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      Effects of Stevia Rebaudiana on Glucose Homeostasis, Blood Pressure and Inflammation: A Critical Review of Past and Current Research Evidence

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          Abstract

          The prevalence of obesity and its related comorbidities continues to rise in the United States and worldwide. Insulin resistance, increased inflammation and oxidative stress are the major pathogenic mechanisms involved in obesity-associated co-morbid conditions. Major efforts to curb the rising tide of obesity, including lifestyle modifications, anti-obesity medications and surgical interventions have shown minimal success. Therefore, introducing new methods to combat obesity, diabetes and associated disorders are desperately needed. Stevia rebaudiana, a natural, non-caloric sweetener has generated significant interest in the scientific community due to its effects on glucose homeostasis, blood pressure and inflammation, all known consequences of obesity. In this review, we assess the effects of Stevia on these parameters in humans as well as in animal models, highlighting its potential role as an effective intervention for the major cardiovascular risk factors associated with obesity.

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          Most cited references43

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          Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels.

          Consumption of sugar-sweetened beverages may be one of the dietary causes of metabolic disorders, such as obesity. Therefore, substituting sugar with low calorie sweeteners may be an efficacious weight management strategy. We tested the effect of preloads containing stevia, aspartame, or sucrose on food intake, satiety, and postprandial glucose and insulin levels. 19 healthy lean (BMI=20.0-24.9) and 12 obese (BMI=30.0-39.9) individuals 18-50 years old completed three separate food test days during which they received preloads containing stevia (290kcal), aspartame (290kcal), or sucrose (493kcal) before the lunch and dinner meal. The preload order was balanced, and food intake (kcal) was directly calculated. Hunger and satiety levels were reported before and after meals, and every hour throughout the afternoon. Participants provided blood samples immediately before and 20min after the lunch preload. Despite the caloric difference in preloads (290kcal vs. 493kcal), participants did not compensate by eating more at their lunch and dinner meals when they consumed stevia and aspartame versus sucrose in preloads (mean differences in food intake over entire day between sucrose and stevia=301kcal, p<.01; aspartame=330kcal, p<.01). Self-reported hunger and satiety levels did not differ by condition. Stevia preloads significantly reduced postprandial glucose levels compared to sucrose preloads (p<.01), and postprandial insulin levels compared to both aspartame and sucrose preloads (p<.05). When consuming stevia and aspartame preloads, participants did not compensate by eating more at either their lunch or dinner meal and reported similar levels of satiety compared to when they consumed the higher calorie sucrose preload. Published by Elsevier Ltd.
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            Adipose tissue inflammation in obesity: a metabolic or immune response?

            Adipose tissue is not only a reservoir for energy, but also an immune organ. In the context of obesity, the development of insulin resistance is now recognised to be initiated by inflammation of the adipose tissue. However, the primary events triggering this inflammation are still unclear, as a complex combination of endocrine and immune factors act to regulate this adipose tissue microenvironment. Below we discuss the different factors involved and how they affect the biology of the adipose tissue in obesity.
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              Metabolism of stevioside and rebaudioside A from Stevia rebaudiana extracts by human microflora.

              Stevia rebaudiana standardized extracts (SSEs) are used as natural sweeteners or dietary supplements in different countries for their content of stevioside or rebaudioside A. These compounds possess up to 250 times the sweetness intensity of sucrose, and they are noncaloric and noncariogenic sweeteners. The aim of this study was to investigate the in vitro transformation of stevioside and rebaudioside A after incubation with human microflora, the influence of these sweeteners on human microbial fecal community and which specific groups metabolize preferentially stevioside and rebaudioside A. The experiments were carried out under strict anaerobic conditions in batch cultures inoculated with mixed fecal bacteria from volunteers. The hydrolysis was monitored by HPLC coupled to photodiode array and mass spectrometric detectors. Isolated bacterial strains from fecal materials incubated in selective broths were added to stevioside and rebaudioside A. These sweeteners were completely hydrolyzed to their aglycon steviol in 10 and 24 h, respectively. Interestingly, the human intestinal microflora was not able to degrade steviol. Furthermore, stevioside and rebaudioside A did not significantly influence the composition of fecal cultures; among the selected intestinal groups, bacteroides were the most efficient in hydrolyzing Stevia sweeteners to steviol.
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                Author and article information

                Journal
                101737788
                48175
                Int J Clin Res Trials
                Int J Clin Res Trials
                International journal of clinical research & trials
                2456-8007
                5 February 2020
                22 January 2021
                2020
                06 March 2020
                : 5
                : 142
                Affiliations
                Department of Medicine, Division of Endocrinology, SUNY-Downstate Health Science University, 450 Clarkson Avenue, Brooklyn, New York, USA
                Author notes
                [* ] Corresponding Author: Prof. Samy I. McFarlane, Division of Endocrinology, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, 11203, USA, Tel: 718-270-6707, Fax: 718-270-4488; smcfarlane@ 123456downstate.edu
                Article
                NIHMS1552191
                10.15344/2456-8007/2020/142
                7059728
                4988e230-10b3-464a-b129-6c39b59a4f19

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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                stevia rebaudiana,obesity,natural sweetener,diabetes,glucose homeostasis,hypertension,inflammation

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