Natural sweeteners: Health benefits of stevia

Abstract

Stevia rebaudiana (Bertoni), a perennial shrub, is the sweetest plant belonging to the Asteraceae family. Stevia
leaves are an excellent source of diterpene glycosides stevioside, rebaudioside A-F, dulcoside, and steviolbioside, which
are responsible for sweetness and have been utilized commercially for sugar substitution in foods, beverages, and
medicines. To the best of our knowledge, a large number of studies have been carried out on composition, health
implications, and safety of steviol glycosides. However, commercial production of stevia-incorporated food products needs
further research in order to meet the huge global demand. Stevia-incorporated products possess better sweetening potency
and maximum consumer acceptability, when compared with other sugar substitutes. Hence, the current research attempts
to review the health promoting effects of stevia with special emphasis on its application in the food system. The paper
majorly features 1) the anti-hyperglycemic, anti-hypertensive, anti-caries, anti-inflammatory, and anti-cancer benefits of
stevia, 2) value-added stevia-incorporated products, e.g. bakery, dairy, and beverages, 3) the effect of incorporation of
stevia on physicochemical, rheological, and nutritional food properties, 4) the current status and regulatory perspective of
utilizing stevia at national and international level. Due to legislative actions and growing consumer awareness, public
interest in natural sweeteners has significantly increased. Since the use of artificial sweetener has recently been questioned,
the data the present article provides will be useful for consumers and manufacturers that seek an alternative.

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392
Foods and Raw Materials, 2018, vol. 6, no. 2 ISSN 2308-4057 (Print)
ISSN 2310-9599 (Online)
Review Article DOI: http://doi.org/10.21603/2308-4057-2018-2-392-402
Open Access Available online at http:jfrm.ru
Natural sweeteners: health benefits of stevia
Sukhmani Gandhi
a
, Yogesh Gat
a,b,
* Shalini Arya
b
,
Vikas Kumar
a
, Anil Panghal
a
, and Ashwani Kumar
a
a Lovely Professional University,
Jalandhar - Delhi G.T. Road, Phagwara, Punjab
144411, India
b Institute of Chemical Technology,
NM Parekh Marg, Matunga, Mumbai 400019, India
* e-mail: yogeshcft10@gmail.com
Received September 1, 2018; Accepted in revised form October 3, 2018; Published December 20, 2018
Abstract: Stevia rebaudiana (Bertoni), a perennial shrub, is the sweetest plant belonging to the Asteraceae family. Stevia
leaves are an excellent source of diterpene glycosides stevioside, rebaudioside A-F, dulcoside, and steviolbioside, which
are responsible for sweetness and have been utilized commercially for sugar substitution in foods, beverages, and
medicines. To the best of our knowledge, a large number of studies have been carried out on composition, health
implications, and safety of steviol glycosides. However, commercial production of stevia-incorporated food products needs
further research in order to meet the huge global demand. Stevia-incorporated products possess better sweetening potency
and maximum consumer acceptability, when compared with other sugar substitutes. Hence, the current research attempts
to review the health promoting effects of stevia with special emphasis on its application in the food system. The paper
majorly features 1) the anti-hyperglycemic, anti-hypertensive, anti-caries, anti-inflammatory, and anti-cancer benefits of
stevia, 2) value-added stevia-incorporated products, e.g. bakery, dairy, and beverages, 3) the effect of incorporation of
stevia on physicochemical, rheological, and nutritional food properties, 4) the current status and regulatory perspective of
utilizing stevia at national and international level. Due to legislative actions and growing consumer awareness, public
interest in natural sweeteners has significantly increased. Since the use of artificial sweetener has recently been questioned,
the data the present article provides will be useful for consumers and manufacturers that seek an alternative.
Keywords: Stevia rebaudiana; sugar substitutes, health benefits, value addition, product characteristics, consumer
acceptability
Please cite this article in press as: Gandhi S., Gat Y., Arya S., et al. Natural sweeteners: health benefits of stevia. Foods and Raw
Materials, 2018, vol. 6, no. 2, pp. 392–402. DOI: http://doi.org/10.21603/2308-4057-2018-2-392-402.
