A Review on the Protective Effects of Honey against Metabolic Syndrome

Exploring honey's potential as a functional food for natural sleep aid

Sleep disorders present significant challenges to public health, necessitating effective and sustainable solutions beyond conventional pharmacological interventions. This study aims to investigate the potential of honey and its compositions as a functional food for addressing sleep disorders. A comprehensive review of existing literature explores honey's intrinsic properties and impact on sleep quality. The findings suggest that honey, with its unique composition and soothing effects, offers a promising avenue for enhancing sleep patterns without relying on pharmaceutical drugs. This study also discusses the possible mechanism of action and the challenges of using honey in this field. While further research is needed to elucidate specific mechanisms and optimal utilisation, integrating honey into holistic sleep management strategies holds promise for improving overall well-being and quality of life.

Protective potentials of polymyxin B and honey against bacterial lipopolysaccharide-induced endotoxemia in mice

Objective

The experiment aimed to determine the effects of lipopolysaccharide (LPS), polymyxin B, and honey on survival rates, hematological parameters, liver and kidney biomarkers, blood glucose levels, serum insulin levels, and histopathology of the liver, kidney, lungs, brain, and pancreas in LPS-challenged mice.

Materials and Methods

50 male Swiss Albino mice (Mus musculus), aged 3 weeks, were randomly assigned into 5 groups (10 mice per group): Control group (A), LPS (2 mg/kg bwt/day IP in NS) treated group (B), polymyxin B (1.2 mg/kg bwt/day IM) pre-treated plus LPS (2 mg/kg bwt/day IP in NS) treated group (C), honey (10 gm/kg bwt/day PO) pre-treated plus LPS (2 mg/kg bwt/day IP in NS) treated group (D), both polymyxin B (1.2 mg/kg bwt/day IM) and honey (10 gm/kg bwt/day PO) pre-treated plus LPS (2 mg/kg bwt/day IP in NS) treated group (E). The LPS was administered intraperitoneally (IP) at 80 µg/mice/day, diluting in normal saline. After 16 weeks, the mice were sacrificed, and blood samples and organs (liver, kidney, lung, brain, and pancreas) were collected for laboratory tests.

Results

The results revealed that in LPS-treated mice, the mortality rate was the highest, and hemato-biochemical parameters were altered. Histopathological examination in the group treated with LPS showed disarrangement of hepatocytes, cellular infiltrations in the glomerulus, alveolar congestion in the lungs, several nerve fiber degenerations in the brain, and degenerative changes in pancreatic islets. The mortality rate and hemato-biochemical and histopathological changes were restored by the combined treatment of polymyxin B and honey.

Conclusion

LPS has detrimental effects on survival rate and hemato-biochemistry, which are lessened by taking honey and polymyxin B supplements.

Natural products for managing metabolic syndrome: a scoping review

Introduction

Metabolic syndrome comprises a collection of metabolic disorders stemming from factors like genetic predisposition, inadequate nutrition, stress, decreased physical activity, aging, and ethnicity. Although traditional pharmaceutical treatments exist for metabolic syndrome, their limited popularity is attributed to high costs and adverse effects. Consequently, natural products with fewer side effects have been explored for managing this condition. This literature review aims to explore the role of natural products including herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements in managing metabolic syndrome.

Methods

This scoping review was conducted in five steps, involving the formulation of a research question, the retrieval and extraction of relevant studies, the selection of pertinent studies, the organization of information into tables, and the reporting of results. Data was collected from various databases including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science, with a focus on studies published from 2010 to the present, available in English and with full-text accessibility.

Results

We identified 1,259 articles, screened their titles, abstracts, and full texts, ultimately incorporating 169 pertinent articles into this review (comprising 90 review articles, 32 trial articles, 6 in vitro articles, 38 in vivo articles, 1 experimental article and 2 observational articles). The study's outcomes revealed that natural products, encompassing plants and their derivatives, vitamins and supplements, as well as probiotics, can exert a beneficial influence on metabolic syndrome by regulating blood sugar, blood pressure, lipid profiles, obesity, and abnormal cholesterol and triglyceride levels.

Conclusion

The current study underscores the significance of natural products in addressing metabolic syndrome. Consequently, it is advisable to conduct further extensive research to assess the efficacy of these products, potentially integrating them into treatment regimens for individuals with metabolic syndrome.

Natural products for managing metabolic syndrome: a scoping review

Introduction

Metabolic syndrome comprises a collection of metabolic disorders stemming from factors like genetic predisposition, inadequate nutrition, stress, decreased physical activity, aging, and ethnicity. Although traditional pharmaceutical treatments exist for metabolic syndrome, their limited popularity is attributed to high costs and adverse effects. Consequently, natural products with fewer side effects have been explored for managing this condition. This literature review aims to explore the role of natural products including herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements in managing metabolic syndrome.

Methods

This scoping review was conducted in five steps, involving the formulation of a research question, the retrieval and extraction of relevant studies, the selection of pertinent studies, the organization of information into tables, and the reporting of results. Data was collected from various databases including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science, with a focus on studies published from 2010 to the present, available in English and with full-text accessibility.

Results

We identified 1,259 articles, screened their titles, abstracts, and full texts, ultimately incorporating 169 pertinent articles into this review (comprising 90 review articles, 32 trial articles, 6 in vitro articles, 38 in vivo articles, 1 experimental article and 2 observational articles). The study’s outcomes revealed that natural products, encompassing plants and their derivatives, vitamins and supplements, as well as probiotics, can exert a beneficial influence on metabolic syndrome by regulating blood sugar, blood pressure, lipid profiles, obesity, and abnormal cholesterol and triglyceride levels.

Conclusion

The current study underscores the significance of natural products in addressing metabolic syndrome. Consequently, it is advisable to conduct further extensive research to assess the efficacy of these products, potentially integrating them into treatment regimens for individuals with metabolic syndrome.

