Nutritional Epidemiology in EPIC

Nutritional epidemiology is the study of human health in relation to nutrition. What started as a small subdiscipline of epidemiology some decades ago has grown into a branch with major public health importance. Now that nutritional deficiencies have been dramatically reduced in most developed countries, the purpose of nutritional recommendations has been the prevention of diseases.

The EPIC study has collected data on dietary habits of more than 500 000 people in 10 European countries with country-specific questionnaires. A 24-hour dietary recall per individual was collected for approximately 37 000 study participants, to correct the diet—disease associations for measurement errors. The availability of biological specimens for the majority of the study population allows for studies to measure pre-diagnostic nutritional biomarkers to use as additional measures of exposure. The collection of detailed data on other lifestyle factors, such as smoking and physical activity, can be used to correct diet—disease associations for potential confounding bias.

As EPIC is one of the largest prospective cohort studies on nutrition, hundreds of studies on nutritional epidemiology have been published from the EPIC study, many of which detected novel associations or provided substantial evidence for existing hypotheses. Although most published studies on nutritional epidemiology from the EPIC study used data from the dietary questionnaires, an increasing number of papers in the past decade made use of nutritional biomarkers as exposure assessment.

Selected publications

1. Bingham SA et al. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet. 2003 May 3;361(9368):1496-501. PMID: 12737858


2. Norat T et al. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition. J Natl Cancer Inst. 2005 Jun 15;97(12):906-16. PMID: 15956652


3. Jenab M et al. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations: a nested case-control study. BMJ. 2010 Jan 21;340:b5500. PMID: 20093284


4. Allen NE et al. Animal foods, protein, calcium and prostate cancer risk: the European Prospective Investigation into Cancer and Nutrition. Br J Cancer. 2008 May 6;98(9):1574-81. PMID: 18382426


5. Johansson M et al. Serum B vitamin levels and risk of lung cancer. JAMA. 2010 Jun 16;303(23):2377-85 PMID: 20551408


6. Gonzalez CA Riboli E. Diet and cancer prevention: contributions from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Eur J Cancer. 2010 Sep;46(14):2555-62 PMID: 20843485


7. Crowe FL et al. Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Eur Heart J. 2011 May;32(10):1235-43. PMID: 21245490


8. Rohrmann S et al. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition. BMC Med. 2013 Mar 7;11:63. PMID: 23497300


9. Schütze M et al. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ. 2011 Apr 7;342:d1584. PMID: 21474525