Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
8 Feb

A Primal Primer: Stevia

After last week’s article many of you asked about a natural alternative to sugar and artificial sweeteners: stevia. It is widely used in the low carb community to satisfy sugar cravings or simply add a touch of sweetness to a hot beverage or dessert, but should it be? What is stevia? Is it safe? What is its effect on insulin, if any, and does it have a place in a Primal Blueprint eating strategy? Let’s investigate.

Stevia is an herbaceous family of plants, 240 species strong, that grows in sub-tropical and tropical America (mostly South and Central, but some North). Stevia the sweetener refers to stevia rebaudiana, the plant and its leaves, which you can grow and use as or with tea (it was traditionally paired with yerba mate in South America) or, dried and powdered, as a sugar substitute that you sprinkle on. It’s apparently quite easy to grow (according to the stevia seller who tries to get me to buy a plant or two whenever I’m at the Santa Monica farmers’ market), and the raw leaf is very sweet.

Most stevia you’ll come across isn’t in its raw, unprocessed form, but in powdered or liquid extract form. The “sweet” lies in the steviol glycosides – stevioside and rebaudioside – which are isolated in these extracts. Some products use just one, while others use both stevioside and rebaudioside. Stevioside is the most prevalent glycoside in stevia, and some say it provides the bitter aftertaste that people sometimes complain about; rebaudioside is said to be the better tasting steviol glycoside, with far less bitterness. Most of the “raw or natural” stevia products use the full range of glycosides, but the more processed brands will most likely isolate one or more of the steviol glycosides. The popular Truvia brand of stevia products uses only rebaudioside, as do both PureVia and Enliten. Different brands provide different conversion rates, but compared to sucrose, stevioside is generally about 250-300 times as sweet and rebaudioside is about 350-450 times as sweet.

Does Stevia Affect Insulin?

There is one in vitro study that showed stevioside acts directly on pancreatic beta cells to stimulate insulin secretion and another which shows similarly insulinotropic effects of rebaudioside, which may give you pause. Insulin secretion sounds like an insulin spike, no? And since we tend to be wary of unneeded insulin spikes, maybe we should avoid stevia. It’s not so simple, of course. For one, this was an in vitro study, performed in a super-controlled laboratory petri dish type setting; this was not an in vivo study of animals or people eating stevia in a natural, organic way. The results of in vitro studies are notorious for not panning out when you try to replicate them in vivo. Secondly, insulin secretion isn’t necessarily a bad thing. I mean, we need it to shuttle nutrients into cells, and we’d die without it. As I mentioned in the dairy post a few weeks back, insulin is millions upon millions of years old. It’s been preserved throughout history because it’s an essential hormone. It’s not always the bad guy, especially if you’re insulin sensitive.

In fact, the evidence is mounting that stevia actually is an insulin sensitizer that can aid in glucose tolerance and clearance after a meal. The Japanese have been using stevia for decades in the treatment of type 2 diabetics. Let’s look at a few recent studies. In fructose-fed rats, a single instance of oral stevioside increased insulin sensitivity and reduced postprandial blood glucose in a dose-dependent manner. The same study also found that diabetic rats given stevioside required less exogenous insulin for the same effect. Taken together, these results suggest that stevia may not just be a good sugar substitute for diabetics, but an effective supplement for treatment of their insulin resistance.

Another study looked at the postprandial effects of stevia, sucrose, and aspartame in human subjects. Compared to sucrose eaters, stevia eaters showed lower postprandial blood sugar levels. Compared to both sucrose and aspartame eaters, stevia eaters had far lower postprandial insulin levels. Furthermore, eating stevia did not induce increased appetite throughout the day, indicating stable blood sugar and satiety levels. Another strike in stevia’s favor.

Any Other Effects?

There are other potential benefits to using stevia unrelated to its apparent benefits on glycemic control. Here are a few studies I was able to dig up:

