The EPIC-Norfolk prospective population study: biological and behavioural determinants of health and disease in an ageing population

欧洲诺福克癌症前瞻性调查的目的是帮助我们了解我们可以做些什么来改善健康，预防疾病和残疾。人们特别关注饮食和体力活动的模式。史诗-诺福克是一项针对30,000名生活在诺福克的男性和女性的研究，他们于1993年首次同意参加这项研究，年龄在40-79岁之间，其中25，00人参加了详细的健康检查，并一直在跟踪调查目前的健康状况。在1993-1997年最初的健康检查中，他们提供了关于他们的健康和生活方式的详细信息，包括非常详细的饮食和体力活动记录、病史和家族史，评估了包括血液胆固醇和血压在内的心脏病风险因素，并提供了供分析的血液和尿样。参与者继续参加反复的健康评估，并采取进一步措施评估骨骼健康、眼睛健康和视觉功能，以及身体和精神表现，最近一次是在2006年至2011年期间，并回答了关于他们健康的进一步问卷，包括压力和焦虑、睡眠模式和生活质量等心理社会因素。因此，我们能够跟踪这些中年老年人口20年来的健康经历，他们的健康水平与英国普通人口相当。我们能够了解心脏病和中风、个别癌症、骨质疏松性骨折、关节炎和糖尿病等重要疾病的风险因素，以及我们可以做些什么来降低这些疾病的风险。随着人口老龄化，人们越来越重视与老年人相关的结果，不仅是疾病的发生和死亡，还包括功能能力，包括身体功能、心理功能、视觉健康以及自我感觉的生活质量。现有的详细数据使我们不仅能够了解心理和身体在生物学上如何老化，而且了解饮食和体力活动等行为因素可能会影响这一过程，以及更广泛的环境决定因素(如社会经济地位、居住匮乏和获得绿地的机会)如何影响我们的健康。这是一项正在进行的人口研究，并有一个积极的参与者小组，就感兴趣的研究问题和未来的研究向我们提供建议。这项研究的结果已经为卫生政策和建议做出了贡献，其中包括卫生部的一项公共卫生倡议“小变化大不同”。我们现在已经能够对参与者进行基因图谱分析，以使我们能够确定我们的基因构成如何影响疾病风险，并将探索健康行为等环境因素如何改变遗传易感性。目前的应用是保持对参与者的跟踪和评估，以了解不同的人可能如何不同地变老，并进一步澄清哪些因素影响老龄化过程以及疾病和残疾的风险，以使干预措施能够改善健康和生活质量。

The aim of the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) is to help us understand what we can do to improve health and prevent disease and disability in later life. There is a particular focus on patterns of diet and physical activity. EPIC-Norfolk is a study of 30,000 men and women living in Norfolk who first agreed to take part in the study in 1993 when aged 40-79 years of whom 25,00 attended a detailed health examination and who have been followed up to the present for health. At the original health examination in 1993-1997 they gave detailed information on their health and lifestyle, including very detailed diet and physical activity records, medical and family history, had assessments of heart disease risk factors including blood cholesterol and blood pressure, and provided blood and urine samples for analysis. Participants have continued to take part in repeated health assessments with further measures to assess bone health, eye health and visual function, and physical and mental performance, the most recent being between 2006-2011, and answered further questionnaires about their health including psychosocial factors such as stress and anxiety, sleep patterns and quality of life. We have thus been able to track the health experiences over 20 years of this middle aged older population who are comparable to the British general population. We are able to obtain an understanding of the risk factors for important diseases such as heart diseases and strokes, individual cancers, osteoporotic fractures, arthritis and diabetes and what we can do to reduce risk of these diseases. As the population ages, there is increasing emphasis on outcomes relevant to older people, not just disease occurrence and death, but functional capacity including physical function, mental function, visual health as well as self perceived quality of life. The detailed data available enable us to understand not just how the mind and body age biologically, but behavioural factors such as diet and physical activity may affect this process and how wider environmental determinants such as socioeconomic status, residential deprivation and access to green space can influence our health. This is an ongoing population study and have an active participants' panel that advises us on research questions of interest and future studies. Results from the study have already contributed to health policy and recommendations including a Department of Health Public Health initiative"Small changes Big difference". We have now been able to conduct genetic profiling of the participants to enable us to identify how our genetic make up can influence risk of disease and will explore how environmental factors such as health behaviours may modify genetic susceptibility. The current application is to maintain follow up of participants and assessments to understand how different individuals may age differently and further clarify what factors influence the ageing process and risk of disease and disability to enable interventions to improve health and quality of life.