I strive to be discerning and unbiased in my work as a Nutritionist, and as an integrative practitioner, I feel that it is paramount to remain open to new perspectives. This doesn’t change the fact that I feel horrible when I realize that I’ve been giving the wrong advice, or that I’ve allowed a potentially harmful product to slip under my radar.
Such is the case with stevia.
I have been anti-artificial sweeteners for many years, where many of my conventional counterparts have welcomed them with open arms. When Truvia came along, I was quick to point out that it was highly processed and contained questionable additives. I recommended having 100% pure stevia in small amounts and limiting the frequency. Not terrible advice, really, but for a Nutritionist who has been on the glycemic regulation band-wagon for quite some time, I might have connected the dots a little sooner.
We’ve known for quite some time, since the late 80’s, in fact, that non-nutritive sweeteners increase food intake. Why didn’t I equate this with blood sugar dysregulation? Blood sugar control for weight management and decreasing inflammation are key to the foundation of my philosophy on optimal nutrition and wellness, especially for those dealing with autoimmune diseases.
Here’s the problem with stevia concerning blood sugar dysregulation—as a non-nutritive sweetener, stevia does not contain any sugars or calories, but it does impart the sweet taste to the taste buds.
When the brain senses the sweet taste, signaling processes clear the blood stream of sugars in order to make way for more sugars. Now, this would be fine if there were actually more sugars (not too many, though) coming down the pike; however, since there are none, this leaves the blood sugar tanked and thus, results in hypoglycemia.
Hypoglycemia, in turn, leads to an effort by the body to replenish blood sugar levels by calling upon stored glucose from the liver and muscles, in the form of glycogen. To accomplish this mobilization of glucose from body stores, stress hormones must be released.
When hypoglycemia becomes a pattern, it leads to excessive appetite (especially for carbohydrates) and belly fat deposition (which is an indicator of inflammation and estrogen dominance) from the regular and excessive release of stress hormones.
For anyone with an autoimmune disease, I would now caution the use of stevia, especially in conjunction with a low or carbohydrate-free meal or snack. Hypoglycemia most often leads to hyperglycemia (i.e., the blood sugar rollercoaster), due to over-eating carbohydrates as an effort to correct, albeit over-correct, low blood sugar levels. This pattern is a recipe for increased inflammation.
That said, even those without autoimmunity should use stevia and other non-nutritive sweeteners sparingly, if at all, just as they should use added sugars. In my opinion, sticking to real sugars in moderation is the way to go.
Safe added sugars to use in moderation include sugars from whole fruits, raw honey, maple syrup and coconut palm sugar. If and when you do consume stevia, it would be best to consume it as a part of a mixed meal or snack, meaning that what you are eating contains a balance of complex carbohydrates, protein and fat. This will offset stevia’s potential hypoglycemic effect.
The other issue, which I’ve already alluded to, is hormonal imbalance. Our hormones exist in a delicate dance with one another. When one hormone is out of balance, they can all become imbalanced. Many people with autoimmunity struggle with hormonal imbalances, such as with stress, insulin, thyroid and sex hormones.
Hormonal imbalances are tightly linked to blood sugar control, and simply stepping off of the blood sugar roller coaster to normalize insulin and stress hormones can be a major factor in restoring hormonal balance and therefore, to feeling better.
So, as paradoxical as it may seem at first glance, regularly consuming non-nutritive sweeteners—even natural versions like pure stevia—is not a good strategy for maintaining optimal blood sugar, hormone and inflammatory responses, particularly when consuming a low-or no-carbohydrate diet, which I actually do not recommend for sustained periods of time in most people. We do need carbohydrates to function optimally—we just need to avoid over-consumption and choose the right ones.
According to Sarah Ballantyne, PhD, and author of The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body, there is also evidence that aside from the hormone-altering effects of hypoglycemia induction, stevia itself may impact estrogen and progesterone levels.
She states that steviol glycocides, which are responsible for the sweet taste of stevia, actually have a hormone structure. In Chapter 3 of her book, she points to studies that have shown contraceptive effects of stevia in rats, and notes that although there have been no human trials, the stevia plant was traditionally used as a female contraceptive by the Guarani Indians in the south of Brazil.
She maintains that, “For those with autoimmune disease, in which hormones have such a dramatic impact on disease development and progression, the impact of consuming stevia on hormone regulation is relevant… While small and occasional consumption of stevia likely has little to no impact on general health, it should not be consumed on a regular basis especially by those with altered hormone balance and dysfunctional immune systems.”
One last issue in my mind is that by using non-nutritive sweeteners, one is not paying attention to breaking the addiction to the sweet flavor, but instead perpetuating it, since non-nutritive sweeteners are considerably sweeter than sucrose and other saccharides.
Additionally, upon substituting non-nutritive sweeteners for sugars, one will likely continue to under-appreciate and under-consume the other flavors—sour, pungent, bitter and astringent. Traditional Chinese Medicine, as well as the ancient science of Ayurveda, would have us consume a balance of all of the flavors for optimal health.
In Western terms, we know that consuming a variety of foods, especially plant foods, ensures a balanced intake of nutrients and antioxidants. Furthermore, if we over-appreciate sweet and under-appreciate bitter, we are missing out on some of the most highly anti-inflammatory compounds that the diet can offer.
For optimal health and management of autoimmunity, my best advice to my fellow Autoimmune Moms regarding sweeteners, is to steer clear of or minimize the use of the non-nutritive ones, including pure stevia. If and when you do consume stevia, make sure it is 100% pure and to only have a very small amount as a part of a balanced meal or snack.
About the Author
Angie King-Nosseir MS, RD is an Integrative and Functional Registered Dietitian, with a passion for walking with people along their path toward health transformation. Angie has a Master’s degree in Nutrition, is a Certified LEAP Therapist, corporate wellness health coach, freelance nutrition and wellness writer, and certified yoga instructor. She is trained in Functional Nutrition and Medicine through the Institute for Functional Medicine and in Food as Medicine through the Center for Mind-Body Medicine.
This blog post was originally published by AutoimmuneMom.com, written by Angie King-Nosseir, and first published on Oct 26, 2014.