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Honey: Natures natural sweetener

A review of recent scientific literature linking consumption

with health benefits

September 2012

Honey has a long history of human consumption and through history has been used in a
number of ways as a sweetener in foods and beverages. Its sweetness, whilst similar to that
of granulated sugar, is brought about by a different composition of sugars and in addition
honey typically has a distinct flavour, resulting in part to other components present. This
taste separation is highly dependent on the sources of the original nectar used by the bees
to make the honey. These additional components have, in folk law, often been associated
with direct health benefits. With the increased popularity in recent years of some specialist
honeys such as New Zealand Manuka, which seek to exploit health attributes, there has
been increased interest from the research community to see if there is any scientific basis
for these. This short review gives some background on the nutritional properties of honey
and highlights some of recent scientific research exploring health benefits.
Honey has a long and varied relationship with humans which in many cases goes beyond its
nutritional attributes but which, for example in religions such as Hinduism and Buddism ,has
other meanings1. Honey has been collected by humans for at least 8000 years and cave
paintings found in Spain2 depict people gathering honey and honey combs from wild bees
Honey formed an important dietary and medical component of civilisations across the globe
including Egypt and the Middle East, China, Mesoamerica (Mayan) and Rome. This role has
continued throughout the ages into modern times.
General Characteristics
The honey consumed by humans is generally formed by wild or cultivated honey bees
although other species of bees and some other insects are known to produce similar
substances. Bees collect nectar from flowering plants and store it as a primary food source
for their colony. Nectar is transformed into honey by the action of the bees.
Honeys main components are sugars and generally honey comprises approximately a
mixture of the monosaccharides fructose (38.5%) and glucose (31%). Sucrose, a disaccharide
of fructose and glucose, most commonly found in granulated sugar, comprises only around
1%. Total disaccharides, including maltose, isomaltose and maltulose comprise around 7% of
the composition with the remaining component mainly water.
Honey is a natural product and there is wide variation in content depending on the type of
flora that were used to produce it. This contributes to the exact ratios of carbohydrate
composition and to the characteristics of individual products. Table 1 summarises some
typical carbohydrate characteristics.

Table 1 Typical carbohydrate composition of Honey 4

Reducing Sugars
Fructose/Glucose Ratio

Average Content


This variation in composition leads to a wide variation in physical characteristics. As

gathered honey is a supersaturated solution (ie contains more sugar than should be
dissolved in water at normal temperatures) and at room temperature this becomes a
supercooled liquid in which the glucose present can precipitate as solid particles (or
crystals). The melting point of crystallised honey varies between 40C and 50C depending
on composition. As a result at room temperature honey can become metastable (will not
crystallise until a seeding crystal has been added) or more commonly labile and self seeding.
Crystallisation occurs fastest between 13 and 17C and below 5C honey does not freeze5.
As a supercooled liquid honey does not freeze solid but becomes an increasingly viscose
liquid, flowing at increasing slower rates until at temperatures below -42C to-51C it enters
the glassy state becoming an amorphous solid6. Viscosity is affected both by the relative
sugar content and amount of water. Some honeys, notably Manuka, show thixotropic
behaviour becoming liquid when stirred but gel like when motionless.
Honey is hygroscopic, ie absorbs water from the air. Levels of water absorbed are affected
by the relative humidity and temperature of the surroundings. The water content affects the
refractive index of honey and this can be used to estimate the water content. Honey is also
affected by polarised light, rotating the polarising plane. Fructose rotates the plane
negatively whilst glucose gives a positive rotation. This can be used to estimate the relative
composition of the honey.
Honey is around 1-1.5 times sweeter than granulated sugar (based on dry weights) and
approximately equivalent as a liquid. Fructose imparts a stronger sweet taste than glucose,
sucrose or other disaccharides and as a result high fructose honeys generally have a sweeter
taste. The disaccharides present also play an important role in the functionality of honey
including moisture retention, shelf life and processing7. The ratio of fructose/glucose and
glucose/water play an important role in predicting the tendency for honey to crystallise and
those with low glucose/water ratios crystallise less easily.
Basic Nutritional Composition
Honey is a natural product whose composition depends on the environment from which the
original nectar was collected. This includes the varieties of plants involved, seasonal and
geographic variations. As indicated previously the major nutritional components are sugars
(mainly fructose and glucose) and water. As a result of the environmental factors honey also
contains a number of micronutrients and other components derived from plants which may
have health impacts on consumers. Table 2 shows an indicative nutritional composition for a
typical honey

