Virginia study reveals air pollution inequities linked to industrial swine facilities are detectable from space

University of Virginia College and Graduate School of Arts & Sciences

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Ammonia Air Pollution as Seen from Space

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Credit: Sally Pusede

A groundbreaking study led by researchers from the University of Virginia has used satellite measurements to show the long-term persistence of air pollution inequalities tied to industrialized swine facilities in Eastern North Carolina. Using satellite data spanning a 15-year period from 2008–2023, the study quantifies disparities in ammonia (NH₃) — an air pollutant emitted by swine operations — for Black, Hispanic and Indigenous communities. These inequalities, exacerbated by hot and calm weather conditions, extend for multiple kilometers beyond the immediate vicinity of the facilities, highlighting the widespread impact of this environmental issue.

 

The study, published in the American Chemical Society journal Environmental Science & Technology by Sally Pusede and her team in the Department of Environmental Sciences at UVA, uses data from the Infrared Atmospheric Sounding Interferometer (IASI) aboard multiple polar-orbiting satellites. By analyzing NH₃ levels in the atmosphere, UVA researchers were able to show that emissions from industrial swine operations result in systematic environmental inequalities.

 

Among the study’s key findings were that air pollution inequalities can be measured from space. Satellite data analyzed by the research team revealed that NH₃ levels were significantly higher in areas with dense populations of Black, Hispanic and Indigenous residents. Compared to non-Hispanic white populations, NH₃ concentrations were on average 27% higher for Black communities, 35% higher for Hispanic communities and 49% higher for Indigenous communities during the years 2016–2021.

 

The study also finds that calm and hot weather conditions amplify these disparities, as low wind speeds reduce pollutant dispersion from swine facilities and because higher temperatures increase NH₃ emissions through the evaporation of NH3 at and even downwind of swine facilities. On calm days, NH₃ inequalities for Indigenous communities were more than twice as severe as on windy days, while hot days intensified NH3 exposures for Black and Hispanic populations.

 

Elevated NH₃ concentrations were also observed several kilometers downwind of swine feeding operations under calm and hot weather conditions, confirming that the environmental impacts of these operations reach far beyond their immediate surroundings. This challenges claims that only those living very near facilities experience adverse effects.

Analysis of NH₃ satellite data over a 15-year period, from 2008 to 2023, shows that disparities in NH3 concentrations have not lessened over time, underscoring the long-term nature of the issue.

 

The study highlights the role of industrial agriculture in perpetuating environmental racism, with communities of color bearing the brunt of air pollution linked to swine operations. These findings come amid ongoing debates about air quality regulations and the lack of federal standards for NH₃, which is not currently covered by the Environmental Protection Agency’s National Ambient Air Quality Standards.

 

“The satellite ammonia measurements are independent, observational evidence of inequalities in the air pollution impacts of industrial swine operations across Eastern North Carolina,” said Pusede. “The satellite measurements are consistent with residents’ claims of unfair and unaddressed air quality issues and highlight the urgent need for regulatory action.”

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Journal

Environmental Science & Technology

DOI

10.1021/acs.est.4c11922 

Article Title

Satellite observations of atmospheric ammonia inequalities associated with industrialized swine facilities in Eastern North Carolina

Article Publication Date

28-Jan-2025

 

Flame retardants in battery enclosures may do more harm than good

Green Science Policy Institute

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As dangerous lithium-ion battery fires are on the rise, regulators and manufacturers are scrambling for solutions. Unfortunately, one common strategy may cause serious health harm and not work to slow or stop the fires. A new Viewpoint in Environmental Science & Technology explains that adding flame retardants to the plastic cases surrounding these batteries has no proven fire-safety benefit. The scientists further warn that the types of flame retardants widely used in electronics enclosures are linked to cancer and other health harms and can end up in children’s toys, food containers, and other products made from recycled plastic.

“The use of flame retardants in plastic battery enclosures has no demonstrated benefit and poses threats that can last generations,” said lead author Lydia Jahl, a scientist at the Green Science Policy Institute. “For example, toxic flame retardants migrate out of plastics into the air and drop into house dust, which we inadvertently breathe and ingest. When those flame-retarded plastics are recycled years later, additional people will be exposed from products made with the recycled plastic.”

Lithium-ion batteries power electric cars, e-bikes, and an increasing array of portable electronics like smartphones and earbuds. As their usage expands, standards are being adopted to mitigate their serious fire risks. For example, “flame ratings” for plastic enclosures are common requirements that are met by adding chemical flame retardants. However, there is no publicly available research demonstrating that this use of flame retardants curbs battery fires under real-world conditions. Flame retardants in plastics likely cannot slow or stop the highly energetic fires from a lithium-ion battery in thermal runaway.

“Trying to stop thermal runaway fires by adding flame retardants to plastic is like adding a screen door to a submarine. It's a futile effort against an overwhelming force,” said distinguished fire scientist Dr. Vyto Babrauskas.  