  • When combined with inulin, a soluble prebiotic fiber, low-dose stevia increased HDL while lowering overall lipids in male rats. Alone, low-dose stevia lowered cholesterol without the potentially beneficial effect on HDL. It’s also useful to note that high-dose stevia negatively affected some toxic parameters – so don’t eat spoonfuls of stevia (not that you would) – but long term low-dose stevia was deemed safe.
  • Lipid numbers are fun and all, but we’re really interested in avoiding atherosclerotic plaque buildup. In mice treated with stevioside, oxidized LDL was reduced, overall plaque volume was reduced, and insulin sensitivity increased. Overall, atherosclerosis was reduced in the stevioside-treated mice. I couldn’t dig up exactly how they were “treated,” however, but they were given doses of 10 mg/kg.
  • In another study, mice memory was impaired by administration of scopolamine, an anticholigernic found in the intensely hallucinogenic jimson weed (or devil’s weed) and datura. Impaired mice were given oral stevioside (250 mg/kg) and tested for memory retention. Memory deficit was largely reversed with administration of stevioside, which also reduced the brain oxidative damage caused by scopolamine. Clinically relevant? Perhaps not, but it’s interesting.
  • A two-year randomized, placebo-controlled study of Chinese patients with mild hypertension (which a rather large swath of society probably suffers from) found that oral stevioside intake significantly reduced systolic and diastolic blood pressure. Patients either took a 500 mg capsule of stevioside or a placebo three times a day for two years. The hypertension situation improved across the board and no downsides were reported or detected. Also of note is the fact that slightly more patients in the placebo group developed left ventricular hypertrophy, a pathological thickening of the heart muscle. Of course, another study using far lower doses (up to 15 mg/kg/day) found no anti-hypertensive effects, so it appears that the dose is key. Maybe somewhere in the middle works well, as one study in hypertensive dogs showed: they used 200 mg/kg to normalize blood pressure in the canine subjects.

We can think about stevia as a Primal sugar alternative with some potentially therapeutic effects. Kind of like cinnamon or turmeric, we don’t consume it for the calories or as literal fuel for our bodies, but for flavor, variety, and, possibly, the health benefits. It may induce insulin secretion, but it increases insulin sensitivity, reduces blood glucose (i.e., the insulin is doing its job), and does not increase appetite. It’s been used by humans for hundreds of years and by diabetic patients in Asia for decades. The goofy health food store dude who claims aspartame was created by Donald Rumsfeld to give us cancer may be a vociferous supporter of it, but don’t hold that against stevia. I’m a fan of the stuff and recommend it as a Primal way to satisfy a sweet tooth.

What do you guys think of stevia? Love it? Hate it? Have you ever used its potential therapeutic effects? Let me know in the comment section!

You want comments? We got comments:

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  1. As well a decades of use in Japan, the Stevia plant has been used for at least hundreds, and probably thousands of years by various tribes of Paraguyan natives (notably the Guarani).

    The extraction process is quite mild if the mixed glucosides are wanted–just a simple water extraction of powdered leaf. Ethanol extration is used to separate the various forms of glycoside.

    Of course, thousands of years doesn’t make it part of our evolutionary heritage. But that goes for any plant fro mthe New World. Myself, I like it and use it without hesitation.

    David I wrote on February 9th, 2011
  2. Stevia? Huh?

    Samantha Moore wrote on February 9th, 2011
    • How does this comment add anything of note to the discussion…? Is there something you don’t understand, something we can clarify for you…?

      Sarah wrote on February 9th, 2011
  3. It’s processed (unless you’re just using the leaf itself), so I don’t use it. My goal is to keep sweets rare, and on the rare occasion I have them, I’ll use honey or maple or sucanat, all whole, real foods. If I had stevia leaf (fresh or dried), I’d use it.

    If it were just leaf, it would be more comparable to cinnamon or turmeric. But a white powder or clear liquid aren’t something that meets my qualifications for regular consumption (could be made in my kitchen with normal, simple kitchen tools).

    MamaGrok wrote on February 9th, 2011
  4. I love stevia, particularly Sweetleaf. Both sugar and artificial sweeteners mess me up bigtime, so I love having the option of stevia for sweetening things. Plus, I think it settles an upset stomach, at least for me.

    cateydid wrote on February 9th, 2011
    • Cateydid, I have noticed the same thing – tea with a little Stevia always settles an upset stomach for me.

      Nicole wrote on February 9th, 2011
  5. i LOVE LOVE stevia, truvia or other…
    i am “addicted” to it. probably just in my head. but i can barely tolerate real sugar anymore, or splenda products. Hope most products replace splenda w/ stevia some day.
    if i could drink the powder i would.
    sorry, but i have a total sweettooth, and if i can have stevia sprinkled on everything and anything, i will.
    wonder if i over do it.
    well i overdo everything, so it wouldnt surprise me.
    Try it on berries if you really want a treat (not too primal, but ok i think)

    alison wrote on February 9th, 2011
  6. I am not a fan of Stevia. I have tried baking with it before and just doesn’t work out. And I don’t really like the idea of it anyways. I know it is “all-natural” and whatever, but then again so is corn syrup, and certain “natural” flavors and colorings. Personally, I don’t add sugar to very many things, maybe a little honey in my yogurt, but most of the sugar I eat is in junk food. I am not a huge fan of replacing indulgences. I would much rather have one cookie or a small scoop of ice cream as opposed to some Steviated alternative. But that’s just me.