Composition, functional properties and safety of honey: a review

Honey has been used not only as a food source but also for medicinal purposes. Recent studies have indicated that honey exhibits antioxidant, hepatoprotective, hypolipidemic, hypoglycemic and anti-obesity properties, as well as anticancer, anti-atherosclerotic, hypotensive, neuroprotective and immunomodulatory activities. These health benefits of honey could be attributed to its wide range of nutritional components, including polysaccharides and polyphenols, which have been proven to possess various beneficial properties. It is notable that the composition of honey can also be affected by nectar, season, geography and storage condition. Moreover, the safety of honey requires caution to avoid any potential safety incidents. Therefore, this review aims to provide recent research regarding the chemical composition, biological activities and safety of honey, which might be attributed to comprehensive utilization of honey. © 2023 Society of Chemical Industry.

Chemical Characterization of Honey and Its Effect (Alone as well as with Synthesized Silver Nanoparticles) on Microbial Pathogens' and Human Cancer Cell Lines' Growth

The antibacterial, anticancer, and wound-healing effects of honey can vary according to the type, geographical region, honey bee species, and source of the flowers. Nanotechnology is an innovative and emerging field of science with an enormous potential role in medical, cosmetics, and industrial usages globally. Metal nanoparticles that derived from silver and range between 1 nm and 100 nm in size are called silver nanoparticles (AgNPs). Much advanced research AgNPs has been conducted due to their potential antibacterial and anticancer activity, chemical stability, and ease of synthesis. The purpose of the present study was to explore the physicochemical properties of honey and the potential to use forest honey to synthesize AgNPs as well as to appraise the nanoparticles' antimicrobial and anticancer effects. Here, we used three different percentages of forest honey (20%, 40%, and 80%) as biogenic mediators to synthesize AgNPs at room temperature. The development of AgNPs was confirmed by color change (to the naked eye) and ultraviolet-visible spectroscopy studies, respectively. The absorbance peak obtained between 464 to 4720 nm validated both the surface plasmon resonance (SPR) band and the formation of AgNPs. Regarding the sugar profile, the contents of maltose and glucose were lower than the content of fructose. In addition, the results showed that the SPR band of AgNPs increased as the percentage of forest honey increased due to the elevation of the concentration of the bio-reducing agent. A bacterial growth kinetic assay indicated the strong antibacterial efficacy of honey with silver nanoparticles against each tested bacterial strain. Honey with nanotherapy was the most effective against hepatocellular carcinoma (HepG2) and colon cancer (HCT 116) cells, with IC₅₀s of 23.9 and 27.4 µg/mL, respectively, while being less effective against breast adenocarcinoma cells (MCF-7), with an IC₅₀ of 32.5 µg/mL.

Honey polyphenols: regulators of human microbiota and health

A comprehensive review of research over the last decade was conducted to carry out this work. The main objective of this work is to present relevant evidence of the effect of honey intake on the human intestinal microbiota and its relationship with the improvement of various chronic diseases, such as cirrhosis, metabolic syndrome, diabetes, and obesity, among others. Therefore, this work focuses on the health-improving honey dietary supplementation implications associated with specific changes in the human microbiota and their biochemical mechanisms to enhance the proliferation of beneficial microorganisms and the inhibition of pathogenic microorganisms. Consumption of honey polyphenols significantly improves people's health conditions, especially in patients with chronic disease. Hence, honey intake unequivocally constitutes an alternative way to enhance health and could be used to prevent some relevant chronic diseases.

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

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.

Comparable Benefits of Stingless Bee Honey and Caffeic Acid in Mitigating the Negative Effects of Metabolic Syndrome on the Brain

There is mounting evidence that metabolic syndrome (MetS) contributes to the development of neurodegenerative disorders such as Alzheimer’s disease. Honey, which has been used for generations, is high in antioxidants and has been demonstrated to benefit the brain and mental health by reducing oxidative stress and boosting cognitive outcomes. Honey from the stingless bees of Heterotrigona itama has been found to have higher phenolic content compared to other types of honeys. The aim of this study is to investigate the effects of stingless bee honey (SBH) supplementation and to compare it with a pure form of antioxidant, caffeic acid (CA), on MetS parameters and inflammatory markers in the brains of MetS-induced rats. A total of 32 male Wistar rats were divided equally into groups of control, high-carbohydrate high-fructose (HCHF) diet (MetS), HCHF + SBH supplemented (1 g/kg) (SBH), and HCHF + CA supplemented (10 mg/kg) (CA) groups. The total duration for SBH and CA supplementation was eight weeks. The HCHF diet was found to promote hypertension, hyperglycemia, and hypertriglyceridemia, and to increase brain TNF-α levels. Supplementation with SBH and CA significantly reversed (p < 0.05) the hyperglycemic and hypertensive effects of the HCHF diet. Although both supplemented groups showed no significant changes to serum HDL or TG, SBH significantly reduced (p < 0.05) brain TNF-α levels and increased (p < 0.05) brain BDNF levels. Immunohistochemistry investigations of neurogenesis (EdU) and apoptosis (TUNEL) on the cornu Ammonis 1 (CA1) and dentate gyrus (DG) areas of the hippocampus showed no changes with SBH and CA supplementation compared to the control. These findings suggest that SBH and CA have the potential to mitigate HCHF-induced MetS effects and possess neuroprotective abilities.

