A new study from the Ben-Gurion University of the Negev found that stevia may cause gut health problems by upsetting the balance of beneficial bacteria.Consumers can purchase a variety of processed stevia products, including ones formulated to resemble ordinary sugar, for use in everything from beverages to baked goods. .

Stevia: Side Effects, Benefits, and More

They’re made from a highly refined stevia leaf extract called rebaudioside A (Reb-A).You can grow stevia plants at home and use the leaves to sweeten foods and beverages.It also left study participants satisfied and full after eating, despite the lower calorie intake.However, one noted limitation in this study is that it took place in a laboratory setting, rather than in a real-life situation in a person’s natural environment.Study participants consumed 20 milliliters of stevia extract daily for one month.Although stevia is considered safe for people with diabetes, brands that contain dextrose or maltodextrin should be treated with caution.A 2019 study reported a possible link between nonnutritive sweeteners, including stevia, and disruption in beneficial intestinal flora.The same study also suggested nonnutritive sweeteners may induce glucose intolerance and metabolic disorders.In some people, stevia products made with sugar alcohols may cause digestive problems, such as bloating and diarrhea.There’s some evidence to suggest that stevia may help fight or prevent some types of cancer.It found that many stevia glycoside derivatives were toxic to specific leukemia, lung, stomach, and breast cancer cell lines.sprinkled on unsweetened yogurt Some stevia brands, such as Stevia in the Raw, can replace table sugar teaspoon for teaspoon (as in sweetened beverages and sauces), unless you’re using it in baked goods.Stevia in the Raw recommends replacing half the total amount of sugar in your recipe with their product.You should add extra liquid or a bulking ingredient such as applesauce or mashed bananas to your recipe to make up for the lost sugar. .

Are There Downsides to the Sweetener Stevia?

A recent small study found, for example, that when participants had a drink sweetened with stevia instead of sugar in the morning, they compensated by eating more at lunch, along with bigger lunchtime spikes in blood glucose and insulin.“Over all, for nonnutritive sweeteners, we lack evidence, but that’s especially true for stevia,” which has not been extensively studied, said Meghan Azad, assistant professor of pediatrics and child health at the University of Manitoba. .

Stevia side effects: What you need to know

Stevia leaves are about 200 times sweeter than traditional white sugar and people have used them for centuries as a sweetener and herbal supplement.However, the United States Food and Drug Administration (FDA) only consider high-purity steviol glycosides to be safe for human consumption currently.Risks and side effects According to the FDA, the acceptable daily intake for steviol equivalents is 4 milligrams (mg) per kilogram of body weight .When used as a sweetener or to flavor foods, experts do not consider highly purified stevia to cause adverse side effects.Because the kidney is responsible for filtering and creating urine, researchers initially thought that long-term consumption of stevia could damage the organ.bloating Several studies using rodent and human cell cultures have demonstrated the potential gastrointestinal benefits of steviol glycosides.Both the FDA and European Commission concluded that the number of individuals who are hypersensitive to stevia or at a risk of having an allergic response to it is low.A 2016 study found that human sperm cells exposed to steviol experienced an increase in progesterone production.Factors that may increase the risk of stevia side effects include: blood pressure conditions and medications.Increasingly, stevia supplements and extracts are being found to contain counterfeit ingredients, primarily artificial sweeteners that are linked to known health risks.Studies using rat embryos have established that stevia did not affect pregnancy or fertility outcomes and was non-toxic to fetal tissues.However, some of the common counterfeit ingredients found in stevia mixtures and formulas are linked to serious complications and may cause birth abnormalities.High doses or heavy, long-term use of stevia may worsen common pregnancy symptoms by increasing the workload on organs such as the kidneys, bladder, and heart. .

