Alternatives to Using Sugar and Artificial Sweeteners
By Keith I. Block, MD
As patients make the decision to stop using table sugar and artificial sweeteners such as aspartame, they often have many questions about which sweeteners are OK to use, how they are best used, and how often they can use them. We have compiled information on some of the most commonly used sweeteners, and will provide you with information on several of them. Please note for all of these sweeteners: Everyone can react different to sweeteners, so we suggest that anyone with diabetes or hypoglycemia test the effect of each sweetener on their blood sugar levels before they begin to use that sweetener regularly.
Today, we’ll take a look at stevia. The stevia plant is a South American species that has sweet-tasting leaves. The leaves taste sweet because they contain several non-caloric phytochemicals that are intensely sweet – about 300 times sweeter than sugar. The extract of the stevia plant has been developed into three kinds of non-caloric sweeteners that are now on the market:
(1) Crushed dry stevia leaves: These are the most natural but they have a complex taste and can be difficult to dissolve in foods.
(2) Stevia extract: The extracts contain most of the natural phytochemicals in stevia and are widely sold, usually in single serving packets like artificial sweeteners. The extracts tend to be available in natural food stores.
(3) Isolated stevia phytochemicals: a single phytochemical, rebaudioside A, has been isolated and developed as a commercial non-caloric sweetener. It is sold in packets and is available in grocery stores. One brand is called “Truvia.”
Is stevia safe?
Based on early studies in animals, there has been some concern that stevia might be mutagenic (a mutagen is a physical or chemical agent that can change the DNA of an organism. Given that many mutations can cause cancer, mutagens are likely a carcinogenic factor). However, these observations have not been confirmed in later studies, and the U.S., the European Union and several other countries have approved stevia for use in the diet. It’s important to note that mutagenic effects have not been reported for rebaudioside A (also called “reb Z”), which is what is readily available to consumers via retail outlets.
There has also been concern that stevia, along with other non-caloric sweeteners, might increase blood sugar or insulin levels. Insulin levels might be increased because the non-caloric sweeteners could “trick” the brain into thinking that sweet food is being eaten. The brain could then signal the pancreas to secrete insulin. This possibility has not been very well scientifically documented, and it’s hard to tell how significant it is. Some diabetics feel that stevia increases their blood sugar; however, some studies have indicated that stevia could have a blood sugar lowering effect, potentially problematic for people who are prone to low blood sugar. Thus, anyone with blood sugar problems should test stevia as well as other non-caloric sweeteners on themselves before starting to use them regularly. Because we do not fully understand their effects on insulin levels, we recommend less than 5 servings per day of non-caloric sweeteners, and the use of stevia be alternated with agave, rice syrup and other recommended natural sweeteners.
How do I use stevia?
Stevia is most easily used as a sweetener for drinks. You can use stevia in recipes that are designed for other non-caloric sweeteners. Because it is much sweeter than sugar, you only need to use tiny amounts of it.
In the next blog posting, we’ll take a look at the sweetener lo han guo.
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