Stevia
What is Stevia?
Stevia (S rebaudiana Bertoni) is a small, bushy shrub that comes from South America. It has been consumed and used as a sweetener for centuries but has recently made its way into the global sweetener market due to its claimed health benefits, as compared to other artificial and refined sweeteners [1].
The sweetness of Stevia comes from a group of compounds found on the stevia leaf called steviol glycosides. These glycosides have been shown to be 250 to 300 times sweeter than table sugar (sucrose) [1].
Data as recent as 2017 has shown that sales and usage of Stevia sweeteners have risen, while those of other sweeteners, including artificial sweeteners such as sucralose and aspartame, have dropped [2].
In 2008, the United States Food and Drug Administration (FDA) approved the use of highly purified steviol glycosides and declared them to be a Generally Recognized As Safe (GRAS) ingredient when used in limited quantities. This paved the way for stevia to be marketed as a no-calorie sweetener and used in a variety of different foods and beverages [3].
There are a number of Stevia sweeteners available on store shelves that come in multiple forms: individual packets/sticks, liquid and granulated. They can be found in Truvia, Pure Via, Stevia Extract in the Raw, and SweetLeaf, along with a number of other retail products.
While research on Stevia and the gut microbiome is conflicting, one study found that the presence of Stevia inhibited the growth of “good” bacteria (L. Reuteri species) in the human gut [4]. The studies done on this particular subject are limited and need to be further evaluated.
Because research is limited on the possible health outcomes of artificial sweeteners and natural sugar alternatives, like Stevia, it would be beneficial to keep intake limited due to the risk for potential adverse side effects.
Nutrient Breakdown
Stevia has essentially no nutritive value. Although the Stevia leaf contains a small amount of vitamins and minerals, most of them are lost when the leaves are harvested and processed [1]. Fillers or bulking agents are often added to Stevia sweeteners so that they have a similar resemblance to table sugar. Some commonly used fillers include: erythritol, xylitol, glycerin, inulin, and maltodextrin. If this is a concern, 100% pure Stevia sweeteners are available (just read the labels).
Foods Containing Stevia
Sweetened beverages
Diet-soda
Tea
Juice
Dessert foods
No-sugar added chocolate
Sweetened yogurt
Sauces and dressings
Protein Powder
Chewing gum
Stevia Alternatives
Dates (sugar or syrup)
Food Reactions
The body can respond to foods in many different ways including food allergies, food sensitivities, or food intolerances. If you suspect a food reaction, you can either choose to avoid the food or seek food reaction testing. Click here more information on the difference in types of food reactions and testing options.
DISCLAIMER: Always consult with your pediatrician and/or your Registered Dietitian to help you test for a food reaction or to aid you in making individualized dietary changes.
Stevia & Autism in the Research
There are no current studies directly looking at autism and Stevia, but there is research that has shown a link between Stevia, gut, cardiovascular and dental health. However, most research is inconclusive.
Gut Health/Microbiome
Studies looking at the impact of Stevia on the gut microbiome are few in number and varied. Some research has shown that steviol glycosides inhibit the growth of naturally occurring bacteria strains that inhabit the gastrointestinal tract and provide protection against various viral, fungal and bacterial diseases. But, all articles have emphasized that more research is needed to confirm the observed effects [4].
Another study looked at the impact of stevioside sweeteners on the microbiome by looking at fecal samples and found no that there was no significant impact [5]. More research needs to be done concerning the health impact, if any, on gut health and artificial sweeteners.
Cardiovascular Health
The sweetener in Stevia, steviol glycoside, has been shown to slightly lower blood pressure. Other studies have found beneficial findings of steviol glycoside on cardiovascular health as well [6]. One in particular, observed the long-term (1-2 years in length) effects of Stevia consumption and found that it was effective in lowering blood pressure in hypertensive patients.
Alternatively, shorter studies (1-3 months in length) supported an increase in blood pressure with Stevia intake [7]. Research in this area is still unclear and needs to be further evaluated.
Dental Health
Information about the safety of Stevia consumption with regard to dental health is few and still being studied. One study, in particular, used rats to examine the tooth-decaying potential of stevioside consumption. The study concluded that there was no increased risk for the development of dental caries [8]. More research is needed looking at the regular consumption of Stevia sweeteners on dental caries and oral health in all populations.
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[1] Ashwell M. Stevia, nature’s zero-calorie sustainable sweetener: a new player in the fight against obesity. Nutr Today. 2015;50(3):129-134.
[2] Ciriminna R, Meneguzzo F, Pecoraino M, Pagliaro M. A bioeconomy perspective for natural sweetener Stevia. Biofuels, Bioprod Bioref. 2019;13(3):445-452.
[3] Perrier JD, Mihalov JJ, Carlson SJ. FDA regulatory approach to steviol glycosides. Food and Chemical Toxicology. 2018;122:132-142.
[4] Deniņa I, Semjonovs P, Fomina A, Treimane R, Linde R. The influence of stevia glycosides on the growth of Lactobacillus reuteri strains. Lett Appl Microbiol. 2014;58(3):278-284.
[5] Gardana C, Simonetti P, Canzi E, Zanchi R, Pietta P. Metabolism of stevioside and rebaudioside A from Stevia rebaudiana extracts by human microflora. J Agric Food Chem. 2003;51(22):6618-6622.
[6] Bundgaard Anker CC, Rafiq S, Jeppesen PB. Effect of steviol glycosides on human health with emphasis on type 2 diabetic biomarkers: a systematic review and meta-analysis of randomized controlled trials. Nutrients. 2019;11(9).
[7] Ulbricht C, Isaac R, Milkin T, et al. An evidence-based systematic review of stevia by the Natural Standard Research Collaboration. Cardiovasc Hematol Agents Med Chem. 2010;8(2):113-127.
[8] Das S, Das AK, Murphy RA, Punwani IC, Nasution MP, Kinghorn AD. Evaluation of the cariogenic potential of the intense natural sweeteners stevioside and rebaudioside A. Caries Res. 1992;26(5):363-366.
Authors
Brittyn Coleman, MS, RDN/LD, CLT
Laura Flournoy, Dietetic Intern