INTRODUCTION
One out of the six basic taste sensations in humans
is sweetness. Honey, coconut sugar, blackstrap
molasses, table sugar, agave, high fructose, corn syrup,
maple syrup and other natural sweeteners contain
glucose, fructose, and sucrose as their primary
constituents. However, sweeteners obtained from
natural sources possess a high caloric value, which
may lead to obesity, diabetes, and cardiovascular
diseases. There has been a gradual rise in the number
of diabetic patients all over the world. India has
become the diabetic capital of the world with about
72 million cases of diabetes in 2017 (International
Diabetes Federation, Diabetic Atlas, 2017). Due to the
growing health awareness, there has been a huge
demand for sugar substitutes that would provide lesser
or no calories and possess better sweetening potency.
There is a variety of artificial zero-calorie sweeteners
on the market, e.g. saccharin, aspartame, acesulfame
potassium, cyclamates, etc. However, artificial sugar
substitutes became associated with health
complications, and the use of these artificial sugar
substitutes has subsequently been restricted. Thus,
there is a continuous search for high intensity low-
calorie or non-caloric sweeteners of natural origin that
are safe for consumption. Stevia, which plays an
important role as a non-nutritive natural sweetener,
emerged as a safe sugar substitute that does not pose
any threat to human health [1].
RESULTS AND DISCUSSION
Stevia rebaudiana (Bertoni) is a perennial shrub
belonging to Asteraceae family, native to Paraguay.
Out of 230, only two species – rebaudiana and
phlebophylla – produce sweet steviol glycosides [2].
Stevia leaves contain eleven diterpene glycosides, such
as stevioside, rebaudioside A-F, dulcoside, etc.
Stevioside and rebaudioside are the sweetest glycosides

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present in stevia leaves, which are 250–300 times
sweeter than sucrose, and are chemically and thermally
stable. Stevioside and rebaudioside obtained from
stevia leaves have been utilized commercially in Japan,
South America, China, and Korea to sweeten various
foods. Dietary supplements containing stevia extracts
have been utilized in USA extensively [3]. Market
stevia products contain such steviol glycosides as
stevioside or rebaudioside A [4].
Health benefits. Stevia is known to provide a wide
variety of health benefits (Fig. 1). The leaves possess
functional properties superior to those of many other
high potency sweeteners. Hence, stevia is likely
to become the ultimate natural sweetener in the
food industry.
Anti-hyperglycemic. According to WHO global
report on diabetes (2016), as many as 422 million
adults were suffering from diabetes all over the world,
and diabetes-related deaths accounted for 1.5 million.
Diabetes mellitus is one of the major metabolic
diseases characterized by hyperglycemia. It is a
chronic disease resulting either from defects in insulin
secretion of β-cells of pancreatic islets (islets of
Langerhans) or from the response to insulin, or
combination of both. Type 1 diabetes mellitus is
juvenile-onset, or insulin independent diabetes
mellitus, in which the exact etiology of the disease
is unknown, while in type 2 diabetes the risk
to predisposal depends upon metabolic and the
genetic factors.
Traditionally, the extract obtained from stevia
leaves proved its effectiveness in treatment of diabetes
[5, 6]. There is a stimulation of insulin secretion from β
cells of islets of Langerhans and INS-1 cells by direct
action of stevioside and steviol [7, 8]. The
antihyperglycemic effect of stevioside was investigated
in type 2 diabetic Goto-Kakizaki rats, and it was
concluded that the hypoglycemic action of stevioside
was due to increased secretion of insulin and induction
of genes of glycolytic pathway [9].
A limited number of human studies have been
reported to depict the mechanism of stevioside (Fig. 2).
A study of acute effects of stevioside was conducted on
twelve type 2 diabetic patients. It was observed that
there was an average 18% decline in the post-prandial
blood glucose levels of the diabetic patients after
supplementing the standard test meal with 1 g
stevioside. However, the slight increase in the insulin
levels was not statistically significant [10]. The effect
of steviol glycosides on insulin sensitivity and glucose
metabolism have been elucidated [11]. In diabetic rats,
intake of steviol glycosides resulted in a decrease in
blood glucose levels, along with a decrease in the rate
of gluconeogenesis and reduction in insulin resistance.
Similar findings suggest that oral administration of
medium polar extract of stevia leaves at 200 and
400 mg/kg body weight basis for 10 days in alloxan-
induced diabetic rats resulted in delayed but significant
antihyperglycemic effect without producing
hypoglycemia, along with lesser body weight loss in
contrast to standard positive control drug
glibenclamide [12].
There was a research on the blood glucose lowering
effects of rebaudioside A on the activity of carbohydrate
metabolizing enzymes in induced diabetic rats [13].
