steviaAfter cutting back on sugar and carbs for a while, you understandably start to miss sweets. A common misconception is that you have to skip sweets to meet your goals, which isn’t the case at all. There are plenty of sugar alternatives that fit within the Primal and keto lifestyles, and stevia is one of them.

Stevia is widely used in the low carb community to satisfy sugar cravings or simply add a touch of sweetness to a hot beverage or dessert, but should it be? What is stevia? Is it safe? What is its effect on insulin, if any, and does it have a place in a Primal Blueprint eating strategy? Let’s investigate.

What Is Stevia?

A lot of people categorize stevia as an artificial sweetener, but it’s important to note that stevia is not an artificial sweetener at all – it’s a plant-derived natural alternative to sugar.

Stevia is an herbaceous family of plants, 240 species strong, that grows in sub-tropical and tropical America (mostly South and Central, but some North). Stevia the sweetener refers to stevia rebaudiana, the plant and its leaves, which you can grow and use as or with tea (it was traditionally paired with yerba mate in South America) or, dried and powdered, as a sugar substitute that you sprinkle on. It’s apparently quite easy to grow, according to the stevia seller who tries to get me to buy a plant or two whenever I’m at the Santa Monica farmers’ market, and the raw leaf is very sweet.

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The Sweet Compounds in Stevia: Stevioside and Rebaudioside

Most stevia you’ll come across isn’t in its raw, unprocessed form, but in powdered or liquid extract form. The “sweet” lies in the steviol glycosides – stevioside and rebaudioside – which are the natural compounds isolated in these extracts. Some products use just one, while others use both stevioside and rebaudioside. Stevioside is the most prevalent glycoside in stevia, and some say it provides the bitter aftertaste that people sometimes complain about; rebaudioside is said to be the better tasting steviol glycoside, with far less bitterness.

Most of the “raw or natural” stevia products use the full range of glycosides, but the more processed brands will most likely isolate one or more of the steviol glycosides. The popular Truvia brand of stevia products uses only rebaudioside, as do both PureVia and Enliten. Different brands provide different conversion rates, but compared to sucrose, stevioside is generally about 250-300 times as sweet and rebaudioside is about 350-450 times as sweet.

Is Stevia Safe, or Bad for You?

The government has approved only isolated steviol glycosides as safe to use in food. Whole or crude stevia is not Generally Recognized as Safe (GRAS) according to government standards.‘>2 This is due to lack of safety information, not so much the presence of known harmful effects.

Does Stevia Affect Insulin?

I wrote an extensive piece on whether artificial sweeteners spike blood sugar a while back. There is one in vitro study that showed stevioside acts directly on pancreatic beta cells to stimulate insulin secretion and another which shows similarly insulinotropic  (insulin-producing) effects of rebaudioside, which may give you pause.

Insulin secretion sounds like an insulin spike, no? And since we tend to be wary of unneeded insulin spikes, maybe we should avoid stevia. It’s not so simple, of course. For one, this was an in vitro study, performed in a super-controlled laboratory petri dish type setting; this was not an in vivo study of animals or people eating stevia in a natural, organic way. The results of in vitro studies do not always match results when you try to replicate them in vivo (in a person).

Secondly, insulin secretion isn’t necessarily a bad thing. I mean, we need it to shuttle nutrients into cells, and we’d die without it. As I mentioned in the dairy post a while back, insulin is millions upon millions of years old. It’s been preserved throughout history because it’s an essential hormone. It’s not always the bad guy, especially if your insulin sensitivity is where it should be.

In fact, the evidence is mounting that stevia actually is an insulin sensitizer that can aid in glucose tolerance and clearance after a meal. The Japanese have been using stevia for decades in the treatment of type 2 diabetics. Let’s look at a few recent studies. In fructose-fed rats, a single instance of oral stevioside increased insulin sensitivity and reduced postprandial blood glucose in a dose-dependent manner. The same study also found that diabetic rats given stevioside required less exogenous insulin for the same effect. Taken together, these results suggest that stevia may not just be a good sugar substitute for diabetics, but an effective supplement for treatment of their insulin resistance.‘>4 Another strike in stevia’s favor.

Stevia-sweetened recipes:

Keto Donuts Recipe

Matcha Mint Keto Green Smoothie Recipe

Grain-free Waffles Recipe

Stevia Side Effects

Allergy to stevia has been reported, but it is rare.

Most people do not experience side effects when using stevia, but some people do experience effects like:

Stomach Issues

  • Nausea
  • Gastrointestinal discomfort
  • Bloating
  • Diarrhea

Most often these effects are from using stevia that is mixed with sugar alcohols, like erythritol or xylitol. If you can tolerate sugar alcohols, you will probably be okay using combination stevia and sugar alcohol products. To be sure, start slow, and watch for symptoms.

