Saturday, January 3, 2015

What is Stevia? What are the health benefits of Stevia?

Stevia rebaudiana is a South American plant of the Asteraceae family, which also includes sunflowers and chrysanthemums. 
Native to Paraguay, stevia has traditionally been used to sweeten beverages and make tea. The term "stevia" refers to the entire plant and its components, only some of which are sweet.1
While the word "stevia" refers to the entire plant, for the purposes of this article, the term "stevia" will be used interchangeably to also refer to "steviol glycosides" - the sweet components isolated and purified from the stevia leaves.
Fast facts on stevia
Here are some key points about stevia. More detail and supporting information is in the main article.
  • Stevia is a plant naturally grown in Brazil and Paraguay.
  • Stevia is much sweeter than sugar - the extract can taste 250-300 times sweeter than table sugar.
  • The extract is contained in a number of food items in the US such as energy bars, candies, protein drinks and some teas.
  • Since stevia is so much sweeter than sugar, recipes require less of it.
  • Stevia does not brown and caramelize the same way sugar does.
  • Stevia is calorie-free, but that does not necessarily mean you will lose weight if you swap sugar for stevia.
  • The stevia leaves contain potassium, zinc, magnesium and vitamin B3.
  • Based on the stevia nutrition facts, it is the 10.77% fiber which helps in curing constipation and promotes proper digestion.
  • One of the benefits of stevia is that it contains a 702 ppm level of iron which can stimulate the production of hemoglobin.
  • Stevia and other artificial sweeteners that have been approved for use in the US do not appear to pose any health risks when used in moderation.

What is stevia?

Stevia plants grow and are harvested in many countries around the world, predominantly in China and Brazil. The plants grow 2-4 feet in height with slim, branched stems, and thrive in temperate and some tropical regions. Stevia is grown by natural, conventional plant breeding methods such as cross-pollination and other non-genetically modified processes.
stevia leaves and sugar cubes
Stevia is an intensely sweet natural sweetener that is harvested around the world from the stevia rebaudiana plant.
The plant is cultivated as a commercial crop in Japan, China, Kenya, Vietnam, India, Argentina, Colombia, Thailand, Paraguay, and Brazil. Currently, China is the leading exporter of stevia products.8,19
Stevia provides an important role in biodiversity due to how little land is required to grow it, allowing farmers to diversify their crops. Unlike commodity crops, stevia is grown on smaller plots of land and provides supplemental income to more commonplace crops.
As stevia is intensely sweet and an extract, it typically requires only a fifth of the land and much less water to provide the same amount of sweetness as other mainstream sweeteners. For example, in Kenya, stevia is typically grown on only a third of the land, with the rest of the land being devoted to other crops.
In a 2013 study, the carbon footprint of stevia was shown to be 79% lower than high fructose corn syrup (HFCS), 55% lower than beet sugar, and 29% lower than cane sugar, based on industry production standards.
There are 150 species of stevia, all native to South and North America. The sweetness of the stevia leaves is caused by eight glycosides contained within them. These glycosides are stevioside, rebaudioside A, C, D, E and F, steviolbioside, and dulcoside A. Stevioside is the most abundant of these components; the leaves of some cultures contain up to 18% stevioside.
Although it was not until the 19th century that scientists began seriously investigating stevia, the indigenous people of Paraguay were using the plant as early as the 16th century to sweeten drinks and medicines.
During his studies of herbs used as sweeteners by native people, Dr Moises Santiago Bertoni, a Swiss botanist of Italian descent, is credited with having notified the world of stevia's existence.
French chemists identified stevioside in 1931 and its use expanded. In the 1950s, Japan began growing the stevia plant as a crop.
Countries with a history of using stevioside as a no calorie sweetener include Japan, China, South Korea, Taiwan, Israel, Brazil, Uruguay, Paraguay, Columbia, Thailand, Germany and Malaysia.
Some of the common and trade names for stevia sweeteners are Enliten, PureVia, Rebaudioside A/Reb A, Rebaudioside B, Rebaudioside C, Rebaudioside D, Rebiana, Stevia, Steviacane, Steviol Glycosides, Stevioside, Stevia Extract In The Raw, and SweetLeaf.

How is stevia extracted?

