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Stevia Health Benefits & Safety -- stevia leaf spoonful of stevia

Answer:

Low-calorie sweeteners and sugar substitutes (also known as artificial sweeteners) are often considered healthier alternatives to sugar, and some are promoted to lower blood sugar and blood pressure, as well as lose weight, but some of these claims are weak, and many of these sugar substitutes can cause side effects. Furthermore, it has been recommended that certain sweeteners (see which ones) should not be used by the general population for weight control or to reduce the risk of cardiovascular and other chronic diseases. Be aware that products that contain sweeteners often contain significant amounts of other sugar-substitutes that labels don't clearly make evident.

The sweeteners fall mainly into three categories: High-intensity sweeteners that have no calories, such as stevia and monk fruit, as well as acesulfame K (Ace-K), aspartame, saccharin, and sucralose (be aware that since such small amounts of high-intensity sweeteners are needed, these are often combined with other, bulkier, sweeteners); Low-calorie sweeteners such as erythritol and xylitol as well as allulose, glycine, inulin, kabocha extract, lucuma, polydextrose, sorbitol, and tagatose; and sugar alternatives such as agave syrup, coconut sugar, date syrup, glycerol, honey, maple syrup, trehalose, and yacon syrup.

The pros and cons of using substitutes for regular, table sugar are summarized in the table below. More information about each specific sweetener, including discussions of brands, safety concerns (including whether sweeteners might increase the risk of atrial fibrillation, which sweeteners may be suitable for people with diabetes, and whether sweeteners such as aspartame increase cancer risk), and our Top Pick sweeteners for use in cold beverages, hot beverages and for baking, are in the full article.

Pros and Cons of Sugar Substitutes

Sweetener Pros Cons
High-Intensity, No Calorie Sweeteners:
Acesulfame potassium (Ace-K)
  • 200 times sweeter than sugar
  • Heat stable
  • Linked with increased cancer risk and early puberty in girls
  • Can have a bitter taste
Aspartame
  • 200 times sweeter than sugar
  • Same calories as sugar
  • Should be avoided by people with PKU
  • Linked with increased risk of obesity, tinnitus, and, possibly, cancer
  • May worsen symptoms of painful bladder syndrome / interstitial cystitis
  • Not heat stable
Monk fruit
  • 100 to 250 times sweeter than sugar
  • No reported side effects
  • Often combined with low-calorie sweeteners such as erythritol
  • Extracts vary widely in sweetness
Saccharin
  • 200 to 700 times sweeter than sugar
  • Linked to tinnitus and weight gain
  • May worsen symptoms of painful bladder syndrome / interstitial cystitis
Stevia
  • Up to 400 times sweeter than sugar
  • Seems to satisfy hunger
  • Not suitable for baking or fermentation
  • May cause mild side effects
  • Might adversely affect the kidneys
Sucralose
  • 600 times sweeter than sugar
  • Dissolves easily in cold drinks
  • Possible health concerns including cancer, less glucose tolerance, formation of toxic byproducts when heated, and possible effects on gut microbiome
Low-Calorie Sweeteners:
Allulose
  • Only 10% of the calories per gram as sugar
  • Does not promote tooth decay
  • Less sweet than sugar
  • May cause GI distress
  • May require adjustment to baking temperature and time when used for cooking
Erythritol
  • Only 5% of the calories per gram as sugar
  • Does not promote tooth decay
  • Slightly less sweet than sugar
  • May cause GI distress
  • Linked with increased risk of heart-related adverse events (research underway)
Glycine
  • May have some health benefits when used as a supplement
  • Slightly less sweet than sugar
  • Sour taste
  • Not generally recognized as safe as a food additive
Inulin
  • About 60% fewer calories than sugar
  • Only about 1/3 as sweet as sugar
  • May cause GI distress
  • May not be suitable for people at risk for, or with early-stage liver disease
Kabocha extract
  • 40% fewer calories than sugar
  • Is primarily xylitol, which can cause gas in some people and has other potential health concerns
Lucuma
  • Fewer calories per tablespoon compared to sugar
  • Contains small amounts of fiber and nutrients
  • Only half as sweet as sugar, so you'd need twice as much
  • No conclusive evidence of health benefits
Polydextrose
  • 75% fewer calories than sugar
  • May taste tart or only slightly sweet
  • Can have laxative effects
Sorbitol
  • 35% fewer calories than sugar
  • Does not promote tooth decay
  • Only about 60% as sweet as sugar
  • May be less beneficial for cavity prevention than xylitol
  • May cause abdominal pain at moderate doses and laxative effects at high doses
Tagatose
  • Similar sweetness as sugar
  • About 60% fewer calories than sugar
  • Lower glycemic index than sugar
  • Does not promote tooth decay
  • Only limited evidence of possible health benefits
  • May cause gastrointestinal side effects
Xylitol
  • 40% fewer calories than sugar
  • Does not promote tooth decay and has little to no effect on blood sugar or insulin
  • Superior for baking compared to other sweeteners
  • Slightly less sweet than table sugar
  • May cause diarrhea in large doses
  • Toxic to dogs
  • Might increase clot risk in people (research underway)
Alternative Sugars:
Agave syrup
  • Lower glycemic index than sugar
  • About 80% sweeter than sugar
  • More calories per spoonful than sugar due to density of syrup
  • Contains high amount of fructose, which may be linked with health concerns
Coconut sugar
  • Slightly lower glycemic index than sugar
  • Contains a small amount of nutrients
  • Is mainly sugar
Date syrup
  • Slightly lower glycemic index than sugar
  • Is mainly sugar
  • More calories per spoonful than sugar due to density of syrup
Glycerol
  • Slightly less sweet than sugar
  • Same calories per spoonful as sugar
Honey
  • Slightly lower glycemic index than sugar
  • 25% sweeter than sugar
  • May improve cold symptoms and improve wound healing
  • More calories per spoonful than sugar due to density of syrup
  • May cause botulism in infants
Maple syrup
  • Slightly lower glycemic index than sugar
  • Contains a small amount of nutrients
  • Is mainly sugar
  • Same calories per spoonful as sugar
Trehalose
  • Causes a slower rise in blood sugar and reduced insulin secretion after consumption compared to glucose
  • Less sweet than sugar
  • Same calories per spoonful as sugar
  • May cause bloating, flatulence and diarrhea at high doses
  • Some people may be intolerant
Yacon syrup
  • Contains small amounts of fiber and nutrients
  • Mixed evidence of benefit for weight loss
  • Is mainly sugar
  • More calories per spoonful than sugar due to density of syrup
  • May cause GI discomfort in large doses

