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Comprehensive Review on Honey: Biochemical and Medicinal Properties

March 2018

Authors:

Saranraj P.

Sacred Heart College

Sivasakthi S.

College of Agricultural Technology, Theni, Tamil Nadu, India

Honey has been extensively used as healing agent throughout the human history in addition to its widespread usage as popular food. Honey is a sweet substance produced as a food source mainly from the nectar and secretions of plants by honey bees. Honey is used to feed bees during the winter. For centuries, honey has been used as food and as natural medicine, being prescribed by physicians of many ancient cultures for the treatment of a wide variety of ailments. The honey has been used from ancient times as a method of accelerating wound healing, and the potential of honey to assist with wound healing has been demonstrated repeatedly. Honey is gaining acceptance as an agent for the treatment of ulcers, bed sores and other skin infections resulting from burns and wounds. The healing properties of honey can be ascribed to the fact that it offers antibacterial activity, maintains a moist wound environment that promotes healing and has a high viscosity which helps to provide a protective barrier to prevent infection. There are many reports of honey being very effective as dressing of wounds, burns, skin ulcers and inflammations; the antibacterial properties of honey speed up the growth of new tissue to heal the wounds. The honey has been shown to have in vivo activity and is suitable for the treatment of ulcers, infected wounds and burns. In this review we provide some of the biochemical and medicinal attributes of honey in detail.

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Journal of Academia and Industrial Research (JAIR)

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ISSN: 2278-5213

Comprehensive Review on Honey: Biochemical and Medicinal Properties

P. Saranraj1* and S. Sivasakthi2

1Department of Microbiology; Sacred Heart College (Autonomous), Tirupattur-635 601, Vellore District, Tamil Nadu, India

2Department of Microbiology, Shanmuga Industries Arts and Science College, Tiruvannamalai, Tamil Nadu, India

microsaranraj@gmail.com*; +91-9994146964

Abstract

Honey has been extensively used as healing agent throughout the human history in addition to its widespread

usage as popular food. Honey is a sweet substance produced as a food source mainly from the nectar and

secretions of plants by honey bees. Honey is used to feed bees during the winter. For centuries, honey has been

used as food and as natural medicine, being prescribed by physicians of many ancient cultures for the treatment

of a wide variety of ailments. The honey has been used from ancient times as a method of accelerating wound

healing, and the potential of honey to assist with wound healing has been demonstrated repeatedly. Honey is

gaining acceptance as an agent for the treatment of ulcers, bed sores and other skin infections resulting from

burns and wounds. The healing properties of honey can be ascribed to the fact that it offers antibacterial activity,

maintains a moist wound environment that promotes healing and has a high viscosity which helps to provide a

protective barrier to prevent infection. There are many reports of honey being very effective as dressing of

wounds, burns, skin ulcers and inflammations; the antibacterial properties of honey speed up the growth of new

tissue to heal the wounds. The honey has been shown to have in vivo activity and is suitable for the treatment of

ulcers, infected wounds and burns. In this review we provide some of the biochemical and medicinal attributes of

honey in detail.

Keywords: Honey, natural medicine, healing properties, antibacterial, biochemical, medicinal.

Introduction

Traditional medicinal system is the method of using various

natural products like seaweeds, plants and plant products

for treating various diseases caused by microorganisms.

The traditional medicinal system was used by the peoples in

the older days but the entry of antibiotics has stopped the

used of traditional medicines based treatment. The world

rotation takes the peoples again to the traditional medicinal

system due to the antibiotic resistance. The presence of

bioactive compounds in the natural products gives an

effective remedy against microbial diseases and prevents

the humans from the risk of various side effects. On that

line, the present study was designed to give the sweet

remedy for microbial diseases using the Honey. The honey is

an important part of traditional medicinal system which was

used from older days to present days by all categories of

peoples (Silva et al., 2006; Saranraj et al., 2016; Kalidasan

et al., 2017).

With bacterial resistance to traditional antibacterial agents

documented in both human and veterinary medicine, it has

become necessary to investigate alternatives to commercial

pharmaceuticals. Honey contains antibacterial compounds

that are effective in inhibiting or killing a broad spectrum of

bacteria (Bang et al., 2003; Mavric et al., 2008) and has been

investigated as an alternative to pharmaceutical wound

healing products in various parts of the world (Lotfy et al.,

2006; Visavadia et al., 2009). A broad spectrum of

antibacterial activity is valuable as many types of bacteria

can pose a problem in open wounds and can impede or

delay healing (Simon et al., 2009). Certain plants can confer

high antibacterial activity to the honey; however, there has

been very little evidence to support a Canadian honey

botanical source that is able to provide superior, broad

spectrum antibacterial activity to honey (Brudzynski, 2006).

