Is Stevia Better or Worse for You Than Other Sweeteners?

There are many options to sweeten your food and drinks if you’re trying to avoid regular table sugar. And these different types of sweeteners are becoming more popular. If you’re looking for a no-calorie sweetener that’s more natural compared to other artificial sweeteners, stevia might be a good option for you. Here, we compare stevia to table sugar and other sweeteners, and discuss its potential risks and benefits when it comes to your health.

What is stevia?

Stevia is a natural sweetener that’s derived from a plant. Sometimes called Stevia rebaudiana, the plant is a member of the sunflower (Asteraceae) family. 

The term “stevia” may be used to describe the sweetener in different forms. But this can be confusing because there’s some overlap in the terminology. Here are some common forms:

• High-purity stevia leaf extract: This is what you’ll find sold in grocery stores. This is also the only form of stevia used in processed foods and drinks. High-purity stevia leaf extract contains 95% of steviol glycosides, the natural compounds present in the plant’s leaf. The most common steviol glycosides are rebaudioside A (Reb-A) and stevioside. 

• Whole plant or “raw” stevia: This is also known as Stevia rebaudiana Bertoni. This form of stevia isn’t approved for use in the U.S., as the ingredients are not regulated and may be unsafe. 

• Stevia extract: This is made from steeping the leaves of the plant in water to extract the sweet compounds into the liquid. Stevia extract isn’t purified. 

A quick note to clarify that the word “stevia” throughout the rest of this article will refer to high-purity stevia leaf extract. This is the version of stevia that most people are familiar with.

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• Are artificial sweeteners harmful? Stevia may be safer than other no-calorie sweeteners, which are associated with health risks. 

• Aspartame and cancer: This has been an ongoing source of controversy. But there’s no clear evidence that aspartame leads to cancer in humans.

• Stevia and blood sugar: Pure stevia does not raise blood sugar. But some stevia products have other ingredients that can be harmful for people with diabetes.

What are the potential health risks of consuming stevia?

Stevia is generally considered a safe food product. Consuming it in moderation doesn’t pose significant health risks. But sometimes stevia is sold with other additives or sugar alcohols to increase its bulk and sweetness. In these cases, there can be some risks to your health including:

• Increased blood sugar: If stevia is combined with additives like maltodextrin and dextrose, it may raise a person’s blood sugar. This is especially important for people with health conditions like diabetes.

• Increased risk of heart attack and stroke: Sometimes stevia is combined with erythritol, a sugar alcohol that has been linked to an increase in heart attack and stroke. 

• Digestive issues: Sometimes other sugar alcohols like xylitol are added to stevia. These have been shown to cause upset stomach and diarrhea. And some studies suggest that stevia alone (without sugar alcohols) can impact the healthy bacteria naturally found in a person’s gut.

This is why it’s important to check the package before assuming you’re consuming pure stevia. But overall, consuming stevia in moderation is unlikely to cause harm. 

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Does stevia have any health benefits?

Although more research is needed to understand stevia’s long-term effects, some studies have shown potential health benefits. Consuming stevia may play a helpful role in the following health conditions.

Fatty liver disease 

Stevia may protect against nonalcoholic fatty liver disease (NAFLD). But most of the research has been done in animals. So, it’s too early to know if this same benefit applies to humans.

Insulin and blood sugar levels 

One study showed that when people with diabetes drank tea sweetened with stevia, it didn’t raise their blood sugar levels or change their hemoglobin A1C (HbA1C) levels. So, stevia may be a good sugar substitute for people trying to manage their blood sugar.

Blood pressure 

People who took 500 mg of stevia powder daily for 2 years experienced a decrease in blood pressure. The decrease in the systolic (top number) was by about 10 mmHg. And for the diastolic (bottom number), there was a decrease of about 6 mmHg. A larger review of several studies showed a small effect on lowering the diastolic blood pressure number, but not the systolic number.

Kidney health 

A study looked at people with early-stage chronic kidney disease (CKD) who took 250 mg of stevia daily. After 9 months, they saw improved levels of certain blood markers that reflected improved kidney function. (Usually these markers rise as kidney disease worsens.)

Cancer 

Many people are familiar with the way artificial sweeteners have been linked to cancer — but this hasn’t included stevia. (Several studies have since shown that there’s likely no link between artificial sweeteners and cancer.) When it comes to stevia, test tube and animal studies have shown that it may stop the growth of cancer cells. But without further studies, it’s too early to tell if this is true in humans.

How does stevia compare to sugar and other artificial sweeteners?

When it comes to taste, stevia is up to 400 times sweeter than standard table sugar. And when it comes to health, stevia may be a better option. Table sugar has been linked to inflammation and other health conditions like increased body fat. 

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Using stevia won’t make you crave sugar or feel hungrier. One study found that consuming stevia doesn’t lead to increased appetite or a decrease in feelings of fullness.

But you may be wondering how stevia compares to these other artificial sweeteners, which are also low in calories:

• Aspartame

• Saccharin

• Sucralose

The key difference between stevia and these other sweeteners is that stevia comes from a plant. Artificial sweeteners, on the other hand, are all developed by modifying the sugar molecule.

Below is a table highlighting the key differences between them.

It’s still unclear how artificial sweeteners affect long-term health. But so far, stevia appears to be safer. 

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Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in New York City. She has held local and national roles at the American Medical Women’s Association including board member of the physician division and physician chair of social media.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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