Stevia is a plant-derived, non-nutritive sweetener (NNS) that has become a popular sugar alternative due to its lack of calories. The sweet compounds are highly refined extracts called steviol glycosides, which are hundreds of times sweeter than table sugar. Many parents are turning to stevia-sweetened products to reduce their children’s intake of added sugars. However, this shift has introduced public concern regarding the long-term safety of regularly consuming such intense sweeteners during a child’s developmental years.
Regulatory Approval and Acceptable Intake Levels
The safety of high-purity stevia extract has been thoroughly reviewed by global health authorities. In the United States, the Food and Drug Administration (FDA) granted high-purity steviol glycosides the Generally Recognized As Safe (GRAS) status.
Regulatory bodies, including the Joint FAO/WHO Expert Committee on Food Additives (JECFA), have established an Acceptable Daily Intake (ADI) for steviol glycosides. This ADI is set at 4 milligrams per kilogram of body weight per day, expressed as steviol equivalents. The ADI represents the amount of a substance that can be safely consumed daily over a lifetime without appreciable health risk.
This safety designation applies only to the highly refined steviol glycosides, which must be at least 95% pure. Crude stevia leaf or whole-leaf extracts, available as dietary supplements, do not have the same GRAS status due to a lack of comprehensive safety data. Children, having a lower body weight, can reach the ADI limit more easily than adults, which requires careful consideration of their total intake from all sources.
Impact on Developing Metabolism and Gut Health
Stevia’s primary metabolic benefit is that its sweetening compounds are not metabolized as glucose, meaning they do not contribute calories or cause a spike in blood sugar levels. Some research suggests that stevia may have an antiglycemic action, possibly by stimulating the TRPM5 ion channel which is involved in glucose-mediated insulin secretion. A recent meta-analysis indicated that stevia consumption was associated with a reduction in blood glucose levels, particularly in individuals with higher body mass index (BMI).
The connection between non-nutritive sweeteners and long-term weight management in youth remains a complex area with conflicting evidence. Short-term studies suggest that replacing sugar-sweetened beverages with NNS options may help reduce weight gain or promote weight loss in children. However, other studies have suggested a possible link between regular NNS use and an increased risk of weight gain, metabolic syndrome, and insulin resistance, though evidence in children is limited.
Steviol glycosides are not absorbed in the upper digestive tract but are instead broken down into the absorbable compound steviol by the bacteria in the colon. While some studies suggest a minimal or neutral effect on the composition of a stabilized human gut microbiota, other in vitro studies have shown that stevia may disrupt the communication pathways of certain bacteria. This potential to interfere with bacterial signaling, known as quorum sensing, suggests that the effects on the gut microbiome may be strain-specific and warrant further investigation in the context of a child’s developing microbial ecosystem.
Practical Guidance on Stevia Use in Children’s Diets
Given the scientific consensus on short-term safety within the ADI, parents can incorporate stevia into their children’s diets. The most practical challenge is accurately monitoring total intake, as non-nutritive sweeteners are found in a growing number of products, making it difficult to track daily consumption against the ADI. The American Academy of Pediatrics has recommended that manufacturers list the exact quantity of NNS on food labels to help families make informed decisions.
A major concern with using any intense sweetener is the potential to reinforce a child’s preference for hyper-sweet flavors. Stevia is many times sweeter than sugar, and consistently offering intensely sweet foods and drinks may make less sweet, healthy options like plain fruits or vegetables less appealing. The goal should be to reduce the overall desire for sweetness, not simply to replace the sugar.
Parents should also carefully read ingredient labels, as stevia products are often blended with other sweeteners or bulking agents like dextrose or erythritol to improve texture and taste. For sweetening foods at home, whole-food alternatives offer nutritional benefits that stevia does not. Examples include using mashed ripe bananas or unsweetened applesauce in baking, or incorporating small amounts of pure maple syrup or honey (for children over one year old).