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8 Feb

A Primal Primer: Stevia

steviaAfter 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:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. Great info on Stevia. It is a great option to Splenda and the other sweetners.

    Legendary Fitness wrote on February 9th, 2011
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. LOVE TRUVIA!!!

    dianna wrote on February 10th, 2011
  16. 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
  17. I use stevia all the time as my sugar substitute!

    ben martin wrote on February 10th, 2011
  18. 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
  19. 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
  20. 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
  21. 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
  22. 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.
    http://www.steviaextractintheraw.com/

    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
  23. 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
  24. 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
  25. 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
  26. Are you able to buy stevia in canada?

    Jasmine wrote on February 16th, 2011
  27. 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
  28. I am drinking tea with stevia leaf sweetener right now. Its delicious.

    Jayza wrote on February 25th, 2011
  29. Thank goodness! For years I have tried so hard to avoid sugar. It is a real treat as my decaf has vanilla, cinnamon and stevia.

    Marjorie MccNay wrote on August 17th, 2011
  30. very good stuff to hear!

    Max@flavortogofast wrote on September 11th, 2011
  31. What about metabolic syndrome…. if you’re eating something that tastes sweet you might as well have sugar.
    Mark, what do you think in light of metabolic syndrome?

    Moe Crocker wrote on September 12th, 2011
  32. I have two sugar in the raws and one stevia with each of my two 16oz coffee’s in the morning. I haven’t seen a doctor since i started my new regimen (more or less Paleo with a small amount of dairy and a cheat once in a while – like today at a B-Day party, I had a slice of cake and some hawaiian bread), but I feel much better. It would certainly be nice if there were multiple positives to an already healthy product.

    Jeff Murphy wrote on September 24th, 2011
  33. I agree with chocolatechip69. KAL brand is the absolute best for coffee/tea/beverages. Been using it for over 5 years; before the FDA approved it as a sweetener. I tried all the other brands mentioned in the comments and really didn’t like them (aftertaste). You need to start small–1/2 of their scoop in a cup to begin and increase to taste. If it has an aftertaste, you added too much. I use 1 scoop in iced tea and 2 in a very large coffee.

    For those very rare occasions of baking, however, I use NuNaturals powder (it’s cheaper) combined with xylitol or erythritol. Stevia alone just doesn’t produce quality baked goods as it lacks bulk.

    Liz wrote on October 17th, 2011
  34. I was reading a study and it said that there was some evidence that stevia impairs male fertility. If you have any knowledge, please elaborate.

    Nelson wrote on December 30th, 2011
  35. I’ve been eating a fair amount of stevia recently and have learned to enjoy the flavor. I think I’m going to give it up though and just use tiny amounts of honey or maple syrup instead. I’ve noticed stevia tends to make me want to binge, whereas natural sweeteners with a sugar content don’t. Literally one bite triggers my brain. It feels like I’m being duped, so I have to eat more and more. For this reason I think stevia’s actually worse for my health and weight than caloric sweeteners.

    Robin H wrote on January 18th, 2012
  36. I’ve been using NuNatural’s NuStevia with Erythritol for years. Instead of drinking liters and liters of sugared soft drinks nowadays, I drink liters and liters of Oolong Tea sweetened with Stevia.

    The funny thing is, while I enjoy the taste of NuStevia sweetened drinks, I haven’t enjoyed the taste of Zevia or Safeway’s Refreshe Natural Soda — both of which are made with Stevia and Erythtritol.

    I’ve been wondering for decades now why the FDA has yet to approve Stevia as a food additive as it should be Generally Recognized as Safe (GRAS).

    With Rebaudioside A Extract having been approved as a Food Additive, I’m still waiting for the day when I can drink Diet Mountain Dew, Diet Coca Cola and Diet Dr. Pepper, all naturally sweetened with Stevia (Rebaudioside A).

    Bruce wrote on March 5th, 2012
  37. I just tried some Jamba Juice home smoothies mix. Something tasted really wierd, (like artificial sweeterner( then i read the package and saw that it has steviol glycosides in it. I’m throwing the other unused 4 packages away. i would never get use to that taste or need to or want to. any opinions?

    sue clark wrote on March 6th, 2012
  38. I don’t recommend stevia. stevia lowers my stable blood sugar below normal levels because of the raised insulin levels and makes me tired and sluggish.

    Erythriol is the only sweetener that I recommend, because it doesn’t effect neither blood sugar nor insulin levels.

    JAUS wrote on April 17th, 2012
  39. Supposedly the new sugar-free mocha at Starbucks is sweetened with Stevia. Can anyone confirm? Thanks

    Jason wrote on April 24th, 2012
  40. I love the Sweetleaf Stevia that I get from Whole Foods Markets. I enjoy it because it contains “natural” Sweetleaf Stevia and Insulin Soluable Fiber. (fiber is good for us to help break down solids)

    When I visited Wal-Mart, I noticed they carry Stevia The Raw. It is blended with Dextros which is derived from corn. This caused my bladder to be overactive all night long; no fun at all. I went out today to Whole Foods to get the regular Sweetleaf Stevia.

    Also, I have learned to just put the sweetner in my drink and allow it to dissolve on it’s own – it will gradually settle to the bottom in a moment or 2. Then as you stir and drink it – it’s much sweeter – I love it and the bitter taste I experienced when I first tried it was widely because, I didn’t give it time to dissolve on it’s own first. I don’t notice an after taste anymore.

    Finally, I use Sweetleaf Stevia whenever I need to do the low-carb diet, it is absolutely a life saver.

    Anngel wrote on June 3rd, 2012

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