Table 2 Typical nutritional compositions data for Honey (per 100g)


1272 kJ( 304kcal)

Of which Sugars
Vitamin B2( Riboflavin)
Vitamin B3(Niacin)
Vitamin B5(Pantothenic Acid)
Vitamin B6
Vitamin B9(folate)
Vitamin C

0.3 g
0.2 g

Depending on its type and origin some honeys also contain other trace elements such as
boron, cobalt, manganese, chromium and selenium in small quantities. Honey also contains
choline and acetylcholine in variable amounts. Choline is important in vascular health, brain
function and cellular membrane repair whilst acetylcholine has a function in neuro

Honey Types
Honey can be classified in a number of ways.:
Monofloral or Floral source: This is based on the floral source of the nectar from
which the honey was made. This can be as a single flower type or be comprised of a
specific post collection blend. In each case pollen in the honey will have a unique
profile and can be used to help track authenticity. Monofloral honey will typically
have a distinct flavour, colour and texture profile linked to that source. If it is
sourced from a geographically restricted plant it may also show seasonal variations
in colour and texture. Production of monofloral honey can be problematic for
beekeepers if the flowering season is short or if there are other nectar rich species
within the flying range of the bees.
Poly floral: This is based on nectar collected from an unspecified range of flowers,
which may be extensive, typically in a geographic region or across a season. It is

sometimes known as Wildflower Honey although not necessarily derived from

wildflowers. The taste and texture of the honey will be dependent on the breadth of
the species from which the nectar has been gathered and local geography. It will also
vary from season to season.
Blended: This forms the majority of high volume commercial honey sold and
comprises a mixture of two or more honeys with different floral and often
geographic origins. The blend is typically made to create a consistent colour, flavour
and physical characteristics profile. It is generally linked with strong commercial
brands where consistency is key.
Honey contains a wide range of different tastes and colours depending on the botanical
origin. High fructose content honey (such as Acacia) are sweeter compared to high glucose
variants (such as rape). Aroma will depend on a number of factors but is typically linked
primarily to the types and amounts of amino acids present( derived from the bees). The
system is complex and recent research8 has shown that there are more than 500 different
volatile compounds responsible for contributing to the aroma profile. Honeys also contain a
range of polyphenols, typically around 50-500mg/kg. These are typically flavenoids (eg
quercitin, luteolin, kaempferol, apigen, and chrysin), phenolic acids and phenolic acid
derivatives9 which are known to be antioxidants. It has been argued9 that this complex map
could also form a tool for provenance and authenticity verification. The main polyphenols
are flavenoids and their higher presence has been linked to hotter and dryer production
regions 10.
In addition to source post harvest processing can further influence classification based on
the form in which the honey is finally presented to the customer. Some examples include:
Comb, where the honey is still in the intact honeycomb, possibly including the
wooden frame in which the comb sits,
Raw, in which honey has been minimally processed from the honeycomb. It may
contain small amounts of pollen and wax from the comb.
Strained, in which the honey has been filtered through a mesh to remove large
particulates (including wax) but in which smaller particulates such as pollen remain.
Filtered, in which honey is more rigorously filtered to remove all particles (including
pollen) and remove trapped air. To speed the process filtering is often undertaken at
temperatures similar to those for pasteurisation with associated impacts (see later).
Filtered honey is slower to crystallise and this brings benefits in pouring and
commercial uses.
Ultra sound treated, where exposure to a burst of ultrasound is used to destroy any
yeasts present (that might stimulate fermentation). The process also impacts on
crystallisation and as a result can help with liquefaction of honey in subsequent
processing or use.
Crystallised, in which some or all of the liquid honey has spontaneously crystallised
or has been induced to crystallise.
Set Honey, where crystallisation has been controlled to produce a large number of
small crystals in the liquid matrix. These small crystals prevent formation of larger

ones and produce a product with an extended texture profile and one which has
consistent properties for spreading.
Pasteurised, in which raw honey has been taken through a pasteurisation process. In
addition to reducing microbial spoilage (which as a result of the high sugar content is
in any case low) the process can be used to reduce crystallisation but can promote
colour, taste and fragrance changes, reduce enzyme activity and lead to production
of other chemical species11.

