The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a

Europe Europe is a continent located entirely in the Northern Hemisphere and mostly in the Eastern Hemisphere. It is bordered by the Arctic Ocean to the north, the Atlantic Ocean to the west, the Mediterranean Sea to the south, and Asia to the east ...

-wide prospective

cohort study A cohort study is a particular form of longitudinal study that samples a Cohort (statistics), cohort (a group of people who share a defining characteristic, typically those who experienced a common event in a selected period, such as birth or gra ...

of the relationships between diet and cancer, as well as other chronic diseases, such as

cardiovascular disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...

. With over half a million participants, it is the largest study of diet and disease to be undertaken. EPIC is coordinated by the

International Agency for Research on Cancer The International Agency for Research on Cancer (IARC; ) is an intergovernmental agency forming part of the World Health Organization of the United Nations. Its role is to conduct and coordinate research into the causes of cancer. It also cance ...

(IARC), part of the

World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...

, and funded by the "Europe Against Cancer" programme of the

European Commission The European Commission (EC) is the primary Executive (government), executive arm of the European Union (EU). It operates as a cabinet government, with a number of European Commissioner, members of the Commission (directorial system, informall ...

as well as multiple nation-specific grants and charities. 521,457 healthy adults, mostly aged 35–70 years, were enrolled in 23 centres in ten European countries:

Denmark Denmark is a Nordic countries, Nordic country in Northern Europe. It is the metropole and most populous constituent of the Kingdom of Denmark,, . also known as the Danish Realm, a constitutionally unitary state that includes the Autonomous a ...

(11%),

France France, officially the French Republic, is a country located primarily in Western Europe. Overseas France, Its overseas regions and territories include French Guiana in South America, Saint Pierre and Miquelon in the Atlantic Ocean#North Atlan ...

(14%),

Germany Germany, officially the Federal Republic of Germany, is a country in Central Europe. It lies between the Baltic Sea and the North Sea to the north and the Alps to the south. Its sixteen States of Germany, constituent states have a total popu ...

(10%),

Greece Greece, officially the Hellenic Republic, is a country in Southeast Europe. Located on the southern tip of the Balkan peninsula, it shares land borders with Albania to the northwest, North Macedonia and Bulgaria to the north, and Turkey to th ...

(5%),

Italy Italy, officially the Italian Republic, is a country in Southern Europe, Southern and Western Europe, Western Europe. It consists of Italian Peninsula, a peninsula that extends into the Mediterranean Sea, with the Alps on its northern land b ...

(9%),

The Netherlands , Terminology of the Low Countries, informally Holland, is a country in Northwestern Europe, with Caribbean Netherlands, overseas territories in the Caribbean. It is the largest of the four constituent countries of the Kingdom of the Nether ...

(8%),

Norway Norway, officially the Kingdom of Norway, is a Nordic countries, Nordic country located on the Scandinavian Peninsula in Northern Europe. The remote Arctic island of Jan Mayen and the archipelago of Svalbard also form part of the Kingdom of ...

(7%),

Spain Spain, or the Kingdom of Spain, is a country in Southern Europe, Southern and Western Europe with territories in North Africa. Featuring the Punta de Tarifa, southernmost point of continental Europe, it is the largest country in Southern Eur ...

(8%),

Sweden Sweden, formally the Kingdom of Sweden, is a Nordic countries, Nordic country located on the Scandinavian Peninsula in Northern Europe. It borders Norway to the west and north, and Finland to the east. At , Sweden is the largest Nordic count ...

(10%) and the

United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...

(17%). One UK centre (Oxford) recruited 27,000

vegetarian Vegetarianism is the practice of abstaining from the Eating, consumption of meat (red meat, poultry, seafood, insects as food, insects, and the flesh of any other animal). It may also include abstaining from eating all by-products of animal slau ...

s and

vegan Veganism is the practice of abstaining from the use of animal products and the consumption of animal source foods, and an associated philosophy that rejects the commodity status of animals. A person who practices veganism is known as a ve ...

s; this subgroup forms the largest study of this dietary group. Recruitment to the study took place between 1993 and 1999, and follow-up is planned for at least ten years, with repeat interview/questionnaires every three to five years. The main prospective data collected are standardised dietary

questionnaire A questionnaire is a research instrument that consists of a set of questions (or other types of prompts) for the purpose of gathering information from respondents through survey or statistical study. A research questionnaire is typically a mix of ...

s (self-administered or interview-based), seven-day food diaries, blood samples and

anthropometric Anthropometry (, ) refers to the measurement of the human individual. An early tool of physical anthropology, it has been used for identification, for the purposes of understanding human physical variation, in paleoanthropology and in various a ...

