The word sugar is on the “naughty” list and we all find ourselves scouring labels from time to time. But remember when 25 years ago fat was the culprit? And then it was carbs? Both of those turned out to be not so simple an enemy, and I predict sugar will be the same. 

Of course, there’s reason to be cautious of too much of any single ingredient, including sugar. But healthy nutrition is more about balance than perfection, and the quality of the ingredient matters too.

When it comes to sugar and your gut—real may actually be better than fake.

Let’s unpack why.

Sugar: A History

Since the 1970’s, high amounts of added sugar have been linked to poor health outcomes and diabetes in several studies. As a result, many calorie-free and low-calorie sweeteners have been developed as a substitute ingredient.

There are 3 types of sweeteners:

1. Sugars: natural sweeteners like cane sugar, maple syrup, and honey.
2. Reduced-calorie sweeteners: sugar alcohols like sorbitol and xylitol, found in sugar-free candy and gum, and now a lot of calorie-free beverages.
3. Artificial Sweeteners (or non-nutritive or no-calorie sweeteners): And the 5 most popular are:

• Saccharin (“Sweet & Low,” found in coffee sweeteners and chewing gum.)
• Aspartame (“Nutrasweet” or “Equal,” found in Diet Coke.)
• Acesulfame Potassium (“Ace K” or “Sweet One,” found in many baked goods.)
• Sucralose (“Splenda,” found in Coke Zero.)
• Neotame (Similar to Aspartame, found in meat products.)

Unfortunately, even though these unnatural substitutes are less harmful to blood sugar levels, several studies have linked these to harmful health outcomes like cancer, indigestion, and overall decline of the gut microbiome. It’s no wonder the search has been ON for a natural, unharmful, non-nutritive sweetener!

Although Stevia held some promise in this category, recent evidence is demonstrating it’s definitely NOT all good, especially when it comes to your gut.

What is stevia?

Stevia is derived from the leaves of the Stevia rebaudiana (Bertoni) plant—an herbal shrub from South America that has been used for centuries as a hypoglycemic agent. It has a very sweet taste, but your body can’t metabolize it, making it calorie-free. According to Mintel, Stevia is added to 14,500 foods and beverages sold on the US grocery shelf. Many of the products that contain stevia are positioning themselves as gut-healthy, like some other kombuchas and certain digestive-supporting soda alternatives.

Could stevia be bad for your gut?

While more studies are needed to confirm this effect in vivo (AKA human trials), at least 4 animal studies and 1 human in vitro study demonstrate that stevia is in fact harmful to the microbiome. Here are the summaries:

• In several studies on mice AND rats, Stevia decreased the number of “good” bacteria in the gut when combined with an American diet (remember from my Meet Your Microbiome? We want to INCREASE, not decrease, bacteria in the gut).
• In one study on rats, Stevia negatively impacted digestion and metabolism in both mother rats and their newborns (meaning it passed through umbilical cord during pregnancy).
• In another study done on rats, Stevia compromised the dopamine transfer mechanism, which is how the gut manages dopamine release. Dopamine is the neurotransmitter responsible for euphoric and happy feelings, so we definitely don’t want to lose it!
• Most recently, a human study demonstrated that stevia significantly reduced “quorum sensing” in the gut. Quorum sensing is an exciting phenomenon that science is discovering about gut bacteria—it’s how the bacteria communicate with each other and your body. In this study, Stevia significantly messed with that function.

All of these studies suggest that Stevia disrupts the microbiome, and therefore may be unhealthy for the gut.

The harm may not stop there

In addition to potential gut imbalance, other adverse effects from Stevia have been recorded and demonstrated across 372 studies, including:

• Increased appetite
• Weight gain
• Headaches
• Depression
• Behavioral and cognitive effects
• Neurological issues
• Risk of preterm delivery
• Cardiovascular effects
• Risk of chronic kidney disease

Recommendation from researchers: avoid stevia or use it sparingly

In general, Stevia is relatively new, and there are still a lot of gaps in the evidence base. There is still more research needed to investigate if the sugar-free benefits of Stevia outweigh the risks. In the meantime, it is advised by ALL the study researchers linked above to use these sweeteners “sparingly” until we know more.

The Takeaway

I am a fan of being mindful of al things we consume and believe moderation is key. I consume sugar mindfully on occasion but find it leads to sugar cravings. For me, I try to reduce most sugars, across the board or I want more “sweet”. I choose to mindfully add date sugar, or coconut sugar to my coffee and prefer desserts with those sweeteners (or honey) in moderation. I reserve actual sugar for a special occasion and at a limited quantity. When it comes to nutrition, my broad recommendation is that folks eat nutrient-dense whole foods and avoid sugar, gluten and dairy.



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