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Assessment of the Overall Impact of Diet on Colorectal Cancer in Cambodia, with Special Emphasis on Endogenous and Exogenous Chemicals Sokneang In

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Assessment of the Overall Impact of Diet on Colorectal Cancer in Cambodia, with Special Emphasis on Endogenous and Exogenous Chemicals Sokneang In Assessment of the overall impact of diet on colorectal cancer in Cambodia, with special emphasis on endogenous and exogenous chemicals Sokneang In To cite this version: Sokneang In. Assessment of the overall impact of diet on colorectal cancer in Cambodia, with special emphasis on endogenous and exogenous chemicals. Food engineering. AgroParisTech, 2012. English. NNT : 2012AGPT0014. pastel-01058622 HAL Id: pastel-01058622 https://pastel.archives-ouvertes.fr/pastel-01058622 Submitted on 27 Aug 2014 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Doctorat ParisTech T H È S E pour obtenir le grade de docteur délivré par L’Institut des Sciences et Industries du Vivant et de l’Environnement (AgroParisTech) Spécialité : Science and processes of Food and bio-products présentée et soutenue publiquement par Sokneang IN Soutenue le 17 février 2012 Evaluation de l’impact global des régimes alimentaires et des composés chimiques endogènes et exogènes sur le cancer colorectal au Cambodge Assessment of the overall impact of diet on colorectal cancer in Cambodia, with special emphasis on endogenous and exogenous chemicals Directeur de thèse : Claude LAMBRE Co-encadrants de la thèse : Mostafa OULD ELHKIM, Philippe VERGER Jury Mme Valérie CAMEL, Professeur, UMR GENIAL, AgroParisTech Présidente M. Alain-Claude ROUDOT, Professeur, Université de Bretagne occidentale Rapporteur M. Bruno LE BIZEC, Professeur, Laberca, Oniris Rapporteur M. Claude LAMBRE, Directeur de recherche, Inserm Examinateur M. Mostafa OULD ELHKIM, Chef d’unité toxicologique et microbiologique, Afssaps Examinateur AgroParisTech REMERCIEMENTS Au Docteur Claude LAMBRE, Mon directeur de thèse, un grand merci pour sa participation dans la direction de cette thèse et pour son encadrement scientifique. Au Docteur Mostafa OULD ELHKIM Mon co-encadrant de thèse, pour sa participation dans la direction de cette thèse. Un grand merci pour son idée de ce projet de recherche et activité d’initiative sur cette thèse. Grace à lui, j’ai obtenu la finance de l’ambassade de France au Cambodge pour cette thèse. Au professeur Valérie CAMEL Au professeur Valérie CAMEL, pour toute l’aide et le soutien qu’elle m’a apportés, ainsi que pour les conseils qui ont permis de faciliter le travail. Un grand merci pour toute son aide et son important investissement dans les derniers moments de la thèse surtout sur la rédaction de la thèse. Un merci ne suffit pas au professeur Valérie, qui sans lui, sans sa patience et son expérience et ces encouragements, ce travail n’aura pas été réalisé. Au Docteur Philippe VERGER Mon co-encadrant de thèse, pour son soutien professionnel avec une approche scientifique toujours critique et pédagogique. Un grand merci aussi pour son important investissement, son conseil précieux tout au long de la thèse et aussi dans les derniers moments de rédaction. Au professeur Douglas RUTLEDGE Directeur du Laboratoire de Chimie Analytique d’AgroParisTech, de m’avoir accueillie au sein de son laboratoire. Je tiens aussi à le remercier pour les nombreux conseils qu’il m’a donnés surtout sur le traitement de donnée. Je remercie l’ensemble du jury, et plus particulièrement les rapporteurs, M. Alain-Claude ROUDOT, Professeur de l’Université de Bretagne Occidentale, et M. Bruno LE BIZEC, Directeur du Laboratoire d’Etude des Résidus et Contaminants dans les Aliments (LABERCA), ONIRIS, pour avoir accepté de juger de la qualité de ce travail. i Je remercie aussi tous les membres du laboratoire de chimie analytique d’AgroParisTech pour leur sympathie: Stéphanie, Camille, Delphine, Yann, Nathalie, Christophe et Stéphane. Un grand merci à tous mes amis, thésards du laboratoire, et tout particulièrement à Faten, Minale, et Radia. Je remercie également les communautés Cambodgiennes en France, particulière à Paris qui sont toujours me soutient le morale. Grace à eux je ne me sens pas toute seule dans le territoire français. Et enfin, un grand merci à toute ma famille qui m’a toujours soutenue durant ces années. ii Abstract From the projection in the future of international bodies, non-communicable diseases such as cancer may increase more than communicable diseases in developing countries. The highlight of this burden may be due to the changing of dietary patterns and lifestyle. Currently, the evolution of food consumption, consumption pattern and colorectal cancer is very