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.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5591507/table/Tab1/‘>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.http://www.ncbi.nlm.nih.gov/pubmed/20303371‘>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.http://www.ncbi.nlm.nih.gov/pubmed/21089163‘>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.http://www.ncbi.nlm.nih.gov/pubmed/20871768‘>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.http://www.ncbi.nlm.nih.gov/pubmed/16775813‘>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.https://www.mdpi.com/2072-6643/10/10/1348/htm‘>1

    Things like sleep deprivation, chronic stress, and gut dysbiosis are also shown to cause cravings for a variety of physiological reasons. But let’s say you’re getting a solid 8-9 hours of uninterrupted sleep, your stress levels are under control, your gut microbiome is balanced — and you’re still struggling with cravings. Then what?

    Why Can’t I Quit Sugar?

    Cravings are often more psychological than they are physiological. Maybe you’ve noticed that too. Maybe you’ve noticed that you start to have cravings any time you have a stressful day or feel anxious or deprived or smell something that reminds you of your favorite snickerdoodle cookie from childhood. In my experience, these are the top 5 emotionally driven reasons you might still be struggling with sugar cravings:

    1. Your Diet is Too Restrictive

    Eliminating certain foods and food-like items like grains, sugar, and refined carbohydrates is a good thing in general. But being too restrictive — or perceiving how you’re eating as a diet can end up backfiring. In fact, this study shows a direct correlation between food restriction and cravings.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114146/‘>3 are also in charge of housing your memories and experiences.

    3. State of Mental Health

    Australian researchers conducted a study on pandemic-related depression, stress, anxiety, and well-being and found that 79% of the participants were struggling with mental health issues due to COVID-19.https://www.researchgate.net/publication/302969772_Effects_of_sugar_rich_diet_on_brain_serotonin_hyperphagia_and_anxiety_in_animal_model_of_both_genders‘>5 the neurotransmitter that regulates your mood. When you eat sugar, you feel happier, more connected, and less stressed out — at least until the sugar crash hits.

    4. Current Rituals

    Frozen junior mints at the movies. A slice of pie at summer barbeques. Checking out the dessert menu after dinner even though you’re stuffed. Your rituals and your environment  influence your behaviours (i.e. trigger you to search for something sweet).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868755/‘>7

    Why It’s So Hard to Stop Eating Sugar

    We’re taught early on that sugar equals love and that feeling “better” is as easy as snuggling a pint of Ben & Jerry’s on the couch. Sure, diving into the emotional side of good health can be uncomfortable, but it’s also extremely necessary if you want to get your cravings under control.

    The more readily you can express and deal with your emotions, the healthier your mind and your body will be. In my 10+ years as a health coach, I’ve helped hundreds of men and women peel back the layers of their sugar cravings. And you can too. With the following strategies, you’ll learn that your sugar cravings aren’t something that need wrangling — they’re something that you can use to learn more about what you’re really craving.

    How to Cut Your Sugar Habit: 5 Strategies to Stop Cravings

    1. Add More Variety

    A steady diet of grass-fed beef and local, organic veggies looks great on paper in respect to quality, but as mentioned above, might also feel too limiting for where you’re at right now. If you’re constantly dreaming of sugar-laden treats, take this opportunity to diversify your plate. By adding a variety of colors, textures, and flavors, you’re giving your brain and your body the signal that you’re having more, not less. And don’t forget to change it up now and then. Typically opt for ribeye? Try a salmon fillet. Love salads? Try grilled asparagus. Always snack on almonds? Buy some salted macadamia nuts. You get the picture.

    2. Keep a Journal

    You don’t have to write down all of your deepest, darkest thoughts, but I do recommend keeping a journal of when your food cravings hit — and this is the important part: what you’re feeling when they come on. Do this exercise without self-editing or judgement. Within a week, my guess is that you’ll start to see a connection between your triggers (which could be memories, celebrations, emotions, people, and places) and your sugar cravings. Research shows that having a practice of mindfulness can help you better manage the uncomfortable feelings that fuel your cravings.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290532/‘>9 levels naturally (and reduce the desire to reach for sugar to feel good) through hugging, laughing, playing, and practicing gratitude. Other things like looking at photos of loved ones, singing, physical exercise, and support from family, friends, and our community here on Mark’s Daily Apple are also great ways to boost oxytocin levels. Emotional trauma of any kind can impact your habits and behaviors as an adult. And while a health coach can help you overcome certain obstacles, it’s crucial to work with a licensed professional trained to navigate these challenges https://link.springer.com/chapter/10.1007/978-94-007-1764-0_51‘>1 and a few surrounding areas, where the conditions are just right to grow and harvest the small, orange-sized fruits.

    Monk fruit belongs to the cucurbit family alongside squash, cucumber, and watermelon. Fresh off the vine, the mini melons have a bitter outer rind encasing a sweet edible pulp and seeds. But unless you know someone who’s managed to cultivate monk fruit in their garden, you’re unlikely to eat a fresh monk fruit. The flesh degrades quickly, meaning most manufacturers dry monk fruit or process it so that it will make it to market.