Manuka honey, derived from the Leptospermum spp. plant

has been shown to be antibacterial at low concentrations

when compared with other types of honey (Molan, 2006).

For several decades, naturally sourced antimicrobial agents

have been investigated as replacements for current

pharmaceutical antimicrobials and biocides; this is

increasingly the case as bacteria continue to acquire

resistance to treatments (Visavadia et al., 2009). These

natural alternatives have been shown, in many cases, to

have greater or equal efficacy when compared with other

antimicrobials in tests against many species of bacteria and

against multidrug resistant bacteria (Blair et al., 2009).

Review

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While many products have been shown to possess some

antimicrobial activity, honey in particular appears to be a

clinically effective antimicrobial agent. The formal discovery

of the antibacterial activity in honey was made in 1892 by

Dutch Scientist Van Ketel (Mohapatra et al., 2011), who

demonstrated that honey was capable of ‘sterilizing’

wounds. In human medicine, honey has been effective in

treating burns, skin ulcers and other lesions (Lotfy et al.,

2006; Molan, 2006). A veterinary laboratory study using

rabbits demonstrated that raw honey applied to open

surgical wounds accelerated healing when compared to

controls. Veterinary and human medical reviews have also

highlighted the healing capabilities of honey in both human

and animal wounds (Mathews and Binnington, 2002; Simon

et al., 2009). Humans have known honey and plants for

many centuries and used them as sources for nutrients as

well as medicine. Today there is a growing body of literature

demonstrating the efficacy of honey in various health

aspects and particularly as a novel agent for wound

management. The potential effects of selected honeys for

the treatment of particular diseases has been known for

centuries as certain honeys were selected for the treatment

of particular ailments; however, it was not until recently

that the research has proved that certain honeys possess

unusual antimicrobial properties (Blair et al., 2009) and

hence have been the choice for wound management.

History of drug discovery

Throughout the ages humans have relied on nature as a

source of many traditional remedies and therapeutics. With

the earliest Egyptian records, dating from 2400BCE, it is

clear oils and plant material were utilized for their medicinal

properties (David et al., 2014). The Greeks and the Romans

also utilized nature as a source of drug discovery (Beutler,

2009), a tradition that has been upheld through to modern

medicine today as plants are the source of many

nutraceuticals and pharmaceuticals (Sumner et al., 2015).

At the beginning of the 19th century plants were thoroughly

studied to determine their therapeutic potential and during

the 1970s the ocean was also targeted as a source for

natural products (David et al., 2014). Nearly, 50% of the

currently marketed drugs approved from 1981 to 2010 are of

natural product origin (Newman and Cragg, 2012, Schmitt

et al., 2011). New drugs were predominantly discovered

through sheer luck, inherited knowledge or trial and error

up until rational drug design was developed. Drug design

starts with a hypothesis that a biological molecule may have

the potential to be used as a therapeutic. Bioactive

compounds have been traditionally characterized following

the fractionation and purification of extracts (Sumner et al.,

2015). In the mid-1990s large drug company utilized

fragment based molecular modeling and computational

chemistry technology to discover and produce synthetic

drugs (Erlanson, 2012).

The production and screening of synthetic compounds has

become more accessible due to the introduction of high

throughput screening methods (HTS) and modern advances

in synthetic chemistry and has led to a focus on laboratory

driven drug development (Cragg and Newman, 2013).

Combinatorial chemistry is a high throughput technique

which has been utilized for the discovery of novel

therapeutics. Points of diversity are assessed in an initial

starting compound or pharmacophore. Different constructs

can be created based on starting material and mathematical

models (Beutler, 2009). Huge libraries can be produced and

the molecular constructions can be analyzed for activity.

However disadvantages include limited yield, poor solubility

and low purity of the created compounds (Beutler, 2009).

The success rate of drug discovery has subsequently been

lower than originally expected (Newman and Cragg, 2007).