Inhibitory effect of selected Indian honey on colon cancer cell growth by inducing apoptosis and targeting the β-catenin/Wnt pathway

Colon cancer is the most prevalent cause of death from cancer across the globe. Although chemotherapy drugs are predominantly used, their toxicity always remains a cause of concern. As an alternative to synthetic drugs, natural compounds or nutraceuticals are comparatively less toxic. Honey is widely used across different cultures as an alternative form of medicine. It represents a prominent source of plant-phenolic compounds and there is demonstrable evidence of its anti-oxidant and anti-microbial activities. The aim of the present work was to investigate the anti-proliferative effect of some Indian honeys and analyze their mechanism of action in colon cancer. In order to establish the composition-activity relationship, we evaluated the bioactive components present in selected honey samples by GC-MS and HPLC analysis. Indian honey samples showed a significant inhibitory impact on cell growth by restricting cell proliferation, causing apoptosis, and restricting the cell cycle in the G₂/M phase specifically for colon cancer cells. The apoptotic activities, as imparted by the honey samples, were established by Annexin V/PI staining, real-time PCR, and immunoblot analyses. The treated cells showed increased expressions of p53 and caspases 3, 8, and 9, thus indicating the involvement of both extrinsic and intrinsic apoptotic pathways. The honey samples were also found to inhibit the β-catenin/Wnt pathway. In the next phase of the study, the efficacy of these honey samples was evaluated in colon carcinoma induced SD-rats. Overall, these findings demonstrated that selected Indian honeys could be established as effective nutraceuticals for the prevention as well as cure of colon cancer.

Chemical Composition Analysis and Antioxidant Activity of Coffea robusta Monofloral Honeys from Vietnam

Monofloral honey samples (Coffea robusta) from Vietnam were determined for their chemical compositions. This is the first report on the chemical composition and antioxidant activity of coffee honey from Vietnam. These samples were characterized by their high contents of total and reducing sugars, total phenolic contents, and total flavonoid contents. The contents of seven phenolic acids (PAs) were quantified by high performance liquid chromatography (HPLC) and analyzed with the assistance of principle component analysis (PCA) to differentiate the honey samples into groups. The hydroxymethylfurfural (HMF) (0.048–2.933 mg/kg) and free acid contents (20.326–31.163 meq/kg) of coffee honey were lower in Nepal, which reflected the freshness of the honey when conducting this survey. The coffee honey had total sugar and reducing sugar contents 831.711 g/kg and 697.903 g/kg, respectively. The high level of total phenolic (0.642 mg GAE/g) and flavonoid (0.0341 mg GE/g) contents of coffee honey contributed to their antioxidant activity of this honey sample. Among the coffee honey tested, the IC₅₀ of DPPH radical-scavenging activities value was 1.134–17.031 mg/mL, while the IC₅₀ of ABTS radical-scavenging activities value was 115.381–213.769 mg/mL. The phenolic acids composition analysis displayed that gallic acid appeared in high concentrations in all studied honey samples, ranging from 0.037–1.015 mg/kg, and ferulic acid content ranged from 0.193 to 0.276 mg/kg. The content of trigonelline and caffeine in coffee honey samples ranged from 0.314–2.399 mg/kg and 8.946–37.977 mg/kg. The data in this article highlight the relevance of coffee honey as a healthy substance.

Protective Effects of Honey-Processed Astragalus on Liver Injury and Gut Microbiota in Mice Induced by Chronic Alcohol Intake

Honey-processed Astragalus (HPA) is a mixture of Astragalus and honey, which is a processed product of Chinese medicine. It has the active ingredients of Astragalus and the unique effects of honey. However, the mechanism of HPA for improving alcoholic liver disease (ALD) is not clear. The purpose of this study is to explore the ameliorating effect and mechanism of HPA (4 and 8 g/kg bw) on alcoholic liver injury. Two doses of HPA were orally administered to alcohol-treated mice for four weeks. The results showed that HPA could effectively reduce triglycerides (TG) by 59% and free fat acid (FFA) and total cholesterol (TC) in serum and hepatic were reduced by least 25.9%. HPA could cause a decrease in serum low-density lipoprotein cholesterol (LDL-C) from 0.145 mM to 0.117 mM, and the serum high-density lipoprotein cholesterol (HDL-C) was increased. After alcohol-treated mice were supplemented with HPA, antioxidant markers (superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and Glutathione peroxidase (GSH-Px)), liver function index (alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP)), proinflammatory cytokines (tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β)), and liver tissue were all significantly improved. This is related to the fact that HPA can promote the expression of oxidative stress-related genes and inhibit the expression of inflammation-related genes. In addition, HPA could also regulate the disturbance of the intestinal microflora. In general, HPA could significantly improve the accumulation of serum and liver lipids caused by alcohol and the imbalance of intestinal flora in mice. It could also improve liver function, oxidative stress, and inflammation.

Non-Centrifugal Sugar (NCS) and Health: A Review on Functional Components and Health Benefits

Non-centrifugal sugar (NCS) is the scientific term the Food and Agriculture Organization (FAO) uses to define a solid product, produced by sugarcane juice evaporation, which is unrefined or minimally refined. NCS is referred to in various names globally, the most significant ones are whole cane sugar, panela (Latin America), jaggery (India) and kokuto (Japan). NCS contains minerals, bioactive compounds, flavonoids and phenolic acids, which have therapeutic potentials from time immemorial. Even though the bioactive property is dependent on the composition, which relies mainly on the agronomic conditions and production process, NCS possesses antioxidant and anti-inflammatory properties. Hence, substituting the consumption of refined sugar with NCS might be helpful in the control of chronic diseases generally connected to oxidative stress and inflammation. Experimental facts from in vitro and in vivo models have proven that NCS plays an essential role in weight management, maintaining insulin sensitivity and preventing neurodegenerative diseases. NCS has also shown hypoglycemic and hypolipidemic effects. This review aims to synopsize the recent literature pertaining to the benefits of NCS in human health. The NCS can be considered a nutraceutical and functional food. However, detailed and regulated studies are important to enhance the beneficial effects in human and animal interventions.