An increase in the rate of glycolysis and reduction
in gluconeogenesis produced a significant
antihyperglycemic effect. Another study featured the
antihyperglycemic mechanism of stevia. It was found
that stevia (400 mg/kg) reduced blood glucose levels
better than pioglitazone (10 mg/kg), which can be used
to control blood sugar levels in diabetics. There was an
elevation in insulin levels due to the impact of stevia on
the pancreatic tissue, and the valuable anti-
hyperglycemic action was exerted via PPARϒ
dependent mechanism and its antioxidant property [14].
Anti-hypertensive. Persistent elevation of systolic
blood pressure (≥ 140 mm Hg), or diastolic blood
pressure (≥ 90 mm Hg), or both is the principal cause
for developing cardiovascular diseases, which are
associated with high mortality rates globally. In
primary hypertension, etiology is unknown and
accounts for 90% of the hypertension cases. By
contrast, secondary hypertension is known, and it
affects less than 10% of the hypertensive population. It
is precipitated by another medical condition affecting
kidneys, arteries, heart, or endocrine system.
An early investigation conducted on rats showed that
stevia extract at doses greater than those used for the
purpose of sweetening resulted in vasodilation and a
lower mean arterial pressure in hypertensive rats [15].
A reduction in blood pressure was elucidated upon
studying the effectiveness of stevioside (250 mg three
times a day for a period of 3 months) in human subjects
suffering from mild or moderate primary hypertension
[16]. The mechanism by which stevioside produces
vasodilatory effect is analogous to that of verapamil, an
antihypertensive drug which acts by blocking calcium
channels in myocardial and arterial smooth muscle cells
(Fig. 3). The antihypertensive effect of stevioside was
antagonized by administration of indomethacin
(parostaglandin synthesis inhibitor), suggesting
stevioside produces reduction in mean arterial pressure
via prostaglandin activity [17]. In the study, to evaluate
the effect of stevia on renal function, it was reported that
steviol increased the excretion of sodium and potassium
along with glomerular filtration rate in a dose dependent
manner. It acted as a diuretic agent by preferably
affecting the Na+-glucose coupled cotransporter in
proximal convulated tubule of kidney [18]. The
hemodynamic effects of rebaudioside A were
investigated in human trial. No significant changes in
mean arterial pressure or heart rate were observed after
daily intake of 1000 mg/kg body weight Rebaudioside A
in healthy individuals who were normotensive or having
low normal mean arterial pressure [19].
Anti-caries. Dental caries is a widespread chronic
disease in humans and affects oral health. Dental caries
may lead to the development of painful sensation in
tooth, infections, oral and pharyngeal cancers, oral
tissue lesions, and the outcome may be life-threatening
if untreated, as in case of cavernous sinus thrombosis
and Ludwig’s angina.

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Fig. 1. Health benefits of stevia on various organs.
Fig. 2. The possible mechanism of anti-hyperglycemic action of stevia.

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Fig. 3. Antihypertensive action of stevioside. Inhibition
of Ca2+ influx in vascular smooth muscle resulting in
vasodilation and hence reduction in systemic vascular
resistance.
Routine consumption of caloric sweeteners, such as
sucrose, results in ingestion of carbohydrates, which
boosts the amount of harmful microbes in the oral
cavity. That may ultimately result in plaque and
gingivitis [20]. Stevia is a non-caloric sweetener that
possesses antimicrobial properties benefiting oral
health via prevention of dental caries. There are
57.82% less chances of developing a plaque with
consumption of stevia, compared to sucrose recorded
by aid of Silness-Loe plaque index [21]. A study on the
cariogenic potential of commercial sweeteners
conducted on artificial enamel proved that stevia-
incorporated products exhibited antimicrobial activity
and showed the least potential to act as cariogenic in
contrast to sucrose and other commercial artificial
sweeteners [22].
Anti-inflammatory. Inflammatory bowel disease, or
IBD, is a group of chronic diseases that involve the
inflammation of the alimentary tract. It includes
Crohn’s disease (inflammation of the entire lining of
alimentary canal) and ulcerative colitis (inflammation
of the innermost lining of intestine). Ample evidences
are available showing that stevioside acts as an anti-
inflammatory in vivo, as well as in vitro. Stevia stem
extract was suggested to act as a gastroprotective since
it reduced histamine-induced gastric abnormality in
rainbow trout [23]. The suggested mechanism of action
was inhibition of smooth muscle contraction by
blocking the calcium channel. The active substance in
the stem extract was stevioside, which was potentially
responsible for decreasing the acid secretion caused by
histamine and inhibiting the action of pepsin [24].
