Stevia rebaudiana Bertoni and its secondary metabolites: Their effects on cardiovascular risk factors

The most common causes of morbidity and mortality are cardiovascular diseases (CVDs), which are typically associated with stress, insufficient exercise, poor diet, and overweight. CVDs can be prevented by modifying certain risk factors, such as cholesterol and blood sugar levels and body weight. Natural sugars from fruits and honey have long been part of the human diet. However, although sucrose was the main sweetener during the 20th century, it is gradually being replaced by artificial sweeteners. These are many times sweeter than natural sugar and as they often have no calories, they may be used for weight control. Some papers indicate that natural sweeteners such as stevia (obtained from Stevia rebaudiana Bertoni) may be safer alternatives for prophylaxis of CVDs. Therefore, this mini-review provides an overview of existing knowledge about the effects of stevia and its secondary metabolites on cardiovascular risk factors, particularly its antihyperlipidemic properties; however, only a few studies have evaluated the effects of stevia in humans, and they tend to be of low quality. For example, only one experiment has confirmed that stevia extract has antihyperlipidemic action in women with hypercholesterolemia, and another indicates that stevioside can manage blood pressure in patients with mild hypertension. Additionally, the concentrations of the bioactive components of stevia leaves have no clear correlation with their biological properties, especially in human models. Therefore, future research should be focused on in vivo studies evaluating the effects of regular consumption of stevia products on the cardiovascular system and CVD risk factors, both in healthy individuals and those with diabetes. Further studies are needed to clarify the mechanism of action behind the functional effects of stevia preparations, including those of two major secondary metabolites: stevioside and rebaudioside A.