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Honey and Health: A Review of Recent Clinical Research

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Honey and Health: A Review of Recent Clinical Research

Abstract


The health benefits of honey have been known since ancient times. Honey has been one of the most appreciated and valued natural products and it has been used not only as a nutritional product but also in traditional medicine as an alternative treatment for clinical conditions ranging from wound healing to cancer.

The aim of this review is to highlight the benefits of honey and its byproducts for medicinal purposes. Traditionally, honey has been used in the treatment of eye diseases, bronchial asthma, throat infections, tuberculosis, thirst, hiccups, fatigue, dizziness, hepatitis, constipation, worm infestation, piles, eczema, healing of ulcers, and wounds and also used as a nutritious supplement. The ingredients of honey have been reported to exert antioxidant, antimicrobial, anti-inflammatory, antiproliferative, anticancer, and antimetastatic effects. Many papers suggest the use of honey in the control and treatment of wounds, diabetes mellitus, cancer, asthma, as well as cardiovascular, neurological, and gastrointestinal diseases. Flavonoids and polyphenols, which act as antioxidants, are two main bioactive molecules present in honey. According to modern scientific literature, honey may be useful for the treatment of various conditions such as diabetes mellitus and diseases of the respiratory, gastrointestinal, cardiovascular, and nervous systems. It may also be useful in cancer treatment because of the many antioxidants present in honey.

Introduction



Most ancient populations, including the Greeks, Chinese, Egyptians, Romans, Mayans, and Babylonians, consumed honey both for nutritional purposes and for its medicinal properties. Honey is the only insect-derived natural product, and it has nutritional, cosmetic, therapeutic, and industrial values. Honey is reviewed as a component of a balanced diet and is equally popular among males and females of all ages. Honey does not require refrigeration, it never spoils, and it can be stored unopened at room temperature in a dry place. The water activity of honey is between 0.56 and 0.62 and its pH is almost 3.9. Honey has been used as a natural sweetener from ancient times since it has high level of fructose (honey is 25% sweeter than tablet sugar). Moreover, the use of honey in beverages is also increasingly popular. Today, articles describing the usage of honey for the cure of many human diseases can be found in general magazines, journals, and natural products publications. Although many studies have been performed on honey, only a few are published. This study, which is a comprehensive review of the current literature, highlights the therapeutic benefits of honey in the management of diseases.


Medicinal History of Honey


Evidence from Stone Age paintings from 8000 years ago shows treatment of disease with a bee product such as honey. Ancient scrolls, tablets and writings such as Sumerian clay tablets (6200 BC), Egyptian papyri (1900 - 1250 BC), Veda (Hindu scripture) from 5000 years ago and Hippocrates (460 - 357 BC) show that honey had been widely used as medicine. Other religious scriptures such as the Bible and the Qur’an an describe the therapeutic value of honey.


Nutritional and Non-Nutritional Components of Honey

 

Today, approximately 300 types of honey have been recognized. These varieties are distinguished by the different types of nectar that have been collected by the honeybees. The main components of honey are carbohydrates that contribute 95 - 97% of its dry weight. Monosaccharides (fructose and glucose) are the most important sugars of honey and contribute most of the nutritional properties of honey. In addition to monosaccharides, smaller quantities of disaccharides are present in honey. Many of these sugars are formed during the honey ripening and maturation process. Gluconic acid, a product of glucose oxidation, is the main organic acid that is present in honey; in addition, small amounts of acetic, formic, and citric have been found. These organic acids are responsible for the acidic (pH between 3.2 and 4.5) level of honey. Honey also consists of some important amino acids, such as all nine essential amino acids and all nonessential amino acids except for asparagine and glutamine. Proline was reported as the primary amino acid in honey. Enzymes (diastase, invertases, glucose oxidase, catalase, and acid phosphatase) constitute the main protein ingredients of honey. The vitamin levels in honey are low and do not approach the recommended daily intake.

Biological activities of honey

 

1. Antioxidant activity

 Antioxidants intercept free radicals before they can do damage. Honey’s antioxidant properties are related to the brightness of honey; darker honey has higher antioxidant values. It has been shown that the phenolic compounds are the major responsible factor for the antioxidant properties of honey, since the phenolic level is related to the radical absorbance activity values of honey. Other investigations showed that the antioxidant activity is related to the combination of the wide range of active compounds present in honey. Thus, honey has the ability to act as a dietary antioxidant. According to scientific literature, honey applied alone or in combination with conventional therapy might be a new antioxidant in the control of diseases commonly associated with oxidative stress.

2. Antimicrobial activity

The main factor for antimicrobial activity of honey is the enzymatic glucose oxidation reaction, but the other factors that can show antimicrobial activity of honey include high osmotic pressure/low WA, low pH/acidic environment, low protein content, high carbon to nitrogen ratio, low redox potential due to the high level of reducing sugars, a viscosity that limits dissolved oxygen and other chemical agents/phytochemicals. Due to characteristics of honey such as low WA and water acidity, glucose oxidase, and hydrogen peroxide, honey does not support the growth of yeast and bacteria.

3. Apoptotic activity

Cancer cells are characterized by inadequate apoptotic turnover and uncontrolled cellular proliferation. Apoptosis is nature’s way of killing cells. Aids and Alzheimer’s patients have high rates of apoptosis while cancer patients have low rates. Chemicals which are indicated for cancer treatment are apoptosis inducers. Honey promotes apoptosis in many types of cancer cells through depolarization of the mitochondrial membrane. The apoptotic properties of honey make it a possible natural anti-cancer agent as many chemotherapeutics currently used are apoptosis inducer agents.