Brands discussed in the full article include Alcohol-Free Stevia (NuNaturals), Allulose (Splenda), Allulose Zero Calorie Sweetener (Wholesome), BetterStevia (NOW Foods), Birch Xylitol Sweetener (Health Garden), BochaSweet, Great Value Stevia (from Walmart), Inulin Prebiotic Fiber Sweetener (It's Just), Liquid Monk Fruit Sweetener Extract Drops (Lakanto), Lucuma Powder (Terrasoul Superfoods), Lucuma Powder (Zint), Monk Fruit Extract (It's Just), Monk Fruit in the Raw (Cumberland Packing Corp.), Monk Fruit Sweetener (Lakanto), Monk Fruit Sweetener (Llinea), Monk Fruit Sweetener (NuNaturals), Organic Coconut Palm Sugar (BetterBody Foods), Organic Coconut Sugar (Bob's Red Mill), Organic Coconut Sugar (MADHAVA), Organic Coconut Sugar (Terrasoul Superfoods), Organic Stevia (Micro Ingredients), Organic Stevia Extract (Trader Joe's), Pure Birch Xylitol (Morning Pep), PureVia (Pepsico and Whole Earth Sweetener Company), RxSugar (Nutrishus Brands), Simply Stevia (Stevita), Stevia Extract (BulkSuplements.com), Stevia in the Raw (Cumberland Packing Corp.), Sunett (Celanese), (Cumberland Packing), Sweet Additions Stevia (from Aldi stores), Swerve (Whole Earth Sweetener Company), Truvia (Cargill), Volcanic Nectar Blue Agave (Global Goods), and XyloSweet (Xlear), as well as various other products by NOW Foods, NuNaturals, Pyure, Splenda, Stevia Select and SweetLeaf.

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