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Stevia, a zero-calorie sugar substitute, is recognized as safe by the Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA). In vitro and in vivo studies showed that stevia has antiglycemic action and antioxidant effects in adipose tissue and the vascular wall, reduces blood pressure levels and hepatic steatosis, stabilizes the atherosclerotic plaque, and ameliorates liver and kidney damage. The metabolism of steviol glycosides is dependent upon gut microbiota, which breaks down glycosides into steviol that can be absorbed by the host. In this review, we elucidated the effects of stevia’s consumption on the host’s gut microbiota. Due to the lack of randomized clinical trials in humans, we included in vitro using certain microbial strains and in vivo in laboratory animal studies. Results indicated that stevia consumption has a potential benefit on the microbiome’s alpha diversity. Alterations in the colonic microenvironment may depend on the amount and frequency of stevia intake, as well as on the simultaneous consumption of other dietary components. The anti-inflammatory properties of stevioside were confirmed in vitro by decreasing TNF-α, IL-1β, IL-6 synthesis and inhibiting of NF-κB transcription factor, and in vivo by inhibiting NF-κB and MAPK in laboratory animals.



Herein, we reviewed fourteen studies. Some of them have shown beneficial or no harmful effects of stevia and its components on gut microbiota, while others indicated harmful effects, potentially, using in vitro and in vivo models (Table 4). We must note that four studies using obesity-induced lab animals examined potential adverse effects of stevia supplementation on the beneficial microbial communities. The authors concluded that this effect was rather due to HFS diets than to stevia. Only four studies showed that stevia is harmful for gut microbiota [29,31,36,38], while one study showed that REB-A and stevioside might interrupt the Gram-negative bacterial communication [36]. In another study, both glycosides impaired the growth of six Lactobacillus reuteri strains in vitro [29].

The Effects of Stevia Consumption on Gut Bacteria: Friend or Foe?

Arezina N. Kasti,1 Maroulla D. Nikolaki,1,† Kalliopi D. Synodinou,1,† Konstantinos N. Katsas,1,2 Konstantinos Petsis,1 Sophia Lambrinou,1 Ioannis A. Pyrousis,1,3 and Konstantinos Triantafyllou4,*

We performed a literature search in PubMed for articles in the English language. We used evidence from original articles, excluding reviews, abstracts, conference presentations, editorials, and study protocols. The search was based on the terms “stevia, gut”, “stevia, microbiota”, “stevia, fecal flora”, and “gut, rebaudioside A”.


Sample Size



Stevia rebaudiana, stevioside, gut microbiota, bacteria, fecal flora

Key Words

Kasti, A. N., Nikolaki, M. D., Synodinou, K. D., Katsas, K. N., Petsis, K., Lambrinou, S., Pyrousis, I. A., & Triantafyllou, K. (2022). The Effects of Stevia Consumption on Gut Bacteria: Friend or Foe?. Microorganisms, 10(4), 744.


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