Abstract

The objective of this study was to evaluate the scientific evidence on stevia, including expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing. This review serves as a clinical support tool. Electronic searches were conducted in 10 databases, 20 additional journals (not indexed in common databases), and bibliographies from 50 selected secondary references. No restrictions were placed on the language or quality of the publications. All literature collected pertained to efficacy in humans, dosing, precautions, adverse effects, use in pregnancy and lactation, interactions, alteration of laboratory assays, and mechanisms of action. Standardized inclusion and exclusion criteria were used for selection. Grades were assigned using an evidence-based grading rationale. Based on the availability of scientific data, two indications are discussed in this review: hypertension and hyperglycemia. Evaluation of two long-term studies (1 and 2 years in length, respectively) indicates that stevia may be effective in lowering blood pressure in hypertensive patients, although data from shorter studies (1-3 months) did not support these findings. A pair of small studies also report positive results with respect to glucose tolerance and response, although the relatively low methodological rigor of these experiments limits the strength of these findings. Further investigation is warranted in both indications.

Cargill, of Minneapolis, Minnesota, issued a press release Wednesday announcing that it has received a “no objection” notification from FDA, verifying that the stevia extract used in the company’s sweetener TruviaTM is “generally recognized as safe.”1

FDA also issued a “no objection” letter to PepsiCo for the stevia extract used in its sweetener PureViaTM.2 Pepsi has been partnering with Merisant, the maker of Equal®, on its stevia-based sweetener, through Merisant’s subsidiary Whole Earth Sweetener.

Wisdom Natural Brands, the first company to market stevia in the United States, starting in the 1980s, completed its GRAS review of the company’s SweetLeaf® stevia sweetener in March.3 PepsiCo and Merisant announced their GRAS review in early May,2 and Cargill and Coke published the results of studies indicating the safety of Rebiana (their trade name for the stevia constituent rebaudioside A) for Truvia’s GRAS status in May.3

Leslie Curry, director of regulatory & scientific affairs at Cargill, told ABC this morning, “We’re very pleased to see FDA’s concurrence on the GRAS status of the safety of high purity, food grade rebaudioside A. FDA’s conclusion is consistent with United Nations and the World Health Organization’s assessment from earlier this year that rebaudioside A is safe for use as a general sweetener” (personal communication to M. Blumenthal, December 19, 2008).

“This is historic news,” said ABC Founder and Executive Director Mark Blumenthal. “Given the FDA’s earlier attempts to keep stevia from the market in the early 1990s, the agency’s approval of stevia as a safe food ingredient is good news for millions of American consumers who are seeking a safe, natural, non-caloric sweetener.”

In related developments, the governments of Australia and New Zealand approved stevia as a food additive in October,4 following the approval of stevia by the United Nations and World Health Organization’s Joint Expert Committee on Food Additives (JECFA) in June,5 after an extensive multi-year review of the safety of the natural sweetener. The JECFA approval relates to stevia extract containing 95% stevia glycosides.

The American Botanical Council has published several recent stories on this subject in previous issues of HerbalGram and HerbalEGram. An article published in the October 2007 issue of ABC’s monthly e-newsletter HerbalEGram provided much background information on the regulatory hurdles that stevia has faced within the sweetener industry.6 Issue 79 of ABC’s quarterly peer-reviewed journal HerbalGram contained an article on the self-affirmation of GRAS status that Wisdom Natural Brands and other companies had recently announced in regards to their stevia-based sweeteners,3 and Mark Blumenthal’s “Dear Reader” article in HerbalGram issue 80 called for the FDA to rescind its out-dated Import Alert on stevia.7

For this morning’s audio coverage of this story on National Public Radio, click here.

References

1. Cargill receives official notification from FDA supporting the safety of TruviaTM Rebiana [press release]. Wayzata, MN: Cargill; December 17, 2008.

2. US Food and Drug Administration issues no objection letter to GRAS status of Rebaudioside A [press release]. Chicago and Purchase, NY: Whole Earth Sweetener Company; December 17, 2008. Available at: http://www.purevia.com/media/081217Pure.aspx.

3. Cavaliere C, Saxton KE. Wisdom Natural Brands begins marketing SweetLeaf® stevia as a sweetener. HerbalGram. 2008;79;20-21.

4. FSANZ Gazette Notices. Amendment No. 103 (FSC 45). Available at : http://www.foodstandards.gov.au/standardsdevelopment/gazettenotices/amendment1039october4070.cfm.

5. Joint FAO/WHO Expert Committee On Food Additives, Sixty-ninth meeting Rome, Italy, 17-26 June 2008. Summary and Conclusions issued 4 July 2008. Available at: http://www.fao.org/ag/agn/agns/files/jecfa69_final.pdf.

6. Cavaliere C, Blumenthal M. Coca-Cola and Cargill developing new natural sweetener from stevia. HerbalEGram. October 2007;4(9).

7. Blumenthal M. FDA should rescind outdated import alert on stevia. HerbalGram. 2008;80:6.

After over a decade of economic special interests seeming to block the way (i.e., Nutrasweet), the FDA has finally approved the healthy herb Stevia as a natural sweetener to add to foods and sodas.

In fact, the first Stevia-sweetened soft drink, “Sprite Green” by Coca-Cola, was on its way to stores.

Pepsi said its first Stevia product, SoBe Lifewater, should hit store shelves next week, and Trop50, a Stevia-sweetened light orange juice product, is due out in January.

Dr. Pepper Snapple, the No. 3 soft drink company, said on Thursday it will market Stevia within a few weeks.

We have recommended Stevia as a safe and healthy natural sweetener for decades — even as the FDA, seemingly driven by someone heavily on the Nutrasweet payroll (though this is simply my impression, of course, without definite evidence) required the first and only book burning demanded by the U.S. government — which just happened to be books recommending Stevia. Till now, the FDA would not allow stevia to be added as a food sweetener. Instead, it could only be added as a “nutrient.”

Stevia is a safe, healthy and calorie free natural sweetener. Expect the media to jump all over bizarre stories raising questions of its safety (which will be fed to the media by publicists for the sugar, Splenda and Nutrasweet trade groups trying to protect their market share). In the middle of their trying to scare you away from this healthy sweetener and back to their toxic ones, let yourself enjoy watching an example of American marketing hype in action. And indulge your sweet tooth

One word of caution. If Stevia is not filtered, it will taste bitter and with a licorice aftertaste. I suspect the large soda companies will do proper filtering to ensure taste.

Stevia simply comes from soaking a Stevia leaf in water and using the sweet liquid.

Stevia — another great example of keeping your pleasures — while staying healthy!

What is stevia?
Stevia is a tropical plant native to South America. Its extract has up to 300 times the sweetness of sugar. Although some people complain of its staying power in the mouth or its sometimes licorice-like aftertaste, it is a popular natural alternative sweetener. As a sweetener, it is low glycemic and has added benefits in potentially helping to control obesity, enhance glucose tolerance, and reduce blood pressure. You would think that with this kind of pedigree, it would qualify as the perfect sugar substitute and be approved for use as an alternative sweetener everywhere. You would be half right. It is widely used throughout Asia (particularly Japan) and South America — not so in the US, most of Europe, and Canada, where it is banned as a food additive. In the United States, and Canada it’s allowed as a supplement, but not in food. In Europe, it’s only allowed as an additive to animal feed.

