Research Shows Food Additive Contributes to C. Diff Outbreaks

 In Naturopathic News

Node Smith, ND

C. Diff and Trehalose Link

A recent study has found that infectious strains of the bacterium Clostridium difficile are able to grow on very low levels of the food additive trehalose.1 This finding may help explain the etiology of some C. difficile outbreaks over the past 2 decades. Trehalose is a nonreducing sugar that is often used as a sugar additive, or sugar substitute. The human digestive tract has enzymes that do break it down (trehalase).

RT027 Strain Particularly Concerning

In addition to the brush border enzyme, trehalase, which breaks down trehalose, endemic strains of C. difficile also are attracted to it. One of these strains is particularly concerning, RT027. RT027 is thought to be responsible for the increase in deaths from C. difficile since 2001. Another strain, RT078 also has become more prevalent in recent years. The dramatic increase in these strains has largely been unaccounted for, however this paper points to the possibility that the addition of trehalose in common foods may be a contributing factor.

Trehalose in Common Foods may be a Contributing Factor

The research paper describes how these 2 specific strains of C. difficile, RT027 and RT078 are able to use low levels of trehalose as a sole source of carbon. RT027 has a mutation that increases affinity for trehalose and the ability to convert trehalose into glucose at very low levels. RT078 has acquired four different gene mutations, including a protein transporter which transports trehalose into its cell.

Metabolized Trehalose Increases Virulence

The researchers show evidence that the metabolism of trehalose actually increases virulence. They showed that deleting the ability for trehalose metabolism significantly reduced virulence. Furthermore, when adding trehalose to the diet of RT027 infected mice increased the risk of death markedly. When trehalose is removed from the diet altogether, the bacterial levels did not change, only the risk of death. This indicates that the trehalose is more related to virulence than presence.

Both of these strains were in existence before 2001. The first discovery of RT027 was in 1985, but wasn’t responsible for hospital outbreaks or increased death rates until after 2001.

FDA Approved Use of Trehalose in 2001

In 2001 the Food and Drug Administration approved the use of trehalose in processed food products. Before then, manufacturing techniques did not exist to make the production of trehalose profitable. Since 2001, trehalose has been added to a variety of foods, including ice cream, minced beef and pasta.


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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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