Known Side Effects of Stevia

Some stevia side effects include digestive or stomach issues, allergies, an increased risk of weight gain and potential endocrine disruption.A study published in June 2019 in Proceedings of the National Academy of Sciences of the United States of America delved into how and why this plant naturally creates such a high level of sweetness.Adding stevia products to foods instead of sugar can lead to lower energy intake, the same study concludes.That same study notes that past research in rats showed stevia had positive effects on kidneys and lowered mean arterial pressure.And finally, the study says that stevia in addition to a regular drug regimen could reduce the progression of chronic kidney disease (CKD).And while the study published in December 2015 in Physiology & Behavior also investigated whether stevia can impair gut flora in the digestive tract, more research is needed to solidify the link.Stevia may cause mild digestive issues like nausea, according to Memorial Sloan Kettering Cancer Center.Remain wary and read labels to make sure you're not consuming stevia leaf or crude extracts, which have not been approved by the FDA.A January 2015 study published in Food and Chemical Toxicology explained that there's little evidence to support that there is any link between allergic reactions and highly purified stevia extracts.Though research on this issue is limited, it's possible that stevia may have an effect on the endocrine system, which includes glands that produce hormones.Finally, Harvard Health cites research that found some non-sugar sweeteners (NSSs) were actually linked to weight gain and obesity, despite their use in attempting to prevent those very problems.People who drank high levels of diet soda, which typically contains NSSs, had increased rates of metabolic syndrome as well as Type 2 diabetes.However, as the research on stevia itself is limited, it's safe to say that incorporating this natural sweetener into your diet as a sugar substitute will likely yield greater benefits than risks. .

Stevia might cause issues for your gut health – UF Health Podcasts

Studies have shown high amounts of sugar can increase our risk of obesity, Type 2 diabetes, kidney damage and cellular aging.The researchers encouraged more studies to explore the effects of stevia and determine the highest daily amount that won’t compromise gut health. .

Does Stevia Cause Diarrhea?

Reb-A is a form of steviol glycoside that's about 200 times sweeter than table sugar and is typically combined with other sweeteners, according to June 2019 research in the ​Proceedings of the National Academy of Sciences​ (PNAS).Truvia is a mixture of Reb-A and erythritol (sugar alcohol), and Stevia in the Raw is a combination of Reb-A and dextrose (glucose).A September 2017 analysis in ​Nutrition Journal​ examined the health outcomes of non-nutritive sweeteners and found that not enough studies had been conducted to make a judgment about stevia's overall safety.Xylitol, erythritol, hydrogenated starch hydrolysates, isomalt, lactitol, mannitol, sorbitol and maltitol are all different types of sugar alcohols.Sugar alcohols are commonly associated with side effects including bloating, gas and diarrhea, according to Yale New Haven Health.So, if it includes sugar alcohols, it's possible that a stevia product can lead to bloating, gas and diarrhea, and may have a laxative effect.Truvia, a product marketed as a natural, stevia-based sweetener, contains stevia and erythritol, which is a sugar alcohol. .

STEVIA: Overview, Uses, Side Effects, Precautions, Interactions

Abudula, R., Jeppesen, P. B., Rolfsen, S. E., Xiao, J., and Hermansen, K.

Rebaudioside A potently stimulates insulin secretion from isolated mouse islets: studies on the dose-, glucose-, and calcium-dependency.Boonkaewwan, C., Toskulkao, C., and Vongsakul, M. Anti-Inflammatory and Immunomodulatory Activities of Stevioside and Its Metabolite Steviol on THP-1 Cells.D'Agostino, M., De Simone, F., Pizza, C., and Aquino, R. [Sterols in Stevia rebaudiana Bertoni].Gardana, C., Simonetti, P., Canzi, E., Zanchi, R., and Pietta, P.

Metabolism of stevioside and rebaudioside A from Stevia rebaudiana extracts by human microflora.Geuns, J. M., Buyse, J., Vankeirsbilck, A., and Temme, E.