This whole separation thing between food additives and supplements as seen in the US and Canada is actually very nebulous — and deliberately so. Although the rulings as written by the various government agencies might appear clear, government authorities choose to interpret them as the mood suits. A good example is the recent censure of Celestial Seasonings teas. Celestial Seasonings followed the letter of the law by labeling their Zingers tea an herbal supplement and including a supplements facts panel on the label, but as it turns out, that didn’t matter. To quote from the FDA notice, “Notwithstanding your use of the term ‘Herbal Supplement’ to identify the product and your use of a supplement facts label for nutrition labeling, your Zingers Tangerine Orange Tea is subject to regulation as a conventional food and not a dietary supplement… Therefore, your stevia-containing Zingers Tangerine Orange Tea is adulterated within the meaning of section 402(a)(2)(C) of the Act.”

To better understand the situation, let’s take a more detailed look at stevia.

What are the studies that support it?
In fact, stevia has been studied extensively. In addition to the studies cited above showing its benefits in regard to obesity, glucose tolerance, and high blood pressure, there are numbers of other studies proving its safety. For example, a 1991 study in Thailand found that even at doses 1,000 times normal human dosage, hamsters demonstrated no difference in growth rate or sexual performance — even through three generations.

In 2004, researchers at the KU Leuven (Belgium) organized an international symposium on ” The Safety of Stevioside.” Scientists from all over the world who attended concluded that stevioside is safe:

* Stevioside is not carcinogenic. On the contrary, studies in Japan have proven that stevioside reduces breast cancer in rats as well as skin cancers in animals models.

* Stevioside is not absorbed by the human gut. Only bacteria of the colon degrade stevioside to steviol. Part of this steviol is absorbed through the intestine but is quickly metabolized to steviol glucuronide and excreted in the urine. No free steviol is detected in the blood.

* Although steviol showed a weak mutagenic activity in one very sensitive strain of bacteria, even high concentrations of oral steviol were harmless (up to 2 g/kg body weight)!

What are the problematic studies?

So is everything rosy for stevia? Not necessarily. There have been some problematic studies. For example:

* A 1984 study found that although stevioside was not cancer causing, steviol, a metabolite of stevioside, is indeed mutagenic in the presence of a specific metabolic activation system — although subsequent studies have either not found it so, or found the effect to be so low as to be insignificant (1, 2). And again, as discussed earlier, any steviol that passes through the intestinal tract is metabolized to steviol glucuronide and excreted in the urine. In fact, some studies have shown that stevia may actually be cancer preventive.

* There were also studies that indicated stevia might negatively affect fertility in rats, but those studies were later refuted by more reliable studies involving higher numbers of rats and more controlled protocols. And this merely reinforces the results of numerous other studies.

The bottom line is that there is no compelling evidence that stevia in any reasonable dosage causes cancer. In fact, it is worth noting that the incidence of cancer in Japan is very low, although stevioside has been used there for over 25 years. And as for the fertility issue, there is no meaningful laboratory evidence that stevia has any effect on male or female fertility, nor on the development or state of the fetus. And again, despite a quarter of a century of use in Japan, there is no actual evidence of any negative effect on fertility or any other aspect of health for that matter.

It should also be noted that all of the problematic studies have used purified stevia at levels far, far, far higher than would ever happen in a normal human diet. Is this important (after all, testing for mutagenic effects at high doses is standard procedure)? The problem is that just because it’s standard doesn’t make it meaningful. Keep in mind that even things that are healthy can become deadly if taken in large amounts. For example, if you have 100 times the normal dosage of protein each day, you will destroy your liver in short order. If you have a 100 times the normal dosage of water, you will die in a single day — in a rather messy explosion.

The bottom line here is that all of the problematic studies have been conducted on rats and hamsters with absurdly high doses. In the real world, stevia has been in use with hundreds of millions of people throughout Asia and South America for as much as a quarter of a century. We’re talking billions of doses and no sign of increased cancer or lowered fertility. If only the alternative sweeteners that the regulators allow could match that kind of track record.

What are the absurdities of the regulators’ positions on sweeteners?
But all that aside, it would at least be understandable if the regulators played with a fair deck and applied equal standards to all alternative sweeteners. But they do not.

Aspartame
* According to the FDA’s own audit on aspartame, the Bressler Report, aspartame triggers brain tumors, mammary tumors, pancreatic tumors, ovarian tumors, pituitary adenomas, uterine tumors, etc. A senior FDA toxicologist, the late Dr. Adrian Gross, who tried to prevent the approval of aspartame, told Congress that it violated the Delaney Amendment because it triggered brain tumors (Congressional Record SID835:131 – 8/1/85).

* Aspartame has also been shown to trigger birth defects and miscarriages — not just if the mother uses it, but the father also.

* Before aspartame was approved in beverages in 1983, the National Soft Drink Association created a THIRTY PAGE PROTEST (that was later read into the Congressional Record) declaring that aspartame was NOT stable, and that it could actually make unwary users FATTER!

The bottom line on aspartame is that its safety record and evaluation record do not even come close to matching the safety of stevia. In fact, FDA’s own evaluation committees rejected aspartame. But in 1983, the Commissioner of the FDA, Dr. Arthur Hull Hayes, overrode his own committees and approved NutraSweet (aspartame) for soft drinks two months before leaving office. A couple of months later, after he had retired from the FDA, he accepted a position as Senior Medical Advisor to Burson Marsteller, the public relations firm that promoted NutraSweet for G.D. Searle, NutraSweet’s manufacturer — at the rate of $1,000 per day. An unfortunate coincidence, one might say.

Sucralose
If you think that sucralose, the new darling of the regulatory agencies, has better science behind it than aspartame, you would be sadly mistaken. As Dr. Mercola points out, as of 2006:
“Only six human trials have been published on sucralose. Of these six trials, only two of the trials were completed and published before the FDA approved sucralose for human consumption. The two published trials had a grand total of 36 total human subjects.The longest trial at this time had lasted only four days and looked at sucralose in relation to tooth decay, not human tolerance.”

In addition, pre-approval research shows that sucralose causes up to 40% shrinkage of the thymus gland and enlarges the liver and kidneys.

High fructose corn syrup
And, of course, high fructose corn syrup, the number one sweetener used in the world today is a health disaster.

What lies in the future?
One has to wonder why aspartame, sucralose, and high fructose corn syrup — all with proven major negative health effects — are approved by regulatory agencies in the US, Canada, and Europe and are currently in widespread use; whereas stevia is not. Not to be cynical, but perhaps the companies behind aspartame, sucralose, and high fructose corn syrup (G.D. Searle, Royal DSM, Tate and Lyle, and ADM) have a political clout that small independent stevia producers cannot muster for a non-patentable natural sweetener.

If that’s true, we can be fairly sure that we will never see stevia approved for commercial use in Europe, Canada, and the US until one of those large corporate entities finds a way to patent it. But wait! Forgive my cynicism! Cargill and Coca Cola are doing just that even as we speak! I think we can look forward to an approval of stevia — in a patented form — in the not too distant future. Will this version be safer? No, of course not. It will merely have a different name, Rebiana. Oh yes, and Coke and Cargill will back it. In the world of nutrition regulation, it appears that money talks… and real nutrition walks. It’s enough to give you high blood sugar, tiny thymuses, brain tumors, and shrunken sex glands!

