Stevia benefits and side effects

Diabetes is a condition in which the body is unable to make or use enough insulin hormone to keep blood sugar levels in check. In addition to taking prescribed medicines, lifestyle changes in diet and exercise are crucial to managing diabetes. This is where stevia can possibly help:

• Research shows that stevia is not digested in the stomach. Instead, gut bacteria in the large intestine break it down into steviol and glucose. The gut bacteria then proceed to use up the glucose so there’s nothing left for the body to absorb. The steviol is broken down further and excreted out of the body. So even though a gram of stevia has 2.7 kilocalories (compared with 4 kilocalories in a gram of cane sugar), none of it is actually absorbed by the body (non-nutritive sugar). What this means is that stevia has a low glycemic index and can sweeten things up without causing a sudden rise (and following drop) in blood sugar levels.
• Diabetics are often advised to lose weight. While there is nothing as beneficial as giving up sweeteners and sugary foods (including white bread) altogether, sugar substitutes at least have fewer calories than sugar.

That said, some studies have raised questions about the usefulness of sugar substitutes, including stevia, on controlling blood sugar. A small study with 10 healthy males found no difference in the 24-hour glucose profile of those who took sugar and those who switched to alternatives. Obviously, more research needs to be done in this area.

Stevia is a known vasodilator: it opens up the blood vessels so the blood flows with less pressure through the body.

This is how it works: the molecules that give stevia its sweet taste also interfere with the absorption of calcium ions in the walls of our blood vessels. Calcium plays a crucial role in monitoring blood pressure: a greater influx of calcium in the smooth walls of the blood vessels cause them to constrict and increase blood pressure.

A multicentre, randomized, placebo-controlled trial of 174 patients over two years found that taking twice daily tablets of 500mg stevioside reduced mean systolic and diastolic blood pressure, however, some patients who received the drug also developed left ventricular hypertrophy during the trial period.

Stevia also helps to maintain body weight, and prevent chronic illnesses like high blood pressure. Since obesity is linked to hypertension, it is a good idea to stave off the extra kilos. This is especially important for those who have a family history of hypertension (high blood pressure) or any other risk factors for it. Chronic illnesses are those that require lifelong management.

Undoubtedly, stevia helps in cutting down on calories. If used in moderation, stevia may be useful for people who are trying to manage their weight. That said, there is conflicting evidence on whether stevia can help people lose, or even maintain, weight. Here's what the research says:

• The promise of low calories can cause some people to overcompensate in other ways. For example, they could let their guard down and eat more because they feel they have earned it by switching out sugar for a low-calorie or zero-calorie sweetener. This type of thinking can be counterproductive, as portion control is important for weight management.
• Ironically, research has also linked non-nutritive sweeteners, especially aspartame, in diet colas to weight gain.
• Some studies have even shown no change in body-mass index (BMI) in people who replaced sugar with stevia and other sweeteners. However, more research and longitudinal studies need to be done on this. BMI is the ratio of weight to height. It can be a useful indicator for being overweight (BMI over 24.9) and obesity (BMI of 30 or more).
• Research has also shown that stevia and other sweeteners may have an adverse effect on gut bacteria. This, in turn, may become a contributing factor to obesity!
  
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Stevia has been shown to have anti-inflammatory and antimicrobial properties. For this reason, beauty experts say that topical use of stevia leaf extract can improve the skin, reduce inflammation and fight acne.

Natural stevia leaf is also antioxidant, as it has been shown to contain flavonoids such as quercitrin, apigenin, luteolin, and kaempferol-3-O-rhamnoside. These antioxidants reduce oxidative stress and can help slow down skin damage and ageing.

Research shows that fresh stevia leaves contain trace amounts of ascorbic acid, b-carotene, chromium, cobalt, magnesium, iron, potassium, phosphorous, riboflavin, thiamin, tin, zinc, among other minerals that are important for good health and skin.

A lab study done on rats found that a 1 mL S. rebaudiana ethanol extract 10% (made with stevia) could increase the speed with which flesh wounds heal.

To make stevia, manufactures soak the leaves in water, treat them with activated carbon, remove the extra minerals and spray-dry it to get a concentrated form of steviol glycoside resin. By the end of this treatment, any vitamins and minerals in the actual stevia leaf are lost.

That said, many of the benefits of stevia can be attributed to the fact that it is not sugar. Sugar, as we know, can affect teeth, gums and oral health in many ways:

• Bacteria present in the mouth can use up sugar and produce acid, which can destroy the tooth enamel little by little. Over time, this can turn into a cavity.
• Sugar can make the mouth more acidic, which can also cause more plaque build-up and eventually cavities. Stevia, on the other hand, does not increase the pH balance of the mouth as much as sugar.
• Sugar combines with saliva and bacteria in the mouth to cause plaque. This, in turn, can cause cavities and gum problems like gingivitis (swelling in the area where the teeth touch the gums).
• Too much sugar also dries out the mouth, which can also hasten tooth decay.

In addition to this, studies have also looked into the potential benefits of stevia for fighting lactobacillus and streptococcus bacteria that are responsible for tooth decay and oral health problems. This is because some stevia extracts have been shown to have antibacterial and antifungal properties (please note, these extracts are not the same as the packaged stevia we get in stores).

At least one study showed that stevia extracts were more effective in fighting lactobacillus than streptococcus bacteria that are responsible for cavities. However, even the authors of this study wrote that more research needs to be done to isolate those elements of stevia that may be beneficial for oral health and study their effects.

Cancer is basically out-of-control growth of cells that encroach on healthy cells of the body. Research has shown that stevia may have an anticarcinogenic (anti-cancer) effect, by inhibiting DNA replication in cancer cells. However, more research needs to be done on this.

According to one study, compounds extracted from steviol showed a capacity to fight cancer cells in leukemia, lung cancer, breast cancer and stomach cancer.

However, studies on stevia and cancer are few and far between and more research is needed to establish a clear creative link.

In April 2020, researchers published the findings of a study on the effects of sugar versus non-nutritive sweeteners like stevia on liver health. The researcher found that stevia extracts exerted a protective effect on the liver and prevented nonalcoholic fatty liver disease in mice in a lab experiment. The findings were published in Scientific Reports, a highly regarded peer-reviewed journal.

A study published in PLOS One, a peer-reviewed journal, found that stevia extracts could retard cyst formation and enlargement in polycystic kidney disease - the in-vitro study used special cells known as MDCK cells that are often used for research in a lab setting.

Studies have shown that stevia extracts exert an anti-inflammatory effect by inhibiting the production of nitric oxide by the macrophages (big immune cells). Further research is needed to establish whether stevia may also be able reduce chronic inflammation (example, in arthritis) and acute inflammation (say, after an injury).