Diabetic Concerns

Stevia is considered safe for the diabetic population, but sometimes it is combined with ingredients that affect carb count, like dextrose and maltodextrin. If you’re diabetic, check your ingredients label and carb counts before adding it to food.

Fertility Issues

Historically, stevia has been used as a form of birth control, so use of stevia may contribute to fertility issues.‘>6 Alone, low-dose stevia lowered cholesterol without the potentially beneficial effect on HDL. It’s also useful to note that high-dose stevia negatively affected some toxic parameters – so don’t eat spoonfuls of stevia (not that you would) – but long term low-dose stevia was deemed safe.

  • Lipid numbers are fun and all, but we’re really interested in avoiding atherosclerotic plaque buildup. In mice treated with stevioside, oxidized LDL was reduced, overall plaque volume was reduced, and insulin sensitivity increased. Overall, atherosclerosis was reduced in the stevioside-treated mice.‘>8 Clinically relevant? Perhaps not, but it’s interesting.
  • A two-year randomized, placebo-controlled study of Chinese patients with mild hypertension (which a rather large swath of society probably suffers from) found that oral stevioside intake significantly reduced systolic and diastolic blood pressure.‘>10 so it appears that the dose is key. Maybe somewhere in the middle works well, as one study in hypertensive dogs showed: they used 200 mg/kg to normalize blood pressure in the canine subjects.‘>1 You don’t have to do zero fat, just don’t pile it on. Cooking with fat shouldn’t be a problem.

    Carb Timing

    I’ve said before that I think carb timing is relatively low on the hierarchy of things to care about. It’s not as important as what you’re eating or how much. I think it’s also less important than your macros—getting sufficient protein and experimenting with different levels of carb intake.

    That said, if you want to experiment with carb timing, go for it. You won’t get a lot of guidance about how to do it, though, at least not from empirical research. I can’t find any studies that systematically vary carb intake, morning versus evening, among people eating anything like a Primal or paleo diet.

    The good news, though, is that there isn’t an obviously wrong way to do this. Carb timing is unlikely to be the factor that makes or breaks your health, fitness, or longevity goals. Still, it might move the needle, so let’s get into it.

    Rationales for Eating Carbs in the Morning

    Insulin Sensitivity is Higher in the Morning

    In my estimation, the best argument in favor of eating most of your carbs in the morning is that that’s when you’re most insulin sensitive. It makes sense to eat your carbs at the time your body is best equipped to handle them.

    Eating a greater proportion of your carbs in the morning also seems to promote insulin sensitivity.‘>3

    For what it’s worth, this is also why proponents of chrononutrition advocate for eating more of your total calories in the morning. Doing so, they argue, takes advantage of the natural peak in insulin sensitivity and acts as a zeitgeber to entrain your circadian rhythm.

    And yes, I usually skip breakfast myself. I also eat a fairly low-carb, and therefore low-insulin-producing, diet. I’m metabolically healthy. My sleep is top notch. I’m not worried about my glucose tolerance nor my circadian rhythm. Both are in tiptop shape. For me, skipping breakfast feels natural, and I like extending my overnight fast. Since it seems to have no ill effects, I’m sticking with that schedule for now, but I’m open to change.

    To “Sleep Low” for Fitness Gains

    This one is really about avoiding carbs in the evening more than eating them in the morning per se. Here’s how it works: In the afternoon or evening, do a high-intensity workout to deplete glycogen stores. Do not eat carbohydrates after. In the morning, do a low-intensity session, such as a light jog, then eat breakfast with a balance of carbs, fat, and protein.

    The purpose of sleeping low is to force your body to upregulate fat metabolism. Researchers have studied this protocol among elite male triathletes. They compared men who ate carbohydrates spread across three meals to men who ate all their carbs at breakfast and lunch and then “slept low.” Both groups ate the same total amount of carbs and did the same workouts.

    In one report, after three weeks of this training, the group that slept low scored significantly better on a test of muscular efficiency. They also performed better on a surpamaximal test—basically pedal until you (almost) puke—and a 10k run in simulated race conditions.‘>5

    Reasons to Eat Most of Your Carbs in the Evening

    Carbs Affect Sleep

    Carbohydrates increase tryptophan production. Tryptophan is a precursor of serotonin, which in turn converts to melatonin. Still with me?

