Stevia, the maligned sweetener

Recognizing its harmful effects, more consumers are choosing products without added sugar. The result is a flourishing alternative sweetener market and confusion about which sugar substitutes are harmful or healthy. Stevia has been a leading natural sweetener until several well-meaning bloggers have maligned it as no better than synthetic sweeteners. So, what is the truth? Is stevia harmful or healthy?

What is stevia?

While the original sugar substitutes were synthetic chemicals (aspartame, sucralose, etc.), several natural options are now available (xylitol, monk fruit, erythritol, etc). One of those natural options is stevia, which is about 250 times sweeter than sugar (sucrose).

Stevia is a small perennial and subtropical herb native to South America. There are more than 150 species of stevia but the most prized variety is Stevia rebaudiana. Two sweet glycosides were isolated from its leaves by scientists in 1931— stevioside and rebaudioside. Both are sweet but stevioside leaves a stronger bitter aftertaste that some find disagreeable. Other naturally occurring glycosides are rebaudioside B and rebaudioside C.

Sweetness comparison (1)

 

Sweetener

Potency

(X sweeter than sugar)

Calories

(per tsp.)

Sucrose

16

Monk Fruit (Lo Han Guo)

300

0

Stevia (highly processed)

250

0

Stevia (Green leaf)

40

0

Xylitol

1

9.6

Erythritol

0.7

1

How stevia is processed

There are three main types of stevia: green leaf stevia, stevia extracts, and highly-processed stevia. Being aware of each type is important for choosing a stevia that is healthy rather than harmful.

  • Green leaf stevia — the type that has centuries of safe use behind it — is minimally processed. The leaves are dried and ground into a fine green powder. This type is approximately 30 to 40 times sweeter than sucrose and retains the health benefits of stevia.
  • Some stevia extracts further process the green powder with water and alcohol (minimally processed stevia extracts). The resulting extract is then subjected to an enzymatic process to reduce the bitter aftertaste. These are often liquid extracts and contain a variety of glycosides, not just one.
  • The worst extracts are highly processed — often undergoing dozens of steps — to create a processed stevia extract that resembles little of what it was in the leaf. These extracts are typically white powders or liquids and concentrated for the sweeter and less bitter part of the leaf (rebaudioside A). Chemical solvents are added to the rebaudioside after it is extracted from the leaf. Then the fillers and other ingredients are added to produce a very sweet and highly treated sweetener. In fact, one commercial stevia product (Truvia) admits on its website that it contains less than 1% stevia. (2) Interestingly, these are the extracts the FDA and other government regulatory agencies have approved for human consumption, but the whole leaf or crude stevia extracts are not.

Concerns over additives

Many bloggers point out that stevia often contains fillers and flavor enhancers like maltodextrin, sugar alcohols, dextrose, cellulose, and other natural flavors. This is true, especially among name-brand stevia products. However, the additive concern can be easily overcome by a savvy label reader. Some manufacturers also share their extraction method/process on their website.

The alleged harmful effects of stevia

Despite its centuries of safe use in Brazil, and Paraguay, and a long history of sage use in Japan several adverse effects have been attributed to stevia consumption. This list includes infertility, hormonal changes, low blood sugar, stressed adrenals, headaches, blood pressure dysregulation, dizziness, thyroid trouble, and even cancer. Let’s explore the evidence to support these allegations.

Infertility and hormonal changes may be a concern if large amounts are consumed. A 1999 study found that administering 6.7g/kg body weight of stevia extract produced functional changes to the male reproductive organs and resulted in lower testosterone levels in rats. (3A,3B) The problem with applying this study to humans is primarily the dose. In 2008, the Joint FAO/WHO Expert Committee on Food Additives established the safe daily intake of steviol glycosides as 4 mg/kg body weight. (3C) This dosage was reaffirmed in 2016. The dose of 6.7g/kg equates to about 469 grams daily in humans. To put this in perspective, you would have to consume over 117 teaspoons of stevia daily to equal this dose. This is an extreme dose that one would hardly be able to consume because of the overwhelming sweetness of stevia.