measurements, such as

body mass index Body mass index (BMI) is a value derived from the mass (Mass versus weight, weight) and height of a person. The BMI is defined as the human body weight, body mass divided by the square (algebra), square of the human height, body height, and is ...

and waist-to-hip ratio. Additionally, the GenAir case-control study is studying the relationship of

passive smoking Passive smoking is the inhalation of tobacco smoke, called passive smoke, secondhand smoke (SHS) or environmental tobacco smoke (ETS), by individuals other than the active Tobacco smoking, smoker. It occurs when tobacco smoke diffuses into the ...

and

air pollution Air pollution is the presence of substances in the Atmosphere of Earth, air that are harmful to humans, other living beings or the environment. Pollutants can be Gas, gases like Ground-level ozone, ozone or nitrogen oxides or small particles li ...

with cancers and

respiratory disease Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, ...

s. Up to 2004, there were over 26,000 new cases of cancer recorded among participants, with the most common being cancers of the breast, colorectum, prostate and lung. Current analyses are focusing particularly on

stomach The stomach is a muscular, hollow organ in the upper gastrointestinal tract of Human, humans and many other animals, including several invertebrates. The Ancient Greek name for the stomach is ''gaster'' which is used as ''gastric'' in medical t ...

, colorectal,

breast The breasts are two prominences located on the upper ventral region of the torso among humans and other primates. Both sexes develop breasts from the same embryology, embryological tissues. The relative size and development of the breasts is ...

prostate The prostate is an male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemica ...

and

lung The lungs are the primary Organ (biology), organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the Vertebral column, backbone on either side of the heart. Their ...

cancers. The different dietary patterns in the different countries should enable reliable associations to be made between particular diets and cancers. The analysis of stored blood samples should also allow dissection of genetic factors involved in cancers, as well as the effects of

hormone A hormone (from the Ancient Greek, Greek participle , "setting in motion") is a class of cell signaling, signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physio ...

s and hormone-like factors.

Key findings

The study and its analysis is ongoing, bu
key results
of the study retrieved in 2008 are: *Lowered sodium from

salt In common usage, salt is a mineral composed primarily of sodium chloride (NaCl). When used in food, especially in granulated form, it is more formally called table salt. In the form of a natural crystalline mineral, salt is also known as r ...

intake, high potassium from

fruit In botany, a fruit is the seed-bearing structure in flowering plants (angiosperms) that is formed from the ovary after flowering. Fruits are the means by which angiosperms disseminate their seeds. Edible fruits in particular have long propaga ...

and vegetable consumption promote healthy blood pressure levels *High physical activity, involving some high impact activities is a good indicator of longevity and low risk of bone fractures *High dietary fibre protects against

bowel cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel ...

*Obesity increases a number of cancer risks *High levels of sex hormones increase risk of breast cancer *Increased fat intake increases the risk of breast cancer *Increases in eating fruit and vegetables reduces the risk from all causes of an early death *High blood glucose levels are associated with increased risk of heart disease *The combined impact of four behaviours – not smoking, being physically active, moderate alcohol intake and the consumption of at least five fruit and vegetable servings a day – was estimated to amount to 14 additional years of life (Khaw ''et al.'' 2008) Subsequent findings from 2012 and 2013 are: *Dietary

flavonoid Flavonoids (or bioflavonoids; from the Latin word ''flavus'', meaning yellow, their color in nature) are a class of polyphenolic secondary metabolites found in plants, and thus commonly consumed in the diets of humans. Chemically, flavonoids ...

intake is associated with reduced gastric carcinoma risk in women but not men *Regular consumption of

processed meat Processed meat is considered to be any meat that has been modified in order to either improve its taste or to extend its shelf life. Methods of meat processing include salting, curing, fermentation, smoking, and the addition of chemical prese ...

increases the risk of cardiovascular diseases and death from cancer Subsequent findings from 2021 are: * Dietary factors associated with reduced cancer mortality included raw vegetable intake; dietary fiber intake; the Mediterranean diet; other diet patterns included low meat eaters, vegetarians/vegans, or fish eaters.

Notes

Selected papers

Review * Primary * * * * * * * * *{{cite journal , vauthors=Verheus M, Peeters PH, Rinaldi S, etal , title=Serum C-peptide levels and breast cancer risk: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) , journal=Int. J. Cancer , volume=119 , issue=3 , pages=659–67 , date=August 2006 , pmid=16572422 , doi=10.1002/ijc.21861, hdl=1874/19269 , s2cid=25233808 , url=https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-859271 , hdl-access=free

External links

EPIC project (IARC)EPIC study (CR UK)EPIC (Oxford centre)
(preferentially recruited vegetarians & vegans)
EPIC-Norfolk (UK Norfolk cohort)
Epidemiological study projects Nutritional science Oncology