    Thus, the theory goes, eating carbs at night will boost melatonin production and, hence, promote sleep. It makes sense, and you can certainly try it, but there’s no concrete evidence it actually works. According to the one tiny study that has examined this effect, your best bet is to eat some high-glycemic carbs four hours before bedtime.‘>7 and college students who were or were not stressed before eating‘>9

    What does this mean? It is true that if you’re hoping to extend an overnight fast and promote fat burning, then eating a high-carb breakfast that raises insulin will be counter to that goal. If you’re specifically worried that it will tank your cortisol, though, it may not be the case.

    However, there is also tremendous variability in individuals’ cortisol responses. Certain people may indeed do better avoiding carbs in the morning. Some practitioners advise individuals with adrenal issues and cortisol dysregulation to eat most of their carbs in the evening instead of the morning.

    For Weight Loss?

    A lot of people tout this benefit, but there is no real evidence to back it up. There are a couple poorly done studies, and one that showed that participants who ate carbs at dinner instead of lunch lost more weight than those who did the opposite. However, that was because they lost lean tissue in addition to fat.‘>11

    After exercise, when glycogen stores have been depleted, muscle cells become more insulin sensitive.‘>13 This only applies if you’ve actually depleted your muscle glycogen, though. A nice long walk, 30-minute bike ride at an aerobic heart rate, or microworkout won’t do it.

    What If You’re Trying to Build Muscle?

    As a pre-workout, consuming a small amount of carbohydrate, 25 to 30 grams, may be beneficial. You don’t need to worry about having full glycogen tanks, though.‘>15

    Should You Eat Carbs Separately from Fat?

    This is another one of those beliefs that makes sense on paper but doesn’t quite bear out in practice. The idea here is that when you eat carbs and fat together, the carbs raise insulin, which unlocks fat cells, which allows the fat you just ate to be easily shoved inside. In other words, carbs + fat = weight gain.

    It can work like that, but it doesn’t have to. This is a much bigger concern if you are eating an excess of calories. If you’re consuming more energy than your body actually needs, and you’re potentiating the fat storage process, then yeah, you’ll end up storing body fat.

    If you’re not consuming more energy than you need, you don’t need to worry. For example, in one study, two groups of patients ate a hypocaloric diet where carbs and fat were eaten either separately or together for six weeks. Both groups lost similar amounts of body fat and showed comparable reductions in plasma glucose and triglycerides.‘>1 has shown that the function of immunity-related phagocytes, the cells that surround and engulf pathogens, is impaired for at least five hours after intake of simple sugars. Free radicals, or damaging oxygen atoms, have their heyday as well within the first few hours after sugar increases oxidative stress$=relatedarticles&logdbfrom=pubmed‘>3 for more than 24 hours.

  • Your sleep is disrupted. At the end of the day, you try to sleep it off, but you toss and turn as your heart continues to beat faster than normal. Little surprise there – the old hormonal system is confounding in its interconnectedness. You lay there cursing not just that cake but the entire cultural custom of birthday celebration. As the sun comes up and you roll out of bed, you think you should be done with this sugar business by now. Maybe, maybe not.
  • How to Recover From a Carb Binge

    As bad as this sounds, it could be worse. If you follow a Primal or keto lifestyle and the carb overload was just a detour, you’ll come out of this generally as healthy as you were before the flub. You’ll experience the effects, and you may feel them more acutely than you did before you chose the low-carb path. This isn’t a bad thing. Nonetheless, after the dust settles, the worst thing you can end up with is maybe a cold you wouldn’t have gotten otherwise. Your system will realign itself pretty readily. After spending a couple days back on your regularly scheduled program, you’ll be as good as new.

    How to Get Back Into Ketosis After Cheating on Keto

    So, you want to get back into fighting shape as soon as possible. Here’s what to do:

    • Scale back your carbs to where you were before you found yourself off-track.
    • Make sure you are getting the correct balance of electrolytes. Read this article to understand why electrolytes are important while transitioning to ketosis and how to make sure you are getting adequate electrolytes.
    • Consume sufficient high-quality fats, especially at first.
    • Don’t overdo the cardio. You can ease back into more intense aerobic exercise once you’re fully transitioned.
    • Consider intermittent fasting. You may have an easier time getting into ketosis for the long haul if you time-restrict food intake, which gets your body used to producing ketones.

    How Long Does it Take to Get Back Into Ketosis?

    You may wonder how long it will take to get back into ketosis after falling off. The answer is, it varies. It depends on how metabolically flexible you were before you started, how insulin-sensitive you are currently, how many carbs you were accustomed to consuming before you increased your carb intake… there are a lot of factors. The vague answer is, it won’t take long to get back. Start now, and you’ll get to where you want to be before you know it.


    The post How to Get Back into Ketosis After a Carb Binge appeared first on Mark’s Daily Apple.

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