Similar findings were reported when the anti-
ulcerogenic activity of stevia was examined by oral
administration of stevia extracts leading to a significant
reduction in the free acidity, which resulted in
inhibition of gastric lesions [25].
Anti-cancer. Cancer can be defined as a group of
diseases involving the abnormal proliferation of cells,
which is associated with high mortality rate. The
anticancer effect of stevioside, isosteviol, and the
derivatives obtained from isosteviol upon microbial
transformation was evaluated. All the components
were found to be potent in inhibiting Epstein-Barr virus
early antigen (EBV-EA) while the highest potency was
exhibited by the derivatives obtained by microbial
transformation [26].
The ent-kaurene diterpene glycosides isolated from
Stevia rebaudiana were investigated for anti-
inflammatory activity against inflammation induced by
12-O-tetradecanoylphorbol-13-acetate (TPA), and it
was found to suppress inflammation along with a
significant inhibitory effect on the tumour formation
[27, 28]. The methanolic and ethanolic extract of
stevioside exhibited anti-cancer potential against the
Caco cell line [29]. Stevioside exhibited in vitro
anticancer activity against MCF-7 cells, which are
most commonly used for breast cancer studies in
humans. The suggested mechanism of antibreast cancer
activity was enhanced expression of proteins
participating in apoptotic pathway [30].
Value-added products prepared with
incorporation of stevia. Value-added products are
prepared for enhancing the value of food items through
the addition of ingredients, processing or packaging.
Value-added food products are more attractive and
usable by the consumer than the original commodity.
Commercially, leaves of stevia are exploited directly or
after processing in preparation of various value-added
products. As a functional food ingredient, stevia has
been partially or fully incorporated into baked, dairy,
confectionery products, etc. The present review
features the commercial use of stevia in various food
products and its effect on various properties.
Bakery products. Sweetened food items, such as
cakes, cookies, muffins, and biscuits, are the major
contributors to sugar intake globally [31]. Sucrose is a
crucial ingredient in baked goods. It contributes not
only to the taste but also to the characteristic texture
and structure [32]. However, excessive consumption of
sugar leads to acute elevation in postprandial glucose
levels [33]. There is an increased risk of obesity,
diabetes, dental caries, and coronary heart disease
associated with regular consumption of high amounts
of sugar-containing foods.
The use of stevia in baked products is suitable since
it maintains its stability throughout the baking process
and can be heated up to 200°C [34]. The non-nutritive
high intensity sweeteners contribute to the sweet taste
of the product, but the maintenance of texture, colour,
and flavour is also crucial. Hence, whenever stevia is
used as a partial replacement of sugar, other additives,
such as bulking agents, hydrocolloids, proteins, etc.,
should be added to compensate for the loss of texture.
To evaluate the physical properties of muffins
sweetened with stevia suggested a study that muffins
with 25% of the sucrose replaced by steviol glycosides
were ranked best in terms of browning index, texture,
cooking yield, and sensory acceptance. Sucrose
replacement greater than 50% had a negative impact on
the quality characteristics of muffins [35]. Low
glycemic index muffins were made by adding stevia
and cocoa dietary fibre. The replacement of 20%
sucrose with stevia along with substitution of cocoa
powder with cocoa fibre did not produce any negative

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impact on the quality attributes and consumer
acceptability [36]. Functional cookies prepared by 20%
replacement with defatted soy flour and powder
obtained from stevia leaves were ranked best for all the
sensory characteristics [37].
Dairy products. Milk and milk-based products are a
vital component of functional foods. Dairy processors
are investigating novel technologies to sweeten their
products without adding more calories, since people are
averted from the consumption of intensely sweetened
dairy-based products. There has been a continual search
for natural low-calorie alternatives to sweeten dairy
products that would reduce the sugar content while
maintaining the texture, body and mouthfeel. Stevia has
emerged as a suitable choice for dairy products since it
preserves its stability, when subjected to heat treatment.
One of the most popular frozen dairy products is ice
cream. Sugar influences its texture, viscosity, and
freezing point and, hence, plays a significant role in
determining the consumer acceptability. The most
popular ice cream sweetener is sucrose because of its
cost effectiveness and consumer acceptability.