H. Metabolism of stevioside by healthy subjects.Jeppesen, P.

B., Gregersen, S., Alstrup, K. K., and Hermansen, K. Stevioside induces antihyperglycaemic, insulinotropic and glucagonostatic effects in vivo: studies in the diabetic Goto-Kakizaki (GK) rats.Jeppesen, P.

B., Gregersen, S., Rolfsen, S. E., Jepsen, M., Colombo, M., Agger, A., Xiao, J., Kruhoffer, M., Orntoft, T., and Hermansen, K.

Antihyperglycemic and blood pressure-reducing effects of stevioside in the diabetic Goto-Kakizaki rat.Kinghorn, A. D., Soejarto, D. D., Nanayakkara, N. P., Compadre, C. M., Makapugay, H. C., Hovanec-Brown, J.

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A phytochemical screening procedure for sweet ent-kaurene glycosides in the genus Stevia.Lee, C. N., Wong, K.

L., Liu, J. C., Chen, Y. J., Cheng, J. T., and Chan, P. Inhibitory effect of stevioside on calcium influx to produce antihypertension.Li, J., Jiang, H., and Shi, R. A new acylated quercetin glycoside from the leaves of Stevia rebaudiana Bertoni.Takasaki, M., Konoshima, T., Kozuka, M., Tokuda, H., Takayasu, J., Nishino, H., Miyakoshi, M., Mizutani, K., and Lee, K.

H. Cancer preventive agents.Taware, A. S., Mukadam, D.

S., and Chavan, A. M. Antimicrobial Activity of Different Extracts of Callus and Tissue Cultured Plantlets of Stevia Rebaudiana (Bertoni).Yang, P. S., Lee, J.

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T., and Cheng, J. T. Stimulatory effect of stevioside on peripheral mu opioid receptors in animals.Yasukawa, K., Kitanaka, S., and Seo, S.

Inhibitory effect of stevioside on tumor promotion by 12-O-tetradecanoylphorbol-13-acetate in two-stage carcinogenesis in mouse skin.Effect of stevia aqueous extract on the antidiabetic activity of saxagliptin in diabetic rats.Effects of stevia on glycemic and lipid profile of type 2 diabetic patients: A randomized controlled trial.Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans.Specific immunomodulatory and secretory activities of stevioside and steviol in intestinal cells.Chan P, Tomlinson B, Chen YJ, et al. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension.The effect of stevioside on blood pressure and plasma catecholamines in spontaneously hypertensive rats.Curi R, Alvarez M, Bazotte RB, et al.

Effect of Stevia rebaudiana on glucose tolerance in normal adult humans.EFSA Panel on Food Additives and Flavourings (FAF), Younes M, Aquilina G, et al. Safety of a proposed amendment of the specifications for steviol glycosides (E 960) as a food additive: to expand the list of steviol glycosides to all those identified in the leaves of Stevia Rebaudiana Bertoni.Farhat G, Berset V, Moore L.

Effects of Stevia Extract on Postprandial Glucose Response, Satiety and Energy Intake: A Three-Arm Crossover Trial.Ferri LA, Alves-Do-Prado W, Yamada SS, et al. Investigation of the antihypertensive effect of oral crude stevioside in patients with mild essential hypertension.Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects.Hsieh MH, Chan P, Sue YM, et al. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study.Jeppesen PB, Gregersen S, Poulsen CR, Hermansen K.