Ethnopharmacological Survey and Comparative Study of the Healing Activity of Moroccan Thyme Honey and Its Mixture with Selected Essential Oils on Two Types of Wounds on Albino Rabbits

Wound healing consists of several continuous phases involving various cells and chemical intermediates. As a rich source of nutrition elements, honey has proved to have potential benefits in the treatment of various diseases. The present study was designed to investigate the healing effect of a honey mixture with selected essential oils on chemical and thermal wound models in rabbits. Dressing mixtures of Thymus vulgaris honey with three essential oils (Origanum vulgare, Rosmarinus officinalis, and Thymus vulgaris) were prepared and applied daily in the treatment groups. These essential oils were rich in phytochemicals and had significant antibacterial activity against four selected ATCC bacterial strains. Madecasol ointment was used as a standard control. The healing effect of the mixtures was evaluated by measuring wound surface area and comparing healing time. The results showed that the healing rate in the treatment groups was significantly higher than that of the untreated group and standard group. The best healing effect for burns was seen in the mixture of honey and Thymus vulgaris essential oil, which had wound closure rates of 85.21% and 82.14% in thermal- and chemical-induced burns, respectively, and showed the shortest healing time (14 days) in comparison to other groups. Therefore, it can be concluded that honey mixtures have significant beneficial effects on skin wound healing and, thus, they may be used as a healing agent in different types of wounds in humans after specific clinical trials.

Kombucha tea from seagrapes (Caulerpa racemosa) potential as a functional anti-ageing food: in vitro and in vivo study

This study wants to investigate the effects of kombucha tea based on seagrapes on blood glucose levels, total cholesterol, and PGC-1α in Swiss albino mice that were given cholesterol- and fat-enriched diets (CFED). Anti-glycation, tyrosinase inhibitory, and α-glucosidase inhibitory activity were also determined. Forty male swiss webster albino mice weighing between 20 g–30 g were used for this study. Animals were distributed in random into 4 groups of 10 animals each; group A served as normal control (received standard dry pellet diet), group B were fed on CFED for 4 weeks, and groups C and D were fed on CFED and were administered 150 and 300 mg/kg of kombucha tea from seagrapes (Caulerpa racemosa) (p.o.). In vitro study show that the activity of anti-glycation, L-Tyrosine, L-Dopa, α-glucosidase, and α-amylase inhibition were 62.79 ± 0.78, 9.05 ± 0.16, 27.14 ± 1.62, 90.42 ± 0.77, and 80.44 ± 1.00, respectively. Group C has a better activity in increasing PGC-1-alpha serum in mice than group D (p < 0.05). There were no meaningful differences between group C and D in blood cholesterol and blood glucose reduction (p = 0.222), both groups have the same effect in lowering total cholesterol and blood glucose in mice. In conclusion, kombucha tea from seagrapes has potential as an anti-ageing functional food.

The Effect of Honey on Lipid Profiles: A Systematic Review and Meta-analysis of Controlled Clinical Trials

Honey is known not only as a natural food but also as complementary medicine. According to the controversial evidence about the effects of honey on blood lipids, this meta-analysis was performed to investigate the potential effects of honey on lipid profiles. Relevant studies were identified by searching PubMed, Web of Science (WOS), Scopus, EMBASE, and Cochrane databases. All human controlled clinical trials (either with a parallel or a crossover design) published in English that reported changes in serum lipid markers (Total Cholesterol (TC), Triglyceride (TG), Low Density Lipoprotein Cholesterol (LDL-C), High Density Lipoprotein Cholesterol (HDL-C), and LDL-C/HDL-C ratio) following honey consumption were considered. Standardized Mean Differences (SMDs) and their respective 95% Confidence Intervals (CIs) were calculated to assess the changes in lipid profiles following honey consumption by random effects model. Statistical heterogeneity, sensitivity analysis, publication bias, and quality of the included studies were assessed, as well. The meta-analysis of 23 trials showed that honey had no significant effects on TC, TG, LDL-C, HDL-C, and LDL-C/HDL-C ratio. Significant heterogeneity was seen among the studies for all the studied factors (I2 index > 50%). Subgroup analysis based on the lipid profile status, types of honey, and intervention duration revealed no significant effect on TC, TG, LDL-C, and HDL-C. Quality of the evidences varied form very low to moderate according to various parameters. In conclusion, honey consumption did not affect serum lipid profiles (TC, TG, LDL-C, HDL-C, and LDL-C/HDL-C ratio).

The Rediscovery of Honey for Skin Repair: Recent Advances in Mechanisms for Honey-Mediated Wound Healing and Scaffolded Application Techniques

Honey is a honey-bee product obtained mainly by the enzymatic processing of nectar from a variety of plants, which leads to the wide range of colours and flavours available on the market. These organoleptic and nutritional features are influenced by the chemical composition, which in turn depends on the botanical origin. Bioactive compounds account for honey beneficial activity in medical applications, which explains the extensive use of honey in ethno-pharmacology since antiquity, from cough remedies to dermatological treatments. Wound healing is one of the main therapeutic uses of honey, and various design options in pharmaceutical technology such as smart delivery systems and advanced dressings are currently being developed to potentiate honey’s valuable properties for better performance and improved final outcome. In this review, we will focus on the latest research that discloses crucial factors in determining what properties are most beneficial when considering honey as a medicinal product. We will present the most recent updates on the possible mechanisms responsible for the exceptional effects of this ageless therapeutical remedy on skin repair. Furthermore, the state-of-the-art in application techniques (incorporation into scaffolds as an alternative to direct administration) used to enhance honey-mediated wound-healing properties are explored.

Augmentation of the Female Reproductive System Using Honey: A Mini Systematic Review

Phytochemical contents of honey are presumed to be beneficial to the female reproductive system (FRS). However, the biological effects of honey supplementation (HS) in vivo on the FRS remain unclear. This review aims to investigate the current literature on the effects of HS on the FRS, particularly on the sex hormone profile and reproductive organs (uterus and vagina). A systematic literature search using Scopus, MEDLINE via Ovid and Cochrane Library databases was conducted. Records were screened and identified for preclinical and clinical studies addressing the effects of HS on the FRS. Data on populations, interventions, outcomes and methodological quality were extracted. Studies were synthesised using tables and written summaries. Of the 198 identified records, six fulfilled the inclusion criteria. All six records were used for data extraction: two experimental studies using rats as the model organism and four human clinical studies of honey on female reproductive health. HS elevated the progesterone levels, restrained body weight increase, prevented uterine and vaginal atrophies in ovariectomised rats, attenuated symptoms of candidiasis and improved oxidative status in patients. Current evidence shows that short-term HS following surgical or physiological menopause exerts an oestrogenic, antioxidant and anti-inflammatory effect on the FRS. However, insufficient long-term studies preclude any definitive conclusions.

