What are the effects of using Stevia (Stevia rebaudiana) as a sugar substitute?

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Last updated: May 17, 2025View editorial policy

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From the Guidelines

The use of stevia sugar is not recommended as a long-term alternative to sugary beverages due to its potential association with increased disease risk factors, such as obesity, hypertension, and type 2 diabetes, as suggested by recent meta-analyses 1. When considering the use of stevia sugar, it is essential to weigh the potential benefits against the potential risks. While stevia is a low-calorie sweetener that may seem like a harmless alternative to sugary beverages, the evidence suggests that its consumption may be linked to adverse health outcomes. Some key points to consider when evaluating the use of stevia sugar include:

  • The potential association between low-calorie sweetened beverages, including those containing stevia, and increased risk of obesity, hypertension, and type 2 diabetes 1
  • The lack of strong evidence supporting the use of stevia sugar as a safe and effective long-term alternative to sugary beverages 1
  • The recommendation by the AHA Nutrition Committee to encourage the use of plain, carbonated, or unsweetened flavored water as an alternative to sugary beverages, rather than relying on low-calorie sweetened beverages like those containing stevia 1
  • The importance of considering the potential risks and benefits of stevia sugar in the context of overall dietary habits and lifestyle, rather than relying solely on its potential benefits as a low-calorie sweetener. In terms of specific guidance, it is recommended to limit or avoid the use of stevia sugar as a long-term alternative to sugary beverages, and instead opt for plain, carbonated, or unsweetened flavored water as a healthier choice 1.

From the Research

Benefits of Stevia Sugar

  • Stevia is a natural sweetener with zero calories, making it a suitable alternative for diabetic and obese individuals with hyperglycemia 2.
  • The plant exhibits various properties, including hypoglycemic, antibacterial, anti-inflammatory, hypotensive, antiseptic, diuretic, anti-fertility, and cardiotonic effects 2.
  • Stevia has been shown to have positive effects on treating skin diseases such as dermatitis, acne, and eczema 2.

Safety and Efficacy of Stevia

  • Extensive scientific research has demonstrated the safety of stevia as a low-calorie sweetener, if taken in acceptable quantities daily 3.
  • A randomized controlled trial found that stevia had no significant effects on blood glucose, HbA1C, insulin, and lipid levels in type 2 diabetic patients 4.
  • Recent studies have investigated the effects of nonnutritive sweeteners, including stevia, on glycaemic control, with most finding no effect on blood glucose and insulin levels 5.

Comparison with Other Sweeteners

  • Stevia is considered a natural alternative to artificial sweeteners, which may pose health risks 3.
  • A review of the scientific evidence on stevia found that it may be effective in lowering blood pressure in hypertensive patients and improving glucose tolerance, although further investigation is warranted 6.
  • Stevia has been compared to other nonnutritive sweeteners, including sucralose, with some studies finding no significant differences in their effects on glycaemic control 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Stevia as a Natural Sweetener: A Review.

Cardiovascular & hematological agents in medicinal chemistry, 2020

Research

Artificial sweeteners: safe or unsafe?

JPMA. The Journal of the Pakistan Medical Association, 2015

Research

Recent evidence for the effects of nonnutritive sweeteners on glycaemic control.

Current opinion in clinical nutrition and metabolic care, 2019

Research

An evidence-based systematic review of stevia by the Natural Standard Research Collaboration.

Cardiovascular & hematological agents in medicinal chemistry, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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