Natural product structures are not limited by the chemist's

imagination and are attractive for drug discovery due to the

evolution of novel bioactive secondary metabolites

(Beutler, 2009). However, the use of HTS and natural

products as leads for drug discovery has diminished in the

past two decades (Harvey et al., 2015). This trend has arisen

due to the complexity of identifying, extracting and

isolating new novel compounds from natural sources

(Beutler, 2009). The decline or leveling out of the discovery

of lead compounds by pharmaceutical companies has been

evident between 1981 and 2010 (Newman and Cragg, 2012).

However, natural products as a source of novel drugs

are re-emerging and pharmaceutical companies are

realizing that these sources need to be re-explored

and combined with diversity-orientated synthetic

methodologies (Newman and Cragg, 2012, David et al.,

2014). Due to the significant advances in our understanding

of natural product biosynthesis, with considerable

developments in approaches for natural-product isolation

and synthesis new paradigms and new enterprises have

recently evolved (Beutler, 2009). Transcriptomics,

proteomics and metabolomics studies have recently

uncovered new knowledge on biosynthesis of bioactive

molecules (Sumner et al., 2015, Harvey et al., 2015). The

production of artemisinic acid has been induced in the

tobacco plant Nicotiana benthamiana for the treatment of

malaria (Van Herpen et al., 2010). The enhanced sensitivity

of HTS technologies including high-performance liquid

chromatography (HPLC), mass spectrometry (MS) and

nuclear magnetic resonance (NMR) has advanced the ability

to elucidate chemical structures from natural products

(Eldridge et al., 2002; Harvey et al., 2015). With the

emergence of high throughput drug screening technologies

related to genetic information, new lines of research are

emerging to rapidly and effectively identify novel lead

compounds (Singh and Barrett, 2006, Cragg and Newman,

2013).

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A total of 25 natural product and natural product derivatives

drugs were approved for marketing from January 2008 to

December 2013, 10 of these are considered to be

semi-synthetic natural products and 10 were natural-

product derivatives (Butler et al., 2014). Surprisingly, less

than 10% of the earth’s biodiversity has been examined for

biological activity, many more useful natural therapeutics

may yet to be discovered (Harvey, 2000). By combining high

throughput technology with natural product screening,

nature will continue to play a vital role in the drug discovery

process.

Antimicrobial natural products

Microorganisms are common sources of novel drugs and

lead compounds, which are extensively used in modern

medicine (Davidson, 1995). The modern era of antimicrobial

therapy began in 1929, with Fleming's accidental discovery

of the bactericidal substance, penicillin (Fleming, 1929).

It was observed that the growth of a fungus, from the

Penicillium genus, had a bactericidal effect on neighboring

Staphylococcus sp. an observation which eventually resulted

in the production of many antibiotic derivatives of penicillin

(Bruggink et al., 1998). The discovery of penicillin prompted

increased interest in identifying novel classes of antibiotics

from natural products and up till 1962 nearly all new

antibiotics came from this source (Singh and Barrett, 2006).

Streptomyces is the largest antibiotic-producing genus of

bacteria, producing various antimicrobials including

Streptomycin and Chloramphenicol. Antifungals including

nystatin, have also been isolated from Streptomyces

noursei. These are a few of many natural products derived

from microorganisms. There is also a diverse array of

unexplored potential for microbial diversity; environmental

samples, extremeophiles, endophytes, marine microbes and

microbial symbionts are yet to be explored (Cragg

and Newman, 2013). Evolutionarily preserved antimicrobial

peptides (host defence peptides) are a diverse family of

cystein-rich cationic molecules which act against a range of

different microorganisms. Defensins are key elements of

the innate immune response and are produced upon

infection or injury to protect the host (Dossey, 2010).

Naturally occurring peptides from various biological sources

are utilised in modern medical therapeutics (Matsunaga

et al., 1985, Hopkins et al., 1994, Klaudiny et al., 2005).

Defensins kill bacteria by increasing the permeability of

their cytoplasmic membrane resulting in a reduction of

cellular cytoplasmic content (Nakajima et al., 2003).

Peptides have a broad antimicrobial spectrum and disrupt

microbial membranes via peptide–lipid interactions by

defensin oligomers. Cationic peptides interact with the

negative charge of the outer membrane, disruption occurs

and peptides can enter the cell.

Peptides can also aggregate into the membrane forming

barrel-like structures which span the membrane causing

disruption of cell death (Sahl et al., 2005). The inner

membrane is also depolarized, cytoplasmic ATP is reduced

and respiration is inhibited resulting in bacterial cell death.