    Most monk fruit finds its way to American shelves as a concentrated natural sweetener. As always, the nature of that sweetener can vary markedly depending on how it was processed.


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    Is Monk Fruit Keto?

    An average serving of pure monk fruit extract contains virtually no carbs, calories or sugars, which makes it a great choice to sweeten keto desserts and drinks.

    It derives almost all of its sweetness from a group of antioxidants https://www.sciencedirect.com/science/article/pii/S0026265X14000733‘>4 the key ingredient is generally mogroside V. This is easily the sweetest-tasting of all the compounds in monk fruit. Very conveniently, your body does not metabolize it in the same fashion as simple sugars like glucose or fructose. Your digestive system does not readily absorb Mogroside V. This accounts for the “zero calorie” claims of monk fruit extract products. It spells good news for those looking to satiate their sweet tooth while avoiding calorie loading or blood sugar spikes.

    Potential Benefits Of Monk Fruit

    While the extraction and refining processes remove most of the original natural compounds from fresh monk fruit, research indicates that the mogrosides and other flavonoids that remain can still benefit your body. Here’s a brief look at some of the benefits (preventative and otherwise) you might enjoy using monk fruit sweeteners.

    Monk Fruit May Combat Obesity

    As Primal folks know, sugar (not fat) is the leading dietary cause of the obesity epidemic. And as the world has ever-so-slowly awakened to the notion that sugar might be doing the most damage, there’s been a push towards sweeteners that don’t elicit the same insulin-meddling, inflammation-elevating, liver-damaging effects as sugar. Preliminary evidence suggests that the mogrosides in monk fruit sweeteners might be just the ticket. A 2012 study showed that total mogrosides extracted from monk fruit “suppressed the increase in body weight, abdominal and epididymal fats weight” in mice placed on a high-fat diet (presumably not good fats).http://www.mdpi.com/1420-3049/23/8/1894‘>6 Researchers thought that the mogrosides achieved this anti-obesity effect by “enhancing fat metabolism and antioxidative defenses.”

    We need more research to verify these findings, especially in humans. But its a promising start.

    READ NEXT: Does Monk Fruit Break a Fast?

    Antidiabetic Applications

    There has been plenty of research into the potential antidiabetic effect of mogrosides found in monk fruit sweeteners. In one study, mogroside extracts from monk fruit administered to diabetic rats significantly eased symptoms and protected against biochemical abnormalities.https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/antidiabetic-effect-of-longterm-supplementation-with-siraitia-grosvenori-on-the-spontaneously-diabetic-gotokakizaki-rat/FC59DC2955AA96A75154985DAE6809E6‘>8

    Yet another study showed that both crude monk fruit extract and mogroside V helped to stimulate the secretion of insulin in pancreatic beta cells.http://www.mdpi.com/2072-6643/8/6/360/htm‘>10 used mogroside IV, extracted from monk fruit, to inhibit the proliferation of both colorectal and throat cancer cells and suppress tumor growth. An earlier study https://pubs.acs.org/doi/abs/10.1021/jf201207m‘>13
    More than half of a more recent study demonstrated the ability of mogroside V to lower induced lung inflammation in mice.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813191/‘>15 We can assume that this is at least partially attributed to monk fruit’s anti-inflammatory compounds.

    Monk and Immunity

    The health-giving powers of monk fruit sweeteners may even extend to immune function. In one study, scientists fed groups of diabetic mice low-dose mogrosides, high-dose mogrosides, or a saline control solution over a month.https://www.ncbi.nlm.nih.gov/pubmed/20183321‘>17 further solidify the immune-boosting effect and prevent the growth of common bacterial pathogens like Streptococcus mutans, Porphyromonas gingivalis, and Candida albicans.

    Are Monk Fruit Sweeteners Safe?

    Long-term, multi-year toxicity trials the best way to evaluate safety, but so far, no tests have yet revealed anything of concern. People sometimes report digestive discomfort with monk fruit, but some say that it would be due to other things that are mixed with the monk fruit (like xylitol or erythritol) and not the monk fruit itself.

    The FDA gave monk fruit products their generally recognized as safe (GRAS) seal of approval in 2010, and it’s of some note that monk fruit has been cultivated and eaten since at least the 13th century, albeit at far lower concentrations.

    Limited trials in humans haven’t reported any adverse effects, and a study in mice showed that, mice who consumed high dosages did not experience toxic or mutagenic effects.http://www.ajcn.org/cgi/content/abstract/26/11/1180‘>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 stresshttp://www.ncbi.nlm.nih.gov/pubmed/18469239?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=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.

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    why willpower doesn't workHi folks, in this edition of Ask a Health Coach, Erin discusses why fasting might feel harder right now, why you need more than just a good workout plan, and what to eat when you’re sick of having eggs for breakfast every day. Keep your questions coming in the MDA Facebook Group or in the comments below.