What about the effects of stevia on blood sugar? This has been tested in both animals and humans. Scientists administered stevia at a dose of 10mg/kg body weight for 28 days in diabetic rats. What the researchers found was that stevia exerted a beneficial effect that increased insulin secretion and reduced blood sugar levels. (4A) This effect appeared to be a result of stevia’s action on the pancreas cells that produce insulin (beta-cells).

Other scientists tested stevia in a food, rather than isolated, which more valid because stevia is typically not consumed alone. This research suggests that consumption of stevia cookies (as opposed to regular cookies) had no significant effect on blood glucose response two hours after consumption. (4B) This same study reported that the stevia cookies reduced hunger — certainly a positive finding for those trying to lose weight. A moringa cookie was also included in the study, which was able to reduce both hunger and blood glucose levels. Similarly, a test in healthy and obsess individuals who consumed tea and crackers with cream cheese sweetened with stevia determined that stevia significantly decreased glucose levels after a meal. (4C) Another clinical study found that stevia enhances glucose tolerance and reduces plasma glucose levels at a dose of 5g of leaf extract every six hours for three days. (4D) Lastly, a single dose of 1,000 mg of stevioside reduced glucose levels after a meal in diabetics. (4E) The current evidence suggests that stevia positively effects blood sugar regulation in healthy and diabetic individuals.

Some experts contend that stevia may stress the adrenal glands. The argument is that the sweet taste of stevia triggers the body to release insulin to shuttle glucose into cells. However, since no glucose exists in the bloodstream, adrenaline and cortisol are released to mobilize sugar stores (glycogen) from other sources (liver, muscles). This argument has some validity and this process might possibly occur. Anecdotal reports from individuals suggest a very small number of people may experience low blood sugar and weakened adrenals after ingesting stevia. But there is little evidence in the form of clinical studies to substantiate this.

The stevia causes cancer fears are a bit of a mystery. Laboratory research suggests that stevioside has an anti-cancer effect in breast, colon, and mouse skin cancer. (5A,5B,5C) Scientists concluded that stevia has no effect on pancreatic cancer development, growth, or death in a mouse model of pancreatic cancer. (5D) One study found that rebaudioside A did not damage DNA or cause genetic mutations in mice when administered at a dose of up to 2g/kg body weight. (5E) A more recent study concluded that stevia and its glycosides do not cause toxicity, cancer, DNA mutations, embryo or fetal harm, and have “therapeutic effects against several diseases such as cancer, diabetes mellitus, hypertension, inflammation, cystic fibrosis, obesity and tooth decay.” (5F) No research to support a carcinogenic effect could be identified. It appears that a connection between stevia and cancer is an exaggeration and not reality.

Current evidence suggests that stevia does influence blood pressure. A two-year, randomized, placebo-controlled study found that taking 500 mg of stevioside powder three times daily significantly reduced both systolic and diastolic blood pressure. (6) No significant incidence of adverse effects was noted between the stevia group and the placebo group. Although four people taking stevia reported gastrointestinal symptoms (abdominal fullness, nausea) and fatigue during the study. Until further clinical research is conducted, it may be prudent for people with low blood pressure to limit stevia.

Stevia doesn’t seem to have any effect on thyroid hormones. (7A,7B) This doesn’t mean that certain people don’t have a bad experience with stevia, some certainly do. Each of us is unique and the foods and supplements we consume will affect us differently. In addition, a small clinical study (16 participants) found that ingestion of 0.2g of stevia three times a day for one week modestly increased cortisol levels and affected the cortisol to cortisone levels in the morning. (7C) Elevated cortisol levels can disrupt thyroid hormone regulation, particularly in those with thyroid disorders. Again, caution should be exercised in people with thyroid disorders.

Steviol is the final product of metabolism and it essentially leaves the body without accumulating. (8) This suggests that stevia and its glycosides are readily metabolized and excreted by the body.