Links with Health

In addition to its role as a natural sweetener honey has, since it was first consumed, been
linked to health benefits. Some of these benefits may derive from the structure and
composition of the sugars present. Others may derive from the presence of other materials,
largely as a result of the action of the bees collecting and making the honey. The health
benefits of honey have historically been linked with folk remedies and alternative
medicines. In recent years there has been increased research to understand the scientific
basis of many of the potential health benefits and a number of useful general review papers
have been published12, 13, 14, 15.
The health benefits can be grouped into a number of broad areas:
Antimicrobial, antiviral and anti-parasitic activity
There is evidence to show that honey inhibits the growth of microorganisms classed as
gram-positive bacteria. A number of these organisms are linked with disease. Table 3
summarises some of the bacteria affected, A more comprehensive list can be found in the
review paper written by Bogdanov et al12.
Table 3 Some bacteria known to be sensitive to honey
Haemophilius influenzae
Helicobacter pylori16
Pseudomonas aerugonisa25
Salmonella sp
Salmonella typhimurium
Streptococcus faecalis
Streptococcus mutans26
Streptococcus pneumoniae
Streptococcus pyogenes27

Related infection
Respiratory infections
Gastric ulcers
Urinary infections , wound infections
Wound infections24,29
Urinary infections
Dental caries
Ear infections, sinusitis
Throat infections, wound infections

The bacteriological effect depends on the structure of the honey which is linked to its
origins. At a macro level low water activity inhibits growth. Enzymes such as glucose oxidase
produce hydrogen peroxide17 which has an antimicrobial effect but production is limited by
other enzyme activity. Peroxides are however destroyed by heat treatment and to maintain
potential activity honey must be processed and stored with care.

Other substances present are also believed to contribute to the antibacterial activity.
Manuka honey is for example believed to be high in aromatic acids and phenolic compounds
and flavenoids, which in addition to their antioxidant properties show antimicrobial
activity18, 19, 20, 21. Similar results have been reported for some other geographic honeys22.
Recent data suggests that peptides present may also contribute to antibacterial properties
particularly in treatment of antibiotic resistant bacteria strains28.
Antioxidant Effects
Oxidative stress or the in balance between production of free radicals and antioxidant
protection is now generally recognised to be linked to the progression of chronic disease 30.
There is evidence that honey contains a number of compounds shown to have antioxidant
capacity. The most important of these are the polyphenols and there is evidence to suggest
that the phenolic content of honey is linked directly to its oxidative protection
characteristics. Human intervention studies31,32 have, for example, used volunteers fed
honeys having different antioxidant capacities (using sugar as a control ) and measures of
oxidative capacity have been assessed using biomarkers. Honey showed increased levels of
antioxidant protection linked to composition. Antioxidant markers such as glutathionine
reductase and uric acid were increased. In each case the authors were though quick to note
that the antioxidant capacity of the honey was highly dependent on the botanical and
geographic source35. Honeys used in the study had been previously benchmarked for
antioxidant capacity using in vitro and chemical tests such as ORAC (oxygen radical
absorbance capacity)33. Some typical ORAC data taken from Bogdanov 12 are shown in Table
Table 4 ORAC antioxidant capacity and phenol content data for some honeys
Buckwheat ( New York)

ORAC capacity

Total Phenolics ( mg/kg)


Recent data has indicated that whilst processing may not affect antioxidant levels storage
can in some cases lead to reductions in levels with time34.
Cancers develop through mutation of the genetic structure of tissues. This mutation is
promoted by chemicals and other stimuli, some of which can be nutritionally based. For
example it is generally accepted that heterocyclic amines and nitrosamines formed during
roasting and frying of food can promote such activity. There is evidence that suggests that
some compounds found in honey may slow or prevent such activity. For example Wang et al
tested a number of different monofloral honeys and showed that they all had antimutagenic
properties36. Work in mice models 37 suggests that honey may stimulate the immune system
and the researchers speculated that consumption prior to tumour formation might slow of
prevent disease progression. The study did not however offer evidence for this speculation.