However, stevia and other non-nutritive sweeteners are
gaining popularity due to health hazards associated
with sucrose. The replacement of sugar with stevia in
ice cream and kulfi can lead to a significant decrease in
the caloric value. Studies revealed that ice cream
mixtures in which sucrose had been partially replaced
with stevia had better sensory scores than those with
stevia only [38, 39].
Yogurt is one of the best-known foods that contain
probiotics. Sensory analysis of strawberry flavoured
yogurt with stevia elucidated that yogurt with a mixture
of stevia and sucrose had the best sensory profile [40].
Stevia exhibited a synergistic sweetening effect when
used in combination with other sweeteners to sweeten
strawberry flavoured yogurt [41].
Flavoured milk supplies vital nutrients equivalent
to plain milk. Studies have revealed that flavoured milk
is preferred for consumption by children and
adults [42]. However, flavoured milk contains a high
quantity of sugar, which has been linked to promotion
of obesity amongst children and adults [43, 44]. The
use of stevia is an appealing alternative in order to
reduce the caloric value of flavoured milk. It is of
primary importance to maintain the acceptance of the
product by the consumer while decreasing the sugar
content. In the study [45], the perception of sweetness
intensity in skim chocolate milk prepared by addition
of extracts of stevia and monk fruit was defermind. It
was established that flavoured milk containing stevia
had a maximum consumer acceptability.
Beverages. The primary function of stevia is
sweetening, but it may modify the flavour in certain
cases.
Peach juice was formulated with a blend of stevia
(160 mg/L) and sucrose (56 g/L), which led to 25%
reduction in calories without affecting the sensory
attributes of the product compared to the control sample
containing 9% sucrose [46]. Orange juice is one of the
most popular non-carbonated beverages globally since it
contains high amounts of vitamin C, carotenoids, folic
acid, flavonoids, etc. It acts as an antioxidant preventing
the damage caused by free radicals to tissues and also
decreases the chances of heart disease and cancer
[47, 48]. Low calorie orange nectar and orange juice
were formulated with the addition of stevia [49, 50].
Other beverages, such as mango nectar and passion fruit
juice, were developed with partial replacement of
sucrose with stevia and evaluated for their sensory as
well as physicochemical parameters [51, 52].
Effect of incorporation of stevia on different
properties. Physicochemical properties. Physical
properties of food material are its measurable and
quantifiable characteristics. They are used to describe
matter without altering its composition. They elucidate
the unique way a food material will react to physical
treatments – thermal, optical, electromagnetic,
mechanical, etc. Knowing these properties helps design
optimum operation parameters and equipment to
ensure the quality and safety of foods.
Some important physicochemical parameters for
evaluation of ice cream are overrun ratio, first melting
point, last melting point, and fat destabilization. The
addition of stevia in ice cream resulted in a higher first
melting time being the longest for the sample
containing stevia and cocoa. Table 1 shows that the last
melting time for ice cream containing cocoa with
sucrose and cocoa with stevia was lower as compared
to plain ice cream with sucrose and plain ice cream
with stevia [38]. The overrun ratio for ice cream with
stevia and cocoa was found to be the highest, while the
overrun ratio was the lowest for plain ice cream with
stevia [38]. Similarly, the overrun ratio of soft ice
cream increased when stevia was added [39]. Fat
destabilization was reported to be slightly higher in ice
cream containing stevia [38]. Increasing levels of sugar
replacement with stevia in kulfi resulted in a decrease
in melting rate [53]. In case of juices, the important
physicochemical properties to be evaluated are °Brix
and titratable acidity.
Rheological and textural properties. Texture may be
referred to as a collection of physical attributes that
emerge from structural makeup of food. They are
perceptible via sense of touch and associated with
disintegration, distortion, and flowability under the
influence of force. Some important textural properties in
foods are hardness, cohesiveness, springiness
(elasticity), adhesiveness, chewiness, gumminess,
resilience fracturability, stringiness, and initial modulus.
Viscosity (the resistance to flow) is an important
evaluation parameter for ice cream mix. As given in
Table 2, a decrease in viscosity of ice cream was
observed when nothing but stevia was added.
However, the ice cream sample containing both stevia
and cocoa possessed the highest viscosity amongst all
other ice cream samples. With a gradual increase in
stevia concentration in ice cream, the viscosity was
relatively lowered, compared to the sample containing
sucrose only [39]. A disaccharide produces the
solution with high osmolality due to its hydrophilicity
and high solubility, as well as its ability to form
hydrogen bonds [54].

