The latest datasets from the EPIC-Norfolk Study – specifically FFQ3, FFQ4, and the 2024 Endpoint datasets – are now available for release. The Food Frequency Questionnaire (FFQ) datasets of FFQ3 and FFQ4 provide energy, nutrient and food group intakes, available from data collected at Health Check 3 and 5, respectively. This builds on the already available datasets of FFQ1 (Health Check 1) and FFQ2 (Health Check 2). The 2024 Endpoint dataset provides endpoints derived from mortality and hospital admissions data through data linkage, with follow-up now up to March 2024.

To access EPIC-Norfolk data, please fill in a data request form.

Open Science is an increasingly important movement across many disciplines. It involves initiatives and resources that make scientific research – including data, publications and software – freely accessible not just to researchers but to society as a whole.

The MRC Epidemiology Unit is committed to Open Science as a means to make our research more accessible, equitable, transparent and reproducible, and to the development of standards and platforms to facilitate this.

The Omicscience webserver is one of the Unit’s Open Science initiatives. Omicscience is a publicly available web resource that was set up in 2020 by Professor Claudia Langenberg and Dr Maik Pietzner at the MRC Epidemiology Unit, along with Dr Gabi Kastenmüller at Helmholtz Munich. Omicscience promotes clinical translation through rapid open access to results and resources from large scale proteomics, genomics and metabolomics studies. These range from the genetic architecture of human proteins that interact with the COVID-19 virus, to human genome variants that are associated with changes in the levels of individual metabolites (substances made or used when the body breaks down food, chemicals, or its own tissue).

A recent Science paper that used data from an MRC Epidemiology Unit study provides a good example of how Open Science platforms can support innovative research in practice.

Can taurine slow aging?

Earlier this month an international team of scientists led by Dr Vijay Yada at Columbia University in New York published a paper in Science reporting that studies in mice and monkeys indicate supplementation of the diet with taurine – an amino acid used in many energy drinks – may slow the aging process. Their findings received international media coverage, including in the Guardian, Time Magazine, The New York Times, El Pais, NBC News, and Hindustan Times, and provoked a lot of discussion.

But do their findings in animals apply to humans? One important question the authors asked was if there was any evidence that circulating taurine levels in humans are associated with age-related health conditions.

Examining the link between taurine and aging in EPIC-Norfolk

To examine this question the authors of the Science paper needed to access data from a large study where not only circulating levels of taurine and its metabolites have been measured, but also clinical risk factors such as BMI, waist-hip-ratio, type 2 diabetes prevalence and measures of inflammation and liver function.

They were able to analyse this data in almost 12,000 participants from the EPIC-Norfolk Study, a large epidemiological study established almost thirty years ago and now run by the MRC Epidemiology Unit. The researchers found that higher levels of circulating taurine and taurine metabolites were associated with several important biological markers of aging in EPIC-Norfolk, results that were consistent with taurine deficiency contributing to aging in humans.

Omicscience is Open Science

It is often still the case that researchers who want to analyse data from large epidemiological studies or clinical trials have to apply to the organisations who manage those studies, specifying what data they wish to analyse and what analyses they will run. The application is then reviewed and if approved the data is made available, taking care to ensure that the privacy and personal data of study participants is protected. This process can be time consuming for all parties involved.

However, rather than having to seek permission to access EPIC-Norfolk data, the researchers in this study were able to download summary statistics from the Omicscience webserver. This allowed them to quickly analyse profiles of circulating metabolites, and the links between them and markers of aging, among the 11,966 participants.  They did not need to ask us if they could download this data: all we asked is that they cite the associated Nature Medicine paper by Maik Pietzner et al.

Open Science at the MRC Epidemiology Unit

Professor Nick Wareham, Director of the MRC Epidemiology Unit, comments:

We believe that by making our research findings available in this way we can accelerate scientific discovery and the development of innovative therapies.”

