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Stay Healthy the Stevia Way (Diabetics, Weight Loss, Children)


© Ray Sahelian MD, Donna Gates

Ray Sahelian We all have a craving for a sweet taste and often satisfy this craving with sugar or fat-filled foods. Even "natural" sugar substitutes, such as honey, maple syrup or molasses, can be unhealthy if over-consumed since they can markedly elevate blood sugar levels. Hence, stevia can be advantageous to practically everyone whose diet contains sweeteners. Although stevia can be helpful to anyone, there are certain groups who are more likely to benefit from its remarkable sweetening potential. These include diabetics, those interested in decreasing caloric intake, and children.

A Godsend to Diabetics
The availability of artificial sweeteners has been of enormous benefit to diabetics. However, there's always been a concern that over consumption of these synthetic sweeteners may cause some unknown harm to the body. Could stevia substitution be a good alternative in diabetics? We believe so. Stevia leaves have been used as herbal teas by diabetic patients in Asian countries. No side effects have been observed in these patients after many years of continued consumption (Suttajit, 1993). Furthermore, studies have shown that stevia extract can actually improve blood sugar levels (Alvarez, 1981, Curi, 1986).

In 1986, Brazilian researchers from the Universities of Maringa and Sao Paolo evaluated the role of stevia in blood sugar (Curi, 1986). Sixteen healthy volunteers were given extracts of 5 grams of stevia leaves every six hours for three days. The extracts from the leaves were prepared by immersing them in boiling water for 20 minutes. A glucose tolerance test (GTT) was performed before and after the administration of the extract and the results were compared to another group who did not receive the stevia extracts. During a GTT, patients are given a glass of water with glucose and their blood sugar levels are evaluated over the next few hours. Those who have a predisposition to diabetes will have a marked rise in blood sugar levels. The volunteers on stevia were found to have significantly lower blood sugar levels after ingestion of stevia. This is a positive indication that stevia can potentially be beneficial to diabetics who substitute stevia in order to decrease their sugar consumption. Even if stevia by itself is not able to lower blood sugar levels, just the fact that a diabetic would consume less sugar is of significant importance in maintaining better blood sugar control.

If you're diabetic, chances are you consume a large amount of artificial sweeteners and you may be concerned about switching to stevia since long-term human studies have not been done with this herb. You may also be accustomed in your use of these artificial sweeteners and would not be willing to completely stop them. One option is to gradually use less of them while substituting stevia. For instance, you can initially use stevia in some of your drinks, like coffee or tea. After a few weeks, if your comfort level with stevia increases, you can gradually use more of the herbal extract. Over the next few weeks and months you can either switch completely to stevia, or you can continue using it in combination with artificial sweeteners. With time more research will become available on the safety of stevia and artificial sweeteners. Based on the results of these studies, you can determine which ones to continue using in a larger amount.

It's also quite possible that artificial sweeteners may be safe in low amounts, but problems could arise when they are used in excessive quantities. By partially or mostly substituting stevia, you can reduce any potential risk.

Weight Loss
It would seem quite obvious that substituting a no-calorie sweetener to sugar would help reduce caloric intake and thus contribute to weight loss. And such is the case with aspartame. Researchers at the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, at Harvard Medical School in Boston, Massachusetts, studied the influence of aspartame on obesity (Blackburn, 1997). One hundred sixty-three women were randomly assigned to consume or to abstain from aspartame-sweetened foods and beverages for 16 weeks. Both groups were also actively involved in a weight-control program using a variety of modalities. At the end of the 16 weeks, both the group on aspartame and the group without the synthetic sweetener lost 10 kilograms. During the maintenance phase that lasted the next two years, women assigned to the aspartame-treatment group gained back 4.5 kilogram, whereas those not on aspartame gained back 9.4 kilograms, practically all the weight they had previously lost. The researchers state, "These data suggest that participation in a multidisciplinary weight-control program that includes aspartame may facilitate the long-term maintenance of reduced body weight."

Unfortunately, no formal studies have been done evaluating stevia substitution in relation to weight loss. We would suspect, though, that the results would be similar to the aspartame study discussed above. If you are the type of person who adds sugar to your morning coffee or tea, or to iced tea, lemonade, and a variety of desserts and baked goods, then, over time, the elimination of these refined sugar calories could make a significant difference.