Three antimicrobial peptides from the marine sponge

Discodermia kiiensis, discodermins models were among the

first peptide antibiotics to be discovered and were shown to

have antibacterial activity against a range of bacteria

including Pseudomonas aeruginosa, Escherichia coli, Bacillus

subtilis, and Mycobatcerium smegmatis. Antimicrobial insect

defensins are a large family of peptides commonly found in

the hemolymph or fat cells of several insect orders,

including honey bees (Ilyasov et al., 2012). Honey bees

produce antimicrobial defence peptides when responding

to an infection (Klaudiny et al., 2005). Four immune system

peptides have been isolated from honey bees; apidaecin,

abaecin hymenoptaecin and defensins (Casteels et al.,

1993). These honey bee defensins are known to leak into

naturally produced bee products. Antimicrobial defensin

molecules have been isolated from royal jelly (Klaudiny

et al., 2005, Fontana et al., 2004) and more recently in

Revamil® (RS) honey (Kwakman et al., 2010).

Emerging of antibiotic resistance in microorganisms

The unearthing of penicillin initiated the ‘Golden Age’

(1940–1962) of antibiotic discovery. Many novel natural

products were discovered leading to overwhelming

excitement and excessive overestimations about their role

in medicine (Singh and Barrett, 2006). Inappropriate and

extensive use of antimicrobials in medicine, veterinary, food

animal production and agriculture sectors encouraged the

microorganism to mutate or acquire resistance genes,

resulting in the emergence of bacterial strains with

resistance to novel therapeutics (Levy and Marshall, 2004).

The mass-production and use of penicillin began in 1943 and

within 4 years resistant strains of Staphylococcus aureus

began to emerge, a trend commonly seen with many

antibiotics. Methicillin resistant Staphylococcus aureus

(MRSA), which is resistant to practically all ß-lactam

antibiotics acquires resistance due to the integration of

staphylococcal cassette chromosome mec (SCCmec)

element. The SCCmec element encompasses the mecA gene

complex and the ccr gene complex which encode resistance

and genetic element motility and integration (Deurenberg

and Stobberingh, 2008). A report on antimicrobial

resistance produced in 2014 predicts that 300 million people

may die prematurely because of antimicrobial drug

resistance over the next 35 years (O’Neill, 2014). The WHO

reported that in the EU (and in Norway and Iceland), an

estimated 25,000 people die every year because of

infections related to antibiotic resistance, most of them

contracted in the health care environment (WHO, 2014).

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These occurrences result in considerable increases in health

and social costs, estimated to be € 0.9 billion annually across

Europe. The WHO global report from 2014 on surveillance of

antimicrobial resistance recognizes the problems

surrounding the global increase in bacterial resistance

and acknowledges that MRSA is a significant threat to

hospitalized and community patients (WHO, 2014). MRSA is

isolated in about 5% of all infections associated with

healthcare. The WHO report (2014) highlighted that

all-cause mortality; intensive care unit (ICU) mortality and

bacterium-associated mortality all increase significantly with

MRSA infection. The resistance of Escherichia coli, Neisseria

gonorrhoeae and Klebsiella pneumoniae to multiple

drugs is on the rise (WHO, 2014). To combat this problem

the WHO aim to strengthen national co-ordination and

communication, to improve surveillance, to promote

strategies which reduce the misuse of antimicrobials and to

promote research into novel therapeutics and technologies.

These strategies aim to reduce the morbidity, mortality and

related expenses associated with antibiotic resistance of

hospital acquired infections. Resistance management is

now part of the process of identifying novel drugs as it is

accepted that the emergence of resistant microorganisms is

inevitable (Singh and Barrett, 2006).

Floral origins of Honey

Since the discovery of the high antimicrobial activity of

Manuka honey, several investigations into the floral origins

and antibacterial activity of other honeys harvested globally

have been reported. Identification of the floral source of

honey with high antibacterial activity is important for

identification of potential mechanisms of activity

and for harvesting the product for medicinal use.

Melissopalynological analysis (visual pollen identification) is

currently the official test to determine the botanical and

geographical origin of honey (Aronne and Micco, 2010).

Many studies have utilized this method to determine the

efficacy of honey, reporting associations between the levels

of phytochemicals and antimicrobial activity by botanical

source (Brady et al., 2004; Irish et al., 2011). A recently

reported technique for identifying the botanical origins of

honey is one utilizing DNA barcoding technology, namely

metagenomics. Metagenomics is a relatively new field that

has been shown to be comparable to visual identification of

pollen for determining the botanical origins of honey. This

method is reported to be more robust, faster and simpler to

implement than the classical visual methods. This method

proposes a DNA barcoding approach that combines

universal primers and massive parallel pyrosequencing.