Omicscience is not the Unit’s only Open Science initiative. Others include the Measurement Toolkit, providing resources or measurement of dietary intake, physical activity and energy expenditure, and anthropometry and body composition; and the Propensity to Cycle Tool (PCT), which provides an evidence base to inform cycling investment. And more than 95% of Unit-led publications are open access.

You can find links to several of our Open Science resources here.

Inhaled cortical steroids (ICS) can help patients manage asthma symptoms, and recent updates to asthma treatment guidelines have expanded recommendations for low-dose treatment. But concerns persist that ICS may reduce production of the steroid hormone cortisol in the body leading to adrenal suppression. While initial adrenal suppression symptoms are subtle, continued progression can lead to fatigue, headache, abdominal pain, vomiting and psychiatric symptoms.

Until now, studies of ICS and adrenal suppression have been limited and have produced conflicting findings.  To better understand the association between ICS and adrenal suppression, researchers from Brigham and Women’s Hospital and the EPIC-Norfolk Study, University of Cambridge conducted the largest metabolomic study of asthma to date. By analyzing the blood plasma  of 14,000 individuals from four independent study cohorts, the team identified 17 steroid metabolites that were reduced in individuals with asthma and found that, even among patients taking low-dose ICS, ICS usage was associated with reduced cortisol levels.

In the Nature Medicine paper reporting their results, the researchers also found significant associations between adrenal insufficiency symptoms, including fatigue and anemia, in asthma patients taking ICS treatment compared to those who were not.

Co-senior author Dr Jessica Lasky-Su, of the Channing Division of Network Medicine at Brigham and Women’s Hospital, said:

The use of ICS has been instrumental in reducing asthma exacerbations and improving overall quality of life. However, while their effectiveness should not be understated, our findings suggest that the risks of ICS usage must also be considered.”

Co-senior author Dr Claudia Langenberg, of the MRC Epidemiology Unit at the University of Cambridge, UK, and Berlin Institute of Health at Charité Universitätsmedizin, Germany, added:

Our work suggests that simple measures, such as regular cortisol monitoring and prescription of the lowest effective ICS dose, may help to mitigate the systemic side effects of ICS use”

Reference

• Priyadarshini Kachroo, Isobel D. Stewart, Rachel S. Kelly, Meryl Stav, Kevin Mendez, Amber Dahlin, Djøra I. Soeteman , Su H. Chu, Mengna Huang, Margaret Cote1, Hanna M. Knilhtilä, Kathleen Lee-Sarwar, Michael McGeachie, Alberta Wang, Ann Chen Wu, Yamini Virkud, Pei Zhang, Nicholas J. Wareham, Elizabeth W. Karlson, Craig E. Wheelock, Clary Clish, Scott T.
  Weiss, Claudia Langenberg, Jessica A. Lasky-Su. Metabolomic profiling reveals extensive adrenal suppression due to inhaled corticosteroid therapy in asthma. Nature Medicine 21 March 2022. DOI:10.1038/s41591-022-01714-5.

Image: Adult using an asthma inhaler. Credit: NIAID

In response to the coronavirus pandemic, the UK government has initiated six National Core Studies to conduct research into COVID-19.

EPIC-Norfolk has been invited to take part in one of these studies — the UK Longitudinal Linkage Collaboration (UK LLC).

The UK LLC will bring together information from longitudinal study volunteers with their routine records in a secure way. This will help researchers work towards improving health and wellbeing throughout and beyond COVID-19.

[Read more…]

A new study published today in Nature Medicine has identified key risk factors that increase the likelihood of individuals developing not only one but multiple non-communicable diseases, which include cardiovascular disease, cancer, chronic respiratory disease and diabetes.

The analysis of over 11,000 people found that rather than being due to chance, there are often underlying biological links in individuals with multimorbidity, which is defined as the co-occurrence of two or more long-term health conditions and is a growing public health challenge.

