Diabetes Self-Management Blog

Due to popular demand, I’ll conclude my series on sweeteners by writing about stevia. I actually wrote about stevia back in 2008, but times have changed (and I realize that perhaps not everyone had an opportunity to read my entry back then!).

Stevia is an herb that belongs to the sunflower family (Asteraceae). It’s grown primarily in Central and South America, and is sometimes called candy leaf. For many centuries, people living in Paraguay and Brazil have used stevia to sweeten a drink called yerba mate. In the early 1930’s, scientists isolated stevioside and rebaudioside, the ingredients that give stevia its sweetness. These ingredients, collectively known as glycosides, are about 300 times sweeter than sugar, but they are calorie-free and carbohydrate-free (meaning they have no effect on blood glucose). Stevia users sometimes describe stevia as tasting a bit like licorice.

Japan, which is the largest consumer of stevia in the world, has been manufacturing stevia since the 1970’s for use in products such as Diet Coke. Stevia is also used in other Asian countries, as well as in Central and South America. Stevia has been available in health food stores in the United States for a long time and was considered to be a dietary supplement until the FDA granted it “GRAS” (generally recognized as safe) status in 2008. However, only one of the stevia extracts, rebaudioside A, or rebiana, has been given the green light by the FDA; whole-leaf stevia has not be given GRAS status.

Cargill and Merisant are the companies that isolated rebaudioside A, the stevia extract that received FDA GRAS status. These companies submitted research to the FDA in 2008 and petitioned the FDA to approve the extract to be used as a sweetener. The rest is history. Cargill came out with Truvia and Merisant debuted Pure Via, which are two of the main stevia-based sweeteners on the market (other brands inlcude Stevia Extract in the Raw and SweetLeaf). Many consumers rejoiced at the arrival of these new sweeteners because they are free of the chemicals that make up the other popular sweeteners such as saccharin, aspartame, and sucralose.

Stevia-based sweeteners are about 300 times sweeter than sugar, calorie-free, very low carb, heat stable (so you can bake with them), and noncariogenic, meaning they don’t promote cavities. On the other hand, they’re somewhat expensive and can have a bitter taste, and there is some controversy surrounding stevia (more on that below).

The Acceptable Daily Intake (ADI) for stevioside equivalents is 4 milligrams per kilogram (mg/kg) of body weight, which translates into 12 mg/kg per day of steviol glycosides (which includes rebaudioside A). This means that a 68-kg (150 pound) person could safely consume 816 mg of rebaudioside A every day over his lifetime without any adverse effects. That would be like consuming roughly 23 teaspoons of Truvia every day. (Truvia and Pure Via are not 100% stevia-extract: Truvia contains natural flavors and erythritol, a sugar alcohol, while Pure Via contains dextrose, cellulose powder, and natural ingredients.)

Stevia’s safety
It’s always a good idea to remember that “natural” doesn’t necessarily mean “safe.” Most of us understand this, but sometimes we can be lulled into believing that products made with natural ingredients surely are fine, since they’re made with products found in nature. Maybe, but cyanide is natural, and obviously that’s not safe.

Studies done several years ago implied that stevia could be harmful. In one study, male and female rodents given large amounts of stevia had fewer and smaller offspring. Large amounts of stevia given to animals have also been found to interfere with carbohydrate absorption. In test tubes, a compound in stevia can become mutagenic (meaning it increases the frequency of certain types of mutations); it’s not known if this could translate into cancer in humans. Another study found that stevioside, when given to rats, caused lesions in the liver, brain, and spleen, thus supporting an earlier study that concluded stevia to be potentially mutagenic.

The European Food Safety Authority published its opinion on stevia’s safety in 2010 and concluded that animal and some human studies did not indicate that steviosides lead to cancer, birth defects, problems with reproduction, or any other kind of damage, for that matter. The Joint FAO/WHO Expert Committee on Food Additives (JECFA) has further concluded that stevia-based sweeteners have no effect on either blood pressure or blood glucose response and that they are safe to use by people with diabetes. The Center for Science in the Public Interest (CSPI), a consumer watchdog group, also grades stevia as “safe,” but it notes that further safety testing of this sweetener would be useful.


  1. Neat: tried it - liked it; no negative issues.

    Posted by jim snell |
  2. So from reading each part on sweeteners, it sounds like Stevia is the safest alternative to sugar…correct?

    Posted by Wayne Z |
  3. Thank you for reviewing all the sweeteners.I certainly have embraced stevia as my sweetener of choice. I have been using it for over 3 years without a problem. I carry packets with me because the restaurants only offer those blue, yellow, & pink ones that have been shown to have so many problems. I use stevia to sweeten coffee,ice tea, oatmeal, smoothies, etc. I also use it to bake bread and cookies with almond flour. The trick is to only use “enough”, don’t go overboard as this will limit the slight bitter after taste. That means start with one packet, then taste before adding another. After awhile, you will know how much to use. In the long run, adjusting to the taste is better than ingesting even more chemicals and toxins that can cause adverse affects! It may even be worth the extra price…it is for me.

    Posted by Mary G |
  4. My biggest problem with all non-nutritive sweeteners is with how they are used by food processors. Without fail, any product made with them tastes dozens, maybe hundreds of times sweeter than the regular sugar sweetened variety. This tends to lead to sour, bitter, or acidic after tastes that so many people find offensive, even in the products that claim to taste “just like sugar.” I’ve written to ask various companies why they don’t scale back on these mega-sweet products in order to more closely approximate the sugared versions and I’m told repeatedly, “Research shows that people who buy “diet” or sugar-free products prefer them to be more sweet than consumers who buy regular products.” I wonder about that. Other than consumer preference surveys, have there ever been and scientific medical studies comparing these products? Do diabetics and dieters really want hyper-sweetened versions of their cab-sweetened favorites? For me, even tough I still like the taste of a little sugar in coffee or a regular soda from time to time, I can’t handle diet soda of any type and I’d rather drink black coffee than use any artificial sweetener.

    Posted by Joe |

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