Conclusion

I originally titled this article the Stevia Shibboleth. A shibboleth, as described in the Bible, was a secret word used by the ancient Gileadites to identify outsiders who were unable to pronounce the word correctly. In a sense, we can see that stevia is being used as a shibboleth by regulatory agencies to separate the insiders (the large commercial entities with major political influence) from the outsiders (the purveyors of all-natural healthy products). And just as the Gileadites put outsiders who failed the test to death, so it would seem our regulators would do the same to manufacturers such as Celestial Seasonings who fail the modern Shibboleth test and pronounce their sweetener: stevia.

This article was originally written as a newsletter which is read by tens of thousands of people in over 120 countries. Of those thousands of subscribers, six have email addresses that carry the @fda.gov ID. This particular issue was written for them — and for the other handful of subscribers who represent the European regulatory agencies.

Guys, as long as you approve aspartame, sucralose, and high fructose corn syrup as healthy and refuse to allow stevia to be used, calling it unsafe, despite all reasonable evidence to the contrary, you will have no credibility among thinking people. It is tantamount to an open admission that approval has nothing to do with safety — only what’s bought and paid for.

Since we’re running a Biblical motif with our shibboleth reference, let’s conclude with another for our regulator friends. To paraphrase Moses, “Let my stevia go!”

Hain Celestial Group Inc., the maker of Celestial Seasonings teas, received a warning from U.S. regulators that some of its powdered drink mixes contain an unsafe herb.

Robbie ate 4 teaspoons straight from the jar and within minutes he turned into a whirling dervish, a cyclone of hyperactivity. He was banging his head against a pillow on my lap one minute and the next tearing down the hall to throw toys around his room. The parents seemed all too familiar with this behavior and began making excuses. He gets like this when we have company, when he’s overtired, when he’s excited.

As a doctor, I immediately knew what the problem was – sugar. Robbie’s parents had already figured out that indulging his sweet tooth lead to hyperactive episodes. But they didn’t make the connection between the peanut butter and the behavior. I took the jar and showed them the label, which listed two different sugars (high fructose corn syrup and sugar). The parents were stunned and said they would be more diligent about cutting out the hidden sugars in their son’s diet. When my husband saw Robbie’s father a week later, he said Robbie was much calmer, was sleeping better, and was like a different person both at home and at daycare.

Most people do realize that sugar can cause hyperactivity, but what they don’t realize is that sugar lurks where you least expect to find it and affects the human body in myriad ways. The sugar industry vehemently denies that sugar is hazardous to human health. Are the parallel increases in sugar consumption, obesity, and diabetes just a coincidence? Here are the straight answers.

I know sugar can lead to weight gain, but is it really all that bad for me?

Yes, it really is. Sugar is a simple carbohydrate found naturally in many foods, including fruits and grains. If the only sugar we consumed were in natural, whole foods, we’d all be just fine. But the average American diet is full of refined, nutrient-depleted foods and contains an average of 20 teaspoons of added, refined sugar every day. That’s twice the amount recommended by the USDA (10 teaspoons and four times the maximum I personally recommend.)

So what’s wrong with refined sugar? Many things. First, sugar compromises immune function. Two cans of soda (which contain 24 teaspoons of sugar) reduce the efficiency of white blood cells by 92 percent – an effect that lasts up to five hours, according to Kenneth Bock, M.D., an expert in nutritional and environmental health. Since white blood cells are an integral part of your immune system, if you happen to meet a nasty virus or bacteria within five hours of drinking a few colas, your immune system may be unable to fight off the invader.

Refined sugar also overworks the pancreas and adrenal glands as they struggle to keep the blood sugar levels in balance. When you eat sugar, it is quickly absorbed into your blood stream in the form of glucose. This puts your pancreas into overdrive, making insulin (which carries glucose to your cells to be used for energy) to normalize blood sugar levels. But this rapid release of insulin causes a sudden drop in blood sugar. In reaction to the falling blood sugar, excess adrenal cortisone is stimulated to raise blood sugar back to normal. A constantly high intake of simple dietary sugar keeps this roller coaster going and eventually overworks or “burns out” normal pancreas and adrenal function leading to early menopause, adult-onset diabetes, hypoglycemia, and chronic fatigue.

The purpose of eating is to provide your body with nutrients. But since sugar is devoid of nutrients, the body must actually draw from its nutrient reserves to metabolize it. When these storehouses are depleted, the body becomes unable to properly metabolize fatty acids and cholesterol, leading to higher cholesterol and triglyceride levels. Drawing on the body’s nutrient reserves can also lead to chronic mineral deficits, especially in magnesium (a mineral required for more than 300 different enzyme activities) and chromium (a trace element that regulates hormones such as insulin), putting you at risk for dozens of diseases, from depression to attention deficit disorder to asthma.

A recent study, for example, found that kids who eat significant amounts of junk food are much more likely to develop asthma than kids who don’t eat junk food. While the researchers didn’t tie asthma to sugar itself, they did point out that a diet full of candy and other highly processed junk foods is deficient in a number of nutrients essential to health. And as I explained earlier, such foods further deplete the body of nutrients once consumed.

In fact, children are the biggest consumers of nutritionally void junk food at a time when their brains and bodies are growing rapidly and in need of a nutrient-dense diet for proper development, both physically and mentally. Criminologist Stephen Schoenthaler has been conducting nutritional studies on delinquents and public school children for almost thirty years. In a paper from 1986 he describes how one million kids improved their test scores when they eliminated sugar and white flour from their diets.

Alexander Schauss, Ph.D., a nutritional researcher and writer, performed similar work in juvenile detention centers and showed that violent behavior decreased dramatically when sugar was eliminated.

But I don’t eat junk food. Why should I be concerned about my sugar consumption?

Unless you’re eating a diet entirely made of whole, unprocessed foods (think fruits, vegetables, grains), you’re probably eating more sugar than you think, and than you should. Sugar, in its myriad forms, is added to virtually every packaged food product you’ll find at the supermarket – not just the sweet stuff. If you drink one soda, even the “natural” variety, used up your day’s sugar allowance.)

Don’t be fooled by the ingredients list. Sugar has hundreds of pseudonyms (see “Stealth Sugars,” for a sampling), and manufacturers have gotten very good at hiding them from consumers. Because ingredients are listed from most to least amount, often three different types of sugars will be in the middle of the list. If all sugars were required to be listed together, sugar would be the first ingredient.

To find out how much sugar you’re actually taking in, try keeping a food diary for one week. Check the labels of the foods you eat and make note of their sugar content. The reality of the numbers may not hit home because most of us don’t think in grams – 4.2 g of sugar is equivalent to 1 teaspoon of sugar. At the end of the week, take the total number of sugar grams and divide it by 4.2 to get your weekly sugar intake in teaspoons. Then divide that number by 7 to get your daily sugar consumption.

Unfortunately, the way the FDA’s labeling rules are set up, manufacturers don’t have to separate added sugars from naturally occurring ones on labels. But your total sugar intake will give you a very good idea of how much added sugar you’re eating. Naturally sweet foods, such as fruit, don’t really contain that much sugar. A cup of strawberries, for example, contains 1/6th the sugar of a can of cola.

Is there such a thing as a safe amount of sugar?

Ideally, you should eliminate all refined sugar from your diet. I’m aware do realize that such a feat may not be realistic for everyone, particularly since a large number of the foods you find at the grocery store have been made with refined sugars (plus the fact that nutrition labels don’t have to list the amount of added sugars a product contains).