    Being home all day has been a real test to my willpower. Fasting is harder and I’m hungry all the time. Any tips for navigating this “new normal?” – Stephanie

    I’m with you Stephanie. A lot of things feel out of our control right now and with so much uncertainty, just rolling with it might be your best bet for the next few weeks. Does that mean saying “screw it!” and scarfing down a few donuts every morning? Or grazing on chips and cookies throughout the day? No. But it does mean acknowledging your new routine, your new struggles, the fact that you’re under more stress than usual, and of course, the reality that you’re surrounded by food 24/7.

    Usually when my clients talk about willpower, I find that they’re white-knuckling it through their day. Flat out resisting the temptation to eat with no strategies other than trying not to think about food. By definition, willpower is simply ignoring hunger. You’re choosing not to eat when your body is begging you to feed it!

    Stress Triggers Sugar Cravings

    Hunger is a biological survival mechanism triggered by our cells and driven by our brains. When you’re eating food, you’re feeding your cells. And when you’re resisting or restricting it, you’re starving your cells. Also keep in mind that extra stress puts you into fight-or-flight mode, making those donuts, muffins, leftover Easter candies look extra good. Your cells are craving sugar! And when you give in, you start the vicious cycle of sugar high, followed by sugar crash, followed by feeling hungry, hangry, and craving everything in sight.

    Sure, you might just be bored or procrastinating on a looming deadline, but if you’re genuinely hungry, put a sheet of bacon in the oven, fry up a few eggs with butter, and sit down to a meal. Actually sit down — don’t check emails, do chores, or stand in front of the fridge with the door wide open. And when it comes to intermittent fasting, no one’s going to come knocking on your door and tell you you’re doing it wrong. There’s no fasting police. It doesn’t make you a bad person if you usually fast for 20 hours and now you’re fasting for 12. As a matter of fact, there’s research that proves that fasting for as few as 10 hours has solid benefits.

    Finally, if you are working from home, make sure your setup isn’t at the kitchen table. I know a lot of people have limited space, but having a designated place to work that doesn’t involve you smelling your family members’ lunches or putting you at arm’s reach from the fridge will serve you well.

    I’ve been following Mark’s Daily Apple for 6 months, but I still have 30 pounds to lose. What’s the best workout for someone on a Primal diet? -Gerald

    I love that you have a specific goal, Gerald. Determining your end point is so important for long-term success. It could be losing 30 pounds like you mentioned, or improving the way your joints feel, or being able to chase your kids around the yard without stopping to catch your breath.

    Honestly, there are tons of workouts out there. Free ones too. In fact, I just Googled “workout plans for Primal diet” and came up with this, this, and this  in about 1.5 seconds. But it’s not just about picking a plan and following it. If it were that easy, everyone would do it.

    Identify your Obstacles and Make a Plan to Get Past Them

    Wellness is a journey. One that requires navigating obstacles and determining the path of least resistance. So, before you dive into your first set of squats, take some time to think about what barriers might stand in your way. Do you have the right exercise equipment at home to complete your workouts? Do you have the support of your family? Have you carved out time and space to exercise? You need to get real about what your obstacles are, so you can devise a plan to get past them and reach your goal. If you need a hand with this step, online health coaches and personal trainers can be a great resource.

    A plan is just a plan. It’s two-dimensional. And things always come up. That’s why it’s crucial to have a strategy for all the ups, downs, and unexpected in-betweens that come with your individual journey.

    I’m tired of eating eggs for breakfast every day. Got recommendations for changing things up? – Jeanine

    You were probably in a nutrition rut before you started the eggs-for-breakfast routine. Let me guess: a light yogurt and banana before work, sandwich for lunch, instant oatmeal packets, cans of soup, take out… Somehow you got yourself out of that rut and into another one.

    Listen, everyone likes the things they’re familiar with, and most people don’t like change. It’s a human truth. You were familiar with eggs. You liked them. You started making them every day. And now you’re completely sick of them. Totally understandable.

    Step Out of Your Comfort Zone

    I’m in the business of getting people out of their comfort zones, but I don’t do meal plans or recipes, simply because they’re too fussy. If I say, “how about venison patties and chopped up veggies” and you don’t happen to like those, what good does it do?” As a health coach, I supply my clients with a comprehensive list of supportive foods they should be eating. I provide the education, but I expect them to go out into the world and figure out what that looks like for them, so they don’t need me to tell them specifically what to eat at every meal.

    Like I’m sure you are, I’m a big fan of protein-rich breakfasts since they’re known to keep you feeling satiated throughout the day. Remember that breakfast doesn’t have to look like a typical breakfast though. There are lots of great protein sources out there — everything from bone broth, beef, and bison to salmon, sardines, and sausage, just to name a few.

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    The post Ask a Health Coach: Why Willpower Doesn’t Work, Primal-Inspired Workouts, and What to Eat for Breakfast appeared first on Mark’s Daily Apple.

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