Honey has been shown to have anti-inflammatory effects in humans consuming around
70g/d 38. Key markers of inflammation such as thromboxane and PGE(2) showed reductions
at 1,2 and 3 hours after ingestion. There is also evidence in mice models that honey has a
positive effect in models of IDB and colitis40. Researchers are still working to understand
which active compounds are responsible. Comparison to the effects of honey in burns and
wound healing39 , which also show inflammatory behaviour,has though suggested that
active compounds prevent formation of free radical release in inflamed tissues as well as
having a direct anti-inflammatory effect.
Oral health
There has been considerable speculation about the role of honey in oral health. There is
though conflicting data concerning dental caries with some reports suggesting a protective
effect41 whilst others liken the effects to sucrose42. These seemingly conflicting observations
may reflect the dependence of functional characteristics on the origin of the honey. It is
likely though that the antibacterial activity of honey highlighted above may influence the
growth of bacteria and that this may be responsible for the protective effect. Certainly one
study43 using Manuka honey, known to have strong antimicrobial activity, has shown
positive effects against formation of dental plaque and the onset of gingivitis.
Whilst these observations have been made it should always be remembered that the main
constituents of honey are sugars, which are strongly linked with poor oral health and thus
results need to be considered with some caution.
Digestive and Gut Health
Honey has been linked with digestive health since ancient times. Early civilisations such as
the Romans and Arabic empires used honey as part of their treatments for gastro intestinal
There is research evidence44, for example, that honey inhibits growth of Helicobacter pylori,
the bacteria associated with development of gastric ulcers. Recent work has highlighted the
potential antibiotic effect of honey with a number of intestinal pathogens 47. The
mechanisms for this remain unclear but it is believed that either components in honey
stimulate sensory nerves in the stomach 45 or the action is linked to an antioxidant effect.
Again some work has shown dependence on floral and geographic origins as a key factor in
There have been health links associated with oligosaccharides present in honey with some
evidence of prebiotic effects similar to fructo-oligosaccharides more commonly used. An
example is a study 46 which showed particular effects on the functionally important bacteria
bifidobacteria and lactobacilli.
Vascular health/ Diabetes
There is evidence to suggest that micro components in honey have a positive effect on
markers of heart health. For example one study48 compared ingestion of a fructose/glucose
mixture with consumption of honey on various heart biomarkers. The study showed honey
to have positive effects on a number of biomarkers of vascular health. Other research has
shown positive vascular effects in diabetic patients postulating that this could be used in the

management of the condition49,50,52 . As in other areas the origin of the effect remains
uncertain however one group 51 has suggested that it could be due oligosaccharides present
.A second has suggested that the effect is linked to stimulation of increased energy
Nitric oxide (NO) metabolites can be present in honey. NO is a known marker of heart
disease and elevated levels of metabolites may be evidence of a protective function53. NO
metabolites levels vary with honey variety, storage and processing.
Honey has played an important role in nutrition since mans earliest days. The perceived
potential health benefits of consumption have been exploited in many cultures for almost as
long but it is not until recently that scientists have sought to understand if there is evidence
to support this.
Honey is a complex mixture of substances, the composition of which is dependent upon a
wide range of natural and man-made variables. For a single flora sourced honey
composition will be highly dependent on the floral source, season and geographic factors as
well as the action of the bees that collect the primary nectar. Further complexity is added
where bees have access to multiple floral sources and individual honeys are combined or
blended by producers. The way in which honey is processed and stored can also be
important in ensuring native health impacts remain intact.
There is an ever growing body of scientific literature showing evidence for a number of
health related impacts from consumption or even application to the body of honey.
However in reviewing this data some caution is needed. Very few of the observed effects
are linked simply with honey as a whole. Rather scientists have identified specific health
impacts linked with honeys showing strong provenance to floral and regional characteristics.
For some, such as Manuka from New Zealand, there is a strong and growing portfolio of
information. For others such as UK honeys scientists are only beginning the journey of
understanding and we still lack some basic information on the composition of specific
honeys and information on the potential bioactives present. Data is needed from different
floral and regional origins before we can fully assess and compare specific health impacts.
As in New Zealand much of this will need to be done at a local level but armed with this
information Scottish and UK producers can begin to look at developing their own healthy

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September 2012
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