The European Prospective Investigation into Cancer and Nutrition (EPIC) is the largest ever in depth study of diet and health. By collecting detailed information from over half a million people, this study is helping to shed light on the complex relationship between a person’s lifestyle and their health.

Why was this work needed?

We know that diet choices affect health, for example the risk of developing cancer or heart disease. However, it’s a complex relationship so it can be difficult to pin down exactly how what you eat affects your health. Large scale studies of health and eating habits are necessary to see the patterns that could indicate the healthiest diets.

What happened?

The European Prospective Investigation into Cancer and Nutrition (EPIC) is the largest detailed study of diet and health ever undertaken. It has followed over half a million people from ten different European countries (including the UK) for almost 25 years.

The research covers a wide range of conditions including cancer, cardiovascular disease and Type 2 diabetes. It also looks more generally at the theme of how to stay healthy as we age.

Some of the studies are focussed on particular types of diet, for example the EPIC Oxford group recruited a large number of vegetarians so that they could see what happens to someone’s health, if anything, when they don’t eat meat.

What were the benefits?

EPIC supports a wide range of research to advance our understanding of how lifestyle influences disease. For example, EPIC researchers have demonstrated that eating a Mediterranean style diet, low in meat and high in fruit, vegetables and other plant foods, is associated with a reduction in risks for cardiovascular disease and some types of cancer. They have also demonstrated connections between a significant proportion of European cancer diagnoses and both obesity and excessive alcohol consumption.

Information of this kind is useful so that people can make informed lifestyle choices. It can also guide the advice that doctors give their patients, as well as backing up evidence-based Government and NHS policy.

What type of data was involved?

There are two UK cohorts involved in EPIC – EPIC Oxford and EPIC Norfolk.

Participants in EPIC Oxford were recruited via their GP practice or through postal recruitment and consented to follow up using their health records, which has been carried out via linkage to Hospital Episode Statistic (HES) data, Office of National Statistics mortality data and cancer registration data via NHS Digital. In addition, forty percent of participants provided a blood sample and consented to its use for medical research.

EPIC Norfolk participants were recruited via GP registers and were followed up through Hospital Episode Statistics (HES) data, death certification and cancer registration.

In both cohorts, participants provided additional information in lifestyle surveys and biological samples.

For part of EPIC Oxford, and for EPIC Norfolk, GPs initially wrote to individuals on their registers asking if they were willing to be contacted by researchers.

For the majority of participants in EPIC Oxford, invitation to recruitment was direct to people interested in vegetarian diets, for example through the memberships of the Vegetarian Society, the Vegan Society, and previous participation in the Oxford Vegetarian Study.

All those who agreed to participate were then contacted by researchers with information sheets explaining the study and were asked to consent to their data to be used in research and their health records being accessed.

Who funded and collaborated on this work?

The UK cohorts are funded by the Medical Research Council and Cancer Research UK.

Where can I go for more information?

EPIC study