Multimorbidity, which affects about two thirds of people aged 65 years or over in the UK, impairs an individual’s quality of life over and above the cumulative burden from each individual disease. Understanding which diseases co-occur not at random but through common mechanisms can aid the identification of preventive strategies and lead to improvements in health care.

[Read more…]

Sarcopenia is characterized by loss of skeletal muscle mass and function during aging and affects more than 50 million people worldwide over the age of 50 years old. Skeletal muscle is involved in voluntary movement and structural support and so a reduction in amount and strength can lead to frailty, reduced quality of life, and death. It may also cause metabolic disturbances, affecting conversion of food to energy in the body, with implications for obesity and type 2 diabetes.

Vitamin C is a nutrient found in fruits and vegetables and can help defend the cells and tissues that make up the body from potentially harmful free radical substances. Unopposed these free radicals can contribute to the destruction of muscle, thus speeding up age-related decline.

This study examined the relationship between dietary and blood vitamin C and the estimated mass of muscle in individuals within a large group of older men and women. We found people with the highest amounts of vitamin C in their diet or blood had greater estimated muscle mass, compared to those with the lowest amounts. This study suggests that dietary vitamin C is relevant for muscle health in older people and may be useful for preventing age 40 related muscle loss. [Read more…]

The majority of patients who require treatment in an acute hospital setting are older people and many have multiple chronic conditions. Known as “multimorbidity”, many studies have shown it to predict an increased rate of mortality. However, few community-based studies have considered the predictors of future hospital admissions with multimorbidity.  This study explores the relationship between this condition and potentially modifiable lifestyle factors such as smoking, obesity, physical inactivity and low plant food intake.

The study found that in people initially free of disease:

  – age and male sex predicted subsequent incident hospital admissions with multimorbidity

  – smoking, body mass index > 30, physical inactivity and a diet low in fruit and vegetables were all independently associated with the condition

Modest differences in lifestyle may have the potential to mitigate the future burden of multimorbidity in the population. [Read more…]

Lack of physical activity and exercise are known risk factors for major health conditions, including cognitive impairments such as memory and concentration problems. However, evidence as to whether physical activity actually protects against cognitive decline has often been mixed and inconclusive. This study examined the relationship between physical activity during work and leisure separately and later life cognition. Participants were from the EPIC-Norfolk study, aged 40-79 years old at baseline, from a wide range of socioeconomic backgrounds and educational attainment.

The study found:

• Individuals with no qualifications were more likely to have physically active jobs, but less likely to be physically active outside of work.
• A physically inactive job (typically a desk-job) is associated with lower risk of poor cognition, irrespective of the level of education.  Those who remained in this type of work throughout the study period were the most likely to be in the top 10% of performers.
• Those in manual work had almost three times increased risk of poor cognition than those with an inactive job

[Read more…]

Men and women aged 40-79 are at significantly lower (25-27%) risk of long or frequent hospital admissions if they do some form of physical activity, a new paper from the EPIC-Norfolk study suggests.

Inactive participants in the study spent just over 4 days more in hospital over the next ten years than those who did at least some physical activity, whether for work or leisure. And similar results were observed 10 years later when the same participants were 50-90 years old.

The study, by researchers at the University of Cambridge’s Department of Public Health and Primary Care and MRC Epidemiology Unit, calculates that for every inactive person who started to take at least some exercise, the NHS could save around £247 per year. This would equate to around 7% of the UK’s per capita health expenditure. [Read more…]

A Mediterranean diet is characterised by high intake of plant-based foods (fruit, vegetables, nuts and cereals) and olive oil, moderate intake of fish and alcohol and low intake of dairy products and red and processed meat.  Studies have shown that many of these dietary components of the Mediterranean diet play an important role in bone and muscle health.  We proposed that the additive effects of these individual dietary components would have a greater impact on musculoskeletal health.  The aim of the study was therefore to examine associations between adherence to a Mediterranean diet and key indicators of bone and muscle status, including fracture incidence, bone density and muscle mass. [Read more…]