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Moderate evidenceHeart & metabolic

Stevia Extract

A zero-calorie sweetener from Stevia rebaudiana. Its value lies in what it replaces: swapping sugar for stevia avoids the glucose load, but stevia itself is not a treatment for diabetes.

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What the science says

  • No acute glucose or insulin rise Moderate evidence

    A randomised crossover trial comparing stevia-, monk fruit-, aspartame- and sucrose-sweetened beverages found the non-caloric options produced no postprandial glucose or insulin rise and did not lead to compensatory overeating at the next meal.

  • Small effects on fasting glucose and HbA1c Limited evidence

    A 2024 meta-analysis reported small reductions in blood glucose and HbA1c with stevia, but the pooled trials were few, short and heterogeneous.

  • Cardiometabolic safety debate is largely resolved in trials Moderate evidence

    An umbrella review using bias-adjusted methods found randomised trials of low- and no-calorie sweeteners show neutral to favourable cardiometabolic effects, while observational reports of harm are largely explained by reverse causality.

Dosage & safety

Studied doseUsed to taste. The acceptable daily intake for steviol glycosides is 4 mg/kg body weight per day expressed as steviol, far above typical consumption.
SafetyApproved as a sweetener in most countries and well tolerated; whole-leaf and crude extracts are not approved forms. Many stevia blends are bulked with erythritol or other sugar alcohols, which cause bloating and loose stools in some people.

How to take it

TimingTiming does not matter; it is a sweetener, used when you want it.
With food?With food or drink, as a sugar replacement.
Worth knowingIf a stevia product upsets your stomach, the cause is usually the erythritol it is bulked with, not the steviol glycosides.

Frequently asked questions

Does stevia raise blood sugar?

No, in a randomised crossover trial stevia-sweetened drinks produced no rise in blood glucose or insulin and did not lead to overeating at the next meal, which is moderate evidence. Stevia's benefit comes from replacing sugar, not from treating diabetes.

Does stevia lower HbA1c or treat diabetes?

A 2024 meta-analysis reported small reductions in blood glucose and HbA1c with stevia, but the trials were few, short and heterogeneous, so the evidence is limited. Stevia is not a treatment for diabetes.

Is stevia safe for your heart?

An umbrella review found randomised trials of low- and no-calorie sweeteners, including stevia, show neutral to favourable cardiometabolic effects, while observational reports of harm are largely explained by reverse causality. Stevia is approved as a sweetener in most countries.

Why does stevia upset my stomach?

If a stevia product causes bloating or loose stools, the usual cause is the erythritol or other sugar alcohols it is bulked with, not the steviol glycosides. The acceptable daily intake for stevia is 4 mg/kg body weight as steviol, far above typical use.

Scientific references

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