 

4. Anti-inflammatory and immunomodulatory activities

Chronic inflammation can inhibit healing by damaging tissues. According to the present literature, honey reduces inflammatory response in animal models, cell cultures, and clinical trials. The phenolic content in honey is responsible for the anti-inflammatory effect.



Medicinal Properties

 

1. Honey and wound healing

Honey is the oldest wound-healing agent known to mankind. Honey induces leukocytes to release cytokines, which is what begins the tissue repair. In addition, it activates the immune response to infection. The stimulation of other categories of the immune response by honey is also reported. Honey induces the generation of antibodies. Much research suggests the use of honey in the control and treatment of acute wounds and for mild to moderate superficial and partial thickness burns. Although some studies indicated the efficacy of honey in relation to leg ulcers, more studies are needed to strengthen the current evidence.

 

2. Honey and diabetes

There is strong evidence which illustrates the benefits of honey in the treatment of diabetes. These results point out the therapeutic prospects of using honey or other potent antioxidants as an adjunct to standard anti-diabetic drugs in the control of type 1 and type 2 diabetes mellitus. In one clinical trial, the application of honey was associated with dramatically lower glycemic index than with sucrose or glucose in type 1 diabetes. In the diabetic patients, honey can induce a significant reduction in plasma glucose levels versus dextran.  However, several questions remains, especially as it relates to the prospect of controlling diabetes mellitus by interventions that target both oxidative stress and hyperglycaemia. In addition, the therapeutic effects of honey in the management of diabetes may not only be restricted to controlling glycemia but also may be extended to ameliorating the associated metabolic complication issues.

3. Honey and cancer

Current studies show that honey may exert anticancer effects through several mechanisms. Investigations have indicated that honey has anticancer properties through its interference with multiple cell-signalling pathways, including inducing apoptosis, antimutagenic, antiproliferative, and anti-inflammatory pathways. Honey modifies the immune responses. Honey has been indicated to prevent cell proliferation, induce apoptosis, modify cell cycle progression, and cause mitochondrial membrane depolarization in many of the most common types of cancer. In addition, honey could be able to inhibit several forms of tumour in animal modelling including breast cancer, carcinoma, melanoma, colon carcinoma, hepatic cancer, and bladder cancer. However, more studies are needed to improve our understanding of the positive effect of honey and cancer.

4. Honey and asthma

Honey is commonly used in folk medicine to treat inflammation, cough, and fever. The use of honey as an agent in reducing asthma-related symptoms or as a preventive agent to preclude the induction of asthma was showed. Chronic bronchitis and bronchial asthma have been treated by oral honey consumption in animal modelling. A study conducted by Kamaruzaman et al. showed that treatment with honey effectively inhibited ovalbumin-induced airway inflammation by reducing asthma-related histopathological changes in the airway and also inhibited the induction of asthma. Inhalation of honey was also discovered to effectively remove mucus-secreting goblet cell hyperplasia. However, future studies are needed to investigate these effects of honey to better understand the mechanisms by which honey reduces asthma symptoms.

5. Honey and cardiovascular diseases

 Antioxidants in honey such as flavonoids, polyphenolics and monophenolics may be associated with a reduced risk of cardiovascular failures. In coronary heart disease, the protective effects of flavonoids reduce the risk of coronary heart disorders through three mechanisms: (a) improving coronary vasodilatation, (b) reducing the ability of platelets in the blood to clot, and (c) inhibiting low-density lipoproteins from oxidizing. Although there is a wide spectrum of antioxidant types, caffeic acid, quercetin, phenethyl ester, kaempferol, galangin, and acacetin predominate in different types of honeys. Several investigations have shown that certain honey polyphenols have a promising pharmacological function in reducing cardiovascular disorders. However, in vitro and in vivo research and clinical trials should be initiated to further validate these compounds in medical applications.

6. Honey and neurological diseases

There is significant scientific literature supporting the use of nutraceutical agents as novel neuroprotective therapies, and honey is one such promising nutraceutical antioxidant. Honey exerts anxiolytic, antidepressant, anticonvulsant, and antinociceptive effects and ameliorates the oxidative content of the central nervous system. Most significantly, honey polyphenols counter neuroinflammation in the hippocampus, a brain structure that is involved in memory. Honey polyphenols prevent memory disorders and induce memory production at the molecular level. Several researchers propose that the modifications of specific neural circuitry underlie the memory improving and neuropharmacological effects of honey. More studies however are needed to determine the ultimate biochemical impact of honey on neurological diseases.

7. Honey and gastrointestinal diseases

Honey has been suggested as potentially useful for various conditions of the gastrointestinal tract, such as periodontal and other oral disorders and dyspepsia, and as part of oral rehydration therapy. In a clinical trial, honey showed therapeutic effects in the treatment of infants and children admitted into hospital with gastroenteritis and indicated significant reduced duration of diarrhea in the honey-treated patients.

Conclusion

Sufficient evidence supports the benefits of honey in the management of many disease conditions. Studies have revealed that the medicinal effect of honey may be due to its antibacterial, anti-inflammatory, apoptotic, and antioxidant properties. This review should provide practitioners with persuasive evidence supporting the use of honey in the medical field. Although some studies exist having tested the efficacy of honey in relation to medical purposes, more studies are needed to cover all medicinal aspects of honey.

 

This paper, published by Samarghandia, Farrkhondeh & Samini, Pharmacognosy Research, April-June, 2017 has been summarized by NRGY Honey.  NRGY Honey does not own the rights to the research.

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