The Fourth Health Check (4HC) ran between September 2012 and March 2016 and a total of 5695 participants attended an appointment during this time. The 4HC appointment lasted on average 1 hour 20 minutes.
The aim of the 4HC was to investigate the levels and patterns of physical activity undertaken by our participants and to relate this to body composition. The data collected will be used towards developing interventions aimed at keeping people more active as they get older.
Previous research has indicated that if fat is carried mainly around the waist, a person is considered to be more at risk of developing
obesity-related health concerns such as diabetes. Therefore, we are also interested in the differences between “apple” and “pear” body shapes.
Many of the tests carried out in the 4HC were repeat measures carried out in previous phases of EPIC. This phase introduced a total body iDEXA scan (DEXA = Dual Energy X-Ray Absorptiometry) which made it possible to measure body composition more accurately. Specifically, this scan enabled us to look at total body fat distribution (overall and regional fat and muscle mass), it also produced results for total bone mineral density.
Some of our participants attending a 4HC were also asked to wear an activity monitor along with a GPS receiver for 7 days following their appointment. These aimed to better assess day to day activity levels and to provide information on the way in which this activity was undertaken.
We also asked participants to complete a questionnaire relating to their medical history, usual diet, physical activity and general lifestyle. At the appointment participants were also given a health perception questionnaire to fill in. We also introduced a family questionnaire aimed at determining the feasibility of carrying out future studies involving the children and grandchildren of our original EPIC participants.
4HC Participant Approaches
Unfortunately, we are unable to see all participants at all health checks. This is due to funding and time limitations associated with each phase. However, EPIC participants not approached for this phase will be prioritised and approached at the beginning of the Fifth Health Check.
Third Health Check Pilot Study
The third health check (3HC) was piloted with participants from Attleborough. The pilot ran from September 2004 through to January 2006 as the EPIC-Norfolk 2004 Study. The pilot study provided a valuable testing ground for a third health check and was used to identify areas of interest and methods of measurement in order to look at aspects of healthy ageing. The positive response to the pilot study contributed to the decision to embark on a full third health check.
At the time of the 3HC, the EPIC-Norfolk participants fell into the 50-92 age group. It was therefore important to have more information on diseases and health endpoints of relevance to the older population. We wanted to see how these may impact on our daily lives making us more prone to serious illnesses such as cancer, heart disease and diabetes. Repeat assessments in this phase included a follow-up health questionnaire, a 7-day food diary and the same physical measures taken at the first and second health checks: height, weight, hip, waist and chest measurements, blood pressure, lung capacity, heel-bone ultrasound, percentage body fat and a blood sample. New assessments in this phase included memory and cognition testing and a thorough eye examination using some of the latest technology in optic nerve and retinal photography. We looked in particular at glaucoma and age related macular degeneration, which are the two major causes of irreversible blindness in this country. The average 3HC appointment lasted 2.5 hours, which is longer than previous health checks and this was due to this check being far more comprehensive than those carried out previously.
The EPIC third health check ran until end of 2011 and was attended by 8623 participants. The number of participants attending this health check was lower than previous phases. This was not due to fewer people being willing or able to attend but due to the nature of the health check and the vast amount of data being collected at this phase. Unfortunately we were unable to see all the participants at the 3HC due to funding constraints, however, participants not approached for the third health check were prioritised at the beginning of the Fourth Health Check phase.