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Observational Cohorts Used in NiaHealth Research

Methodology & Approach
Date:
March 18, 2026
Written by:
Emma Billington, MD
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Where data from observational cohort studies is likely to be useful for answering a research question, the NiaHealth research team focuses on studies conducted in large, well-described cohorts. Several relevant cohorts are described below.

Well-described Canadian and international cohorts

Canadian Health Measures Study (CHMS)

Tremblay et al., 2007

  • Canadian national health survey
  • ~5,000–6,000 Canadians from the general population age 3–79 recruited for each cycle
  • First cycle in 2007, currently on cycle 8
  • Repeated cross-sectional design rather than longitudinal (new participants recruited for each cycle)
  • Health/lifestyle questionnaires, physical measurements, biospecimen samples, environmental measures

Relevant outcomes: Prevalence of chronic conditions (obesity, hypertension, diabetes and others), exposure biomonitoring, development of reference standards and norms

Canadian Partnership for Tomorrow Project (CanPath)

Dummer et al., 2018

  • Pan-Canadian cohort
  • 307,000 adults from the general population age 30–74 recruited between 2008–2015
  • Health/lifestyle questionnaires, physical measurements, biospecimen samples (half of participants)

Relevant outcomes: Passive surveillance through health records. Aim is to study how genetic, environmental, and lifestyle factors contribute to chronic diseases (cancer, cardiovascular disease, diabetes, etc).

Canadian Longitudinal Study on Aging (CLSA)

Raina et al., 2009

  • Canadian national cohort focusing on aging over 20 years of follow-up
  • 51,338 adults from the general population age 45–85 enrolled between 2010–2015
  • Health/lifestyle questionnaires
  • ~30,000 participants underwent physical exams and provided blood and urine samples

Relevant outcomes: Follow-up every 3 years. Tracks a wide range of health outcomes relevant to aging, including chronic disease incidence (cardiovascular, cancer, cognitive decline), disability, and frailty.

National Health and Nutrition Examination Survey (NHANES)

Zipf et al., 2013

  • US nationwide population-based survey
  • Running since 1971; since 1999 the survey has included all ages, data released in biennial cycles with ~10,000 participants recruited in each cycle
  • Repeated cross-sectional design rather than longitudinal (new participants recruited for each cycle), but some historical NHANES cohorts have been followed longitudinally through separate initiatives
  • Health/lifestyle questionnaires, physical measurements, biospecimen samples, environmental measures
  • Some cycles include grip strength, treadmill exercise, and DXA

Relevant outcomes: Provides national prevalence estimates for numerous conditions, including obesity, diabetes, hypertension, dyslipidemia. Also covers environmental exposures, chronic disease risk factors, and forms basis for national reference standards.

All of Us Research Program

All of Us Research Program Investigators et al., 2019

  • US cohort launched as part of the NIH Precision Medicine Initiative
  • >500,000 adults from the general population enrolled since 2018; indefinite follow-up planned
  • Health/lifestyle questionnaires, physical measurements, biospecimen samples (including genetic material), electronic medical record data, wearables data

Relevant outcomes: Aim is to identify how individual variation in genetics, lifestyle, and environment influence health and disease. Wide range of outcomes including common chronic diseases and pharmacogenomic responses.

Framingham Heart Study (FHS)

Dawber & Kannel, 1958

  • US long-term cohort
  • Began in 1948 with 5,209 adults from the general population, extended with a second-generation offspring cohort in 1971 (n=5,124) and a third generation cohort in 2002 (n~3,900); over 15,000 participants in total
  • Participants undergo follow-up examinations every 2–6 years
  • Health/lifestyle questionnaires, physical measurements, biospecimen samples (including genetic material), echocardiography, advanced imaging

Relevant outcomes: Initially focused on risk factors for cardiovascular disease but has broadened to other aspects of health. Outcomes include cardiovascular events, cancer, cognitive decline; now exploring genomics and novel risk factors.

Multi-Ethnic Study of Atherosclerosis (MESA)

Bild et al., 2002

  • US cohort focusing on cardiovascular disease development
  • >6,800 adults from the general population age 45–84 recruited since 2000; focus on recruitment from four self-identified racial groups (White, Black, Hispanic, Chinese-American)
  • Serial follow-up exams every 1–2 years in first decade, now less frequent
  • Health/lifestyle questionnaires, physical measurements, biospecimen samples (including genetic material), CAC scoring, cardiac MRI, carotid ultrasound

Relevant outcomes: Primary outcomes are cardiovascular events, heart failure, and diabetes.

Prospective Urban Rural Epidemiology (PURE) Study

Teo et al., 2009

  • Global prospective cohort
  • ~500,000 participants (~225,000 with detailed data) from over 1,000 rural and urban communities in 27 countries (including Canada) recruited since 2002; follow-up planned until at least 2030
  • Collects data on the impact of modernization, urbanization and lifestyle change on health
  • Health/lifestyle questionnaires, physical measurements, biospecimen samples (including genetic material)

Relevant outcomes: Major events such as myocardial infarction, stroke, cancer, injuries, deaths, other chronic diseases.

UK Biobank

Sudlow et al., 2015

  • UK biomedical cohort
  • >500,000 adults from the general population age 40–69 recruited between 2006–2010
  • Health/lifestyle questionnaires, physical measurements (including fitness tests), biospecimen samples (including genetic material), some accelerometer data, multi-modal imaging (MRI of brain/heart/body, DNA); data linked to participants’ NHS records

Relevant outcomes: NHS digital records provide data on hospital admissions, cancer diagnoses, deaths, primary care.

