Food Highlight: Stevia

With all the buzz around sugar, sugar substitutes, and low carbohydrate diets lately, sweeteners have become quite confusing. Many people are shunning real sugar to lower their carbohydrate intake, others are shunning sugar substitutes to avoid potentially harmful chemicals, and others are left scratching their heads when deciding how to sweeten their morning coffee. One new choice on the market is stevia. We will take a closer look into stevia extract, from its origins and uses, to the controversies surrounding this sweetener.

Stevia extract is a sugar substitute that is isolated from the stevia plant. Stevia rebaudiana is grown naturally in South America, where people have been using it for hundreds of years to sweeten their food and drinks and even use it to treat stomach discomfort and burns. In recent years several food manufacturers have found a way to isolate sweet compounds from the stevia leaves and have created their products using these extracts. Purified rebaudioside A, which is extracted from the stevia plant using a multistep chemical process, has been FDA-approved since 2008.

Stevia extract is around 150-200 times sweeter than table sugar, so you can use a lot less in your food and drinks. Combine this with the fact that stevia is calorie free, and it seems like a winning combination. You can use it to sweeten ice tea, use it for baking, or buy products containing stevia extract such as chewing gum, soda, or yogurt to reduce the amount of sugar you consume. Since it is calorie free and replaces sugar, using stevia extract can reduce the calories of a product compared to one made using sugar. This can be especially beneficial if need to watch your sugar intake, such as post surgical bariatric patients who have had lap band, gastric sleeve, or gastric bypass surgery. As stevia itself does not contribute to raising blood sugar levels, it can be a good alternative to other no calorie sweeteners for diabetics. Another benefit is it does not contribute to tooth decay as table sugar does.

However, there is no conclusive evidence that using sugar substitutes leads to weight loss. While replacing sugar with stevia extract can reduce the calories of a single food item, it does not mean that your total caloric intake over the course of the day is lower. Bariatric patients still need to watch their overall caloric intake in order to continue losing weight. Foods made with stevia may have less calories than their sugar produced counterparts, but they still have calories.

Stevia users should also be aware that stevia manufacturers often mix their stevia extract with other products to add bulk. Some stevia manufacturers combine the extract with sugar alcohols, while others use dextrose, agave, or silica. Read the labels carefully when choosing a stevia extract product. Also, be aware that while stevia extract rebaudioside A is FDA- approved, whole leaf stevia and “crude” stevia extracts are not on the “generally recognized as safe” list.

Stevia extracts may also have some other side effects. They may reduce blood pressure, therefore some people taking blood pressure medication may need to be careful with stevia, as well as those with low blood pressure. Stevia may also have a negative impact on those taking lithium. It may also have an adverse effect on those taking prescribed amounts of diabetes medication.

The demand for lower- and no- calorie sugar substitutes is huge, and stevia extract products fit squarely into this growing market. If you choose to use sugar substitute products, read product labels carefully, make sure they don’t interfere with any prescriptions medications you take, and use according to the manufacturer’s directions.

This food highlight is offered by Dr. Shillingford, M.D., P.A., a board certified surgeon specializing in adjustable lap band, gastric sleeve, and gastric bypass surgeries. Dr. Shillingford’s bariatric weight loss practice is located in Boca Raton, Florida and serves patients from all over South Florida including Coral Springs, Delray Beach, Miami, Wellington, Naples, and Fort Lauderdale. Dr. Shillingford’s bariatric patients often ask about ways to reduce calories in their diets, including using sugar substitutes.