High intake of added or free sugars has been shown to contribute to the rise in obesity, type 2 diabetes, and cardiovascular disease.1 Health and nutrition guidelines call for a reduction in consumption of added sugars, with health agencies recommending an intake of no more than 5% to 10% of total energy intake per day.2,3 Most regulatory agencies, including the World Health Organization, the Heart and Stroke Foundation, and the US Food and Drug Administration, include honey within their definition of free or added sugars.2–4 In contrast, honey is often regarded by the public as a healthier alternative to sugar, with the National Honey Board Consumer Attitudes and Usage Study of 2020 reporting that honey had surpassed white sugar as the preferred sweetener.5,6
Honey is a complex composition of sugars (common and rare), organic acids, enzymes, proteins, amino acids, minerals, vitamins, and bioactive substances made by honeybees from the nectar of flowers.7,8 It has shown many benefits for cardiometabolic health in in vitro, animal, and clinical trials. Among these benefits are improvements in body weight, inflammation, lipid profile, and glycemic control. However, the evidence for this effect in human studies has not been systematically evaluated and quantified.9,10 Furthermore, it is unclear whether the effect of honey differs by the type of honey, such as floral source, and whether honey is raw or processed. Therefore, a systematic review and meta-analysis of controlled trials was conducted to examine the effect of honey intake on adiposity, glycemia, lipids, blood pressure, markers of nonalcoholic fatty liver disease, and inflammatory markers and to assess the certainty of the evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.
Ahmed, A. et al. (2023)