Stevioside acts directly on pancreatic beta cells to secrete insulin: actions independent of cyclic adenosine monophosphate and adenosine triphosphate-sensitive K+-channel activity.Lemus-Mondaca R, Vega-Galvez A, Zura-Bravo L, Ah-Hen K. Stevia rebaudiana Bertoni, source of a high-potency natural sweetener: A comprehensive review on the biochemical, nutritional and functional aspects.The hemodynamic effects of rebaudioside A in healthy adults with normal and low-normal blood pressure.Effect of calcium and verapamil on renal function of rats during treatment with stevioside.Melis MS. A crude extract of Stevia rebaudiana increases the renal plasma flow of normal and hypertensive rats.Chronic administration of aqueous extract of Stevia rebaudiana in rats: renal effects.Pezzuto JM, Compadre CM, Swanson SM, et al. Metabolically activated steviol, the aglycone of stevioside, is mutagenic.Prakash I, Dubois GE, Clos JF, et al. Development of rebiana, a natural, non-caloric sweetener.Effects of the Daily Consumption of Stevia on Glucose Homeostasis, Body Weight, and Energy Intake: A Randomised Open-Label 12-Week Trial in Healthy Adults.Stamataki NS, Scott C, Elliott R, McKie S, Bosscher D, McLaughlin JT.Stevia Beverage Consumption prior to Lunch Reduces Appetite and Total Energy Intake without Affecting Glycemia or Attentional Bias to Food Cues: A Double-Blind Randomized Controlled Trial in Healthy Adults.Tomita T, Sato N, Arai T, et al. Bactericidal activity of a fermented hot-water extract from Stevia rebaudiana Bertoni towards enterohemorrhagic Escherichia coli O157:H7 and other food-borne pathogenic bacteria.Wasuntarawat C, Temcharoen P, Toskulkao C, et al.

Developmental toxicity of steviol, a metabolite of stevioside, in the hamster. .

The Best and Worst Sweeteners for Your Gut

I call these sweeteners "GI neutral" because the vast majority of people can consume them in pretty high doses without experiencing digestive distress.But if you divorce philosophical or moral opinions from consideration and focus purely on physiology, you'll see that the human body was designed to absorb sugar quickly, easily and completely.Simple sugars like glucose, maltose and sucrose are therefore unlikely to provoke digestive distress in the vast majority of people.Because maple syrup is primarily composed of sucrose, it has a pretty neutral effect on the digestive tract, too.For them, simple sugars can pose a significant problem called "dumping syndrome" that results in diarrhea, dizziness and weakness.).Aspartame, saccharin and acesulfame potassium are the artificial sweeteners that are best tolerated digestively, though the Center for Science in the Public Interest has raised safety concerns about chronic use of all three of them.Among the natural sweeteners, stevia and monkfruit extract shouldn't aggravate sensitive bowels, either, though beware for branded products like Truvia that blend these ingredients with other less digestively-friendly ones like erythritol.Erythritol is a so-called "sugar alcohol" that's somewhat better absorbed than its cousins whose names also end with "ol," though it can still provoke gas and diarrhea in people who are fructose intolerant.In short-term studies of healthy volunteers consuming very high doses of sucralose (the equivalent of 28 Splenda packets per day for a 150-pound person), no adverse digestive symptoms were reported.However, digestive tolerance has not been studied in people with irritable bowel syndrome, and given a number of studies in both animals and humans that found sucralose to have adverse effects on the gut microbiota, I wouldn't be so quick to give it the green light as "GI neutral.".But isolated lactose is used as an added sweetener to items ranging from birth control pills to milk chocolate-based candy bars. .

Can Stevia Upset Your Stomach?

Stevia originates in South America, and the Guarani Indians knew the plant as the "sweet herb" plant because of its intensely sweet properties, according to the book "The Stevia Story" by author Donna Gates.The U.S. Food and Drug Administration cautions against using unrefined stevia available on the Internet or in health-food stores because of its concerns that stevia can cause difficulty with maintaining steady blood sugar levels, may negatively impact your kidney or cardiovascular functions and has the potential to cause reproductive problems.Consuming the refined version of stevia, rebaudioside A, may cause you to only to experience some nausea or a bloated, full feeling in your abdomen.Memorial Sloan-Kettering Cancer Center lists nausea and abdominal fullness among the reported adverse reactions in patients who consumed about 500 milligrams of "stevioside powder.".If you want to continue to use stevia as an alternative to higher calorie refined sugars, try using the FDA approved sweetener rather than unrefined herbal supplements you can purchase in health food stores. .


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