Many people subscribe to the bizarre logic that if they overindulge in sweets and don’t wake up the next day with diabetes or some horrible disease then it must be okay. Dr. Abraham Hoffer, a psychiatrist in British Columbia who has been studying the effects of sugar on health for more than 40 years, says that it takes roughly 15- 20 years of steady consumption of refined sugar and junk food before an individual develops a chronic illness like diabetes. And it doesn’t take a lot of sugar to put you at risk. Hoffer’s statistics show that once intake exceeds 20 teaspoons daily, the risk of chronic disease increases exponentially.

If you can’t completely cut sugar from your diet, due to eating out and not being in control of ingredients, try not to ingest more than two or three teaspoons a day. That way you will stay well below 70 pounds annually (20 teaspoons daily) which is the cut off point for sugar-induced chronic disease. At the level we’re eating sugar now (20 teaspoons per person daily), it is only a matter of time before we’re facing an epidemic of sugar-induced diseases. In fact, the epidemics may have already begun – according to the Centers for Disease control in Atlanta, the incidence of adult-onset diabetes, has increased by 70 percent among people in their 30s in the past 10 years.

What does processing do to sugar?

Processing sugarcane, or any whole food, strips it of most if not all of its nutritional value. Researchers found that the refining process of sugar removes 93 percent of its chromium, 89 percent of its manganese, 98 percent of its cobalt, 83 percent of its copper, 98 percent of its zinc, and 98 percent of its magnesium. Ironically, the end product, the refined sugar, is what we consume, while the nutritious residues are discarded and generally fed to cattle.

In the 1920s, Sir Frederick Banting, the Canadian medical researcher scientist, who first discovered insulin, visited Panama to study diabetes among workers in the sugar cane fields. He could find almost no incidence of diabetes among the workers who ate the whole sugarcane plant daily. But among their Spanish employers – who incorporated the refined end product, white sugar, into their diets – the disease was rampant.

Is fructose healthier than sugar?

Many people mistakenly believe that fructose is a healthier sugar – especially since it is used in many so-called “natural” foods. While there is a small amount of fructose naturally present in fruit, the fructose that is added to many commercially prepared foods is nearly as refined as plain white sugar.

Most of the fructose you’ll encounter is in the form of high-fructose corn syrup (HFCS), which has nearly eclipsed sugar as the most consumed sweetener in the United States. It is added to thousands of products, from cola to cookies and even to canned vegetables. HFCS is a highly refined sweetener that is virtually identical, chemically speaking, to refined white sugar; during digestion sugar breaks down into equal parts of glucose and fructose; HFCS contains 55 percent fructose and 45 percent glucose.

Why do I crave sugar?
You may crave sugary foods for many reasons. As I explained earlier, refined sugar stresses the pancreas and depletes the body’s supplies of chromium. A common symptom of chromium deficiency is sugar cravings. And satisfying these cravings further lowers chromium and increases cravings. And eating sweets is just plain pleasurable. Chocolate, for example, has been found to stimulate the production of serotonin, the feel-good brain chemical.

But the human body is drawn to carbohydrates for reasons other than instant gratification. Carbohydrates are necessary for metabolic processes in our body. Whole, unrefined carbohydrates like grains break down into sugar when chewed. After proper chewing, grains will taste sweet. Grains contain B vitamins and magnesium, these nutrients are important co-factors in hundreds of metabolic processes in the body. And the sweetness of the foods that contain B-vitamins and magnesium may create a conditioned response to these foods. In other words, sweetness makes your body think you are getting beneficial vitamins and minerals. But when we get empty carbs like sugar with no other nutrients—the body craves more and more to try to meet its nutrient demands.

So, if your body needs these vitamins and minerals and is attracted to carbohydrates to get them, and if instead of a whole grain you eat a refined empty product, then you will probably keep craving carbohydrates until you get the vitamins and minerals you need. That’s why many doctors recommend B-complex vitamins and magnesium supplements help to control carbohydrate addiction. Of course, eating organic whole grains would be the optimum solution.

The main reason for our sugar cravings it that we’ve had a lifetime of refined sugar. It’s in baby food, snacks and treats at every turn; Madison Avenue is able to sell 10 cents worth of junk food for $2.00 because it appeals to our sweet tooth. We’re hooked and we’re not complaining as long as the supply holds out. And as Dr. Hoffer says it’s a stronger addiction than heroin.

Another cause of sugar cravings is a yeast overgrowth, also known as candidaisis. Candida is a yeast that is naturally present in the human body. But some things, such as antibiotics and too much sugar in the diet, can cause the yeast to multiply, leading a number of health problems, from vaginal yeast infections to severe fatigue. And these yeast, when present in abnormally high numbers, can cause strong cravings for sweet, starchy foods, causing the problem to perpetuate. (If you suspect a yeast overgrowth, your doctor can perform a saliva or stool test for yeast antibodies.) (Dr. Dean is the medical advisor to yeastconnection.com. Visitors to the site can take the Yeast Questionnaire to help determine if they have a yeast problem. If so, a 6-Point Yeast Fighting Program will help eliminate the sugar and yeast from your life.)

Are natural sweeteners like honey better than white sugar?

Regardless of what kind of sweeteners you eat, they should account for no more than 5 percent of your daily calories. Some natural sweeteners, such as blackstrap molasses, unprocessed honey, fruit juice, brown rice syrup, and evaporated cane juice do contain low levels of nutrients, such as the B vitamins, and minerals such as iron, calcium and potassium. But don’t be fooled, these “natural” sweeteners are only marginally better than plain white table sugar and dietary intake of them should be limited.

What about calorie-free sugar substitutes such as Nutrasweet? Sweet N’ Low?
Don’t be fooled into switching from sugar to sugar-free substitutes; they’re even more unhealthy, especially aspartame (Nutrasweet). If you want to add a touch of sweetness without any calories, try stevia*. Stevia is an extremely safe herb that is not only an excellent sweetener, but it actually lowers blood sugar levels in diabetics by helping to regulate pancreatic function. And unlike sugar, which weakens the immune system, stevia has antimicrobial properties and actually helps the body fight off colds and flus.

Aspartame (Nutrasweet),on the other hand, is a neurotoxin and should be avoided like the plague. Aspartame has been shown to cause birth defects, brain tumors and seizures and to contribute to diabetes and emotional disorders.

Aspartame has three components: phenylalanine (50 percent), aspartic acid (40 percent) and methanol, also termed wood alcohol (10 percent). Those in support of this popular artificial sweetener, state that the two primary amino acids, which comprise 90 percent of aspartame by weight, are a harmless and natural part of our diet. While phenylalanine and aspartic acid are naturally occurring amino acids, our bodies and brains are not equipped to handle such high concentrations as found in a diet soda where they disrupt nerve cell communication and can cause cell death. The neurotoxic effects of these isolated amino acids can be linked to headaches, mental confusion, balance problems and seizures.

Methanol, too, is naturally present in fruits and vegetables but these foods also contain ethanol, which neutralizes the methanol. The Environmental Protection Agency (EPA) defines safe consumption of methanol as no more than 7.8 mg per day of this dangerous substance. Yet a one-liter beverage, sweetened with aspartame, contains about 56 milligrams of wood alcohol, or seven times the EPA limit.
And the absolute irony of the use of aspartame in diet products is that it can actually cause weight gain. Phenylalanine and aspartic acid, found in aspartame, stimulate the release of insulin. Rapid, strong spikes in insulin remove all glucose from the blood stream and store it as fat. This can result in hypoglycemia (low blood sugar) and sugar cravings. Additionally, phenylalanine has been demonstrated to inhibit carbohydrate-induced synthesis of the neurotransmitter serotonin, which signals that the body is full. This can cause you to eat more than your normally would and, ultimately, gain weight. In one study a control group switching to an aspartame-free diet resulted in an average weight loss of 19 pounds.