Steviol glycosides are extracted from the stevia leaf, filtered, and purified. This process is similar to how other plant ingredients such as sugar and vanilla extract are obtained. The sweet molecules in the stevia plant are extracted by steeping the dried leaves in water, followed by separating and purifying the best-tasting steviol glycosides.9
The steps of the extraction process may include:
dried stevia leaves
The sweet molecules in the stevia plant are extracted by steeping the crushed, dried leaves in water, followed by separating and purifying the best-tasting steviol glycosides.
  • Crushing the leaves
  • Extracting with water
  • Filtering and separating the liquid from plant material
  • Further purifying the extract with water or food grade alcohol
  • Drying - to obtain high purity stevia leaf extract.
Subsequent to the extraction and purification process, the steviol glycosides are equal to those found in the stevia leaf, that is, they are molecularly identical. 
The process simply gives purified stevia leaf extract a cleaner, more sugar-like taste than crude stevia extracts. The crude stevia extracts may contain plant components that tend to add additional flavors other than a purely sweet taste.
Purification is also essential to observe the safety standards for food and beverage use.
Stevioside and rebaudioside A are the component glycosides of principal interest for their sweetening property. Associated glycosides including rebaudioside C, dulcoside A, rubusoside, steviolbioside, and rebaudioside B are present in preparations of steviol glycosides at levels lower than stevioside or rebaudioside A.4

Steviol glycosides

Steviol glycosides are found in the leaves of the stevia plant. They have particular taste profiles and intense sweetness. Steviol glycosides can be isolated and purified from the leaves of the stevia plant and are approved for use in countries including Australia, Brazil, China, Japan, Korea, New Zealand and Paraguay. In the US, steviol glycosides with high rebaudioside content are Generally Recognized As Safe (GRAS) for use as a tabletop sweetener.

Rebaudioside A

Rebaudioside A is one of the many steviol glycosides in stevia leaves that provide sweetness. In the US, rebaudioside A is GRAS for use as a general-purpose sweetener and may be used in foods and beverages, excluding meat and poultry products. Rebaudioside A is approximately 250-300 times sweeter than sucrose.6
All steviol glycosides share a common steviol backbone. The differences between the various steviol glycosides are due to the number and arrangement of sugar molecules attached to the steviol core.14
The end product is a highly purified stevia glycoside sweetener or flavor suitable for use in a range of foods and beverages. It only takes an average of three stevia leaves to reduce 25% of the calories in a can of soda (12 oz; 355ml).

How is stevia used?

More than 5,000 food and beverage products currently use stevia as an ingredient worldwide, including tabletop sweeteners for baking as well as other everyday products.
Stevia sweeteners are used as an ingredient in products throughout Asia and South America such as:
stevia leaves and chocolate
Stevia-sweetened chocolate contains all the sweetness you crave but with far fewer calories.
  • Ice cream
  • Desserts
  • Sauces
  • Yogurts
  • Pickled foods
  • Bread
  • Soft drinks
  • Chewing gum
  • Candy
  • Seafood
  • Prepared vegetables.
In the US, stevia sweeteners are primarily found in tabletop products and reduced calorie beverages as sugar substitutes.2 Extracts from the stevia leaf have been available as dietary supplements in the US since the mid-1990s and many contain a mixture of both sweet and non-sweet components of the stevia leaf.6
Stevia sweeteners provide an alternative sugar substitute when sweetening foods such as cereal, yogurt and fruit. Some recipes allow for cooking and baking with these sweeteners. However, appropriate usage levels vary according to the stevia sweetener, and manufacturer's guidelines should be followed.

The sweet components in stevia sweeteners are naturally occurring, which may further benefit consumers who prefer foods and beverages they perceive as natural. Components of stevia sweeteners contain zero calories, which mean these sweeteners may sweeten food and beverages in fewer calories than traditional sweeteners.

Does stevia have health benefits?

Steviol glycosides have zero calories. Stevia-based tabletop sweeteners can have zero or minimal calories per serving, depending upon the other food ingredients with which they are combined. These factors could have a positive effect on those looking to control weight or manage diabetes.
Stevia also contains certain vitamins (A, B, C), minerals (iron, zinc, calcium), electrolytes (sodium, potassium), proteins, and other elements.21
Below, we take a look at the possible health benefits of stevia.8

Diabetes

various forms of stevia
Research indicates that stevia sweeteners do not contribute calories or carbohydrates to the diet and do not affect blood glucose or insulin response.
Research has shown that stevia sweeteners do not contribute calories or carbohydrates to the diet and do not affect blood glucose or insulin response, which allows people with diabetes to consume a wider variety of foods and comply with a healthful meal plan.
A randomized controlled trial over 16 weeks had 122 participants take four doses of approximately 330 mg of steviol equivalents over the course of a day. Compared to placebo, there was no impact on blood sugar levels. For this study, >97% rebaudioside A was used.
Additionally, a position paper on nutritive and non-nutritive sweeteners from the Academy of Nutrition and Dietetics reviewed five randomized controlled trials examining the effects of stevia compared with placebos on metabolic outcomes.
The studies reported minimal to no effects on blood glucose, insulin levels, hypertension and body weight. In one study showing minimal effects, subjects with type 2 diabetes reported reduced postprandial blood glucose and glucagon response after a test meal of stevia versus placebo.

