Stevia Consumption May Lead to Gut Health Imbalance, Study Shows


Key Takeaways

  • Popular plant-based sweetener stevia may have a negative effect on gut health, a recent study suggests.
  • Sugar has been linked to numerous negative health issues, which makes use of artificial sweeteners more appealing, but they’re not without their own risks.
  • Rather than simply replacing sugar with stevia, RDs recommend moderation when using these sweeteners.

Popular plant-based, non-sugar sweetener stevia may contribute to an unbalanced gut, according to a recent study in the journal Molecules.

Researchers looked at two forms of stevia, which is derived from a plant in the chrysanthemum family. The commercialized herbal sweetener they examined showed an inhibitory effect on bacterial communication.

This is important because bacteria molecules in the digestive system need to communicate with each other for ideal gut function and regulation. When this process is disrupted, the researchers note, it can lead to an unbalanced gut and reduced function.

The researchers concluded that more research needs to be done, but urged the food industry to do more investigation before replacing sugar and artificial sweeteners with stevia.

Switching to Non-Sugar Sweeteners

The health risks of added sugar have become increasingly highlighted and researched in the past several years, and high consumption has been linked to higher risks for:

  • Weight gain and obesity
  • Diabetes
  • Cardiovascular disease
  • Metabolic syndrome
  • Nonalcoholic fatty liver disease
  • Alzheimer’s disease and dementia

According to the University of California San Francisco’s SugarScience research effort, added sugar is in about 74% of packaged foods.

That’s led to a surge in interest in non-sugar sweeteners, also called nonnutritive sweeteners (NNS), and stevia is leading the pack. A study in the Journal of the Academy of Nutrition and Dietetics, looking at purchasing trends from 2002-2018 in U.S. households, found a decrease in sugar consumption, but a boost in NNS.

In that timeframe, stevia consumption increased from 0.1% to 26%, with beverages representing the largest shift.

Potential Side Effects

Concerns about sugar consumption may have led the shift to NNS, but as the recent study shows, it’s unknown what effect substitutes like stevia will have over time, since they are fairly new to the marketplace, says dietitian Melissa Hooper, RD.

In addition to potential gut imbalance, other adverse effects may occur, according to a research review in Nutrition Journal. After looking at 372 studies involving NNS, researchers found reports of outcomes such as:

  • Increased appetite
  • Weight gain
  • Headaches
  • Depression
  • Behavioral and cognitive effects
  • Neurological issues
  • Risk of preterm delivery
  • Cardiovascular effects
  • Risk of chronic kidney disease

However, those researchers concluded that, overall, the evidence is inconsistent and there are "numerous gaps in the evidence base." Much more research needs to be done to investigate whether these are widespread concerns, but in the meantime, it’s advisable to be sparing with these artificial sweeteners, Hooper says.

Focus on Moderation

Many people use sweeteners like stevia as a way to lose weight, but research on the effectiveness of that tactic is lackluster in terms of evidence.

For example, a research review published in Obesity found that in observational studies, NNS consumption is associated with higher body weight and metabolic disease, which means it may have the opposite effect of what you might intend. Although these sweeteners were more likely to be useful in randomized, controlled trials, that may be because they were used in addition to weight-loss counseling, not as a standalone strategy.

Melissa Hooper, RD

The issue with replacing sugary treats and beverages with those containing something like stevia is that your body associates that sweet taste with increased calories and it prepares itself for a subsequent energy boost.

— Melissa Hooper, RD

“The issue with replacing sugary treats and beverages with those containing something like stevia is that your body associates that sweet taste with increased calories and it prepares itself for a subsequent energy boost,” says Hooper. “When it doesn’t get the calories it expects, the body tends to compensate by increasing your appetite. That can easily lead to overconsumption and higher risk of weight gain as a result.”

A better tactic, she says, is to use stevia and other sweeteners in moderation, the same way you would with traditional sugar.

Real Food, Real Effects

Another issue that comes up with overuse of stevia is that although it’s a plant-based product, it’s still heavily processed and may be in foods that are also less than ideal when it comes to nutrient density, according to dietitian Maria Zamarripa, RD, who specializes in helping with sugar cravings.

“A better approach, rather than loading up on these foods, even though they don’t have sugar, is to introduce more whole foods into your diet,” she says. “Real food, along with other healthy habits like meaningful social connection, rest, movement, and living with purpose, can all make you feel more nourished.”

Rather than replacing sugar with stevia, it may be more helpful to move away gradually from that constant consumption of sweet foods overall, she advises, and toward whole foods like fruits and vegetables instead.

What This Means For You

Stevia can likely be helpful if you’re trying to reduce your sugar consumption, but research suggests there may be concerns if you’re simply replacing one for the other. A better strategy may be to cut down on sugary options in general, and use stevia sparingly.

3 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Markus, V.; Share, O.; Teralı, K.; et al. Anti-Quorum Sensing Activity of Stevia Extract, Stevioside, Rebaudioside A and Their Aglycon SteviolMolecules. Published November 23, 2020;25, 5480. doi:10.3390/molecules25225480

  2. Johnson, R.K., Appel, L., Brands, M., Howard, B., Lefevre, M., Lustig, R., Sacks, F., Steffen, L., & Wyllie-Rosett, J. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart AssociationCirculation. Sept. 15, 2009;120(11), 1011-20.

  3. Lohner, S., Toews, I. & Meerpohl, J.J. Health outcomes of non-nutritive sweeteners: analysis of the research landscapeNutr J 16, 55 (2017). doi:10.1186/s12937-017-0278-x

By Elizabeth Millard
Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition.