Trehalose (a sugar product) and C Diff

When I was researching C Diff, I came across an article about the correlation between Trehalose, a sugar additive from the early 2000s, and C Diff. Also, I learned that Trehalose was introduced into packaged foods in the early 2000s--and Quebec and Ontario's rates of C Diff increased around that time. For example, Quebec had an outbreak of C Diff between 2002-2004, and a hospital in Ontario had a C Diff outbreak in 2006-2007. It seems to me that there is a link between Trehalose and C Diff. That said, Nagase Foods and Katherine Beals, PhD, RD state that correlation does not equal causation (Article: Trehalose is not associated with the emergency and spread of epidemic CLostridium difficile strains).

Trehalose can be found in ice cream

Trehalose may be called "natural flavour" on ingredients' lists: https://www.nutraceuticalsworld.com/breaking-news/treha-trehalose-available-as-natural-flavor/.

Sources/factoids:

https://www.supplysidesj.com/supplement-regulations/trehalose-receives-gras-status

https://www.nature.com/articles/nature25178 - correlation between Trehalose, which was introduced into some packaged foods in the early 2000s, and the virulence of C Diff

• Quebec had an outbreak in the early 2000s - https://www.sciencedirect.com/science/article/abs/pii/S0924857907002671#:~:text=A%20massive%20outbreak%20of%20a,prescription%20is%20associated%20with%20C.

• https://www.thespec.com/news/hamilton-region/jo-brant-hospital-settles-c-diff-suit-for-9-million/article_0d12085a-9e70-5756-9b2c-a018138effb6.html

https://www.nagase-foods.com/global/treha/assets/pdf/Trehalose_is_not_associated_with_the_emergence_and_spread_of_epidemic_Clostridium_difficile_strains.pdf

https://pmc.ncbi.nlm.nih.gov/articles/PMC6546318/

"...Regulatory approval in the 2000s led to widespread adoption of trehalose in the USA and Europe. Foods where trehalose addition has been proposed to be beneficial include: baked goods, breakfast cereals, rice and pasta, processed vegetables, fruit (dried and juiced), milk products, meat and fish products, sweets, chewing gum, and ice cream."

"our data suggests that the increase in dietary trehalose during the 21st century has resulted in this sugar being available in the distal gut where it can be metabolised by microbes. We have now provided evidence that three epidemic strains of Clostridium difficile have evolved independent mechanisms to better metabolize this nutrient resource. Our work does not suggest that people should be broadly concerned about trehalose consumption. We do, however, expect that the impact of dietary trehalose in the severity of CDI will be further investigated in clinical settings." [The role of trehalose in the global spread of epidemic Clostridium difficile] [emphasis added]

This blog post was first published on May 26, 2025.