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Table 1. Effect of stevia on physicochemical properties of various food products
Product Stevia form Amount of stevia, % Description Reference
Ice cream Stevia leaf powder 0.862 ↑ in last melting time [38]
↓ in over run ratio
Ice cream with
cocoa
Stevia leaf powder 0.786 ↑ in first melting time [38]
↑ in fat destabilization
↑ in over run ratio
Ice cream Stevia powder (> 90%
steviol glycosides)
0.02–0.11 ↑ in over run [39]
↓ in melting resistance compared
to ice cream sweetened with sucrose
Kulfi Stevia extract powder
with 91.1% stevioside
0.05–0.07 ↓ in specific gravity [53]
↑ in the freezing point compared
to kulfi sweetened with sucrose
↓ in melting rate
↓ in penetration
Herbal Kulfi Stevia powder 0.05–0.07 ↓ in melting rate [58]
Passion fruit juice Stevia extract 0.09924 ↓ in ᵒBrix [52]
↑ in titrable acidity
Mango nectar Stevia with 97%
Rebaudioside
0.052 ↓ in ᵒBrix value was lower as compared to
nectar sweetened with sucrose
↑ in ᵒBrix valueas compared to nectars with
other sweeteners
[51]
↔ in ᵒBrix during storage
Orange nectar Stevioside powder
(85–95% purity)
0.02–0.06 ↓ in titrable acidity during storage [49]
↓ in ᵒBrix with addition of stevioside
↔ in ᵒBrix during storage
Note. ↑ – increase, ↓ – decrease, ↔ – non-significant
Table 2. Effect of stevia on rheological and textural properties of various food products
Product Form of stevia Amount of stevia, % Description Reference
Plain ice cream Stevia leaf powder 0.862 ↓ viscosity [38]
Ice cream with
cocoa
Stevia leaf powder 0.786 ↑viscosity amongst all samples of stevia [38]
Ice cream Stevia powder (> 90%
steviol glycosides)
0.02–0.11 ↓ viscosity [39]
Orange nectar Stevioside powder
(85–95% purity)
0.02–0.06 ↑ in viscosity [49]
Mango nectar Stevia with 97%
Rebaudioside
0.052 ↑ in viscosity [51]
Muffin Stevianna with 98%
Rebaudioside A
9.97 and 19.76 ↑ in firmness value in contrast
to muffin with sucrose
↓ in firmness value in contrast
to muffin with inulin
[32]
↑ in springiness value in contrast to muffins
with inulin and sucrose
Muffin Stevia powder with 95%
steviol glycosides
0.075–0.300 ↑ in hardness and springiness as more sugar
was replaced with stevia
[35]
↔ in cohesiveness with addition
of stevioside
Muffin Stevia powder with 95%
steviol glycosides
0.09 ↑ in firmness with addition of stevia [36]
↓ in porosity when stevia and sucrose were
used in combination
Functional
yoghurt cake
Stevia leaves liquid
extract
3.33 ↑ in firmness [56]
Similar deformation
to regular yoghurt cake
Bittersweet
chocolate
Stevia extract 0.16 ↑ in hardness values in low fat samples
sweetened with stevia
[57]
Note. ↑ – increase, ↓ – decrease, ↔ – non-significant
Viscosity of the low calorie nectar (sugar content
reduced to 70% compared to the control sample) was
found to be slightly higher than that in the blank sample,
which was possibly due to incorporation of 0.03% pectin
in the sample [49]. Similar results were seen in the case
of mango nectar, in which the sample sweetened with
stevia exhibited a higher viscosity compared to nectar
sweetened with other sweeteners [51]. The critical
textural variables for muffins are firmness, springiness,
and cohesiveness. The texture profile analysis (TPA) of

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muffins revealed that with the increase in replacement of
sucrose with stevia, a significant increase in hardness
and springiness was observed [36]. The possible reason
for this was the decrease in the amount of sucrose in the
muffins since sucrose played a significant role in
governing the texture [55]. Reduction in the amount of
sucrose led to an increase in porosity. However, when
sucrose was used in combination with stevia, the value
of porosity was slightly lower [36]. In a functional
yogurt cake, an increase in firmness and hardness after
adding ground stevia leaves has been reported [56].
When bittersweet chocolate was combined with
rebaudioside A, which is the sweetest component
present in stevia leaves, it resulted in an increase in
hardness of low fat chocolate [57].