Saccharin is a petroleum-derived sweetener discovered in 1879 and was used extensively during the sugar shortages during World Wars I and II. The sweetener got a bad reputation in l977 when the FDA proposed restrictions on its use saying studies involving male rats given large amounts of saccharin developed urinary bladder tumors. The National Toxicology Program (NTP) then officially classified saccharin as an “anticipated human carcinogen.” But researchers have since been unable to reproduce the results from 1977, and saccharin was recently removed from the NTP’s list. Saccharin might be the lesser of two evils, but it’s still a synthetic substance.)

Many low-carbohydrate foods, like the Atkins Bars, contain sugar alcohols. What are they?

Stealth Sugars

It sometimes requires a little detective work to find the hidden sugars in foods. You probably know the “ose”s (maltose, sucrose, glucose, fructose), but there are dozes more that you’d never suspect. The following is a list of 100 common names for sugar that you may encounter in ingredients of your favorite foods.

Fruit Juice contains 40g

Where We Get Our Sugar:

Then and Now
In 1973, the per capita consumption of sugar and other highly refined sweeteners (such as high-fructose corn syrup) was 126 pounds a year. Today, it’s 158 pounds – an increase of 26 percent. During the same time period, the percent of overweight Americans increased by nearly 20 percent.

Soda Overload
A single can of soda contains 12 teaspoons of added sugars. That’s 120 percent of the USDA’s recommended daily intake of sugar. Researchers have found that just two cans of soda can suppress immune function for up to five hours.

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* As a physician, I have found that reducing sugar intake is one of the most important ways to control hypoglycemia, diabetes, and intestinal yeast. Reduce your sugar intake by supplementing your tea, water, and other beverages with Stevia. Please go to www.CarolynDean.com and click on Dean Wellness for my personal Stevia recommendation.

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Originally published in Natural Health Magazine, 2000.

]]> 21372 https://healthy.net/2007/05/13/a-better-alternative-to-sugar-and-artificial-sweeteners/?utm_source=rss&utm_medium=rss&utm_campaign=a-better-alternative-to-sugar-and-artificial-sweeteners Sun, 13 May 2007 15:33:00 +0000 https://healthy.net/2007/05/13/a-better-alternative-to-sugar-and-artificial-sweeteners/ Most medical experts would agree that one of the best ways to improve your health is to reduce your sugar intake. Doing this can help decrease one’s chances of getting diabetes and being overweight or obese—both epidemics in this country with adults and children alike. Consider these facts:

• Since 1985, childhood diabetes has increased ten-fold. The Centers for Disease Control predicts that if this trend continues, one out of every three children born beginning in 2000 will develop diabetes in their lifetime.
  
• About 2/3 of U.S. adults are overweight or obese; while up to 30% of children are overweight, compared to 4% in 1982. In the past 25 years, obesity in children has more than doubled, affecting at least 15% of school-age children!
  

The average American ingests over 150 lbs. of sugar annually! That represents a whopping 30- 5 lb. bags of sugar each year! In reality, much of this sugar is in the form of high fructose corn syrup prevalent in foods because it’s much cheaper than sucrose, common tabletop sugar.

While some might think that artificial sweeteners are the best solution to curb our love affair with sugar, others disagree. Artificial sweeteners do eliminate the high calories and carbohydrates associated with sugar, however many believe that these alternatives are unsafe and are actually worse than sugar. So is there yet another alternative available?

If there were an all-natural sweetening ingredient that’s been used safely for over 30 years in other parts of the world for food applications and diabetes management with no ill effects, would you be interested? Well, such a substance does exist and it’s called stevia.

Using stevia, an all-natural alternative to sugar and artificial sweeteners, is gaining increasing popularity worldwide. Stevia rebaudiana, its botanical name, is derived from a plant in the chrysanthemum family grown primarily in South America and Asia. The plant’s intense sweetening qualities are complex molecules called steviosides that are glycosides made of glucose, sophorose and steviol. These are what make stevia up to 300 times sweeter than sugar and non-caloric. These glycosides do not get absorbed into the body; rather simply pass through leaving no calories. The Japanese have used stevia in food applications from soft drinks to soy sauce since the 1970s and recent reports indicate that stevia commands up to an incredible 50% share of Japan’s commercial sweetener market. Moreover countries like Brazil use stevia for the treatment for diabetes.

The advantages to stevia are numerous, so the following are the most frequently cited. In its pure form, it’s non-caloric and doesn’t affect glucose levels, an advantage for diabetics and hypoglycemics. Also, it has no carbohydrates or fat, so it’s great for dieters, especially those watching carb intake. Unlike artificial sweeteners, high quality stevia has little aftertaste when measured properly. It has no known side effects like some chemical sweeteners and has been safely consumed around the world for decades. Actually, stevia’s original medicinal uses date back centuries ago with the Paraguan Indians who mixed the herb in teas for its healing properties. Since stevia is sugar-free, candida sufferers can use it. Health conscious consumers take advantage of stevia to avoid sugar and help prevent diabetes and obesity. The website www.ncbi.nlm.nih.gov, under the direction of the National Institutes of Health, National Library of Medicine and National Center of Biotechnology Information, offers abstracts from stevia studies that indicate it may also aid in lowering blood pressure and regulating glucose levels.

The average consumer may not have heard about stevia until recently because of its current FDA approval as a dietary supplement, not as a sweetener or food additive. Numerous studies worldwide tout its overall safety and health benefits. As of this writing, about ten countries, including Japan, Paraguay and Brazil have approved stevia as a sweetener and/or food additive. The FDA approved the use of stevia only as a dietary supplement since 1995. This means stevia companies must maintain a fairly low profile, thereby limiting its distribution and marketing potential. For instance, health food stores and natural grocers must place stevia in the supplements section, not with the natural sweeteners for fear of the FDA mandate. The stores cannot promote the “sweetening” qualities of stevia, even though that’s why it is purchased.

Stevia can be used as a healthy substitute in most sugar applications, including baking and cooking since it is heat stable. The average conversion rate of sugar to stevia is one cup of sugar per one teaspoonful of pure stevia extract. Clearly very little stevia is needed to replace sugar. When used in beverages, stevia dissolves quickly and easily and, depending on your taste preference, only a pinch is needed. The real challenge to using stevia effectively is knowing what ingredients to use in a recipe to make up for the volume and consistency lost with the elimination of sugar, especially in baked goods. That’s why it’s a good idea to find stevia cookbooks with proven recipes when you’re starting out. You can also find some free recipes online. Finally, stevia is not appropriate in recipes that require sugar caramelizing or browning like meringues.

Stevia is available in many forms including liquid, teas, plants/leaves, pure white and green powdered extract and powdered blends with different fillers. In baking, the pure extract is used primarily and, in some cases, the liquid variety. Stevia can be purchased at health food stores, natural grocers, food coops and online. Currently a big push is underway to expand distribution into grocery stores, vitamin shops and drugstores.

Due to the number of factors that can influence your stevia purchase experience, the following guidelines provide some good advice:

• You often do get what you pay for; don’t buy based solely on price; taste and quality matter.
  

