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

诺福克欧洲癌症前瞻性调查（EPIC-Norfolk）的目的是帮助我们了解我们可以做些什么来改善健康，预防晚年的疾病和残疾。特别关注饮食和身体活动的模式。EPIC-Norfolk是一项针对3万名居住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，当时年龄在40-79岁之间，其中25,000人参加了详细的健康检查，并一直随访到现在。在1993-1997年的首次健康检查中，他们提供了详细的健康和生活方式信息，包括非常详细的饮食和体育活动记录、医疗和家族史，评估了包括血液胆固醇和血压在内的心脏病风险因素，并提供了血液和尿液样本供分析。参与者继续参加反复的健康评估，进一步采取措施评估骨骼健康、眼睛健康和视觉功能以及身心表现，最近一次是在2006-2011年之间，并进一步回答了关于其健康状况的问卷，包括压力和焦虑等心理社会因素、睡眠模式和生活质量。因此，我们能够追踪这些中年老年人20多年来的健康经历，他们与英国普通人口相当。我们能够了解重要疾病的风险因素，如心脏病和中风、个体癌症、骨质疏松性骨折、关节炎和糖尿病，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有关的结果，不仅是疾病的发生和死亡，而且包括身体功能、心理功能、视觉健康以及自我感知的生活质量在内的功能能力。现有的详细数据不仅使我们能够了解身心在生物学上是如何衰老的，而且饮食和体育活动等行为因素也可能影响这一过程，以及社会经济地位、居住剥夺和获得绿色空间等更广泛的环境决定因素如何影响我们的健康。这是一项正在进行的人口研究，有一个积极的参与者小组，就我们感兴趣的研究问题和未来的研究提出建议。这项研究的结果已经为卫生政策和建议做出了贡献，包括卫生部公共卫生倡议“小变化大差异”。我们现在已经能够对参与者进行基因分析，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，以了解不同个体的年龄差异，并进一步阐明影响老龄化过程和疾病和残疾风险的因素，从而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.