Stevia and Insulin Resistance

June 1, 2022 1:59 PM

So I picked a drink today because the front label said only 1g of sugar and "no artificial sweeteners" expecting it would basically be non-sweet. But it's a little sweet and I like it. And now having read the back of the label, it has Stevia. I know artificial sweeteners trigger the release of insulin and teach your body to ignore insulin which is bad news. My attempts to find out of this is true of stevia have left me confused. Is stevia consumption associated with insulin release/insulin resistance/diabetes?

I am not qualified to read peer-reviewed findings on this and I don't trust internet nutrition gurus or anyone selling anything.

posted by If only I had a penguin... to Health & Fitness (10 answers total)

The "cephalic phase response" is the effect you're referring to. If it exists, it would also be present when eating food sweetened with stevia since you obviously interpreted the taste as sweet. I personally think it's a non-issue with any artificial sweetener. If you're diabetic, recommend getting your hands on a CGM so you can verify what your blood sugar is doing.
posted by michaelh at 2:16 PM on June 1, 2022 [2 favorites]

Studies seem to show that artificial sweeteners don’t trigger insulin release and therefore don’t cause insulin insensitivity and metabolic syndrome.

But fairly recent work suggests that's only true of artificial sweeteners acting alone. When they’re combined with a carbohydrate, things change:

The tests allowed the scientists to assess any changes in the participants’ brain activity in response to different tastes — including sweet, sour, and salty — as well as to measure their taste perception and insulin sensitivity.

Yet, when they analyzed the data they had collected thus far, the investigators found surprising results. It was the intended control group — the participants who had ingested sucralose and maltodextrin together — that presented altered brain responses to sweet tastes, as well as altered insulin sensitivity and glucose (sugar) metabolism.

To verify the validity of these findings, the researchers asked another group of participants to consume drinks containing either sucralose alone or maltodextrin alone over a further 7-day period.

The team found that neither the sweetener on its own, nor the carbohydrate on its own seemed to interfere with sweet taste sensitivity or insulin sensitivity.

…
So what happened? Why did the sweetener-carb combo impact participants’ ability to perceive sweet tastes, as well as their insulin sensitivity?

The researchers are, as yet, unable to say for sure, but they do have some working hypotheses.

“Perhaps the effect resulted from the gut generating inaccurate messages to send to the brain about the number of calories present,” suggests Prof. Small.

“The gut would be sensitive to the sucralose and the maltodextrin and signal that twice as many calories are available than are actually present. Over time, these incorrect messages could produce negative effects by altering the way the brain and body respond to sweet taste,” she adds.

So somewhat paradoxically, the small amount of sugar in your drink could be making the sweetness of the stevia trigger an insulin response that it wouldn’t on its own, which might cause some problems.
posted by jamjam at 3:03 PM on June 1, 2022

Right now, the "cephalic phase insulin response" is still being studied, as some people are more prone to it than others, and some people seem to respond more to solid food than beverage, at least from a study published in 2017. I am not aware of any way to know if you are affected other than with a continous glucose monitor, as @michaelh suggested.
posted by kschang at 3:06 PM on June 1, 2022 [3 favorites]

Response by poster: Thanks, all. I'm not diabetic, but just looking to keep it that way and my understanding was that artificial sweeteners can interfere with that goal.
posted by If only I had a penguin... at 8:21 PM on June 1, 2022

Best answer: I'm an emergency physician/medical toxicologist. As the latter, I'm fairly well versed in the negative (and positive) effects of food ingrediens, including sweeteners

Stevia is the brand name for a 100% natural, plant-sourced artificial sweetener known as Xylitol in scientific circles. Like every other artificial sweetener it has no calories, but it is otherwise unique, in a class by itself. Here's why

1) It is the only artificial sweetener that has virtually no effect on glucose and insulin, and therefore virtually no effect on metabolism.

2) It is the only artificial sweetener that has prebiotic effects which can reduce blood glucose, triglycerides, and cholesterol

3) It is the only artificial sweetener that promotes the production of gut hormones essential for the proper functioning of appetite- and metabolism-regulating neurocircuitry

4) It is the only sweetener of any kind used to treat hyperglycemia, because it is the only artificial sweetener that the body can metabolize independent of insulin

Xylitol's long-term effects have not been studied and are not well understood. It's short-term effects, however, have been studied in some depth. And the collective medical and scientific communities are in near complete agreement about Xylitol having virtually no negative effects on any body system involve in metabolism
posted by BadgerDoctor at 9:49 PM on June 1, 2022 [4 favorites]

Best answer: Sorry, I'm not a doctor but that doesn't sound right to me. Stevia isn't xylitol. Stevia also isn't a brand name.

Xylitol is a sugar alcohol derived from cellulose biomass: https://en.wikipedia.org/wiki/Xylitol

Stevia is a processed glycoside from a stevia rebaudiana leaf: https://en.wikipedia.org/wiki/Steviol_glycoside

There are multiple artificial sweeteners that don't raise blood sugar, and that don't need insulin because they are are processed in the intestine and liver.
posted by michaelh at 11:12 PM on June 1, 2022 [10 favorites]

Best answer: Micaelh--

You are correct about xylitol NOT being Stevia. Thank you for pointing out my error. I was writing quickly and for some reason confused the two. It takes balls to call out a doctor. I salute you

OP--all of the information in my answer applies to Stevia, not Xylitol. That's the sweetener you should use to avoid metabolic effects.
posted by BadgerDoctor at 1:17 AM on June 2, 2022 [6 favorites]

You could just buy a glucose meter and some test strips and do some tests. Not free, but perhaps not cost-prohibitive. One bottle of strips would be ample. CGMs are great but I don't think you need one to answer this question for yourself.
posted by bluebird at 3:25 AM on June 2, 2022

Response by poster: Thanks everyone...I'm not going to buy a glucose meter, but just curious, would that even tell me if my body was releasing insulin? I guess my sugar would go down if I didn't also have any carbs, but that just happens over time, too, right?
posted by If only I had a penguin... at 7:43 AM on June 2, 2022

If you’re not diabetic or pre-diabetic you wouldn’t get anything from a CGM, other than confirmation you are not diabetic, because your body will keep you glucose levels too even to measure anything.
posted by michaelh at 7:41 PM on June 2, 2022 [1 favorite]