A Scoping Review of the Evidence for the Medicinal Use of Natural Honey in Animals

Honey has a history of medicinal use that predates written records. In recent decades, there has been renewed interest in the use of honey in human medicine, particularly for the treatment of burns and other wounds. Several recent systematic reviews in the human literature have demonstrated the efficacy of honey in the treatment of a number of conditions, including burns, wounds and oral mucositis. The goal of this scoping review was to describe the nature and extent of the current body of evidence addressing the medicinal use of natural honey and/or its derivatives in animals. Although the focus of this review was the veterinary literature, all animal species except insects and humans were eligible, including animals used for biomedical research. Electronic databases searched were MEDLINE, CAB Abstracts, AGRICOLA, Web of Science Core Collection, and Web of Science SciELO Citation Index. A total of 397 articles reporting 436 primary research studies were included in this review. The majority of the articles were biomedical research articles (n = 350); fewer veterinary research articles were identified (n = 47). Apart from one systematic review, all biomedical studies were challenge trials. Most veterinary studies were case reports/series (n = 23), followed by challenge trials (n = 18) and controlled trials (n = 8). The animal species examined within veterinary articles consisted primarily of dogs, horses, cats and cattle, whereas the majority of biomedical research articles examined rats and mice. Wound healing was the most common indication examined; other indications examined included the prevention or treatment of gastric ulcers, bacterial and parasitic infections, toxic exposures, metabolic conditions (e.g., diabetes) and neoplasia. The majority of interventions consisted of non-medical grade honey (n = 412/436), followed by medical-grade honey (n = 29/436) and derivatives of natural honey (n = 9/436). With much of the current veterinary literature consisting of case reports and case series, high-quality primary veterinary research in the form of controlled trials or challenge trials is needed to advance this field, as well as to provide sound data for evidence-based assessments of the efficacy of honey in clinical veterinary practise.

Feeding pattern, biochemical, anthropometric and histological effects of prolonged ad libitum access to sucrose, honey and glucose-fructose solutions in Wistar rats

BACKGROUND/OBJECTIVES

The exposure to sucrose in rats has mimic abnormalities attributed to metabolic syndrome (MetS). The effects of honey bee and "free" glucose and fructose, have not been explored in this context. The aim was to expose Wistar rodents to sucrose solution (SS), honey solution (HS) and fructose/glucose solution (GFS) at 30% to assess their effects.

SUBJECTS/METHODS

HS (n = 10), SS (n = 10) and GFS (n = 10) groups were formed. Solutions were ad libitum along 14-weeks.

RESULTS

Between solutions consumptions, honey was significantly 42% higher (P = 0.000), while similar consumption was observed among GFS and SS. The feeding pattern of HS consumption was irregular along experiment; while the food intake pattern showed the similar trend among groups along time. Non statistical differences were obtained in any biochemical and anthropometric measure, however, a higher concentration of leptin (721 ± 507 pg/mL), lower concentration of total cholesterol (TC; 48.87 ± 2.41 mg/100 mL), very low density lipoprotein (VLDL; 16.47 ± 6.55 mg/100 mL) and triglycerides (82.37 ± 32.77 mg/100 mL) was obtained in SS group. For anthropometric values, HS showed less total adipose tissue (AT; average 26 vs. 31-33 g) and adiposity index (average 6.11 vs. 7.6). Due to sugar-sweetened beverages consumption increases the risk for the development of chronic diseases; correlations between fluid intake and anthropometric and biochemical parameters were assessed. A moderate correlation was obtained in groups with the weight of total AT and solution intake; for the weight gain in GFS group and for triglycerides in HS and GFS. The highest hepatic tissue damage was observed in SS group with multiple intracytoplasmic vacuoles, atypia changes, moderate pleomorphism and hepatocellular necrosis.

CONCLUSIONS

In spite of the significantly higher consumption of HS, biochemical, anthropometrical and histological effects were not remarkably different in comparision to other sweeteners.

Association between consumption frequency of honey and non-alcoholic fatty liver disease: results from a cross-sectional analysis based on the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Recent evidence has suggested the protective effects of honey consumption against the metabolic syndrome, but the association between honey intake and NAFLD is still unclear. We investigated how the consumption frequency of honey was associated with NAFLD in the general population. This was a cross-sectional study of 21 979 adults aged 20-90 years. NAFLD was diagnosed based on the ultrasound-diagnosed fatty liver without significant alcohol intake and other liver diseases. Diet information, including consumption frequency of honey, was assessed by a validated 100-item FFQ. OR with 95 % CI were calculated by the binary logistic regression model, adjusting for confounding factors identified by the directed acyclic graph. Overall, 6513 adults (29·6 %) had NAFLD. Compared with participants consuming ≤1 time/week of honey, the multivariable OR of NAFLD were 0·86 (95 % CI 0·77, 0·97) for 2-6 times/week and 1·10 (95 % CI 0·95, 1·27) for ≥1 times/d (Pfor trend = 0·90). The results were generally similar in subgroups of BMI at a cut-point of 24·0 kg/m2 (Pfor interaction = 0·10). In this large-scale study, consuming honey 2-6 times/week was inversely associated with NAFLD, whereas consuming honey ≥1 times/d had no association with NAFLD. These results need replication in other large-scale prospective studies.