  
  

• Higher % of stevioside doesn’t necessarily make the stevia better; you can find excellent tasting stevia with this key plant composition at even 80%.
  

  
  

• If you purchase the green powder for its slightly higher health benefits, it will usually have more aftertaste than the white powder.
  
• The product’s country of origin doesn’t matter; it’s farming, manufacturing and processing experience and techniques do.
  
• At this time, stevia production is not standardized, so taste and strength do differ depending on brand.
  
• Use a minimal amount; can be overwhelming if you add too much initially; add more later if needed.
  

Widespread use of sugar and artificial sweeteners are at dangerous levels. The negative side effects and controversial studies regarding their proposed safety suggest that another alternative is desirable and necessary. Stevia may be a welcome option for those who want to ingest more natural ingredients with no known side effects, no calories, no carbs, no fat, no affect on glucose levels and no sugar or artificial sweeteners. Stevia may also be advantageous in the prevention and treatment of diabetes, obesity and other health conditions. Check with your doctor before including stevia to your diet. If he/she doesn’t recommend it, politely ask why to see if the reason is satisfactory to you.

For more information on stevia or to try free stevia recipes, visit the web or http://www.steviadessert.com and cookbooks like Sensational Stevia Desserts by Lisa Jobs, $19.95 retail price, Healthy Lifestyle Publishing LLC, Copyright ©2005. The book is available at various online sites including www.steviadessert.com, Amazon, Barnes & Noble, health food stores or you can order it at your favorite bookstore.

]]> 21362 https://healthy.net/2003/04/10/the-secret-of-stevia/?utm_source=rss&utm_medium=rss&utm_campaign=the-secret-of-stevia Thu, 10 Apr 2003 22:57:44 +0000 https://healthy.net/2003/04/10/the-secret-of-stevia/
Stevia Rebaudiana is a small shrub native to portions of Northeastern Paraguay and adjacent sections of Brazil. It flourishes in the sandy soil of this elevated terrain and may grow to a height of 80 cm when it is fully mature. While native Indians of the Guarani Tribe appear to have used the leaves of this herb as a sweetener since pre-Columbian times, it was not until 1887 when a South American natural scientist named Antonio Bertoni first “discovered” it.

Bertoni originally designated this plant as Eupatorium Rebaudianum Bertoni (related to boneset), but later reassigned it to the genus Stevia, (1905). It is estimated that there are over 80 species of Stevia known to grow wild in North America and perhaps as many as two hundred additional species native to South America. Of these, only Stevia Rebaudiana and another now-extinct species appear to posses the natural sweetness which are their distinguishing characteristics.

The sweet secret of Stevia lies in a complex molecule called Stevioside which is a glycoside composed of glucose, sophorose and steviol. It is this complex molecule and a number of other related compounds that account for Stevia Reubaudiana’s extraordinary sweetness. The Stevia herb in its natural form is approximately 10 to 15 times sweeter than common table sugar. Extracts of Stevia in the form of Steviosides can range anywhere from 100 to 300 times sweeter than table sugar. And best of all, Stevia does not affect blood sugar metabolism according to most experts. Some studies even report that Stevia reduces plasma glucose levels in normal adults.

Why has Stevia been kept such a secret? How was it used historically? How is it grown? What are its pharmacological and nutritive benefits? How is it used around the world today? Why was it kept off the market for so many years? Are steviosides safe? And finally, how can we use Stevia in cooking and preparing our foods each day? These are the questions that this book will try to answer. Hopefully it will give you some insight into this wonderfully sweet herb and allow you to make the decision of how and why to include it in your daily diet.

]]> 15962 https://healthy.net/2001/12/13/keeping-sugar-in-balance-2/?utm_source=rss&utm_medium=rss&utm_campaign=keeping-sugar-in-balance-2 Thu, 13 Dec 2001 23:54:28 +0000 https://healthy.net/2001/12/13/keeping-sugar-in-balance-2/ One of the challenges to health in modern cultures throughout the world is our access to refined sugar as processed and junk foods–candy, sodas, ice cream, cookies, and other baked goods. Industry is the pusher and many humans, especially children, are the addicted victims. I make it sound like a huge drug deal, because it is. Sugar is the number one drug on the planet Earth. (And the current sugar replacement, aspartame, has its own risks and damage.) Now, as the light wanes and the major holiday season is ahead, this brings out many sweet treats. These sweets will sit in us, stored as added body fat (in an already overweight population) unless we utilize the energy, which is usually short-lived, and sweat out the excess to keep current.

Some will experience another dark time addiction, trying to create more light with more appliances turned on. We overstimulate our brains with more television, computer time and higher electric bills. This brings on even more stress during the holiday season, which is the natural time of simplicity and shared joy with family and friends.

Fall is also the preparation time for Earth to receive the food that the elements have provided. Observe the many colors of the harvest and choose a variety to feed your inner rainbow. What is not used, returns to be remade once again in the promise of another flower, fruit or seed.

Here are some building tools for your healthy harvest; these encompass the awareness that you will be offered every sweet thing and every holiday distraction and temptation to overspend your personal energy and your resources. You may feel an imbalance in your ingestion and digestion allowance. Often, the sweet and processed foods look more enticing than the healthier foods, especially to the child in you. Learning what you are all about is the gift of tuning in, discovering your own vital life and light. However, much wisdom may be gained from extreme experience.

Ideas and Tips for Wise Sugar Use

1. Sugar is found in so many foods that are now available in the modern grocery stores and even natural food stores. It goes into food primarily as refined cane sugar (including brown sugars) and high-fructose corn syrup (the new leader of sugar consumption). More natural sugars include honey, maple syrup, malt sugar, date sugar, molasses, and others. Foods that are high in sugars should be used only as occasional Œtreats¹ in the diet, not as a main component of our food consumption. The best natural sugar may be the herb, stevia, also called sweetleaf. Some natural desserts include almonds, apples, and dates.

2. Traditional Chinese Medicine views the desire for sugar, or the sweet flavor, as a craving for the mother (yin) energy, a craving that represents a need for comfort or security. In Western cultures, we have turned sugar into a reward system (a tangible symbol of material nurturing) to the degree that many of us have been conditioned to need some sweet treat to feel complete or satisfied. We continue the pattern with our children, unconsciously showing our affection for them by giving them sugary foods. We do not want to unconsciously reinforce the Œtreat¹ pattern.

3. For most of us, sugar is a symbol of love and nurturance. As infants, our first food is lactose, or milk sugar. Over-consumption and daily use of sugar is the first compulsive habit for most everyone with addictions later in life. Simple sugar, or glucose, is what our body, our cells and brain, use for fuel for energy. Some glucose is stored in our liver and muscle tissues as glycogen for future use; excess sugar is stored as fat for use during periods of low-calorie intake or starvation. If we don¹t exercise or take periods of low calorie intake, the fat never disappears.

4. Our problem with sweets comes from the frequency with which we eat them, and the quantity of sugar we consume. The type of sugar we eat is also a contributing factor. Refined sugar or sucrose (a disaccharide made up of two sugars — glucose and fructose) is usually extracted from sugar cane or sugar beets, initially whole foods. However, most all of the nutrients are removed and retained only in the discarded extract called molasses. When the manufacturing process is complete, the result is pure sugar, a refined crystal that contains four calories per gram and essentially no nutrients.

