A quarter of a million people in Norfolk have been tracked for decades, giving blood samples and undergoing repeated health checks, to reveal why some people age well while others do not. This matters because most research focuses on disease, not on the biological and genetic factors that allow people to maintain physical strength, sharp thinking, and independence into old age. The EPIC-Norfolk study has already collected detailed data on diet, activity, body composition, cognition, and a wide range of blood biomarkers. Now, by expanding genome-wide analysis to the entire cohort, researchers can link genetic variation directly to measures of healthy ageing—such as grip strength, walking speed, and muscle mass—rather than only to disease outcomes. If this work succeeds, it could identify the specific genes and biological pathways that protect against frailty and cognitive decline. That knowledge might eventually guide the development of interventions—drugs, dietary advice, or lifestyle recommendations—that help people stay healthier for longer. The project is fundamentally about understanding the biology of ageing, not about an immediate product or treatment. Similar long-term population studies have previously uncovered unexpected links between inflammation, nutrition, and chronic disease, showing how fundamental genetic research can quietly reshape medical thinking.
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The EPIC-Norfolk study is a prospective population-based cohort study which recruited 25,000 men and women aged 40-79 years at baseline between 1993 and 1997 from 35 participating general practices in Norfolk. Individuals provided information about lifestyle behavioural factors including diet and activity and attended for a baseline health check including the provision of blood samples for concurrent and future analysis. They provided consent to future linkage to medical record information and a wide range of follow-up studies for different disease endpoints (including incident T2DM) have subsequently been undertaken (see www.srl.cam.ac.uk/epic). From 1998, participants were re-invited to attend a second health check at which baseline measures were repeated and additional measurements were added including ultrasound measurement of heel bone density and impedance assessment of total body fat. Between 2006 and 2011 a third health check was completed in which the focus of attention was on functional capacity with assessment of cognition, visual function and physical performance. A fourth health check is currently underway in which assessments of functional capacity are being repeated (grip strength, balance test, gait speed and chair stand) together with objective measurement of body composition including lean muscle mass by DEXA and physical activity and sedentary behaviour by accelerometry (Actigraph). DNA has been extracted from all EPIC participants and stored blood has been analysed for an extensive range of classical and novel biomarkers including measures of inflammation, sex hormones and nutrition (e.g. plasma vitamins C, and D, and carotenoids). A genomewide association study was originally conducted with EPIC-Norfolk in a case-cohort study design for obesity (N= 3552) including a random sub-cohort of 2417 individuals and 1135 obese people. The GWAS coverage is now being expanded to the entire EPIC Norfolk cohort funded by MRC.
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