Effect of honey on cardiometabolic risk factors

Nicola Royce

Nicola Royce

Registered Dietitian,
Postgraduate Diploma Diabetes
Masters in Nutrition

The World Health Organization suggests limiting added sugar consumption due to its link with obesity, heart disease, and type 2 diabetes. A study found that unprocessed, raw honey, though equally calorific as cane sugar, has a unique composition that may positively impact glycaemic control and lipid levels. It reduces systolic blood pressure and increases 'good cholesterol' (HDL-cholesterol). However, the benefits vary based on the honey's floral source and processing method. Therefore, it's recommended to include raw honey in a balanced diet, replacing other added sugars.
Read the takeaway message here
Health agencies, such as the World Health Organization (WHO), recommend that added sugars should be limited to less than 5 – 10% of total energy intake per day as part of global health and nutrition guidelines2,3. This is due to the association between added sugar and the rise in obesity, type 2 diabetes, and heart disease. Added sugars include cane sugar, brown sugar, honey, syrup, high-fructose corn syrup, sucrose, glucose, dextrose, maltose, and maltodextrin.

While honey has the same caloric value as cane sugar, its composition is quite different. It contains a complex composition of sugars (including ‘rare sugars’), organic acids, enzymes, proteins, amino acids, minerals, vitamins, and bioactive substances, made by honeybees from the nectar of flowers. Various clinical trials have shown that honey offers improvements in body weight, inflammation, lipid profile, and glycaemic control. However, the benefits offered for each of these components have not been systematically evaluated and quantified.

A meta-analysis was thus conducted by Ahmed and others, to quantify the effect of honey on cardiometabolic risk factors, and was published at the end of 2022.¹ A meta-analysis involves systematically searching for relevant studies, grading their quality, and then quantifying the changes for each aspect of the study. The use of honey as part of an intervention ranged from 1 – 24 weeks (median 8 weeks), and doses ranged from 5 – 125 g (median 40 g, roughly 2 tablespoons). 

“Unprocessed, raw honey may offer improved glycaemic control and lipid levels when eaten as part of a healthy eating pattern.” ¹

Raw honey was found to reduce fasting glucose, total cholesterol, and fasting triglycerides, and increase ‘good cholesterol’ (HDL-cholesterol). A dose-response effect was seen for honey intake and systolic blood pressure (SBP), where the more honey was consumed, the lower the SBP. However, after grading the quality of the studies that were included, the only outcomes that have a high certainty of taking place are the increase in HDL-cholesterol and reduction in SBP. 

The rare sugars have slight differences in their chemical structure, which moderate the effect of fructose and glucose through the inhibition of certain enzymes or downregulation of glucose transporters. This potential effect is supported by the 0.25% reduction in HbA1c (a long-term measure of blood sugar) in the meta-analysis. Isomaltulose is one of the rare sugars in honey and has been shown to promote the growth of certain bacteria that are associated with a healthy microbiome. Furthermore, honey is rich in phenolic compounds, which have anti-inflammatory effects and may beneficially influence total cholesterol, LDL-cholesterol, HDL-cholesterol, and fasting triglycerides. Certain components of honey may also support the body’s immune responses. 

Processing honey appears to change the composition and bioactivity of honey. For example, processing honey kills beneficial bacteria found in honey – known as probiotics. Raw honey contains probiotics that improve the regulation of the immune system, lower lipids, and assist with the production of short-chain fatty acids in the intestine. Processing honey also affects the activity and quantity of enzymes and phenolic compounds, which limits its benefit for reducing lipid levels and fasting glucose. 

In addition to processing, the floral source of honey is an important consideration, as the source of nectar influences the composition and bioactive components of honey, which may or may not impact cardiometabolic risk factors. Clover and Robinia honey sources appear to offer the most benefit for fasting glucose and total cholesterol

For more information on the study, refer to the reference list below.

So, what is the take away message?

Honey can be included as part of an overall healthy diet but should be consumed within the restraints of limiting added sugar intake to less than 10% of total energy intake per day. If already consuming added sugar, replacing this with raw honey may be a healthier alternative for systolic blood pressure and HDL-cholesterol. CLICK HERE to read about how almost half of the honey imported into the European Union is fake. 

Conclusion

It turns out that unprocessed, raw honey has potential to positively impact glycaemic control and lipid levels when incorporated in a balanced diet. As health organizations advocate for strict limitations on added sugars to combat the surge in obesity, type 2 diabetes, and heart disease, honey emerges as a distinctive sweetener, sharing caloric value with cane sugar but boasting a complex composition enriched with rare sugars, organic acids, enzymes, and bioactive substances. However, further exploration needs to done to harness the full cardiometabolic potential of this natural sweetener.

Liviana® Honey

We at Liviana® pride ourselves in sourcing some of the best honey that South Africa has to offer! Our honey originates from the Outeniqua Mountains and we have two floral sources, offering distinct and delicious taste profiles. Our honey is raw and of the highest quality, and you rest assured that we are not putting any ‘funny stuff’ in there.

To read more about our honey and to purchase a jar today, CLICK HERE.

References
  1. Ahmed A, Tul-Noor Z, Lee D, et al. 2022. Effect of honey on cardiometabolic risk factors: a systematic review and meta-analysis. Nutrition Reviews, 00(0):1–17. Available here.
  2. World Health Organization. 2015. Guideline: sugars intake for adults & children. Available here.
  3. Reduce sugar. Heart and Stroke Foundation of Canada website. Available here.
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