Is Stevia Bad for You? What Experts Say About This Sugar Substitute

Stevia's popularity is soaring even as other non-sugar sweeteners fall from grace, but where did this sugar substitute come from, does it have side effects, and is it safe?

When stevia first hit the U.S. market in 2008, many in the nutritional community were over the moon about the health potential of this new sugar substitute.

There was finally a “natural” sugar substitute with zero calories that was up to 300 times sweeter than sugar. The hope was that stevia could aid weight loss efforts without sacrificing taste and would play a role in managing diabetes. In fact, some of this has come to fruition.

Stevia remains popular, and much of this may be related to the rise in diabetes as well as the plant-based natural food craze. While use of other artificial sweeteners declined, sales of products containing stevia rose 16% from 2017 to 2018, according to a Nielsen survey.

What is stevia?

Derived from the South American Stevia rebaudiana plant, this sugar substitute is also known as rebaudioside A, reb-A, or rebian. The plant contains steviol glycosides, which are used as sweeteners. Stevia brand names include PureVia, Truvia, and SweetLeaf Sweetener. Stevia can be found in drinks, desserts, gum, baked goods, candy, yogurt, and packets for use in beverages, and can also be used when baking at home.

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Is stevia safe?

Stevia is considered a “generally recognized as safe (GRAS)” ingredient by the U.S. Food and Drug Administration (FDA).  This doesn’t apply to stevia leaf and crude stevia extracts, which don’t have FDA approval for use in food.

There was some initial concern that stevia might increase the risk of cancer or reproductive problems based on animal studies; the watchdog group Center for Science in the Public Interest (CSPI) led the charge calling for the FDA to hold back GRAS status. But now after 10-plus years on the market, stevia is safe even by CSPI standards, although the group still wants more testing to further establish its safety.

Stevia: Exploring potential health benefits

Controlling blood sugar levels is the cornerstone of diabetes management, and some foods have more dramatic effects in this regard than others. Stevia does not raise blood sugar, explains Leah Kaufman, MS, registered dietician and certified diabetes educator in the weight management program at NYU Langone in New York City. “Stevia would be a good and safe sugar alternative for the patients with diabetes,” she says.

There is even some evidence suggesting that stevia may be beneficial beyond what you’d expect from cutting back on sugar. In a 2017 study in Nature Communications, researchers at the University of Leuven in Belgium showed that stevia stimulates a protein that is essential for taste perception and is involved in the release of insulin after a meal. The hormone insulin is produced by your pancreas to regulate blood sugar. (Here are 21 great foods for people with diabetes.)

The American Diabetes Association and the American Heart Association agree that stevia can be beneficial for people with diabetes if they use it in moderation and do not compensate by eating extra calories at a later time. The European Food Safe Authority and the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives established an acceptable daily intake range of no more than 12 mg daily, which is the equivalent of 40 packets for a 150-pound person, Kaufman say.

Stevia is a good substitute for regular-caloric sucrose as it has zero calories. “Those who are choosing to substitute sugar with stevia may benefit from this alternative; however, weight loss is not guaranteed,” Kaufman says.

In fact, at least one small 2016 study showed that when participants had a drink sweetened with stevia instead of sugar in the morning, they compensated by eating more at lunch.

Yes, you will consume fewer calories if you use stevia instead of sugar, says David Levitsky, PhD, professor, division of nutritional sciences at Cornell University.

“Theoretically this could lead to weight loss over time, but this is very hard to show in studies,” he says. “For losing weight, this is one mechanism to use, but it’s not going to make you lose 100 pounds. Reducing fat, monitoring portion size, and eating only when you are hungry, are far more effective than substituting stevia for sugar, for weight loss.”

What does stevia taste like?

Does it taste like sugar? Not exactly, he notes. “You will never get a sugar substitute that tastes exactly like sugar.”

Stevia is derived from a plant, which is seen as a benefit by many people who prefer to eat foods that are natural, he says.

Because it is so, so sweet, you don’t need that much, so stevia is often mixed with a bulkier “carrier” agent such as erythritol or dextrose (which is a sugar from corn), which also gives it a more sugar-like appearance and texture.

“The stevia you may purchase at the store may be mixed with Reb-A or erythritol, a sugar alcohol, which can have negative gastrointestinal effects and cause digestive problems in some people,” Kaufman warns. Sugar alcohols are found in many sugar-free gums and candies (not necessarily along with stevia) and eating too much can cause diarrhea.

Make sure to read the labels so you know exactly what is in your sugar substitute, she says.

Sources

Denise Mann, MS
Denise Mann is a freelance health writer whose articles regularly appear in WebMD, HealthDay, and other consumer health portals. She has received numerous awards, including the Arthritis Foundation's Northeast Region Prize for Online Journalism; the Excellence in Women's Health Research Journalism Award; the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery; National Newsmaker of the Year by the Community Anti-Drug Coalitions of America; the Gold Award for Best Service Journalism from the Magazine Association of the Southeast; a Bronze Award from The American Society of Healthcare Publication Editors (for a cover story she wrote in Plastic Surgery Practice magazine); and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Her first foray into health reporting was with the Medical Tribune News Service, where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and Los Angeles Daily News. Mann received a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill., and her undergraduate degree from Lehigh University in Bethlehem, Pa. She lives in New York with her husband David; sons Teddy and Evan; and their miniature schnauzer, Perri Winkle Blu.