Nutritional properties. Excessive consumption of
food containing high content of sugar and saturated fats
is one of the most critical nutritional issues mankind
have to face in the current scenario. It has been linked
to serious health problems. Health awareness is
growing nowadays, and this has led to a significant rise
in demand for low-calorie/fat products. Many low-
calorie food products have been developed with the
addition of dietary fibre or low calorie sweeteners as
the consumers are striving to choose healthier food
alternatives (Table 3).
Significant reduction of glycemic index and caloric
value was reported in ice cream prepared with addition
of stevia, which propounds the utilization of stevia as a
substitute for sugar and a healthy alternative for people
who are predisposed to diabetes [39]. Kulfi samples
prepared with incorporation of stevia showed a
decrease in calorific value but a significant increase in
fat, ash and protein content, due to a decrease in total
solids, which resulted from partial replacement of
sugar with stevia [53]. Similar results were reported for
herbal kulfi that contained both stevia and a mixture of
herbs including Foeniculum vulgare, Ocimum sanctum,
and Piper betle [58]. A hot water extract of stevia
leaves was used to produce a functional yoghurt cake.
There was a reduction in calories by 35.72% as
compared to a regular yoghurt cake. The biological
evaluation of yoghurt cake in diabetic rats revealed that
there was no significant change in blood levels of
cholesterol, alkaline phosphatase, bilirubin, glucose,
creatinine, and triglycerides. However, the level of urea
and Aspartate transaminase (AST), as well as HDL
cholesterol, decreased slightly. Lower doses did not
produce any effect on serum glucose, AST, ALT, total
cholesterol, protein, and triglycerides, but higher doses
produced a slight elevation in these parameters [56].
Similarly, muffins prepared by partial replacement of
sugar with steviol glycosides showed a decrease in
caloric value [32, 36]. The incorporation of stevia into
muffins led to a prolonged release of reducing sugars
during the digestion of starch in vitro, thus, reducing
the predicted glycaemic response [32]. A decrease in
energy value was noted when sucrose free chocolates
were prepared with the addition of stevia [59].
Sensory properties. Sensory properties of a food
product are regarded as one of the most crucial attributes
since they are most noticeable by the consumer [60].
Sensory evaluation refers to the scientific technique of
invoking, computing, analysing, and interpreting the
responses by the perception of senses [61]. The
palatability of the product has become the primary
criteria for consumers nowadays, whereas such
parameters as nutritional value and the wholesomeness
of the product are secondary. Therefore, to ensure
market success, a product must have the desired
sensorial characteristics, i.e. taste, flavour, aroma,
mouthfeel, aftertaste, and textural parameters.
As described in Table 4, kulfi prepared with addition
of stevia indicated maximum overall acceptability,
whereas no significant effect was observed on the body,
texture, and flavour of the kulfi if the level of
replacement of sugar with stevia was less than 50%.
However, a negative impact on the textural properties, as
well as flavour, was observed when the level of sugar
replacement with stevia exceeded 50% [53].
Table 3. Effect of stevia on nutritional properties of various food products
Product Stevia form Amount of stevia, % Description Reference
Ice cream Stevia powder
(> 90% steviol glycosides)
0.02–0.11 ↓ in calorific value and glycemic index [39]
Kulfi Stevia extract powder
with 91.1% stevioside
0.05–0.07 ↓ in calorific value [53]
Herbal Kulfi Stevia powder 0.05–0.07 ↑ in fat and protein content [58]
↓ in carbohydrate content
Muffin Stevianna with 98%
Rebaudioside A
9.97 and 19.76 ↓ in calories and post
prandial insulin levels
[32]
Muffin Stevia powder with 95%
steviol glycosides
0.09 ↓ in caloric value [36]
Functional
yoghurt cake
Stevia leaves liquid extract 3.33 ↓ caloric and energy values [56]
Chocolate Stevia extract with
Glucosyl stevioside
0.5 ↓ in energy value [59]
Orange nectar Stevioside powder
(85–95% purity)
0.02–0.06 ↓ in phenolic, ascorbic acid and stevioside
content after 2 month storage at room
temperature and 4°C
[49]
Note. ↑ – increase, ↓ – decrease, ↔ – non-significant

Gandhi S. et al. Foods and Raw Materials, 2018, vol. 6, no. 2, pp. 392–402
399
Table 4. Effect of stevia on sensory properties of various food products
Product Stevia form Amount of
stevia, % Description Reference