5. Many nutritional authorities feel that the high use of sugar in our diet is a significant underlying cause of disease. Too much sweetener in any form can have a negative effect on our health; this includes not only refined sugar, but also corn syrup, honey and fruit juices, and treats such as sodas, cakes, and candies. Because sugary foods satisfy our hunger, they often replace more nutritious foods and weaken our tissue’s health and disease resistance via stressing our immune system.

6. The use of sugar in our culture sometimes resembles a drug, and can be treated as such. If you are Œhooked,¹ make a clear plan for withdrawal, while working emotionally to eliminate the habit. Our responses to certain flavors, and the feelings we get from them are usually conditioned. Self-reflection can be valuable when trying to understand these compulsions. To stop bad habits and see things clearly, we may need to talk these feelings through, transitioning from compulsion to a safe and balanced lifestyle. Talk to your hands and guide them to reach for healthier foods and snacks.

7. From my discussion last month about the Glycemic Index, quick-absorbing sugars are more of a concern with our blood sugar and energy. It may be helpful to consume some protein, such as a few nuts or nut butter, when eating some simple sugar like fruit, or easily assimilated carbohydrates like rice, bread, or potatoes. Remember to read those labels in the stores; there are loads of hidden sugars in items you wouldn¹t even think should have added sweetener, and concentrated sugars in some juice drinks.

8. If we do crave sugar, there are several supplements that can help us utilize the sugar better as well as reduce our desire for those sweets. These include the B vitamins (25-50 mg of most twice daily), vitamin C (500-1,000 mg twice daily, calcium (250-500 mg), and magnesium (150-300 mg). Chromium helps our body utilize the sugars more efficiently; it is usually supplemented in 100-200 mcg twice daily, in the morning and about 3pm. Also, the amino acid, L-glutamine (500-1,000 mg 2 to 3 times daily), helps to feed the brain and reduce sugar (and alcohol) cravings.

9. Drinking plenty of water is crucial to keep the body balanced and lessen cravings and addictions. An alkalinizing diet reduces cravings as well and helps with detoxification. Also, regular exercise does the same. Don¹t be afraid to move that body for fitness with active aerobics and weight training. Yoga stretches can also give you inner and outer strength to be your true self. Walking in Nature is another way to get in touch with your inner nature and gain your will power.

10. There are usually emotional issues around excess sugar and carbohydrate consumption, and being overweight. Be open to explore these areas as you attempt to heal your habits and create a healthier body and weight. A support group or a counselor can help in this healing process. Good luck and make wise choices!

]]> 22329 https://healthy.net/2000/12/06/vitamin-b3-niacin-2/?utm_source=rss&utm_medium=rss&utm_campaign=vitamin-b3-niacin-2 Wed, 06 Dec 2000 13:28:02 +0000 https://healthy.net/2000/12/06/vitamin-b3-niacin-2/
Vitamin B3 (Niacin) is used commonly to refer to two different compounds, nicotinic acid and niacinamide. B3 was first isolated during oxidation ofnicotine from tobacco and was thus given the name nicotinic acid vitamin, shortened to
niacin. It is not, however, the same as or even closely related to the molecule nicotine. Niacin, as nicotinic acid or niacinamide, is converted in the body to the active forms, nicotinamide adenine dinucleotide (NAD) and a phosphorylated form (NADP).

Niacin is one of the most stable of the B vitamins. It is resistant to the effects of heat, light, air, acid, and alkali. A white crystalline substance that is soluble in both water and alcohol, niacin and niacinamide are both readily absorbed from the small intestine. Small amounts may be stored in the liver, but most of the excess is excreted in the urine.

Another important fact about vitamin B3 is that it can be manufactured from the amino acid tryptophan, which is essential (needed in the diet). So niacin is not truly essential in the diet when enough protein, containing adequate tryptophan, and other nutrients are consumed. When niacin is not present in sufficient amounts, extra protein is needed. Also, when we are deficient in such nutrients as vitamins B1, B2, and B6, vitamin C, and iron, we cannot easily convert tryptophan to niacin. Many foods that are low in tryptophan are also low in niacin or, as in corn, the niacin is not readily available. Corn is low in tryptophan and its niacin is bound, so it must receive special treatment. Native Americans knew this and would soak corn in ash water before or after grinding to release the niacin. Even when they subsisted almost solely on corn, they did not experience the serious niacin deficiency
disease called pellagra. In the time around the American Civil War, in the South poor white farm workers subsisted on “quick cornmeal,” the poorly prepared white people’s version, and pellagra was epidemic until the discovery that it was a dietary deficiency disease. Pellagra, the disease of the “three Ds”–diarrhea, dermatitis, and dementia–historically
has been a problem of corn-eaters, whereas beriberi has been a disease most correlated with rice-eating cultures.

Sources: Only small to moderate amounts of vitamin B3 occur in foods as pure niacin;
other niacin is converted from the amino acid tryptophan, as just discussed. The best sources of vitamin B3 are liver and other organ meats, poultry, fish, and peanuts, all of which have both niacin and tryptophan. Yeast, dried beans and peas, wheat germ, whole grains, avocados, dates, figs, and prunes are pretty good sources of niacin. Milk and eggs are good because of their levels of tryptophan. Though B3 is stable, the milling and processing of whole grains can remove up to 90 percent of the niacin. Thus, manufacturers will often “enrich” their products by adding niacin.

Functions: Niacin acts as part of two coenzymes, nicotinamide adenine dinucleotide (NAD)
and nicotinamide adenine dinucleotide phosphate (NADP), that are involved in more than 50 different metabolic reactions in the human species. They play a key role in glycolysis (that is, extracting energy from carbohydrate and glucose), are important in fatty acid synthesis and in the deamination (nitrogen removal) of amino acids, are needed in the formation of red blood cells and steroids, and are helpful in the metabolism of some drugs and toxicants. Thus, niacin is a vital precursor for the coenzymes that supply energy to body cells.

Basically, the coenzymes of niacin help break down and utilize proteins, fats, and carbohydrates. Vitamin B3 also stimulates circulation, reduces cholesterol levels in the blood of some people, and is important to healthy activity of the nervous system and
normal brain function. Niacin supports the health of skin, tongue, and digestive tract tissues. Also, this important vitamin is needed for the synthesis of the sex hormones, such as estrogen, progesterone, and testosterone, as well as other corticosteroids.

Niacin, taken orally as nicotinic acid, can produce redness, warmth, and itching over areas of the skin; this “niacin flush” usually occurs when doses of 50 mg. or more are taken and is a result of the release of histamine by the cells, which causes vasodilation. This reaction is harmless; it may even be helpful by enhancing blood flow to the “flushed” areas, and it lasts only 10-20 minutes. When these larger doses of niacin are taken regularly, this reaction no longer occurs because stores of histamine are reduced. Many people feel benefit from this “flush,” but if it is not enjoyable, supplements that contain vitamin B3 in the form of niacinamide or nicotinamide can be used, as they will not produce this reaction. (Note: When vitamin B3 is used to lower cholesterol levels, the nicotinic acid form must be used; the niacinamide form does not work for this purpose.)

Uses: Niacin is used to support a variety of metabolic functions and to treat a number of
conditions. Many niacin deficiency symptoms can be treated by adjusting the diet and by supplementing B3 tablets along with other B complex vitamins. Many uses of niacin are based primarily on positive clinical experience and are not as well supported by medical research, although more studies are being done.