Association of Major Food Sources of Fructose-Containing Sugars With Incident Metabolic Syndrome: A Systematic Review and Meta-analysis

IMPORTANCE

Sugar-sweetened beverages (SSBs) are associated with increased risk of metabolic syndrome (MetS). However, the role of other important food sources of fructose-containing sugars in the development of MetS remains unclear.

OBJECTIVE

To examine the association of major food sources of fructose-containing sugars with incident MetS.

DATA SOURCES

MEDLINE, Embase, and Cochrane Library were searched from database inception to March 24, 2020, in addition to manual searches of reference lists from included studies using the following search terms: sugar-sweetened beverages, fruit drink, yogurt, metabolic syndrome, and prospective study.

STUDY SELECTION

Inclusion criteria included prospective cohort studies of 1 year or longer that investigated the association of important food sources of fructose-containing sugars with incident MetS in participants free of MetS at the start of the study.

DATA EXTRACTION AND SYNTHESIS

Study quality was assessed using the Newcastle-Ottawa Scale. Extreme quantile risk estimates for each food source with MetS incidence were pooled using a random-effects meta-analysis. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). Dose-response analyses were performed using a 1-stage linear mixed-effects model. The certainty of the evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Results were reported according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines.

MAIN OUTCOMES AND MEASURES

Pooled risk ratio (RR) of incident MetS (pairwise and dose response).

RESULTS

Thirteen prospective cohort studies (49 591 participants [median age, 51 years; range, 6-90 years]; 14 205 with MetS) that assessed 8 fructose-containing foods and MetS were included. An adverse linear dose-response association for SSBs (RR for 355 mL/d, 1.14; 95% CI, 1.05-1.23) and an L-shaped protective dose-response association for yogurt (RR for 85 g/d, 0.66; 95% CI, 0.58-0.76) and fruit (RR for 80 g/d, 0.82; 95% CI, 0.78-0.86) was found. Fruit juices (mixed and 100%) had a U-shaped dose-response association with protection at moderate doses (mixed fruit juice: RR for 125 mL/d, 0.58; 95% CI, 0.42-0.79; 100% fruit juice: RR for 125 mL/d, 0.77; 95% CI, 0.61-0.97). Honey, ice cream, and confectionary had no association with MetS incidence. The certainty of the evidence was moderate for SSBs, yogurt, fruit, mixed fruit juice, and 100% fruit juice and very low for all other food sources.

CONCLUSIONS AND RELEVANCE

The findings of this meta-analysis suggest that the adverse association of SSBs with MetS does not extend to other food sources of fructose-containing sugars, with a protective association for yogurt and fruit throughout the dose range and for 100% fruit juice and mixed fruit juices at moderate doses. Therefore, current policies and guidelines on the need to limit sources of free sugars may need to be reexamined.

Honey and obesity-related dysfunctions: a summary on health benefits

Honey is a natural product, containing flavonoids and phenolic acids, appreciated for its therapeutic abilities since ancient times. Although the bioactive potential is linked to the composition, that is variable depending on mainly the botanical origin, honey has antioxidant and anti-inflammatory properties. Therefore, honey, administered alone or in combination with conventional therapy, might result useful in the management of chronic diseases that are commonly associated with oxidative stress and inflammation state. Obesity is a metabolic disorder characterized by visceral adiposity. The adipose tissue becomes hypertrophic and undergoes hyperplasia, resulting in a hypoxic environment, oxidative stress and production of pro-inflammatory mediators that can be responsible for other disorders, such as metabolic syndrome and neurodegeneration. Experimental evidence from animals have shown that honey improves glycemic control and lipid profile with consequent protection from endothelial dysfunction and neurodegeneration. The purpose of the present review is to summarize the current literature concerning the beneficial effects of honey in the management of the obesity-related dysfunctions, including neurodegeneration. Based on the key constituents of honey, the paper also highlights polyphenols to be potentially responsible for the health benefits of honey. Further well-designed and controlled studies are necessary to validate these benefits in humans.

Antimicrobial activity of honey in periodontal disease: a systematic review

BACKGROUND

Honey has shown positive antimicrobial and anti-inflammatory actions in several dermatological studies; however, it is unclear if it could be effective in the treatment of periodontal disease.

OBJECTIVES

To answer the question: Does honey have antimicrobial activity against periodontopathogens?

METHODS

Six electronic databases were screened from initiation to 31 January 2019 for randomized clinical trials (RCTs) and controlled in vitro studies exploring the antimicrobial effect of honey against periodontopathogens. Honey's botanical origin, periopathogens that showed microbial susceptibility to honey, MICs, microbial growth conditions, control product and clinical follow-up were the main investigated outcomes. The risk of bias (RoB) of included RCTs was assessed using the Cochrane Collaboration RoB tool. The RoB of in vitro studies was evaluated based on the Sarkis-Onofre judgement model adapted to the context of honey.

RESULTS

A total of 1448 publications were found as search results in the screened databases. Sixteen eligible papers were included based on predetermined inclusion criteria. Retained studies included 5 RCTs and 11 in vitro controlled trials. Manuka and multifloral honeys were the most studied varieties. The tested honeys showed a significant antimicrobial action, with different MICs, against eight periopathogens. Four of the five RCTs showed a high RoB, while 4 of the 11 retained in vitro studies showed a medium RoB.

CONCLUSIONS

Honey showed a significant antimicrobial activity against all targeted periopathogens. Additional experiments are required to explore the entire antimicrobial spectrum of honey towards all pathogens involved in periodontal disease.

