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:

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. 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
  2. very good stuff to hear!

    Max@flavortogofast wrote on September 11th, 2011
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. Supposedly the new sugar-free mocha at Starbucks is sweetened with Stevia. Can anyone confirm? Thanks

    Jason wrote on April 24th, 2012
  12. 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
  13. A local doctor recommends cinnamon for weight loss, up to 4 tsps. a day. Though I read cinnamon increases insulin levels. Is cinnamon good or bad for health? Thanks

    Delaney wrote on June 4th, 2012
  14. I love stevia. I use a couple small packets a day in coffee or to sweeten water with lemon squeezed in it ( tastes convincingly like lemonade!). I haven’t experienced any side effects from it. The only brand I like is by Nunaturals. It’s sold at wholefoods, GNC & the like.

    I’m new to the primal lifestyle ( 1 week in) & I feel fantastic. I honestly dont crave any sweets or other carbs to my great suprise. I’m glad to know I can still have stevia! It’s just a little sweetness without any guilt.

    Sarah wrote on June 22nd, 2012
  15. I know this is an old thread, but I just read it and I have to comment on something you said: “The goofy health food store dude who claims aspartame was created by Donald Rumsfeld…” That is incorrect. It was NOT created by Rumsfeld, it was only MARKETED by him. To find out more of where aspartame originated, please go here: http://www.wnho.net/history_of_aspartame.htm
    or youtube the documentary: Sweet Misery and you will get more than your fair share of info on the stuff.

    C.M. wrote on July 25th, 2012
  16. I use powdered stevia, but just enough to give a slightly sweet taste.
    Apparently you can also use stevia on your skin, to help with exema problems.
    Didn’t read that here, so I thought I’d pass it on!

    Marion wrote on August 7th, 2012
  17. I use a product (can’t think of the name) that is simply the leaf, ground up. It’s the best for me so far but I don’t use it very much. It tastes like a ground up leaf, just sweet. :) I recently tried it in my Pemmican and it really helped make it taste better. I used only a little and got no leaf taste. I do think in the future, I will grow and grind my own Stevia as I don’t “really” know how mine was grown although it claims to have been done organically and without chemicals.

    On thing though, when I first tried Stevia, I tried the liquid kind. I immediately got light headed and nearly passed out. A friend of mine (who is no doctor of course), thought my body was expecting glucose and realized that’s not what it was. Not sure if I think the same but I haven’t had that reaction since the first time.

    ThreeWest wrote on August 22nd, 2012
  18. I wanted to know if the PLANT was nutritious all this talks about is the sweetener you find in stores. I want to know are there vitamins, minerals in the plant? -facepalm-

    Dave wrote on August 26th, 2012
  19. The weird aftertaste kinda got to me. Got used to it after about a week. I don’t think of it as a sugar substitute. I think of it as an herb. Helps justify the aftertaste.

    Nathan wrote on October 17th, 2012
  20. I dont care for the aftertaste stevia leaves in coffee and tea,but I love to use it in cooking. I made candied yams and they were very good with Stevia!

    sassy54 wrote on November 26th, 2012
  21. Rebaudioside,stevioside? Can someone dumb this down for me? I’m new to primal, a T2 diabetic and I want to use Stevia occasionally but I don’t know what specific kind or brand would have the most health benefit. Can someone point me in the right direction?

    LM wrote on January 3rd, 2013
  22. Why not just start to teach our palettes to not need everything sweetened?

    We don’t use it.

    Montecristo Travels (Sonja) wrote on January 25th, 2013
  23. I’ve been working the last 8 months to completely get off of sugar with the exception of a little very dark chocolate and a little local raw honey. I’ve given up a number of favorite savory recipes because they had some sugar in them (and needed it for recipe balance.) I’m really happy to see that my palate detects a lot of sweet flavors in foods that it didn’t before.

    All that said I miss my cole slaw and stir fry but have always avoided artificial sweeteners. I put stevia in the same camp (natural, yeah, heard that before) but after this article (the idea of improved insulin sensitivity) I decided to give it a go. I talked to a worker at the market about the best for taste and additives and she recommended “Better Stevia”. I made some cole slaw the other day and couldn’t tell the difference from the sugared version! I don’t know if this would extend to making actual sweet desserts with it but all I really wanted was my sweet-n-sour savory dishes back. I’m a happy primal woman.

    Kristin wrote on January 29th, 2013
  24. I am using Stevia for nearly a year, it is preferable above refined sugar, because Stevia is pure natural, can even be used by people with sugar disease. And although some people say it is expensive, it is wrong. Instead of one or two teaspoons of refined sugar, you use 1/32 teaspoon in your coffee or tea, or even less and you will enjoy its taste. Buy it as this website: http://www.ZNaturalFoods.com

    Aart Liberty wrote on March 22nd, 2013
  25. Stevia caused irregular heart beats in my case…Its a vasodilator, and in some people not beneficial. I thought I had a heart problem…Went through a Stress test, nuclear test, and and angiogram, only to find out later it was the STEVIA.!!!

    ANNE MURRAY wrote on March 25th, 2013
  26. I use NuNaturals liquid stevia in my green tea (I carry a bottle in my purse).

    I read recently that because stevia increases insulin production, that it is a good idea to always consume it with food. That way the body actually has nutrients to process with that insulin.

    So I don’t sweeten my in-between meals tea, but I do the tea I drink with meals.

    I also occassionally drink the stevia-sweetened diet soda, Zevia, with a meal.

    Casey wrote on April 3rd, 2013

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