Niacin helps increase energy through improving food utilization and has been used beneficially for treating fatigue, irritability, and digestive disorders, such as diarrhea, constipation, and indigestion. It may also stimulate extra hydrochloric acid production.
Niacin, mainly as nicotinic acid, helps in the regulation of blood sugar (as part of glucose tolerance factor) in people with hypoglycemia problems and gives all of us a greater ability to handle stress. It is helpful in treating anxiety and possibly depression. B3 has been used for various skin reactions and acne, as well as for problems of the teeth and gums. Niacin
has many other common uses. It is sometimes helpful in the treatment of migraine-type headaches or arthritis, probably in both cases through stimulation of blood flow in the capillaries. This vitamin has also been used to stimulate the sex drive and enhance sexual experience, to help detoxify the body, and to protect it from certain toxins and pollutants. For most of these problems and the cardiovascular-related ones mentioned below, the preference is to take the “flushing” form of niacin, or nicotinic acid, not niacinamide.

Nicotinic acid works rapidly, particularly in its beneficial effects on the cardiovascular system. It stimulates circulation and for this reason may be helpful in treating leg cramps caused by circulatory deficiency; headaches, especially the migraine type; and Meniere’s syndrome, associated with hearing loss and vertigo. Nicotinic acid also helps reduce blood pressure and, very importantly, acts as an agent to lower serum cholesterol. Treatment with about 2 grams a day of nicotinic acid has produced significant reductions in both blood cholesterol and triglyceride levels. To lower the LDL component and raise the good HDL
cholesterol, people usually take 50-100 mg. twice daily and then increase the amount slowly over two or three weeks to 1500-2500 mg. Generally, for those with high cholesterol levels it has been used to help reduce the risk for atherosclerosis. Because of its
vascular stimulation and effects of lowering cholesterol and blood pressure, vitamin B3 has been used preventively for such serious secondary problems of cardiovascular disease as myocardial infarctions (heart attacks) and strokes. Also, some neurologic problems, such as Bell’s palsy and trigeminal neuralgia, have been helped by niacin supplementation. In
osteoarthritis, to help reduce joint pain and improve mobility, niacinamide has been used in amounts beginning at 500 mg. twice daily up to 1,000 mg. three times a day along with 100 mg. daily of B complex.

Niacin has been an important boon to the field of orthomolecular psychiatry for its use in a variety of mental disorders. It was initially well demonstrated to be helpful for the neuroses and psychoses described as the “dementia of pellagra,” the niacin deficiency disease. Since then, it has been used in high amounts, well over 100 mg. per day and often over 1,000
mg. per day (up to 6,000 mg.), to treat a wide variety of psychological symptoms, including senility, alcoholism, drug problems, depression, and schizophrenia. Niacin has been helpful in reversing the hallucinatory experience, delusional thinking or wide mood
and energy shifts of some psychological disturbances. Though this therapy has its skeptics, as does all application of nutritional medicine, some studies show promising results in treatment of schizophrenia with niacin and other supplements. Other studies show little or no effect. More research is definitely needed on niacin’s effect in mental disorders.

People on high blood pressure medicines and those who have ulcers, gout, or diabetes should be very careful taking higher-dose supplements of niacin because of its effect of lowering blood pressure, its acidity, its liver toxicity, its potential to raise uric acid levels, and its effect in raising blood sugar–though recently niacin has been shown to have a positive effect on glucose tolerance (it is part of glucose tolerance factor) and, thereby, on diabetes as well. Exercise and niacin are helpful for people with adult diabetes through their positive effects on blood sugar and cholesterol.

Deficiency and toxicity: As with the other B vitamins, there are really no toxic effects from
even the high doses of niacin, though the “niacin flush” previously described may be uncomfortable for some. However, with the use of high-dose niacin in recent years, the occasional person experiences some minor problems, such as irritation of the
gastrointestinal tract and/or the liver, both of which subside with decreased intake of niacin. In addition, some people taking niacin experience sedation rather than stimulation.

Deficiency problems have been much more common than toxicity, and for a long period of history, the niacin deficiency disease, pellagra, was a very serious and fatal problem. Characterized as the disease of the “three Ds,” pellagra causes its victims to experience dermatitis, diarrhea, and dementia. The fourth D was death.

As described previously, the classic B3 deficiency occurs mainly in cultures whose diets rely heavily on corn and where the corn is not prepared in a way that releases its niacin. One of the first signs of pellagra, or niacin deficiency, is the skin’s sensitivity to light, and the skin becomes rough, thick, and dry (pellagra means “skin that is rough” in Italian). The skin then becomes darkly pigmented, especially in areas of the body prone to be hot and sweaty or those exposed to sun. The first stage of this condition is extreme redness and sensitivity of those exposed areas, and it was from this symptom that the term “redneck,” describing the bright red necks of eighteenth- and nineteenth-century niacin-deficient fieldworkers, came into being.

In general, niacin deficiency affects every cell, especially in those systems with rapid turnover, such as the skin, gastrointestinal tract, and nervous system. Other than photosensitivity, the first signs of niacin deficiency are noted as decreased energy
production and problems with maintaining healthy functioning of the skin and intestines. These symptoms include weakness and general fatigue, anorexia, indigestion, and skin eruptions. These can progress to other problems, such as a sore, red tongue, canker sores, nausea, vomiting, tender gums, bad breath, and diarrhea. The neurological symptoms may begin with irritability, insomnia, and headaches and then progress to tremors, extreme anxiety, depressionÑall the way to full-blown psychosis. The skin will worsen, as will the diarrhea and inflammation of the mouth and intestinal tract. There will be a lack of stomach acid production (achlorhydria) and a decrease in fat digestion and, thus, lower availability from food absorption of the fat-soluble vitamins, such as A, D, and E. Death could occur, usually from convulsions, if the niacin deficiency is not corrected.

Niacin deficiency symptoms can be seen in diets with niacin intake below 7.5 mg. per day, but often this is not the only deficiency; vitamin B1, vitamin B2, and other B vitamins, as well as protein and iron may be low. To treat pellagra and niacin deficiency disorders, vitamin B3 supplements should be taken along with good protein intake to obtain adequate levels of the amino acid tryptophan. As described earlier, about 50 percent of daily niacin comes from the conversion in our livers of tryptophan to niacin with the help of pyridoxine (vitamin B6).

Requirements: Many food charts list only sources that actually contain niacin and do not
take into account tryptophan conversion into niacin. Approximately 60 mg. of tryptophan can generate 1 mg. of niacin. But tryptophan is available for conversion only when there are more than sufficient quantities in the diet to synthesize the necessary proteins as tryptophan is used in our body with the other essential amino acids to produce protein.

Niacin needs are based on caloric intake. We need about 6.6 mg. per 1,000 calories, and no less than 13 mg. per day. Women need at least 13 mg. and men at least 18 mg. per day. The RDA for children ranges from 9-16 mg.

Niacin needs are increased during pregnancy, lactation, and growth periods, as well as after physical exercise. Athletes require more B3 than less active people. Stress, illness, and tissue injury also increase the body’s need for niacin. People who eat much sugar or refined, processed foods require more niacin as well.

Realistically, 25-50 mg. per day is adequate intake of niacin if minimum protein requirements are met. On the average, many supplements provide at least 50-100 mg. per day of niacin or niacinamide, which is a good insurance level. For treatment of the variety of conditions described previously, higher amounts of niacin may be needed to really be helpful, and levels up to 2-3 grams per day are not uncommon as a therapeutic dose. The other B vitamins should also be supplied so as to not create an imbalanced metabolic condition.

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