(P25-022-25) Comparative Effects of Stevia on Glycemic, Metabolic, and Hormonal Parameters: A Systematic Review

Objectives: To evaluate the acute and chronic effects of stevia, a natural non-nutritive sweetener, on glycemia, cardiometabolic markers, and satiety hormones compared to caloric and artificial sweeteners.

Methods: This systematic review followed PRISMA guidelines and included 27 studies comparing stevia with caloric or artificial sweeteners. Outcomes included acute and chronic blood glucose, insulin levels, lipid profiles, body weight/BMI, blood pressure, satiety hormones, and other cardiometabolic markers. Studies were identified through PubMed, EMBASE, Scopus, Google Scholar, and Cochrane database searches. Data were extracted for qualitative synthesis.

Results: Compared to glucose and sucrose, stevia was associated with lower postprandial glucose and insulin without affecting GLP-1, ghrelin, or amylin. Longer-term studies show reductions in fasting glucose, total and LDL cholesterol, weight, BMI, blood pressure, and leptin at 4 months of stevia substitution. Comparisons with the artificial sweeteners aspartame and sucralose showed no differences in any glycemic, hormonal, or cardiometabolic markers, except lower postprandial glucose and insulin with replacement as a preload. When substituted for saccharin, stevia was associated with lower postprandial glucose, but no changes in insulin resistance, lipids, or GLP-1 after 3 months. However, at this time point, stevia was associated with no weight gain, in contrast to saccharin. Comparisons with neotame showed no differences in any marker at any time point. Substituting starch or maltodextrin with stevia was associated with lower postprandial and fasting glucose through 1 month, with no differences in other markers. Daily placebo (pill or NG tube routes) and unsweetened comparisons showed no differences except reduced blood pressure and weight at 3 months, respectively.

Conclusions: Stevia shows promise as a natural sugar alternative, being associated with better glycemic control and less weight gain compared to other sweeteners. However, its long-term effects on lipids, satiety hormones, and other cardiometabolic outcomes remain inconsistent, warranting further research.

Funding Sources: Supported by the Summer Scholarly Award Experience (SSAE) grant from the University of South Florida Morsani College of Medicine.