Effect of honey on cardiometabolic risk factors: a systematic review and meta-analysis

Abstract

Context Excess calories from free sugars are implicated in the epidemics of obesity and type 2 diabetes. Honey is a free sugar but is generally regarded as healthy. Objective The effect of honey on cardiometabolic risk factors was assessed via a systematic review and meta-analysis of controlled trials using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Data Sources MEDLINE, Embase, and the Cochrane Library databases were searched up to January 4, 2021, for controlled trials ≥1 week in duration that assessed the effect of oral honey intake on adiposity, glycemic control, lipids, blood pressure, uric acid, inflammatory markers, and markers of nonalcoholic fatty liver disease. Data Extraction Independent reviewers extracted data and assessed risk of bias. Data were pooled using the inverse variance method and expressed as mean differences (MDs) with 95%CIs. Certainty of evidence was assessed using GRADE. Data Analysis A total of 18 controlled trials (33 trial comparisons, N = 1105 participants) were included. Overall, honey reduced fasting glucose (MD = −0.20 mmol/L, 95%CI, −0.37 to −0.04 mmol/L; low certainty of evidence), total cholesterol (MD = −0.18 mmol/L, 95%CI, −0.33 to −0.04 mmol/L; low certainty), low-density lipoprotein cholesterol (MD = −0.16 mmol/L, 95%CI, −0.30 to −0.02 mmol/L; low certainty), fasting triglycerides (MD = −0.13 mmol/L, 95%CI, −0.20 to −0.07 mmol/L; low certainty), and alanine aminotransferase (MD = −9.75 U/L, 95%CI, −18.29 to −1.21 U/L; low certainty) and increased high-density lipoprotein cholesterol (MD = 0.07 mmol/L, 95%CI, 0.04–0.10 mmol/L; high certainty). There were significant subgroup differences by floral source and by honey processing, with robinia honey, clover honey, and raw honey showing beneficial effects on fasting glucose and total cholesterol. Conclusion Honey, especially robinia, clover, and unprocessed raw honey, may improve glycemic control and lipid levels when consumed within a healthy dietary pattern. More studies focusing on the floral source and the processing of honey are required to increase certainty of the evidence. Systematic Review Registration PROSPERO registration number CRD42015023580.

A comprehensive characterization of phenolics, amino acids and other minor bioactives of selected honeys and identification of botanical origin markers

“…Rare sugars have individually shown to have metabolic benefits with majority being non-cariogenic (Ooshima et al, 1983) and exerting prebiotic (Chung et al, 2017;Hodoniczky et al, 2012;Sanz et al, 2005), anti-glycemic (Lee et al, 2016), anti-inflammatory (Chung et al, 2017), and immune modulation (Mirosaki et al, 1999) effects in animal models. These rare sugars have also been found to reduce blood glucose, body weight (Ahmed et al, 2022), and acute metabolic hormones related to obesity like GIP and GLP-1 activities in human studies (Keyhani-Nejad et al, 2015), thus explaining some metabolic benefits of honey (Ahmed et al, 2023).…”

Honey beyond science

“…Carbohydrate metabolism involves the activity of certain specific enzymes and the biochemical analysis of honey highlighted their presence in the analyzed honey samples such as diastase, glucose oxidase, glucosidase, invertase, and catalase. Diastase concentration may also be used as an indicator of honey quality, with higher-quality honey usually containing more diastase [42,43].…”