Stevia

Stevia, also known as "candyleaf", is a bush native to Central and South America. Extracts from the stevia plant are rapidly appearing in our food supply since the FDA recently recognized the "Generally Recognized as Safe" (GRAS) status of the extract, Reb A. This has raised the question of whether stevia products are allowed on the FODMAPS elimination diet.

Reb-A, the stevia derivative used in most products, is up to 300 times sweeter than sugar. It is used in very minute quantities, and has zero calories. With no sugars or fibers to be malabsorbed or fermented, it cannot be a FODMAP, therefore it is allowed on the FODMAPS elimination diet.

Be aware of what fillers are used in the stevia product, however. Many of the products are designed to be substituted for sugar on an equal volume basis. For example, you are supposed to be able to substitute 1 cup of stevia product for 1 cup of sugar. If less than one percent (1/300th) of the product is stevia, you have to ask yourself, "What is the other 99% of the white fluffy stuff in the measuring cup or packet"? Some of those fillers are definitely fermentable by gut bacteria, and shouldn't be consumed on the elimination phase of your FODMAPS elimination diet. Some manufacturers consider this a plus, and are market the stevia product as "pre-biotic", which translates to "food for gut bacteria". Although this may be fine for most people, in my opinion, IBS sufferers who are sensitive to FODMAPS could potentially experience symptoms when consuming these fillers in large quantities. I'd suggest waiting to try them during the fructans challenge phase of the diet.

If you can locate a stevia product with no fillers, such as a SweetLeaf SteviaClear, you can use it during the elimination phase. You may be able to locate stevia products that are filled with "allowed ingredients". For example, Truvía, manufactured by Cargill, can be used during the elimination phase, as it is filled with erythritol, which is not fermentable by gut bacteria.

Finally, don't forget that foods sweetened with good old-fashioned table sugar and maple syrup are allowed on the elimination phase of the FODMAPS diet. While it isn't necessary to use non-nutritive sweeteners such as stevia on the diet, it is nice to have options.

Update 9/23/09 Sun Crystals with Stevia is another product you can use during the elimination phase of the diet. It's ingredients are pure cane sugar and stevia.

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Comments

[Kathy]

I just received your book today, and it seems to be EXACTLY what I have been looking for! I have been wildly eliminating and reintroducing "suspect" foods for years, but my disorganized, unscientific approach has left me a confused and frustrated food phobe! I plan to follow your elimination schedule carefully and try to regain my food sanity.

One question: Why is maple syrup allowed? It is heavily weight toward fructose, isn't it?

[Patsy Catsos]

Thanks for writing with your excellent question. Could you be thinking of pancake syrup? We must distinguish between real maple syrup and maple-flavored pancake (table) syrup. Living here in Maine, it didn't occur to me to put the word "real" in front of the phrase "maple syrup" but it might be different where you are, Kathy.

Real maple syrup is 2.37% glucose and only .88% naturally occurring fructose, according to the USDA database for standard reference. Because there is more glucose than fructose, fructose malabsorption isn't likely to occur if the portion size is modest. So you can eat real maple syrup during the elimination phase of the diet.

Pancake (table)syrups that just contain a "drop" of real maple syrup, or none at all, usually contain high fructose corn syrup as one of the first three ingredients. It's possible, or even likely, this could cause the amount of fructose to be in excess of glucose, which could lead to fructose malabsorption. We wouldn't know for sure unless the manufacturer disclosed what type of high-fructose corn syrup was used or provided a detailed breakdown of the glucose/fructose content of the syrup, which they don't do.

To err on the side of caution, avoid pancake syrup during the elimination phase; go ahead and try it during the fructose challenge phase.

[Kathy]

Ok, since you were kind enough to respond, let me ask you two more questions:

What do you know about fructose and tryptophan? I have read that malabsorbed fructose binds to tryptophan and prevents its absorption as well, leading to problems of deficiency, such as insomnia.

Have you seen any evidence that sourdough bread is more easily tolerated than other wheat breads? Some claim that the fermentation process "destroys" the fructans

[HAlley]

What about "Stevia in the Raw"?

[Patsy Catsos]

The packets look fine. The cup-for-cup product is mostly maltodextrin, by volume, and I would not consider it FODMAP-friendly in that quantity.

[Donella]

I have ulcerative colitis and recently started using stevia (never used other sweeteners because they either taste horrid or give me palpitations)
After my recent exploratory results I found that for the first time in 15 years sice diagnosis I am in remission, I've never felt better
Could be coincidence but that has been my only change in what I consume in the last few years
Stevia breaks down into something that the bacteria in the colon consume and any other waste is weed out, I can only guess that it's keeping my colon bacteria to busy to attack me!

[Patsy Catsos]

Glad to hear you are feeling better. I am not aware that stevia has any healing properties such as this, but whatever the case, I'm sure you must be pleased. Is the stevia by itself or part of a product with other ingredients?