    And Dan Quinn is completely insane.

    Phil wrote on February 9th, 2011
    • Dan Quinn is not insane. He is the Patriarch of Stevia and will make Stevia go global. He is the angel Maitreya. tust and believe, Joe Rogan

      Tara Chow wrote on February 11th, 2011
      • Real talk homey. Cold fission.

        Phil wrote on February 11th, 2011
  7. I grew Stevia one year (just for grins) and I really liked it in coffee or tea. It’s amazing how sweet the leaves are. Unfortunately I didn’t try to dry any for winter uses and it didn’t survive for the following growing season.

    Jane wrote on February 9th, 2011
  8. I’m a big fan of stevia glycerite. I buy the “Now” brand in an 8 oz bottle. It’s a honey-like consistency WITHOUT a bitter aftertaste.

    Mary wrote on February 9th, 2011
  9. Just be careful, I became allergic in a big hurry, and had major gastro-intestinal problems! Lost 12 pounds, had bad problems for 47 days, until we figured out what it was, within 48 hours of stopping it, the symptoms dissapeared…..for sure don’t over use this!

    Sandy wrote on February 9th, 2011
  10. super fan…SweetLeaf Stevia in Venti Americano…perfect 😉 or a mixture of coconut oil/unsweetened cocoa powder/stevia for homemade chocolate bars…yum

    Santiaggie wrote on February 9th, 2011
  11. I have tried Stevia–i think Sweetleaf–and dislike it. Not sure I could ever get to like it, and prefer honey, sugar, agave or maple syrup to the artificial or alternative sweeteners.

    obligatecarnivore wrote on February 9th, 2011
    • If you really like maple products, check out Aqua-Mapelle(.com) – drinks made from pure maple “juice”/sap.

      terrym wrote on February 10th, 2011
  12. Great info on Stevia. It is a great option to Splenda and the other sweetners.

    Legendary Fitness wrote on February 9th, 2011
  13. Actually, I was also wondering whether it’s OK to use tapioca syrup as a sweetener, since tapioca is considered a safe starch by some. From what I could find tapioca syrup has zero fructose, and contains glucose and maltose. Any thoughts?

    Mia wrote on February 9th, 2011
  14. Truvia isn’t the best choice (read the ingredients)though it’s more likely to be available at grocery stores. I use the Vitamin Shoppe house brand, which is much cheaper than Truvia or SweetLeaf. Vitamin Shoppe sells on Amazon and can save you some driving if you don’t usually shop their stores locally.

    Edd wrote on February 10th, 2011
  15. Hi Sarah,

    The NuNaturals Vanilla that I was referring to is the alcohol free variety that they also offer.

    Kelly wrote on February 10th, 2011
  16. May I suggest a brand of pure stevia called KAL? I’ve just recently came across this brand and it’s outstanding.
    For one, it is almost 100% pure stevia powder without any fillers, but it also tastes great and not at all bitter.

    I’ve been using stevia for over 2 years now and I think it does take a little while to get used to the aftertaste (if present), but once you do, you no longer notice the difference.

    I tried liquid form a few times and for some reason either I keep getting it in deluted form ot just pick wrong brands, but I find it not as sweet. I drink lots of green tea during the day and like to add stevia and lemon juice for flavor, but it takes me 40-60 drops of liquid stuff to sweeten a 32oz mug, vs quarter of a teaspoon of powder, so it’s much easier.

    Check out Amazon for KAL brand. It has a lot of positive reviews.

    chocolatechip69 wrote on February 10th, 2011
  17. Stevia is good, but does anyone ever use crystallized maple sugar or maple sugar products? 100+ years ago, that’s all any of us would have used for the most part.

    There aren’t many products, but one in my area that is delicious and available online is Aqua-Mapelle(.com) – they have a small line of drinks made from pure maple “juice” (sap).

    Terry wrote on February 10th, 2011
  18. LOVE TRUVIA!!!

    dianna wrote on February 10th, 2011
  19. I agree with an earlier poster that Stevia, or any other artificial sweetener, works best as a transition from a sweet tooth to a non-sweet tooth. Did everyone have a taste for beer or wine when they first tried it? No, the taste was acquired. And we can all acquire a taste for things not so sweet. This is less likely to happen if you keep your food sweet-tasting.