Weight control

The causes of overweight and obesity around the globe are quite complex and include factors such as an increase in physical inactivity due to increased sedentary time and increased intake of energy-dense foods that are high in fat and added sugars.
The intake of added sugars has been shown to contribute an average of 16% of the total calories in the American diet, and has been linked to weight gain and adverse effects on glycemic control.11
Plant-based, zero calorie stevia can be part of a well-balanced diet to help reduce energy intake without sacrificing taste.
Replacing just 25g (about 6 teaspoons) of nutritive sweeteners in foods and beverages can provide a 100-kilocalorie reduction.

Metabolism

Steviol glycosides are poorly absorbed in the body and pass through the upper gastrointestinal tract, including the stomach and small intestines, fully intact.
Once steviol glycosides reach the colon, gut bacteria hydrolyze steviol glycosides into steviol by snipping off their glucose units. Steviol is then absorbed via the portal vein and primarily metabolized by the liver, forming steviol glucuronide, before being excreted in the urine.
Research has shown that there is no accumulation of stevia (or any byproduct of stevia) in the body during metabolism. It is a result of this essentially poor absorption in the digestive tract which ultimately contributes to the fact that stevia has zero calories and does not raise blood glucose or insulin levels when digested.

Pancreatic cancer

Stevia plant has many sterols and antioxidant compounds like triterpenes, flavonoids, and tannins. Some of flavonoid polyphenolic anti-oxidant phytochemicals present in stevia are kaempferol, quercetin, chlorogenic acid, caffeic acid, isoquercitrin, and isosteviol. Studies have found that kaempferol can reduce the risk of pancreatic cancer by 23% (American Journal of Epidemiology).

Blood pressure

Certain glycosides in stevia extract have been found to dilate blood vessels, increase sodium excretion, and urine output. In effect at slightly higher doses than as a sweetener, stevia can potentially help lower blood pressure.
The plant may have cardiotonic actions, which normalize blood pressure and regulate heartbeat. The plant displayed vasodilatory actions in both normotensive and hypertensive animals.

Special populations

Regulatory health agencies around the world have approved high purity stevia leaf extract for safe use. This includes special populations such as pregnant and nursing women, children and people with allergies or diabetes.

Children

Foods and beverages containing stevia can play an important role in decreasing calories from unwanted sweeteners in children's diets. There are now thousands of products containing naturally-sourced stevia on the market, ranging from salad dressing to snack bars, that allow children to consume foods and beverages that taste great without added calories.
Multiple global regulatory organizations, including the Food and Agriculture Organization of the UN (FAO) and World Health Organization's (WHO) Joint Expert Committee on Food Additives (JECFA), European Food Safety Authority (EFSA), and the Food & Drug Administration (FDA) have determined that high purity stevia extract is safe for consumption by the general population including children, when consumed within the recommended levels.

Allergies

In 2010, the EFSA reviewed literature to determine if there was any cause for concern regarding the potential for allergenicity of the stevia plant. The reviewers concluded that "steviol glycosides are not reactive and are not metabolized to reactive compounds, therefore, it is unlikely that the steviol glycosides under evaluation should cause by themselves allergic reactions when consumed in foods."
Additionally, while there is no scientific reason to suggest genetically modified crops or "GMOs" cause allergies, it is worth pointing out that stevia plants are not genetically modified, and therefore there should be no concerns regarding potential for allergenicity.

Other uses

Stevia extract has exhibited strong bactericidal activity against a wide range of pathogenic bacteria, including certain Escherichia coli strains. Steviol was observed to be mutagenic toward Salmonella and other bacterial strains under various conditions and toward certain cell lines.
Stevia may also be effective against Candida albicans and has shown some anti rotavirus activity. Stevioside has shown promising immunomodulating effects in rats and cell lines. In addition, stevia may have antiproliferative/antimutagenic/antioxidant properties. One report addresses stevia's role in reducing dental plaque.

Is stevia safe?