worrying worldwide. It is a disease in economically ‘developed’ populations, and it is the second killer among other cancers; however, its incidence seems lower in poor countries. As the other developing countries, Cambodia has no system of food survey, no monitoring and control system of chemical substances, and also, there is no control and registration system for cancer. Thus, the objective of this research was to start the first observation of the relationship between dietary pattern and colorectal cancer in Cambodia. The general idea of the study was to identify the dietary patterns, and larger contributors to colorectal cancer in Cambodia, then to translate them into calories, nutrients and bioactive compounds, based on the existing database. Another goal was to assess the difference of dietary habit and cooking methods in the studied population that could lead to the production of colorectal carcinogens such as heterocyclic amines (HAs) and benzo[a]pyrene (BaP). In order to create the food consumption database needed for food risk assessment, a food consumption survey was conducted using 24-hour recall and food frequency questionnaire. A dietary assessment of HAs and BaP has been done, in order to establish a hierarchy of the importance of the risk that these substances represent to the health of this population. Dietary exposures to HAs and BaP were obtained by combining food consumption data, obtained from the individual food survey specially designed and carried out during this research, with the contamination data gathered from chemical analysis reported in the recent literature. The observation results have been compared with the toxicological reference values. The results show that dietary patterns in Cambodia have not changed yet to adapt to the Western diet, and contain higher levels of protected nutrients. The exposure to neoformed contaminants (HAs and BaP) was lower than the values reported among other Asian countries, and lowest as compared to the developed countries. The presence of endogenous compounds such as carbohydrates, dietary fibers, calcium and vitamin C, seems to protect the Cambodian population from colorectal cancer. Further research is needed to study the interaction of diet, lifestyle and the genetic background, and other factors as well. Key words: Cambodia, colorectal cancer, colorectal carcinogens, diet, dietary patterns, nutrients. iii Résumé Dans les pays en voie de développement, les évolutions prévues par les organismes internationaux montrent une progression beaucoup plus importante des maladies chroniques non transmissibles, comme le cancer, que des maladies transmissibles. Actuellement, la majorité des études montre que la tendance à l’augmentation de l'incidence et de la mortalité par cancer colorectal est plus marquée dans les sociétés riches que dans les sociétés pauvres. Dans les pays développés le cancer colorectal est au deuxième rang en ce qui concerne la mortalité par cancer et les changements dans les habitudes alimentaires et le mode de vie sont souvent mis en cause dans son développement. Bien que les données épidémiologiques soient rares, les populations de la plupart des pays asiatiques ne sont pas conscientes du risque grandissant que peut constituer pour eux le cancer colorectal. Comme les autres pays en développement, le Cambodge n'a pas de système d'enquête de consommation alimentaire, ni de système de surveillance ou de contrôle des substances chimiques, ni de système d’enregistrement, de contrôle ou de dépistage des cancers. L’objectif de cette recherche était de débuter la première observation d’une relation entre régime alimentaire et cancer colorectal au Cambodge. L’idée générale était d’identifier les aliments grands contributeurs des régimes alimentaires de la population cambodgienne, et de les traduire en calories, nutriments et composés bioactifs en se fondant sur les bases de données existantes. Une étude a également été menée sur les comportements de cette population, en ce qui concerne ses habitudes alimentaires et les modes de préparation des aliments susceptibles de produire des substances cancérigènes telles que des amines hétérocycliques (AH) et du benzo[a]pyrene (BaP). Pour réaliser ce travail de recherche, une enquête de consommation alimentaire a été effectuée à l'aide d’un rappel sur 24 heures et d’un questionnaire de fréquence alimentaire, afin de créer une base de données dédiée pour servir à l'évaluation des risques. Ensuite, une évaluation de l’exposition aux AH et BaP a été effectuée, afin d'établir une hiérarchie du risque que ces substances posent pour cette population d'étude ; celle-ci a été réalisée en croisant les données de consommation alimentaire,
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