    Will wrote on February 10th, 2011
  20. I use stevia all the time as my sugar substitute!

    ben martin wrote on February 10th, 2011
  21. The one time I tried Stevia was in a popular fruit-flavored drink of some kind, I can’t remember the name, maybe one of the diet SOBE? I had heard all these wonderful things about it.

    I got a bad headache from it before I even finished the drink. I get a similar reaction to Nutrasweet. Splenda will also cause headaches if I use it too often or on a day when I’m easily triggered.

    I suffer from migraines and diabetes. So Primal is good for me, and Stevia would be excellent for my diabetes, if only I could use it. *sad face*

    I am wondering if anyone else has had any effect like this from natural or other sweeteners? It may even have been something else in the drink for all I know, a coloring maybe.

    I currently use Ideeli xylitol-based sweetener when I feel the need, and I’m okay with maltitol.

    Sloooowly going Primal…Baby steps. It’s interesting being sugar-free. I’m to the point now that I can detect something sugary with my nose! Everything tastes different!

    Thanks for the site Mark, and thanks to all the helpful Groks too!

    Queenbee wrote on February 11th, 2011
  22. A lot of good info here. I don’t really care for stevia or other sugar substitutes. If I want to sweeten something like coffee I use a touch of honey. If it’s a food item then I use dates but sparingly.

    Ami wrote on February 11th, 2011
  23. Excerpt BACKGROUND Stevioside a natural glycoside isolated from the plant Stevia rebaudiana Bertoni has been used as a commercial sweetening agent in Japan and Brazil for 20 years. Excerpt AIMS Stevioside is a natural plant glycoside isolated from the plant Stevia rebaudiana which has been commercialized as a sweetener in Japan for more than 20 years. Leaves of Stevia rebaudiana are a source of several sweet glycosides of steviol.

    Monty Langley wrote on February 13th, 2011
  24. For those that find stevia is too strong, or has a bitter aftertaste.

    – Get a good brand – NuNaturals is the best I’ve tried, some are terrible.

    – Mix it with other natural sweeteners to smooth the taste. I use erythritol and inulin, which are mostly fiber, to make up the bulk. Most people won’t be able to tell it isn’t sugar in drinks or baking, but you still have to use it in lesser quantities as it is still much sweeter than sugar.

    rs wrote on February 13th, 2011
  25. I have been using “STEVIA EXTRACT IN THE RAW’ it ROCKS !!! there is no bad aftertaste like most other stevia products and it is all natural straight from the leaf. I buy it here in Hawaii at the local Safeway store.

    Here is the web site where you can find more info.

    Dr. Mercola Highly recommends it and I use it in a teriyaki sauce which I marinate my beef in for Jerky . It tastes so good. Try it you will LOVE it

    Scott wrote on February 13th, 2011
  26. I’ve been using stevia since 2003. Love the stuff. I make sure to use stevia that isn’t chemically attached to milk sugars. I haven’t found an easy source of green powder but I hope to soon. Great post, Mark! Thanks!

    gilliebean wrote on February 14th, 2011
  27. Wow, that is a pretty sweet review on stevia – pun intended. I’ve been using stevia in my own recipes for a while now (although it’s not easy to get in Belgium) and I’ve been having good results with it!

    Jo wrote on February 16th, 2011
  28. Thank you to everyone who recommended “NuNaturals”. I just bought the NoCarb Blend packets and they are great!! I only need 1 in my morning coffee (I usually use splenda)…no carbs & no bitter aftertaste :)

    Leah wrote on February 16th, 2011
  29. Are you able to buy stevia in canada?

    Jasmine wrote on February 16th, 2011
  30. I just bought some Truvia and have just started experimenting with it. As others have said, I’m trying to reduce my “need for sweet.” I’m doing quite well overall; but I still have a few challenges where I can’t completely get over my sweet tooth.

    My biggest sugar challenge is coffee. I have reduced my morning coffee sugar from two large teaspoonfuls to two small teaspoonfuls. Not a huge improvement, but some. Truvia in coffee is AWFUL. But in tea in small amounts – sometimes mixed with sugar also – it’s palatable. I haven’t tried baking with it but it sounds like a good idea to try it in yogurt (another one where I still like more honey than I should).

    Does anyone else think that Truvia or another rebaudioside-only brand has a slight vanilla-like taste or aftertaste?

    Carrie wrote on February 19th, 2011
  31. I am drinking tea with stevia leaf sweetener right now. Its delicious.

    Jayza wrote on February 25th, 2011

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