Stevioside, a main glycoside of stevia, was found to be nontoxic in acute toxicity studies in a variety of laboratory animals.21
stevia sweeteners
Independent scientific experts in both the US and globally have concluded that stevia sweeteners are safe for people of all ages and populations.
No major contraindications, warnings, or adverse reactions have been documented.
In 2008, the FDA declared that stevia was safe in foods and beverages. The US may see numerous companies incorporate it into their products since there is considerable consumer interest in natural, low, or no calorie sweeteners.7
Studies clearly support the safety of stevia sweeteners. Further, clinical studies show that steviol glycosides, meeting purity criteria established by the JECFA, have no effect on either blood pressure or blood glucose response, indicating stevia sweeteners are safe for use by individuals with diabetes.
Based on the wealth of published research, independent scientific experts in both the US and globally have concluded that stevia sweeteners are safe for people of all ages and populations and an Acceptable Daily Intake (ADI) of four mg/kg body weight (expressed as steviol) has been established.
Stevia leaves naturally contain sweet compounds called steviol glycosides. High purity stevia leaf extract, the ingredient form approved for food and beverage by regulatory authorities, contains 95% or more of these steviol glycosides. It is this high purity form that has been tested rigorously in more than 200 scientific studies and approved for human consumption by multiple major regulatory organizations around the globe.10
Multiple, major global regulatory organizations, including the Food and Agriculture Organization/World Health Organization's Joint Expert Committee on Food Additive (JECFA), the EFSA, the FDA and Food Standards Australia New Zealand (FSANZ), have determined high purity stevia leaf extract to be safe for consumption by children, adults and special populations.15

Regulatory status

In order for a new food or beverage ingredient to enter the US food supply, the ingredient must either be a FDA approved food additive or GRAS. The quality and quantity of scientific evidence required for a substance to achieve GRAS status are the same as for FDA food additive approval.
stevia pancakes
Stevia leaf extract has been evaluated and approved for use as an ingredient in food and beverages by multiple regulatory agencies throughout the world, and can even be used on your breakfast pancakes!
In December 2008, in response to GRAS notifications submitted to the US FDA, the FDA stated it has no questions regarding the conclusion of expert panels that rebaudioside A is GRAS for use as a general purpose sweetener in foods and beverages, excluding meat and poultry.4
In June 2009, FDA stated it has no questions regarding the conclusion of an expert panel on the GRAS status of another steviol glycoside extract with high rebaudioside A content for use as a tabletop sweetener.
In 2010, the EFSA assessed the safety of steviol glycosides from stevia and established an ADI for their safe use. In November 2011, the European Commission authorized the use of steviol glycosides as a sweetener in foods and beverages.
Stevia sweeteners are approved for use in many other countries, including Korea, Mexico, Japan, Paraguay, Taiwan, China, Russia, Australia, Argentina, New Zealand, Colombia, Peru, Uruguay, Brazil and Malaysia.
The majority of scientific research on stevia uses high purity stevia extracts. Confusion has resulted in the past when research conclusions about stevia were drawn based on studies testing crude stevia extracts.
In some countries, crude stevia extracts or whole stevia plant leaves are often sold as dietary supplements, but it is important to note that only high purity stevia leaf extract has been evaluated and approved for use as an ingredient in food and beverages by multiple regulatory agencies throughout the world.
Around the world, stevia is listed differently due to regulations from country to country. This is because different countries have their own established food policies on stevia and labeling policies vary from country to country.
References:
1.        Stevia Benefits What is stevia? accessed 11 December 2014.
2.        Stevia Benefits Living naturally, accessed 11 December 2014.
3.        Stevia Benefits Rooted in research, accessed 12 December 2014.
4.        Stevia Benefits Regulatory status, accessed 12 December 2014.
5.        FAO Steviol glycosides, accessed 12 December 2014.
6.        Stevia Benefits FAQs, accessed 12 December 2014.
7.        Union County College Stevia, accessed 12 December 2014.
8.        Nutrition and you Stevia plant (herb) nutrition facts, accessed 12 December 2014.
9.        Global Stevia Institute Where does stevia come from? accessed 12 December 2014.
10.     Global Stevia Institute Nutrition and Health, accessed 12 December 2014.
11.     Global Stevia Institute Weight management, accessed 12 December 2014.
12.     Global Stevia Institute Metabolism, accessed 12 December 2014.
13.     Global Stevia Institute Special populations, accessed 12 December 2014.
14.     Global Stevia Institute Food science, accessed 12 December 2014.
15.     Global Stevia Institute Safety and food policy, accessed 12 December 2014.
16.     Global Stevia Institute Stevia safety, accessed 12 December 2014.
17.     Global Stevia Institute Regulatory approvals, accessed 12 December 2014.
18.     Global Stevia Institute Food policy guidance, accessed 12 December 2014.
19.     Global stevia Institute Stevia farming, accessed 12 December 2014.
20.     Global Stevia Institute Stamp of approval, accessed 12 December 2014.
21.     Drugs.com Stevia, accessed 12 December 2014.

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