How to Choose a Healthy Stevia Sweetener



Are you trying to cut back on sugar – but can’t seem to drink a cup of coffee or tea without a touch of sweetness? We understand. Although we have both given up sweet things, a cup of coffee still tastes better with a little coconut milk and sweetener.


Can’t blame you for wanting a sugar alternative on some occasions. But, it’s best to limit those occasions so you can gradually wean yourself off of sugar. You can do it! I did. 


Have you tried Stevia?  If you aren’t familiar with Stevia, it’s an herbal sweetener. Stevia comes from a herb in the Chrysanthemum family called Stevia rebaudiana.


How to Choose a Healthy Stevia Sweetener


Stevia-based sweeteners are growing in popularity, but they’re nothing new. In fact, Stevia rebaundiana was used historically by native Indians in Paraguay. Plus, it’s been widely used as a sweetener in Japan since the 1970s.


Over 200 years, indigenous tribes of South America used the leaves to sweeten their drinks and adopted the habit of chewing on the sweet leaves.


A primitive form of chewing gum? We don’t chew on it anymore but it’s still around and is still a sweetener that’s rapidly growing in popularity. 


When you hear the term “stevia extract,” it denotes the liquid made by steeping leaves from the Stevia plant to extract some of the sweet chemicals. Studies looking at Stevia mainly use a highly purified extract made from the Stevia leaf, but when you buy Stevia preparations at the grocery store, the preparations on the shelves may not have the same high concentration of active compounds called steviol glycosides, the components that give the plant its sweetness. 


In fact, Stevia extract contains at least 11 types of steviol glycosides. Among the most common are steviosides and rebaudioside A. 


How is Stevia sweetener made? First, the makers allow the freshly picked, sweet leaves to dry. Once dried, they toss the leaves into a vat of hot water to allow the sweet steviol glycosides to enter the water. Then, the extract is purified, using water or alcohol. After extraction and purification, alcohol, if it was used, is no longer in the product. But, as you’ll see, stevia extractions may contain other additives. 


What about Safety? 


With its long track record, you might wonder the FDA has been so slow approving it? There were concerns about its safety after studies in rats showed reproductive problems and DNA damage. These studies have since been discredited by most sources.


In the event they’re legitimate the amount of Stevia you’d have to consume to get these effects is well beyond the amount an ordinary person would consume.


In fact, studies show that Stevia glycosides are processed by gut bacteria and metabolized by the liver before passing out of the body. Stevia doesn’t accumulate in the body, nor does its metabolism produce significant amounts of energy. So, Stevia is essentially a calorie-free sweetener. 


But, is Stevia safe? The Food and Drug Administration granted Stevia GRAS status to indicate that it’s generally recognized as safe. But, can you trust the data they used? 


Over 200 peer-reviewed studies have looked at the safety of purified Stevia extract. Based on this studies, a 150-pound individual could consume 12 milligrams of purified stevia extract per kilogram of body weight per day to reach the ADI, or acceptable daily intake. This would roughly be 40 small packets of Stevia for a 150-pound individual. 


After reviewing the literature, we believe Stevia is one of the safest non-calorie sweetener alternatives out there. In fact, some research shows it helps with blood sugar and blood pressure control. Studies show it does not negatively impact blood glucose or insulin.


Some research even suggests that purified Stevia modestly lowers blood glucose in response to a meal.


Despite its apparent safety, don’t go overboard with it. Use it in moderation, as sweeteners are meant to be used. Just because something has no calories and little or no impact on blood sugar doesn’t mean you should use it in abundance 


Although, we believe Stevia is safe based on the research that’s out there, ideally we’d like to see you gradually wean yourself off of ALL forms of sweeteners including sugar so you aren’t dependent on any of them.


You really do lose the taste for sweet things if you stay away from them long enough. Still, we can understand how you might want to sweeten your coffee or tea.


The Sweetness of Stevia


Stevia contains two main types of glycosides called rebaudiosides and steviosides. These are the compounds that give it its sweetness. In fact, it’s MUCH sweeter than sugar, almost 300 times sweeter. As a result, you don’t need as much Stevia-based sweetener to sweeten coffee as you do sugar. It does have a slight aftertaste but how much of an aftertaste it has depends on the brand you use.


Are you a do-it-yourselfer in the kitchen? You can make your own Stevia extract. This is the healthiest alternative but, we tried it and at least to our tongues and it left too much of an aftertaste for us. If you want to give it a whirl, here’s how:



Choosing a Healthy Stevia Sweetener


If you decided making your own healthy Stevia sweetener isn’t for you, you can buy one of the growing number of commercial brands. Some are better than others. Ideally, you want one that’s as unprocessed as possible and without added fillers. That’s why making your own Stevia (if you can deal with the aftertaste) is the healthiest alternative.