The flame retardants widely used for this purpose are organohalogens and organophosphates linked to cancer as well as neurological, reproductive, and immune harm. Young children and pregnant women are the most vulnerable. The authors illustrate how people may be exposed to these harmful chemicals during battery manufacturing, use of the original product (e.g., earbuds or an e-bike), disposal and recycling, and the use of recycled products (e.g., the infamous black plastic spatula or sushi tray).

This would not be the first time that the use of flame retardants to meet flammability standards has resulted in health harm without proven fire-safety benefits. For example, an unfortunate long-time California furniture flammability standard did not reduce fire deaths. Meanwhile, one of the flame retardants most commonly used to meet that standard was linked to the loss of three to five IQ points among U.S. children and a 300% increase in the risk of dying from cancer. Since that standard was updated a decade ago to be met without flame retardants, furniture fires have remained minimal or even decreased.

“The best solution for both public health and fire safety is to prevent battery fires from occurring in the first place,” said co-author Arlene Blum, executive director of the Green Science Policy Institute. “Strategies like improving battery management systems and stopping the use of faulty batteries can prevent dangerous thermal runaway fires. This would save lives both from fires as well as from cancer and the many other health harms linked to flame retardants.”

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Journal

Environmental Science & Technology

DOI

10.1021/acs.est.4c10630 

Method of Research

Commentary/editorial

Article Title

High Potential Harm, Questionable Fire-Safety Benefit: Why Are Flame Retardants in Lithium-Ion Battery Enclosures?

Article Publication Date

28-Jan-2025

 

Archaeologists find ‘lost’ site depicted in the Bayeux Tapestry

Newcastle University

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Figure 1: The Bayeux Tapestry, showing King Harold riding to Bosham, where he attends church and feasts in a hall, before departing for France. © The Society of Antiquaries of London. 

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Credit: © The Society of Antiquaries of London.

Archaeologists have uncovered evidence that a house in England is the site of a lost residence of Harold, the last Anglo-Saxon King of England, and shown in the Bayeux Tapestry.

By reinterpreting previous excavations and conducting new surveys, the team from Newcastle University, UK, together with colleagues from the University of Exeter, believe they have located a power centre belonging to Harold Godwinson, who was killed in the Battle of Hastings in 1066.

Bosham, on the coast of West Sussex, is depicted twice in the Bayeux Tapestry, which famously narrates the Norman Conquest of England in 1066 when William, Duke of Normandy, challenged Harold for the throne. The Tapestry culminates in Williams’s victory at Hastings, but earlier in the artwork Bosham is shown as the place where Harold enjoys a feast in an extravagant hall before setting sail for France, and again on his return.

The location of Harold’s residence at Bosham has never been proved, although it has been suggested that a house in the village — now a private home — stands on the site.

Archaeological detective work

The team of archaeologists used a range of methods to unpick the early history of the property, including a geophysical survey of the surrounding area, assessment of standing remains, scrutiny of maps and records, and re-examination of evidence from excavations carried out in 2006 by West Sussex Archaeology.

This confirmed the existence of two previously unidentified Medieval buildings: one integrated into the current house and another in the garden. The crucial indication that the site had even earlier origins comes from the excavations in 2006, which identified a latrine within a large timber building. In the past decade or so archaeologists have begun to recognise a trend in England, beginning during the 10th century AD, for high-status houses to integrate toilets. The discovery of the latrine therefore indicated to the team that the timber building was of elite status, and almost certainly represents part of Harold’s residence illustrated on the Bayeux Tapestry. The hall was one part of a more extensive complex, that also included a church, which still survives.

The research, which is published in The Antiquaries Journal, was led by Dr Duncan Wright, Senior Lecturer in Medieval Archaeology at Newcastle University, who said: “The realisation that the 2006 excavations had found, in effect, an Anglo-Saxon en-suite confirmed to us that this house sits on the site of an elite residence pre-dating the Norman Conquest. Looking at this vital clue, alongside all our other evidence, it is beyond all reasonable doubt that we have here the location of Harold Godwinson’s private power centre, the one famously depicted on the Bayeux Tapestry.”

Professor Oliver Creighton of the University of Exeter, and Co-Investigator of the project, added: “The Norman Conquest saw a new ruling class supplant an English aristocracy that has left little in the way of physical remains, which makes the discovery at Bosham hugely significant — we have found an Anglo-Saxon show-home.”

The research at Bosham was carried out as part of the wider Where Power Lies project, with a team drawn from Newcastle University and the University of Exeter, and funded by the Arts and Humanities Research Council. The project aims to explore the origins and early development of aristocratic centres like Bosham, assessing for the first time the archaeological evidence for these sites across the entirety of England.

 

Part of the garden ruin at Bosham, confirmed as a medieval building by recent research.

Holy Trinity Church, Bosham, looking east.

Credit

Newcastle University

ENDS  

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Journal

The Antiquaries Journal

DOI

10.1017/S0003581524000350 

Article Title

Where Power Lies: Lordly Power Centres in the English Landscape c. 800–1200

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