Honey Research Update 2013
August 28, 2013
Jacob Schor ND, FABNO
The Jewish New Year, Rosh Hashanah, is near upon us. This year the holiday starts Wednesday evening, September 4th. One tradition we take part in as we celebrate this holiday is to eat slices of apple dipped in honey. It has over the last few years also become customary for me to take a few moments at this time and review new studies of interest that have been published in the scientific literature over the past twelve months.
This has become more challenging at the years have gone by as the number of new studies worthy of consideration has grown dramatically year after year. Thus I find myself limiting my online searches to clinical trials that are less than 12 months old.
Before discussing these new trials, there is an older article worth mentioning that was missed when it first came out.
In the November 7, 2011 issue of the magazine Food Safety News, Andrew Schneider reported on a research project that the magazine had conducted with Vaughn Bryant, a professor at Texas A&M University and one of the nation’s premier melissopalynologists, or investigators of pollen in honey. After examining hundreds of honey samples collected from retail stores across the country, Professor Bryant reported that three quarters of them were counterfeit. They no longer contained pollen. The FDA defines honey as still containing pollen. It has become common practice in certain countries to ultra-filter honey to remove the pollen and thus disguise the country of origin. Those of you interested in the details might find the original article interesting reading.
11-7-2011 Food Safety News: Vaughn Bryant: http://www.foodsafetynews.com/2011/11/tests-show-most-store-honey-isnt-honey/#.UhpGRGRARlw
Suffice to say, that honey that has undergone this sort of super-processing may have none of the nutritional or health benefits of real honey. The enzymes normally found in honey have been destroyed and the pollen removed. It is probably worth our effort and expense to buy local honey that we are assured has been minimally processed.
OK, so let’s look at articles of interest from the past twelve months.
Type 1 Diabetes and honey:
In January 2012, Abdulrhman et al reported on a randomized crossover trial in which twenty young Egyptian patients with type 1 diabetes mellitus (ages 4-18) consumed honey for three months at a dose of .5ml/kg body weight per day. For a 50 pound child that would be (25 kg x .5 ml/kg =12.5 ml/day ) about 2 ½ teaspoons of honey, a scant Tablespoon per day.
Taking honey like this resulted in significant decreases in subscapular skin fold thickness, fasting serum glucose, total cholesterol, serum triglycerides, and low-density lipoprotein, and significant increases in fasting C-peptide and 2-h postprandial C-peptide. They also reported long-term effects of honey after the experiment was over including, fasting serum glucose, 2-hour postprandial serum glucose, triglycerides and hemoglobin A1c.  Obviously this is not what many would have predicted though earlier animal studies have suggested this sort of effect might be possible. 
Honey versus zinc barrier cream for intertrigo.
Last Fall, Dutch researchers reported that honey is effective in treating intertrigo.
“Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. Intertrigo frequently is worsened or colonized by infection, which most commonly is candidal but also may be bacterial, fungal, or viral. Intertrigo commonly affects the axilla, perineum, inframammary creases, and abdominal folds…. Intertrigo is a common complication of obesity and diabetes.”
Nijhuis et al recruited 31 patients with symmetrical intertrigo in large skin folds and compared two topical treatments, either the standard treatment with zinc oxide ointment or a honey based cream. Patients were treated twice a day for three week. There was no significant difference in results, either treatment seemed worked equally well. However those patients who used the honey complained less about itchiness, about half as much. So while both treatments worked, patients were more comfortable using the honey. 
Also last fall, German authors reported on a case series of 36 patients with wound healing disorders in the head and neck area that they had treated with honey. They reported that treatment leads to fast healing without problems especially in poorly healing and infected wounds. Similar results have been reported in earlier years by other researchers so perhaps we shouldn’t be surprised.
Wound healing meta-analysis:
While on the topic of wound healing, last July’s issue of the journal Burns, published a meta-analysis of fifty-five earlier studies of honey and wound healing.
“… honey seems to be a dressing with wound healing stimulating properties. In burns there is also evidence for its antibacterial capacity. In general, honey is also been mentioned to have deodorizing, debridement, anti-inflammatory and wound pain reducing properties, although the evidence for these properties is rather limited.” 
Israelis doctors reported that honey syrups worked well to treat nighttime coughs in 300 children aged 1 to 5 years, with upper respiratory infections. The study compared three different types of honey against a cough syrup made from dates. All of the syrups proved to help reduce the coughing but the date syrup less than the honey syrups.
Aparna et al tested the antibacterial and anti-plaque action of a honey mouthwash against 0.2% chlorhexidine or a salt water solution. They first did a ‘test-tube trial’ to determine the minimum inhibitory concentration (MIC) that would completely inhibit the growth of six common oral bacteria. A double-masked parallel clinical trial was then conducted with sixty-six volunteers on plaque regrowth. Both the honey and the chlorhexidine mouth washes effectively inhibited plaque formation.