The bottom line

Reasonable use of stevia poses little risk of harmful effects in healthy individuals. People with adrenal fatigue, low blood pressure, low blood sugar, thyroid disorders, or cortisol imbalances may want to limit stevia, especially its long-term use. Your safest bet is to use reasonable amounts of a green leaf extract or minimally processed extracts. Highly processed stevia extracts that don’t contain fillers and additives have a long history of safe use as well but are less preferred. Chances are these are the ones in your favorite products and you have to decide if that product’s benefits outweigh the minimal risks.

 

 

 

Surviving the 2018 flu season

The peak of the 2018 flu season is upon us with outbreaks being reported across North America. The influenza virus has hit every state in the continental United States and the media reports that Canadian emergency rooms are overcrowded with sick patients. A number of schools have canceled classes due to a rapid rise in flu-related absences. The flu shot has been a miserable failure, particularly since the mutated H3N2 strain that is spreading is difficult to prevent with the vaccine. And people are missing work, negatively affecting businesses. With the significant effects of the flu this year, some are wondering whether they should isolate themselves at home until the peak flu activity ends in April.

What is the flu and what are the symptoms?
Influenza is a contagious respiratory infection caused by a group of viruses known as influenza. There are four types of influenza viruses: A, B, C, and D. Influenza D primarily affects cattle and does not cause illness in humans. Human influenza A and B are responsible for the seasonal flu. Influenza C generally only causes mild respiratory symptoms and is not believed to cause seasonal epidemics.

Influenza A is further divided into different strains based on the presence of two proteins on the surface of the virus: hemagglutinin (H) and the neuraminidase (N). There are 18 different H subtypes and 11 different N subtypes. Influenza A also involves different strains due to virus mutation. H1N1 and H3N2 are two of the most common strains responsible for seasonal flu. They may be labeled according to the year they were most virulent, such as 2009 H1N1 Influenza.

The flu can cause mild to severe illness depending on the age and current state of health of the individual. It usually comes on suddenly and includes the following symptoms:
• Fever
• Chills
• Cough
• Headache and body aches
• Fatigue
• Sore throat
• Runny or stuffy noise

The role of the immune system
Whether or not you get the flu depends on the strength of your immune system. This is why the elderly, very young, and people with chronic medical conditions tend to be hit the hardest by the flu — both in incidence and severity.

The immune system is relatively immature at birth and has to adapt during life through exposure to multiple foreign challenges (viruses, bacteria, etc.). Babies produce their own antibodies each time they are exposed to a foreign challenge. Infants rely upon antibodies passed from their mother to protect them against germs for their first few months of life. Breastfed babies continue to receive a boost of disease-fighting antibodies through breast milk that is rich in cells that fight infection. By age one, their immune system has developed significantly but not fully. An immature immune system obviously increases the risk of influenza infections in infants.

The effects of aging on the immune system include a reduced production and diminished function of key immune cells. (1) In other words, the immune system detects and responds to foreign challenges more slowly with fewer cells performing this vital function. The body also heals more slowly in aged adults. As a result, elderly individuals experience a decline in immune function that makes them more susceptible to illness and a greater risk for complications.

