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Agnès Giboreau: “Taste is a construction”

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Agnès Giboreau is director of the research center at the Institut Paul-Bocuse. On May 31, the “Food and cancer” evening for the general public takes place at the Cité de la gastronomie. The opportunity to explain how the center tries to help cancer patients, whose chemotherapy deteriorates taste and smell, to rediscover the pleasure of eating.

Having a research center in a structure like the Paul-Bocuse Institute may seem surprising. What is its origin ?

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Agnes Giboreau: “Its creation dates back 15 years. When I started, I was all alone and today, we are about thirty! We have a team of six permanent researchers, three of whom are qualified to direct research and supervise doctoral students. We have research managers, engineers, chefs…

Combining research, food and Paul Bocuse in a single place is not easy, however… What was the meaning of the bet?

Dialogue with scientists has established that it is useful to focus on the pleasure of eating, but also to understand why we take this pleasure in eating. Our approach was to deal with this question in a multidisciplinary way: sociological, cultural, through food science… “Pleasure, health, economy” were the three keywords. Health was also the focus of our early work. We then asked ourselves the question of the role of the kitchen in supporting the sick, but also in the general population, in prevention. We also always work with the elderly, those with cognitive disorders or obesity, or with children. We also create recipe guides for the general public or for patients, as in our Canut project, “Cancer, nutrition and taste”.

Canut, whose objective is to compensate for the loss of taste and smell of patients undergoing chemotherapy, is this about right?

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Better understanding these alterations is indeed the starting point. The project was initiated with the Hospices Civils de Lyon (HCL) who had noticed that the patients no longer ate, because they no longer took pleasure in it. According to studies, this still concerns 50 to 80% of patients. We put forward two hypotheses: one related to dietary and social practices, with causes of illness, fatigue, etc. And another based on the impact of chemotherapy on taste and smell cells.

Read also on Tribune de Lyon: Immersion: “I was a guinea pig for a study on smell”

Because these are cells that renew themselves: if you burn your tongue, you lose the taste, but it comes back. However, treatments that aim to stop the reproduction of cancer cells also stop the cells of taste and smell. Two exploratory studies in the 2010s have made it possible to say that it is in this direction that we should dig in order to inform the general public and provide solutions.

Hence the publication of a specific recipe booklet to learn how to compensate for these deficits induced by the treatments?

It is the idea of ​​the Canut project to produce a recipe and support guide for patients. But we first became aware of the extent of the lack of knowledge. We needed quantitative data, psychophysical tests and not just declarative, since we are not educated to differentiate taste from smell.

What do you mean ?

Taste is a construct that encompasses three sensory systems: taste, smell, and the trigeminal. The trigeminal nerve is a nerve with three branches: one in the eye, one in the nose, one in the mouth. It has nerve ramifications sensitive to certain molecules to prevent pain: pepper, for example. It is therefore disconnected from olfaction. But when you are anosmic (without smell, Editor’s note)the trigeminal nerve still works: pepper, tabasco, mustard, it stings despite everything.

Read also on Tribune de Lyon: Cancer: the Paul-Bocuse Institute to the rescue of patients’ taste

And the taste?

It is also detected in the mouth, and not in the nose. When we only have the touch of smell, we can therefore play on the taste and the molecules that we detect at the level of the taste buds of the tongue, as well as with the trigeminal nerve. This is one of the solutions being explored in the case of cancer and anosmia.

Can we really “compensate” for the lost sense of smell by reorganizing taste?

The taste of food comes from a conjunction of the three sensory systems and in patients with cancer, one can have an impairment of olfaction and taste. But it is the sense of smell that gives us the difference between a strawberry and a raspberry, for example. If you make a syrup from the two, it doesn’t have the same “taste”, which is actually the aroma of strawberry or raspberry. Because in reality, the taste is the same: it’s sugar. But the nose makes the difference between a strawberry and a raspberry. We also use the English term “flavor” which associates the three systems.

“The goal of the Canut project is to produce a recipe and support guide for patients. »

Agnes Giboreau

How did you go about developing a solution?

We first implemented tests with impregnated strips and vials. We observed 50% of patients undergoing chemotherapy who had lost their sense of smell. Then we developed, with the cooks of the research center, an experimental meal. We have refocused on breast cancer patients. They came and had a test meal with starter, main course, dessert. Then they returned after 6 and 12 weeks, and we then measured their sensitivity to taste and smell, and their appreciation of the meal, which presented four variants each time: a standard reference dish; a dish enriched with molecules that reinforce the sweet, salty side…; another pushed in odors, spices; and a texture-enriched variant.

Isn’t this a fundamentally individualized work, and therefore endless?

This is our hypothesis and the challenge of the project: to be able to support patients in making their own diagnosis. The second part of Canut is this guide for patients which includes an explanation and nutrition part, as well as 24 recipes, each of which has several variants: sweetened, enriched in aroma, and ways to put them to your own taste.

Read also on Tribune de Lyon: Sleep and confinement, smell and Covid-19: two Lyon laboratories are conducting the investigation

This guide is being evaluated in a trial involving patients of all types of cancer: 50 patients have the guide, 50 do not have it, and after a few months we will measure the impact on the pleasure of eating at residence.

Can the objective be to come up with a global guide to reach all patients?

We hope. We are going to work on a European consortium to extend Canut’s work on a European scale. The goal is to obtain a larger volume of data. With the guide, we have an objective of 100 patients, but in relation to the number of patients affected and their diversity, we must take into account the differences in culture and diet. One could imagine in this consortium to offer the meal created in Écully, but also to create one adapted to each country. We have therefore by no means finished acquiring all the necessary knowledge with the Canut project. We fully intend to have more data and to work on different types of cancer at the national and international levels. »

My lunch with Agnès Giboreau

It seemed unavoidable that this lunch take place at the restaurant of the Paul-Bocuse Institute, place Bellecour. Agnès Giboreau arrives there by bicycle from the site of the Institute in Écully, which remains an association under the 1901 law recognized by the State: the center must find its own funding to carry out its research and an operating budget of nearly 1.5 million euros. “On the Canut project, we were helped by the Clara Regional Cancéropôle to set up a consortium with the HCL, the Léon-Bérard Center, the Lyon Neuroscience Research Center, the Rhône-Alpes Human Nutrition Research Center, the Onco Aura network and two companies, Apicil and Elior, all funded by the Métropole and the Region, then by the G&G Pélisson Foundation for the Paul-Bocuse Institute to extend the project given the health crisis.”details the native of Melun.

But the center also works on shorter missions with communities or companies. “For example, we are members of a European project around microalgae, with a start-up from the Gard which has raised funds to create microalgae factories. We are in charge of developing recipes, evaluating the potential of seaweed in drinks, desserts… and testing the acceptance of these products by consumers in Europe in finished products. » Agnès Giboreau, from her perch on our food, is careful not to stand up as the vertical authority of “eating well”. Gluten-free, vegan, flexitarian…

“It’s up to everyone to integrate the combination of pleasure and health that suits them. We’re not going to ask a vegan to eat meat because protein is good. But we will tell him that vegetable proteins are less accessible, you have to eat more of them to get the right amount. We can still say that the best model will be inspired by the Mediterranean diet, therefore rather flexitarian. »

Paul Bocuse Institute
20 Place Bellecour, Lyon 2and.

– Our meal –
Two roasted pollock with fennel,
panisse fries, tangy condiment and grilled fennel jus.
two coffees,
Bottled still mineral water.

– The bill –
78 €

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