There are reports from several ‘test tube' experiments that are worthy of mention.
Honey triggers apoptosis in human leukemia cells. Three types of crude Spanish honey were found to trigger cell death in human leukemia cells and the higher the phenolic content of the honey, in particular the more variety of flowers from which the nectar was collected, the more effective. The cancer cell killing effect interestingly did not depend on reactive oxygen species generation and N-acetyl-L-cysteine (NAC) did not block the honey from triggering cancer cell death. 
We never know what effects that are seen in rat studies will be reproducible in humans but I suppose it’s worth mentioning that honey was reported to protect the fertility of male rats under stress  and also improve the memory of stressed menopausal female rats. 
On that encouraging note, let us wish all of you a Happy and Sweet New Year. May the sweet taste of honey remind you of the delights that either random evolution or a benevolent Creator have blessed us with.
Honey articles from past years:
Honey to treat wounds after cancer surgery:
Honey improves skin conditions: eczema and psoriasis
Honey increases antioxidant levels in blood
Honey and Herpes
Honey as Medicine and Baklava recipe Update: 2005
Honey Update 2006: wound Healing Sept 2006
Honey Update 2009: Sept 2009
Honey Update 2011 Sept 2011
Honey Update 2012 Sept 2012
1. ANDREW SCHNEIDER. Tests Show Most Store Honey Isn’t Honey
Ultra-filtering Removes Pollen, Hides Honey Origins.
Food Safety News NOVEMBER 7, 2011
2. Abdulrhman MM, El-Hefnawy MH, Aly RH, Shatla RH, Mamdouh RM, Mahmoud DM, Mohamed WS. Metabolic effects of honey in type 1 diabetes mellitus: a randomized crossover pilot study. J Med Food. 2013 Jan;16(1):66-72. doi: 10.1089/jmf.2012.0108. Epub 2012 Dec 20.
3. Erejuwa OO, Sulaiman SA, Wahab MS. Honey--a novel antidiabetic agent.
Int J Biol Sci. 2012;8(6):913-34. doi: 10.7150/ijbs.3697. Epub 2012 Jul 7.
5. Nijhuis WA, Houwing RH, Van der Zwet WC, Jansman FG. A randomised trial of honey barrier cream versus zinc oxide ointment. Br J Nurs. 2012 Nov 8-21;21(20):9-10, 12-3.
6. Knipping S, Grünewald B, Hirt R. [Medical honey in the treatment of wound-healing disorders in the head and neck area]. HNO. 2012 Sep;60(9):830-6. doi: 10.1007/s00106-012-2503-4.
[Article in German]
7. Vandamme L, Heyneman A, Hoeksema H, Verbelen J, Monstrey S. Honey in modern wound care: A systematic review. Burns. 2013 Jul 26. pii: S0305-4179(13)00197-6. doi: 10.1016/j.burns.2013.06.014.
8. Cohen HA, Rozen J, Kristal H, Laks Y, Berkovitch M, Uziel Y, Kozer E, Pomeranz A, Efrat H. Effect of honey on nocturnal cough and sleep quality: a double-blind, randomized, placebo-controlled study. Pediatrics. 2012 Sep;130(3):465-71. doi: 10.1542/peds.2011-3075. Epub 2012 Aug 6.
9. Aparna S, Srirangarajan S, Malgi V, Setlur KP, Shashidhar R, Setty S, Thakur S. A comparative evaluation of the antibacterial efficacy of honey in vitro and antiplaque efficacy in a 4-day plaque regrowth model in vivo: preliminary results. J Periodontol. 2012 Sep;83(9):1116-21. doi: 10.1902/jop.2012.110461.
10. Morales P, Haza AI. Antiproliferative and apoptotic effects of spanish honeys. Pharmacogn Mag. 2013 Jul;9(35):231-7. doi: 10.4103/0973-1296.113276.
Free PMC Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713579
11. Hemadi M, Saki G, Rajabzadeh A, Khodadadi A, Sarkaki A. The effects of honey and vitamin E administration on apoptosis in testes of rat exposed to noise stress. J Hum Reprod Sci. 2013 Jan;6(1):54-8. doi: 10.4103/0974-1208.112383.
Free PMC Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713579/
12. Al-Rahbi B, Zakaria R, Othman Z, Hassan A, Mohd Ismail ZI, Muthuraju S. Tualang honey supplement improves memory performance and hippocampal morphology in stressed ovariectomized rats. Acta Histochem. 2013 Jun 26. pii: S0065-1281(13)00103-7. doi: 10.1016/j.acthis.2013.05.004. [Epub ahead of print]