Sugar additive may cause bowel issues

Updated 4/14/2021 10:44 PM

Trehalose is a simple sugar commonly added to many processed foods. On the surface it is a boon to the food industry, but recent medical research has suggested that trehalose has a darker side.

It may stimulate a specific bowel bacterium, Clostridium difficile to become more virulent.


Trehalose is comprised of two glucose molecules. It is found naturally in bacteria, fungi, plants and some animals. It is believed to be important for survival since it strongly holds onto water.

This allows bacteria, plants and animals to withstand prolonged dry periods. Trehalose's ability to hold onto water has made it a favorite hydrating agent for many food and some cosmetics.

For food it's ability to hold onto water significantly prolongs shelf life. Trehalose was not used in the food industry until about 2000 when the Hayashibara company, originally a starch syrup manufacturer, discovered a way to inexpensively extract large amounts of trehalose from starch.

From there trehalose rapidly made its way into the American food market in many food including pasta, ice cream and processed beef. Although trehalose is a good way to extend the shelf life of foods, it recently was discovered that it makes Clostridium difficile more virulent.

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Clostridium difficile is a serious bowel infection whose symptoms include copious watery diarrhea, fever and abdominal pain. It is commonly associated with antibiotic use and the life-threatening complications include pseudomembranous colitis, toxic megacolon, perforation of the colon and death.

There is an increased risk of infection with antibiotic and proton pump inhibitors use, hospitalization and older age. Almost 500,000 cases of Clostridium difficile infection were reported in the United States in 2011 with 29,000 deaths. Clostridium difficile infections and deaths have dramatically increased between 2001 and 2016, corresponding with the introduction of trehalose into the American food system.

A recent publication in the science journal Nature showed that several strains of Clostridium difficile (RT027 and RT078) can utilize even low doses of trehalose as a food source. The research showed that in the process of metabolizing small amounts of trehalose the virulence of these specific bacteria significantly increased.

It is not that trehalose increases the number of the bacteria, but it does stimulate a higher production of a Clostridium difficile toxin which is the cause of the life-threatening illness.


Prior to 2000, infections caused by RT027 or RT078 were very rare. Then suddenly, about 15 years ago, at the same time trehalose was increasingly used in foods, these specific bacteria emerged as the cause of near epidemic levels of Clostridium difficile infections.

This is an example of unintended circumstances where adding a naturally occurring sugar to foods may contribute to illness and death.

Now, certainly correlation does mean causation. These results are preliminary and need further confirmation before definitive conclusions can be drawn, but from my perspective where there is smoke there usually is fire.

Even though trehalose is naturally occurring in many foods, it seems prudent to examine the labels of foods to see if trehalose has been added. It may fall under "added sugar" or "sugar."

Buyer beware.

• Patrick B. Massey, MD, PH.D., is president of ALT-MED Medical and Physical Therapy, 1544 Nerge Road, Elk Grove Village. His website is

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