Prevention strategies
Prevention is a far better strategy than treating the flu, especially if you are in the more vulnerable populations. Flu-related complications — such as pneumonia, sinus or ear infections, myocarditis (inflammation of the heart), and more — resulting in hospitalization and sometimes death are more likely in the elderly, very young, and chronically ill. Here are some tips to reduce your risk of infection:
Wash your hands with soap and warm water regularly. The flu virus is spread via contact with respiratory droplets. This contact can occur through direct contact with the virus or by contact with a surface the has the virus (like a door handle or shopping cart). Washing your hands frequently can reduce your risk of infection.
Eat real whole foods (not packaged, processed foods). Your body relies on a daily infusion of vitamins, minerals, and other nutrients necessary for proper immune function. Inadequate supply of nutrients weakens your immune defenses and makes you more susceptible to illness. On the contrary, eating fresh fruits and veggies improves your immune defenses. (2)
Reduce sugar intake. Sugar depresses the activity of white blood cells, (3) which not only protect your body from viruses and germs but help prevent some medical conditions. Indeed, recent research suggests that drinking 1 liter (33.8 ounces) of sugary soda — or 100 grams of sugar — can disable the immune system for up to five hours. (4) Sugar also has a similar structure to vitamin C and competes with C, resulting in less vitamin C in white blood cells. Vitamin C is important for both the production and function of white blood cells.
Be physically active. Regular physical activity isn’t just good for your heart, body, and mind. Thirty minutes of moderate-intensity physical activity most days of the week may reduce the risk of respiratory infections. (5) Regular low to moderate activity also decreases flu-related mortality. (6)
Take a vitamin D supplement daily. Research has made it abundantly clear that vitamin D plays an important role in immune system regulation. (7) Experts concluded that about 41.6% of U.S. adults are deficient in vitamin D, with those of African American decent reaching 82.1%. (8) Individuals who are deficient can see up to a 50% reduction in influenza risk by taking vitamin D according to a 2011 study. (9) Ideally, people would have their vitamin D status determined by a blood test. However, in the absence of a test it is not unreasonable for elementary aged children to take 1,000 to 2,000 IU daily during flu season, and older teens and adults 2,000 to 5,000 IU daily.
Take probiotics daily. You may not realize it but about 70% of your immune system lies within your gut as the gut-associated lymphoid tissue, or GALT. (9) Probiotics play a vital role in the gut microbiome and therefore significantly impact immune function. A review of 13 randomized controlled trials concluded that probiotics reduced the number of people who experienced an acute upper respiratory-tract infection. (10) Another review that included 23 trials and 6,269 children determined that probiotic consumption reduced the incidence of respiratory tract infections in children. (11) Look for a multi-strain probiotic with at least 10 to 15 billion CFU and take one to two daily.
• Wear a mask if you choose. Although not very attractive, wearing a respiratory mask has proven significantly effective in reducing the risk of influenza. (12)

Natural solutions if you get the flu
Despite your best efforts, you may still get influenza. If this happens, a number of natural solutions exist to help speed your recovery.
Rest. Your body needs time to heal and recover, so take it easy. Stay home from work or school. Not only does this provide much needed rest but you reduce the spread of the virus.
Drink plenty of fluids. Water, herbal teas, and broth keep your respiratory system hydrated and thin mucus for expulsion. Don’t drink sodas, sugary sports-drinks, or other sugary beverages that will depress your immune system.
Take elderberry syrup. Preliminary research suggests that taking elderberry syrup reduces both the severity and duration of the influenza A and B. (13) Thousands of individuals can also attest to its effectiveness. As outlined in SuperCritical Essential Oils, typical doses are as follows: teens/adults: 10–15mL, 4 times daily for 5 days; children 1–6 years old: 5mL, twice daily for up to 5 days; children 7–12 years old: 5 mL, 4 times daily for 5 days.
Use essential oils. Teens and older adults can take a few drops of an immune-supporting blend with two drops of one or two SuperCarrier oils (balsam fir, lavender, lemongrass, ginger, and ylang ylang) in a capsule up to three times daily. This will help support normal immune activity to identify and eliminate the virus. Be sure to diffuse a respiratory blend to support mucus expulsion and respiratory function as well. Younger children can have an immune-supporting blend rubbed onto their feet with carrier oil. Diffusing respiratory supportive oils is also helpful in children three and older. For more information on how to use essential oils see Surviving When Modern Medicine Fails, Evidence-Based Essential Oil Therapy, or Medicinal Essential Oils.
Take homeopathic Oscillococcinum. If you catch the flu within the first 12 hours — even better within the first two hours — then you may have success with Oscillococcinum. It is designed to reduce flu-like symptoms such as body aches, fever, chills, fatigue, and headache. Take as directed in the supplement box.

Conclusion
You don’t need to panic and sequester yourself until Spring. Take reasonable and appropriate measures to protect you and your family and life will continue without inviting the dreaded flu into your home.