Front-Face Fluorescence of Honey of Different Botanic Origin: A Case Study from Tuscany (Italy)

Honey is a natural pure food produced by honeybees from the nectar of various plants, and its chemical composition includes carbohydrates, water, and some minor compounds, which are very important for honey quality and authentication. Most of honey’s minor components are related to the botanic origin, climate, and geographic diversity. In this work, we report an original case study on monofloral honey samples of twelve different botanic origins produced in Tuscany (Italy) based on the ‘semi-quantitative’ analysis of emission, excitation, and synchronous front-face fluorescence spectra. This is the first front-face fluorescence study of Italian honey samples and, to our knowledge, the first fluorescence investigation of honey from inula (Inula viscosa (L.) Aiton), marruca (Paliurus spina-christi Mill.), lavender (Lavandula L. 1753), sulla (Hedysarum coronarium L.), arbutus (or strawberry tree) (Arbutus unedo L., 1753), and alfalfa (Medicago sativa L.) plants. Results obtained from fluorescence spectroscopy are discussed in terms of characteristic spectral emission profiles typical of honey of different botanic origins. Moreover, the spectral analysis based on the decomposition of the front-face fluorescence (FFF) spectra in terms of single main fluorophores’ components is here proposed to identify several minor compounds, such as amino acids, phenolic acids, vitamins, and other fluorescent bioactive molecules.

Honey consumption is inversely associated with prediabetes among Chinese adults: results from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) Cohort Study

Evidence has suggested that honey intake has a beneficial impact on glycaemic control in patients with type 2 diabetes. Whether these findings apply to adults with prediabetes is yet unclear. The aim of the present study was to examine whether honey intake is associated with a lower prevalence of prediabetes. A cross-sectional study was performed in 18 281 participants (mean age 39·6 (sd 11·1) years; men, 51·5 %). Dietary intake was assessed through a validated 100-item FFQ. Prediabetes was defined according to the American Diabetes Association criteria: impaired fasting glucose, impaired glucose tolerance or raised glycosylated Hb. Multivariable logistic regression models were used to estimate the association between honey consumption and prediabetes. As compared with those who almost never consumed honey, the multivariable OR of prediabetes were 0·94 (95 % CI 0·86, 1·02) for ≤3 times/week, 0·77 (95 % CI 0·63, 0·94) for 4-6 times/week and 0·85 (95 % CI 0·73, 0·99) for ≥1 time/d (Pfor trend < 0·01). These associations did not differ substantially in sensitivity analysis. Higher honey consumption was associated with a decreased prevalence of prediabetes. More large prospective cohort studies are needed to investigate this association.

Upper Respiratory Tract Infection-Associated Acute Cough and the Urge to Cough: New Insights for Clinical Practice

Upper respiratory tract infection (URTI)-associated acute cough is the most common symptom both in children and adults worldwide and causes economic and social problems with significant implications for the patient, the patient's family, and the health care system. New pathogenic mechanisms in acute cough, including the urge to cough (UTC) mechanisms, have been recently identified. The brainstem neural network, pharyngeal sensory innervation, airway mechanical stimulation, inflammatory mediators, and postnasal drip actively participate in the onset and maintenance of acute cough and the urge to cough phenomenon. However, there is still no effective pharmacological treatment capable of interfering with the pathophysiologic mechanisms involved in URTI-associated acute cough. Moreover, severe adverse events frequently occur in administering such cough medications, mainly in children. New evidence has been provided concerning polysaccharides, resins, and honey as potential cough relievers with high antitussive efficiency, effect on the UTC, and minimal side effects.

Antioxidant, hypoglycemic, and hepatoprotective effect of aqueous and ethyl acetate extract of carob honey in streptozotocin-induced diabetic rats

Aim:

The aim of the study included the effect of aqueous extract (AE) and ethyl acetate extract (EAE) on blood sugar in diabetic rats and their effects on liver enzymes and lipid panel in control and diabetic rats. Furthermore, the antioxidant activity of the EAE was studied in vitro and compared with AE.

Materials and Methods:

Sugar and antioxidant content of AE and EAE were determined. In vitro antioxidant activity of AE and EAE was estimated by 2, 2-diphenyl-1-picrylhydrazyl and ABTS*+ radical scavenging assay, ferric-reducing antioxidant power assay, and total antioxidant assay. To study the effect of the extracts on blood glucose level (BGL), lipid profile, and liver function in non-diabetic and diabetic rats, five groups of six rats each were treated with distilled water, AE, EAE, glibenclamide (GLB), and sucrose for 8 days. Plasma glucose level (PGL), total cholesterol (TC), triglycerides (TG), transaminases (alanine transaminase [ALT] and aspartate transaminase [AST]), and alkaline phosphatase (ALP) were determined. The effect of the interventions on BGL after acute administration also was investigated. Diabetes was induced by streptozotocin injection.

Results:

EAE contains significantly lower content of fructose and glucose than AE (p<0.05), and it has no sucrose. AE and EAE exhibited a significant antioxidant activity and high antioxidant content; the antioxidant content was higher in AE than EAE (p<0.05). In diabetic rats, acute treatment by AE increased PGL, while EAE significantly lowered BGL as compared to the untreated diabetic rats. Both interventions significantly decreased BGL as compared to the sucrose treated group in diabetic rats (p<0.05). EAE was more potent than GLB. Sucrose caused 13% increment in BGL after 8 days of induction of diabetes, while AE caused only 1.3% increment. Daily treatment by EAE decreased significantly AST, ALT, ALP, and TC. EAE decreased significantly TC and TG level in diabetic rats in comparison to the untreated diabetic group.

Conclusion:

The study showed for the 1^st time that EAE has more hypoglycemic effect than AE, and both extracts prevent the increment in BGL on day 8 after induction of diabetes observed in the control and sucrose treated group. EAE significantly ameliorated the lipid and liver function disorders induced by diabetes.

Honey and Its Phenolic Compounds as an Effective Natural Medicine for Cardiovascular Diseases in Humans?