European Prospective Investigation into Cancer and Nutrition (EPIC)

Riboli et al., 2002

  • Pan-European cohort
  • >520,000 adults age 35–70 recruited between 1992 and 2000 across 10 European countries; ongoing follow-up for over 25 years
  • Health/lifestyle questionnaires (focused on nutrition), physical measurements, biospecimen samples (including genetic material)

Relevant outcomes: Data linked to regional and national cancer registries, death registries, and hospital discharge databases to determine cancer incidence, causes of death and other disease outcomes.

All of Us Research Program Investigators, Denny, J. C., Rutter, J. L., Goldstein, D. B., Philippakis, A., Smoller, J. W., Jenkins, G., & Dishman, E. (2019). The “All of Us” Research Program. The New England Journal of Medicine, 381(7), 668–676. https://doi.org/10.1056/NEJMsr1809937

Bild, D. E., Bluemke, D. A., Burke, G. L., Detrano, R., Diez Roux, A. V., Folsom, A. R., Greenland, P., Jacob, D. R., Jr, Kronmal, R., Liu, K., Nelson, J. C., O’Leary, D., Saad, M. F., Shea, S., Szklo, M., & Tracy, R. P. (2002). Multi-Ethnic Study of Atherosclerosis: objectives and design. American Journal of Epidemiology, 156(9), 871–881. https://doi.org/10.1093/aje/kwf113

Dawber, T. R., & Kannel, W. B. (1958). An epidemiologic study of heart disease: the Framingham study. Nutrition Reviews, 16(1), 1–4. https://doi.org/10.1111/j.1753-4887.1958.tb00605.x

Dummer, T. J. B., Awadalla, P., Boileau, C., Craig, C., Fortier, I., Goel, V., Hicks, J. M. T., Jacquemont, S., Knoppers, B. M., Le, N., McDonald, T., McLaughlin, J., Mes-Masson, A.-M., Nuyt, A.-M., Palmer, L. J., Parker, L., Purdue, M., Robson, P. J., Spinelli, J. J., … with the CPTP Regional Cohort Consortium. (2018). The Canadian Partnership for Tomorrow Project: a pan-Canadian platform for research on chronic disease prevention. Journal de l’Association Medicale Canadienne [Canadian Medical Association Journal], 190(23), E710–E717. https://doi.org/10.1503/cmaj.170292

Raina, P. S., Wolfson, C., Kirkland, S. A., Griffith, L. E., Oremus, M., Patterson, C., Tuokko, H., Penning, M., Balion, C. M., Hogan, D., Wister, A., Payette, H., Shannon, H., & Brazil, K. (2009). The Canadian longitudinal study on aging (CLSA). La Revue Canadienne Du Vieillissement [Canadian Journal on Aging], 28(3), 221–229. https://doi.org/10.1017/S0714980809990055

Riboli, E., Hunt, K. J., Slimani, N., Ferrari, P., Norat, T., Fahey, M., Charrondière, U. R., Hémon, B., Casagrande, C., Vignat, J., Overvad, K., Tjønneland, A., Clavel-Chapelon, F., Thiébaut, A., Wahrendorf, J., Boeing, H., Trichopoulos, D., Trichopoulou, A., Vineis, P., … Saracci, R. (2002). European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutrition, 5(6B), 1113–1124. https://doi.org/10.1079/PHN2002394

Sudlow, C., Gallacher, J., Allen, N., Beral, V., Burton, P., Danesh, J., Downey, P., Elliott, P., Green, J., Landray, M., Liu, B., Matthews, P., Ong, G., Pell, J., Silman, A., Young, A., Sprosen, T., Peakman, T., & Collins, R. (2015). UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Medicine, 12(3), e1001779. https://doi.org/10.1371/journal.pmed.1001779

Teo, K., Chow, C. K., Vaz, M., Rangarajan, S., Yusuf, S., & PURE Investigators-Writing Group. (2009). The Prospective Urban Rural Epidemiology (PURE) study: examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. American Heart Journal, 158(1), 1–7.e1. https://doi.org/10.1016/j.ahj.2009.04.019

Tremblay, M., Wolfson, M., & Connor Gorber, S. (2007). Canadian Health Measures Survey: rationale, background and overview. Rapports Sur La Sante [Health Reports], 18 Suppl, 7–20. https://pubmed.ncbi.nlm.nih.gov/18210866/

Zipf, G., Chiappa, M., Porter, K. S., Ostchega, Y., Lewis, B. G., & Dostal, J. (2013). National health and nutrition examination survey: plan and operations, 1999-2010. Vital and Health Statistics. Ser. 1, Programs and Collection Procedures, 56, 1–37. https://pubmed.ncbi.nlm.nih.gov/25078429/

Our research standards & process

At NiaHealth, we do not make decisions first and look for evidence later. The entire process — from which tests we offer, to how we interpret results, to the recommendations we make — is grounded in clinical evidence from the ground up. Our research team is continually reviewing the literature to make sure the information we provide reflects current medical evidence. And frankly, we don’t think “trust us” should be the standard here. We think you should be able to see the process for yourself. Learn more here.

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