While this technique holds promise, further research

is warranted to confirm consistent and accurate

identification of floral origins of honey (Wooley et al., 2010).

The introduction of honey as an effective wound care

product into modern medicine has been aided by the

commercialization of ‘therapeutic honeys’ such as manuka

honey and Revamil. However, further investigation into

other honeys and their floral/geographical sources is

essential to determine their antimicrobial activity and their

availability globally.

Nomenclature and classification of Honey

Honey is a saturated or supersaturated sugar solution

produced by social bees and some other social insects. Bees

and insects gather nectar or honeydew from the flower of

living plants and process by the addition of enzymes into

honey, then store as a food for use in dearth periods (Crane

and Visscher, 2009). Despite the contributions of few other

insects honey is chiefly produced by the bees which are

social insects with a perennial life cycle. The bees are mainly

classified into different groups which include all honey bees

(Apis spp.), stingless bees (Melipona and Trigona spp.) as

well as Nectarina wasps in South America and several

species of honey ants, especially Melophorus inflatus in

Australia. There are other social wasps and bumblebees

(Bombus spp.) with annual life cycles which produce honey,

but only very little (Crane, 1999).

Nectar Honey

The European Commission Council Directive 2001/110/CE (EU

110, 2001) defines nectar honey as natural sweet substance

produced by Apis mellifera bees from the nectar of plants

which the bees collect, transform by combining with

specific substances of their own, deposit, dehydrate, store

and leave in honeycombs to ripen and mature (EU 110,

2001).

Honeydew honey

European Commission Council Directive 2001/110/CE defines

honeydew honey as a food obtained from secretions of

living parts of plants or from excretions of plant-sucking

insects. The plant-sucking insects (Hemiptera) pierce the

foliage or other plant covering parts, feed on the sap, and

excrete the surplus as droplets of honeydew, which are

gathered by the bees (EU 110, 2001). Although, the

differentiation of honeydew honeys and nectar honeys

could be done by pollen analysis they are far better

distinguished through their physicochemical profiles since

the honeydew honeys have higher pH, acidity, ash, electrical

conductivity, and darker colour, as well as lower

monosaccharide and a higher di- and trisaccharide content

(Mateo and Bosch-Reig, 1998). In addition, honeydew

contains cells of algae and fungi; however, they are not

specific for its origin (Bogdanov et al., 1997).

Honey applications – A historical perspectives

Honey has been a valuable food, medicine and sweetener

throughout the ages. Although it is difficult to follow

exactly when the relationship between humans and the

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bees started and all the efforts by which ancient people

have tried to domesticate the bees and how exactly humans

have learned to get the best out of them this section

summarizes some of the literature citing the uses of honey.

Honey in ancient times

The use of honey for therapeutical purposes is well

established in ancient prescriptions as well as modern

wound management. The earliest records of the application

of honey in medicine could be traced back to the Egyptian

Papyri as well as Sumerian clay tablets dated from 1900 to

1250 BC where honey was in almost one third of the

prescriptions (Molan, 1992). Other uses of honey by ancient

Egyptians also included treatments for the eyes and skin as

well as in embalming and wounds. “Hippocrates (460-357

BC) found that honey cleaned sores and ulcers of the lips

and healed buncles and running sores. Aristotle (384-322

BC) referred to pale honey being a good salve for sore

eyes” (Al Waili, 2003). The ancient Greeks were reported to

have used honey to treat fatigue: athletes drank a mixture

of honey and water before major athletic events (Crane,

1975). The Babylonian used honey for the treatment of ear

infections, eye infections and an ointment for the skin

(Henriques, 2006).