Sweet Teeth with No Cavities
Even a five-year old child knows that sugar causes tooth cavities. There are certain bacteria in our mouths, particularly streptococci mutans, that ferment various sugars to produce acids. These in turn eat through the enamel of the tooth causing pockets or cavities. For a long time, scientists have searched to find alternative sweeteners that are not fermentable by bacteria and hence do not cause cavities. Artificial sweeteners have been helpful in this regard.

Does ingesting stevia lead to tooth cavities? A study done on rats has not shown this to be case. Stevioside and rebaudioside A, the two primary sweet constituents of the stevia plant, were tested in a group of sixty rat pups (Das, 1992) in the following way:

Group 1 was fed sucrose (table sugar), at 30 percent of their diet
Group 2 was given 0.5 percent of their diet in stevioside
Group 3 got 0.5 percent of their diet in rebaudioside A
Group 4 ingested no sugars.

After 5 weeks, all four groups had their teeth evaluated. There were no differences in food and water intake and weight gain between the four groups. However, the first group had significantly more cavities than the rest of the groups. Groups 2, 3, and 4 were equivalent. The researchers state, "It was concluded that neither stevioside nor rebaudioside A is cariogenic [cavity causing] under the conditions of this study." It appears that the chemicals within the stevia plant that impart its sweetness are not fermentable, and thus do not cause tooth cavities.

Use in Children
Candies, sodas, ice cream, pies, cakes... it's disturbing how many sweet products are ingested by children on a daily basis. All that sugar can lead to tooth cavities and obesity. We believe that partially substituting with stevia can help children satisfy their sweet tooth while decreasing the risks from excessive sugar intake.

If you're a parent, you can take advantage of the many recipes provided in the second half of this book to provide your children with tasty sweets that will satisfy their sweet teeth but not cause damage to the teeth. Obesity in children is a growing problem in this country and any method we have of helping children reduce their caloric intake will be greatly beneficial.

We also are concerned with children overconsuming excessive amounts of artificial sweeteners. The potential, long-term health consequences of saccharin and aspartame ingestion are currently not fully known, but they do need to be kept in mind. Eliminating all artificial sweeteners will be a frustrating enterprise since they are extremely prevalent. However, by partially substituting stevia in homemade desserts, you can significantly reduce your children's exposure to these artificial chemicals.

Hopefully, with time, stevia can be added to a variety of sodas, candies, gums, and other foods in the US, just like it currently is in Japan and other countries.

Blood Pressure
In 1991, Dr. M.S. Melis, from the Department of Biology at the University of Sao Paulo in Brazil, gave a one-time high dose injection of stevioside to rats and found that it caused a reduction in blood pressure as well as an increased elimination of sodium (Melis, 1991). A slight diuretic effect also occurred. The effect was additive when stevia was combined with verapamil (a medicine used to lower blood pressure in humans who have high blood pressure).

Dr. Melis repeated a similar study in 1995. This time, he administered extracts of stevia to rats for 20, 40, and 60 days. After 20 days, there were no changes in the stevia-treated rats compared to the control group (the ones that didn't receive the extracts). However, after 40 or 60 days of administering the extract, there was a lowering of blood pressure, a diuretic effect was noted along with loss of sodium. The amount of blood going to the kidneys was increased.

When normal human volunteers between the ages of 20 to 40 years were given a tea prepared with stevia leaves, a lowering of blood pressure occurred (Boeck, 1981). This study was done in Brazil. Certainly more human studies are needed before we can come to any conclusions regarding the full effect of normal daily ingestion of stevioside on blood pressure.

Update May 2000 by Ray Sahelian, MD
How does stevia’s sweetness compare to other artificial sweeteners? Does it even come close to their potency? A new study done at the Department of Food and Nutrition, FCF-UNESP in Araraquara, Brazil, compared the relative sweetness of stevia to that of aspartame, a cyclamate/saccharin combination, and a 10 percent sucrose concentration. The results were interesting. An equivalent dose of stevia, aspartame, the cyclamate/saccharin combination and a 10 percent sucrose concentration all had practically the same potency! Cardello HM, Da Silva MA, Damasio MH. Measurement of the relative sweetness of stevia extract, aspartame and cyclamate/saccharin blend as compared to sucrose at different concentrations. Plant Foods Hum Nutr 1999;54(2):119-30.

 
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