Cambridge University

Current Phase: Fifth Health Check (5HC)

What is the purpose of EPIC-Norfolk?

The European Prospective Investigation of Cancer and Nutrition (EPIC) is a well-established observational study looking at the relationships between diet and lifestyle, and how these affect health. Between 1993 and 1997 the European arm of EPIC recruited over half a million men and women in ten European countries and 30,000 of those people lived in Norfolk (EPIC-Norfolk).

There have been four previous phases of the study and at each stage we have been broadening the focus of the diseases studied. Our aim is to look at the mechanisms which contribute to disease risk and what we can do to maintain health in later life.

Participant approaches

Participants have been participating in EPIC-Norfolk for over twenty years and we would like to continue to monitor their health over time. Before they decide whether or not to continue with this phase of the study, it is important they understand why the research is being carried out and what it will involve.

What is the rationale behind the EPIC-Norfolk Fifth Health Check (5HC)?

The aim of this phase of EPIC-Norfolk (5HC) is to investigate measures to understand better how health changes as individuals age, and further clarify the factors that influence the ageing process and risk of disease. We will be looking at cognitive function (including memory), the levels and patterns of physical activity undertaken by participants and relating this to change in function and body composition as we age.

There is evidence that lifestyle factors (such as diet, smoking and exercise) are associated with the risk of a number of the common conditions linked to ageing e.g. diabetes, heart disease and dementia. The EPIC-Norfolk study has collected over twenty years of lifestyle, biological and genetic information and is well placed to identify not only factors associated with decline but also those associated with the maintenance of health and functional ability in older age.

Who is organising and funding the 5HC?

This phase of the EPIC-Norfolk study is being sponsored by the University of Cambridge and is funded by the Medical Research Council. Prof. Nick Wareham, Director of the MRC Epidemiology Unit is the Chief Investigator leading this phase of EPIC-Norfolk, in collaboration with Prof. Kay-Tee Khaw, Head of Clinical Gerontology, both of the University of Cambridge.

The 5HC appointment

The 5HC appointment will be carried out at the EPIC-Norfolk Research Unit at the Norwich Community Hospital. This will be a single visit lasting approximately 2 -2 1/2 hours. The length of the appointment will vary between individuals, but we expect it to take no longer than 3 hours.

During the visit a number of procedures will be carried out as follows:

Informed consent

We will ensure that participants understand what is being asked of them as part of the appointment and time will be allowed to ask questions.

Measurement of diet and other lifestyle patterns

Participants will fill in a questionnaire relating to their medical history, usual diet, physical activity and general lifestyle.

Medication list

We ask participants to bring along a list of the current medications they are taking. These are either those prescribed by a GP, or supplements bought over the counter at the chemist or health food store.

Blood pressure

Two measurements of blood pressure will be taken, one at the beginning of the appointment and one towards the end.

Anthropometric measurements

Height and weight will be measured, along with waist and hip measurements.

Lung function

participant with spirometer

A measurement of lung function will be taken using a hand-held Spirometer to measure
the volume of air and mechanical characteristics of the lungs, along with the flow of air
through the airways.

Grip strength

participant with dynamometer

Loss of muscle strength occurs with age and this affects performance in carrying out
activities of daily living such as moving and lifting heavy objects, and opening bottles,
jars etc. Muscle strength will be measured using a hand-held dynamometer.


Participants will be asked to complete a set of simple balance tests to assess the ability to hold basic standing positions. We will also assess leg strength by asking participants to complete a series of chair stands and a timed walk over a set distance.

Cognition and memory function

Cognition is a range of processes that enable us to function and deal with the world around us. Measurements of cognition were first introduced to EPIC-Norfolk at the third health check (2004 - 2011). A number of measurements were conducted to assess a range of cognitive functions including memory, language, attention, learning and information retention. Some of the measurements being carried out in the 5HC will be familiar to participants as these will be repeat measures. Other measurements are new to this health check and will consist of a set of simple response tasks.

Body composition

dexa scan machine

Our ability to measure body composition has changed recently with the development of new technology. We have installed an iDEXA Scanner (DEXA = Dual Energy X-Ray Absorptiometry) and the body composition results produced give an accurate measurement of fat distribution. This method also determines the overall density of bones and measures overall fat, regional fat, and muscle mass.

This scan takes approximately 7-10 minutes and causes no discomfort. During the scan participants will be required to lie still on a bed whilst the scanner passes directly over them. At no time will individuals enter a tunnel for this scan.

Wearing of physical activity monitors (hip and wrist)

We will ask if participants would be willing to wear two activity monitors following their appointment. The devices look at the level of physical activity undertaken as they go about daily life.

wrist monitor on participant hip monitor on participant

Further information on the EPIC-Norfolk 5HC

If you would like further information on the EPIC 5HC then contact us using our free phone number 0800 616911. You can also e-mail the team using the contact us page on this website and we will get back to you as soon as we can, alternatively contact the Research Site Manager in Norwich on telephone number 01603 218165.