Honey is a sweet, viscous syrup produced by the honey bee (Apis mellifera). It is probably the first natural sweetener ever discovered, and is currently used as a nutritious food supplement and medicinal agent. The aim of the present mini-review is to summarize and update the current knowledge regarding the role of honey in CVDs based on various experimental models. It also describes the role of its phenolic compounds in treating CVDs. Many such phenolic and flavonoid compounds, including quercetin, kaempferol, apigenin, and caffeic acid, have antioxidant and anti-platelet potential, and hence may ameliorate cardiovascular diseases (CVDs) through various mechanisms, such as by decreasing oxidative stress and inhibiting blood platelet activation. However, as the phenolic content of a particular type of honey is not always known, it can be difficult to determine whether any observed effects on the human cardiovascular system may be associated with the consumption of honey or its constituents. Therefore, further experiments in this area are needed.

The Beneficial Effects of Stingless Bee Honey from Heterotrigona itama against Metabolic Changes in Rats Fed with High-Carbohydrate and High-Fat Diet

Metabolic syndrome (MetS) is a group of conditions including central obesity, hyperglycemia, dyslipidemia, and hypertension that increases the risk for cardiometabolic diseases. Kelulut honey (KH) produced by stingless honey bees has stronger antioxidant properties compared to other honey types and may be a functional food against MetS. This study aimed to determine the efficacy of KH in preventing metabolic changes in rats with MetS induced by high-carbohydrate and high-fat (HCHF) diet. Male Wistar rats were randomly assigned to the control (C), HCHF diet-induced MetS (S), and MetS supplemented with KH (K) groups. The K group was given KH (1 g/kg/day) for eight weeks. Compared to the control, the S group had significant higher omental fat mass, serum triglyceride, systolic blood pressure, diastolic blood pressures, adipocyte area, and adipocyte perimeter (p < 0.05). KH supplementation significantly prevented these MetS-induced changes at week 16 (p < 0.05). Several compounds, including 4-hydroxyphenyl acetic acid, coumaric and caffeic acids, had been detected via liquid chromatography-mass spectrometry analysis that might contribute to the reversal of these changes. The beneficial effects of KH against MetS-induced rats provide the basis for future KH research to investigate its potential use in humans and its molecular mechanisms in alleviating the disease.

The effect of different types of honey on the lipid profile of streptozotocin-induced diabetic rats

INTRODUCTION

The effect of honey consumption in diabetic patients has been contradictory. The aim of the present animal study was to compare the effect of different types of honey on the lipid profile in diabetic rats.

MATERIAL AND METHODS

Sixty-four male Wistar rats were divided into two main groups: a streptozotocin-induced diabetes mellitus (DM) group (including four subgroups) and a healthy group (including four subgroups), based on random allocation. Three subgroups of each main group were given 1 mg/kg of three different types of honey (acacia, astragalus, and artificial honey) by oral gavage for 10 weeks. The control groups were given distilled water. Blood samples were collected, and the lipid profile was measured and compared between the eight groups after the intervention.

RESULTS

The levels of LDL, triglycerides (TG), and total cholesterol (Tchol) in DM rats treated with astragalus honey were significantly lower and the HDL level was significantly higher compared to the other DM and healthy groups (all p-values < 0.05). LDL, TG, and Tchol levels in DM rats treated with artificial honey were significantly higher, and HDL levels were significantly lower than for other types of honey and for the control groups (all p-values < 0.05). LDL, HDL, TG, and Tchol levels in healthy rats were not significantly different between the groups (p-value > 0.05).

CONCLUSIONS

Different types of honey (acacia, astragalus, and artificial honey) had various effects on serum lipid profiles in diabetic rats. The results of this study indicated that the effect of honey on diabetic patients can vary widely based on its source.

Efficacy of traditional Chinese medication Tangminling pill in Chinese patients with type 2 diabetes

The morbidity of type 2 diabetes mellitus (T2DM) has been increasing rapidly worldwide. Tangminling pill, consisting of ten Chinese herbal medications, is usually prescribed for T2DM in mainland China. Whether treatment with Tangminling can improve clinical outcomes of T2DM patients was still debated. Four studies comparing Tangminling vs. placebo treatment in T2DM patients were included and 767 T2DM patients were enrolled in our analyses. Tangminling treatment exhibited better efficacy than placebo in reducing hemoglobin A1c (HbA1c) (1.11 vs. 0.32%; pooled weighted mean difference [WMD]: 0.80; 95% confidence interval [CI]: 0.65–0.96; P<0.001), fasting plasma glucose (0.82 vs. −0.40 mM; WMD: 1.10; 95% CI: 0.56–1.64; P<0.001), 2-h postprandial glucose (2-hr PG) (2.81 vs. 1.11 mM; WMD: 1.80; 95% CI: 1.72–1.88; P<0.001), homeostatic model assessment-β level (4.28 vs. 0.41; WMD: 0.44; 95% CI: 0.27–0.61; P<0.001), waist circumference (WC) (1.04 vs. 0.36 cm; WMD: 0.78; 95% CI: 0.37–1.19; P<0.001) and body weight index (0.37 vs. 0.11 kg/m²; WMD: 0.30; 95% CI: −0.00 to 0.61; P=0.05). Tangminling pill might reduce glucose level and body weight and improve β-cell function in T2DM patients. Our study highlights the important role of Tangminling pill in the management of T2DM.

Wound Healing Properties of Selected Natural Products

Wound healing is a complex process of recovering the forms and functions of injured tissues. The process is tightly regulated by multiple growth factors and cytokines released at the wound site. Any alterations that disrupt the healing processes would worsen the tissue damage and prolong repair process. Various conditions may contribute to impaired wound healing, including infections, underlying diseases and medications. Numerous studies on the potential of natural products with anti-inflammatory, antioxidant, antibacterial and pro-collagen synthesis properties as wound healing agents have been performed. Their medicinal properties can be contributed by the content of bioactive phytochemical constituents such as alkaloids, essential oils, flavonoids, tannins, saponins, and phenolic compounds in the natural products. This review highlights the in vitro, in vivo and clinical studies on wound healing promotions by the selected natural products and the mechanisms involved.