Ice cream Stevia leaf powder 0.862 ↑in overall acceptance than sucrose sweetened ice-
cream [38]
Ice cream with
cocoa Stevia leaf powder 0.786 More preferred in terms of taste, color , flavor,
melting in mouth and texture [38]
Ice cream Stevia powder
(> 90% steviol glycosides) 0.04 Higher suitability in terms of taste, texture and
mean liking [39]
Herbal Kulfi Stevia powde
r
0.05
–
0.07 ↓ in overall acceptability [58]
Passion fruit
juice Stevia extract 0.09924 ↓ in aroma, flavor and overall impression [52]
Muffin 0.075 0.075
–
0.300 ↑ in scores for color, porosity and overall quality [35]
Muffin Stevia powder with 95% steviol
glycosides 0.09 ↑ in scores for overall quality,
softness and taste [36]
Bittersweet
chocolate
Stevia extract with different
Rebaudioside A contents
(60%, 80% and 90%)
0.16 Stevia with 60% rebaudioside was more preferred
in terms of sweetness, bitterness and melting rate [57]
Note. ↑ – increase, ↓ – decrease, ↔ – non-significant
Current status and future perspective of utilizing
sweeteners at national and international front. The
US Food and Drug Administration regulate sweeteners
as food additives. Food additives must be approved by
the FDA, which publishes a Generally Recognized as
Safe (GRAS) list of additives. To date, the FDA has not
been presented with scientific information that would
support a change in conclusions about the safety of the
five approved artificial sweeteners (saccharin,
aspartame, sucralose, neotame, and acesulfame
potassium). The safe conclusions are based on a detailed
review of a large body of information, including
hundreds of toxicological and clinical studies. Steviol
glycoside has been used as a non-nutritive low calorie
sweetener in beverages, teas, and medicines in Japan,
China, South America, and Korea. Many international
beverage industries use stevia as a sweetener in different
fruit juice drinks. The incorporation of stevia into such
bakery products as puddings and cakes is highly suitable
since stevioside is required in minute quantities to
sweeten the product. It neither ferments nor exhibits any
browning reaction during cooking, which broadens the
field of application in baking and makes it possible to
enhance the quality, decrease the calories, and increase
the shelf-life. Stevia can be used as a sugar substitute in
confectionery to sweeten chewing gums, candies, mints,
chocolates, etc. Besides, stevia can be extensively used
to sweeten various products, e.g. ice-cream, chocolates,
fruit drinks, biscuits, soft drinks, yoghurt, biscuits,
beverages like tea, and coffee.
The joint FAO/WHO expert committee on food
additives (JECFA, 2008) stated that steviol glycosides
were safe for use in foodstuffs and beverages. JECFA
also suggested the acceptable daily intake (ADI) of
0–4 mg/kg body weight of steviol glycosides, which is
equivalent to 0–10 mg/kg stevioside [62]. Currently,
the largest market for production and application of
stevia and its glycosides is in China and Japan. In
2009, the use of rebaudioside A was permitted in
France. In European Union, the approval for use of
steviol glycosides as food additive was granted by
European Commission in 2011.
In India, the use of steviol glycosides was permitted
by FSSAI in a notification issued in 2015 for a variety
of products, including yoghurts, carbonated beverages,
jams, fruit nectars, dairy based desserts, ready-to-eat
cereals, etc.
CONCLUSION
Diterpene glycosides obtained from Stevia
rebaudiana can be used to sweeten various foods and
beverages without increment in calories. Apart from
sweet contents, the other constituents of Stevia
rebaudiana exert various health benefits, such as anti-
hyperglycemic, anti-cancer, hepatoprotective, anti-
hypertensive, anti-caries, antioxidant, and
antimicrobial. Low-calorie stevia-incorporated
products are rich in antioxidants, amino acids, and
certain vitamins. They possess many other therapeutic
properties in that they are anti-diabetic, anti-
hypertensive, antitumor, antiulcer, etc.
CONFLICT OF INTEREST
The authors declare that there are no conflicts of
interest related to this article.
ACKNOWLEDGEMENTS
The authors would like to thank the Department
of Food Technology and Nutrition, Lovely
Professional University, for providing all the
necessary resources.
FUNDING
The authors received no specific funding for this
work.
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ORCID IDs
Sukhmani Gandhi https://orcid.org/0000-0003-3456-558X
Yogesh Gat https://orcid.org/0000-0002-6038-6123
Shalini Arya https://orcid.org/0000-0003-4255-7766
Ashwani Kumar https://orcid.org/0000-0001-6315-5710