Title: Alternative Sweeteners

452 Richards and Dexter
tions was slower after trehalose ingestion. A third study by Bergoz et al. reported
on 50 hospitalized control subjects (61). Patients were given glucose and trehalose
oral tolerance tests as described previously. Control subjects had a median
absorption ratio of 0.70 (range, 0.31–1.52) and tolerated the trehalose exposure.
These values were essentially the same as in the second study.
Twenty patients in Czechoslovakia with no bowel symptoms or disease
were examined for trehalase activity (62). None of these subjects were considered
to be trehalase deficient (58).
Murray et al. reviewed several reports on trehalase activity in various
groups of patients, and presented data on 369 subjects from the U.K. with healthy
intestinal histology (62a). Of the 369 subjects, only 1 was shown to be slightly
deficient in trehalase activity. The authors used a different standard to classify
trehalase deficiency, and although not identical to the other methods it appears
that the data can be compared.
In summary, no indication of trehalase deficiency was reported in 500 biopsies
specimens in a Danish population (58). Welsh’s group studied 123 subjects
from the Southwestern United States. The lowest value of trehalase activity was
7 IU/g in an infant(s) less than 1 year of age; however, there were no statistical
differences in means between age groups. In addition, no adults had low enzymatic
levels (59). Bergoz et al. assayed biopsies specimens from 100 controls
and showed substantial trehalase values in 98 samples (60). Bergoz found no
abnormalities in trehalose absorption in 16 control patients (4). Fifty hospitalized
patients showed normal trehalose absorption (61). Twenty patients sampled in
Czechoslovakia did not display a trehalase deficiency, and only one of the 369
was found to have low activity in the U.K. (62, 62a). Taken together, it appears
that when trehalase activity assays or trehalose absorption tests are performed
on hundreds of control subjects, only a few individuals can be identified with
low trehalase activity. Importantly, this percentage ( 1%) appears substantially
less than for lactase and possibly other disaccharidase deficiencies (63).
Trehalase is also found in human peripheral blood, urine, kidney and liver,
and urine (64, 65). The serum concentrations of trehalase appear to be fairly
constant in an individual, although they can vary widely within the population.
Significant sex or age differences have not been reported. The presence of trehalase
in these areas of the body do not appear to be related to the absorption of
trehalose from the gut.
XV. MALABSORPTION AND INTOLERANCE
Malabsorption and/or intolerance to trehalose has been reported (58–63). The
clinical symptoms and the pathophysiology appear to be identical to those seen
in other disaccharide malabsorption syndromes and are therefore self-limiting