When you buy Stevia sweeteners at the grocery store, they’ve been processed to some degree to remove the aftertaste. Of course, you’re sacrificing some of the health benefits of using an unprocessed sweetener to get a product that tastes better.


If you don’t want to make your own and you want an unprocessed sweetener, you could use coconut palm sugar, pure maple syrup or honey but these options aren’t calorie-free and they will raise your blood sugar level.


Stevia and Its Many Forms


If you look in the aisle of your favorite natural food store, you’ll see Stevia sweeteners in liquid form, powder form and some even have added flavorings like vanilla, grape, root beer etc. so you can add flavor when you sweeten your tea or coffee.


How do they add the flavor? Most of them use “natural flavors,” which you’ll see from reading this article, doesn’t necessarily mean healthy. In fact, you don’t know what you’re getting when you buy a product that has natural flavors since it isn’t an FDA-regulated term. We’re a little wary of natural flavors ourselves.


Another thing to avoid, especially if you’re taking medications, are Stevia sweeteners that contain grapefruit extract. Grapefruit extract is often used as a preservative. You can find out why by reading this article.


It’s usually liquid forms of Stevia that have grapefruit extract. added to them. Most of the time it’s listed as an ingredient on the label and isn’t “hidden” under natural flavorings, although I would call the company to make sure.


Other Additives to Steer Clear Of


We recommend avoiding Stevia sweeteners that contain two common additives – maltodextrin or dextrose. Dextrose can raise your blood sugar just like sugar. It essentially IS sugar. Maltodextrin is made from starch, usually corn or potato starch. It has no nutritional value and can also raise your blood sugar level. Plus, it may be genetically-modified if it comes from corn.


You’ll see a number of Stevia sweeteners contain a sugar alcohol called erythritol. Sugar alcohols like erythritol are found in natural sources like fruits and vegetables, although the version added to Stevia sweeteners is synthesized.  All sugar alcohols have fewer calories than sugar and erythritol has the least calories of all the sugar alcohols, about 0.2 calories per teaspoon.


Sugar alcohols don’t significantly raise your blood glucose level like sugar does. The exception is maltitol syrup. Maltitol syrup does cause blood sugar spikes in some people.


The problem with sugar alcohols is they can cause gas and bloating. Erythritol is less likely to do this than other sugar alcohols. The problem with erythritol is it’s sometimes made from corn. This means it may be genetically-modified.


One Stevia-based sweetener that doesn’t live up to its “natural” claim is Truvia. Truvia is made from rebiana. Rebiana is derived from the Stevia leaf but it’s highly processed and altered so the end product is NOT true Stevia. In fact, it’s exposed to a number of chemicals during manufacturing. Plus, the makers of Truvia add erythritol and “natural flavors.” There’s very little natural about Truvia. 


Choose Wisely


Now you know what to avoid when choosing a healthy Stevia sweetener – grapefruit extract, dextrose, maltodextrin, rebiana, erythritol and natural flavorings. If you want a Stevia product that’s minimally processed, look for one that says “whole leaf stevia” so you can enjoy Stevia in its most natural form.


You’ll discover some versions of Stevia, like Sweet Leaf Liquid or Powder Stevia, one of the better choices out there, contains inulin. Inulin is a naturally-occurring fiber that may actually have health benefits.  The other one we like is Now Foods Organic Better Stevia. It’s organic and has no bitter aftertaste.


The Bottom Line?


Hope this gives you some guidance on how to choose a healthy Stevia sweetener. They’re NOT all the same. Best idea – give up all sweeteners entirely. More realistic – choose a healthy, Stevia sweetener and use it in moderation. 


Take-Home Ponts:


  • Purified Stevia extract appears to be safe when used in moderation. 
  • Stevia is metabolized & eliminated from the body and provides no significant calories.
  • More than 200 studies demonstrate the safety of Stevia extracts. 
  • Stevia extract is up to 300 times sweeter than table sugar. 
  • Although purified Stevia extract doesn’t cause a rise in blood sugar, some of the additives used in certain Stevia preparations may. 
  • Many brands of Stevia on the market are processed to some degree to remove bitterness & may contain additives.




ACE Fitness. “The Truth about Stevia – The So-Called Healthy Alternative Sweetener International Journal of Food Sciences and Nutrition, 61, 1-10.
 2010 Apr;8(2):113-27.
. 2015 May; 50(3): 129–134.

Kristie Leong M.D.

Dr. Kristie Leong and Dr. Apollo Leong are physicians helping you to lead a healthy lifestyle by sharing nutrition and fitness tips and keeping you abreast of the latest health news.