The medicinal uses of honey alone and in combination with

other components including herbs and essential oils to treat

various ailments including burns, wounds, eye infections as

well as gastrointestinal disorders might be traced back to

ancient civilizations of the Egyptians, Assyrians, Greeks and

Romans (Zumla and Lulat, 1989). In 50 AD, Dioscorides

described honey as being “good for all rotten and hollow

ulcers” and “good for sunburn and spots on the face”

(Molan, 2006). Many African tribes use honey to treat

snakebites, fever and as a laxative. Moreover, the Masai

warriors have used honey to gain more power and enhance

their strength which is probably due to the high sugar

content of honey (Henriques, 2006). It has been reported

that the Egyptians used honey in their spiced breads, cakes

and pastries, and for priming beer and wine (Tannahill,

1975). In Ancient Rome honey was used in a wider range of

culinary dishes. Honey has been used in salad dressings in

order to balance the acidity of the vinegar as well as an

essential ingredient of many sauces (Crane, 1975). Reports

have mentioned that the wines drunk at the beginning and

end of meals were sweetened with honey; and meat, while

fruit and vegetables were sometimes preserved by

immersion in honey (Free, 1982). Refined sugar which is

used in cooking today has been known and used in

medicines, but had no place in cooking (Wilson, 1973).

Almost half of one late Roman cookery book included

honey as an ingredient in almost 500 recipes (Style, 1992).

Honey use in middle ages

During the Middle Ages honey was used for sweetening all

type of dishes from appetizers, soups, cheese to fish dishes,

roast meats as well as vegetables. However, it is difficult to

predict whether a dish is savoury or sweet from the title

assigned to it in a recipe. Today it is easy to predict a meat

or cheese dish will usually be savoury; however, it was not

the same in the Middle Ages, where meat, fish dishes and

the pastry lids of ‘savoury’ pies might often be sweetened

(Wilson, 1973). Daude de Pradas has reported the

application of honey in folk medicine in approximately 1200

AD (Crane, 1975). In a text book about honey Beck and

Smedley (1997) have mentioned that honey has been used

as a remedy for gastric and intestinal complaints, the

diuretic effect of honey were recorded as a favoured

remedy for kidney inflammations and stones. In addition

Hindu people had great faith in the medical virtues of

honey, mainly for the treatment of coughs, pulmonary

issues and gastric disorders. Moreover, they have reported

the use of particular honeys for the treatment of specific

disorders and the general application of honeys for

treatment of skin diseases and smallpox, as well as in

surgical dressings. Furthermore, they also reported the use

of a mixture of honey and crushed bees by German women

for the regulation of the menstrual flow as well as the

energetic and cosmetic benefits (Beck and Smedley, 1997).

Honey in modern medicine

In more recent times, honey has played a relatively minor

role in medicine in the developed countries mostly due to it

not being accepted by Western practitioners who preferred

to use to antibiotics since they were not sure of the honeys’

mode of action (Molan, 1992a). However; the applications

of honey continued in the Middle East, China, Africa and

Indian nations since they consider honey as a valuable

source for the treatment of internal as well as external

ailments (Beck and Smedley, 1997). Populations in rural

communities from almost all nations have documented the

use of honey for wounds management as well as other

ailments through time (Henriques et al., 2010). Honey has

been shown in one clinical trial to be effective against

bacterial diarrhoea, (Haffejee and Moosa, 1985), and to aid

in the treatment of eye infections (Molan, 2001; Al Waili,

2004). Although, honey has played a minor role in Western

medicine since the development of Penicillin and other

antibiotics which were considered as miracle drugs they

were forced to rediscover the antibacterial potential of

honeys; probably due to the emergence of multi-drug

resistant pathogens such as methicillin resistant

Staphylococcus aureus (MRSA), vancomycin resistant

enterococci (VRE) and Pseudomonas aeruginosa (Molan,

1992).

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Throughout the last two decades much research has been

carried out in order to explore the mysterious role played by

honey in the management of wounds and burns, which has

led to scientific evidence that demonstrated honey is an

effective antibacterial agent (Molan and Allen, 1996; Cooper

et al., 2002). The in vitro findings that honey is an effective

antibacterial agent and proved to be even superior to many

antiseptics and antibiotics are matching with the clinical

trials as well as the in vivo and in vitro experiments that was

demonstrated by many cases in which honey successfully

eradicated antibiotic resistant and sensitive strains

that conventional therapy has failed to eradicate

(Subrahmanyam, 1991). Medicinally, honey is used to

enhance wound- healing in humans (Aysan et al., 2002),

treatment of gastric ulcer (Kandil et al., 1987) and

shortening of the duration of diarrhoea (Haffejee and

Moosa, 1985). The use of honey was based on empirical

knowledge rather than scientific knowledge. People didn’t

know how honeys cured infections but, knew it worked,

this fact led to the use of antibiotics instead of honey

(Molan, 2001). Only now researchers are beginning to

understand why honey has such therapeutic and beneficial

potential; honey indeed could be the elixir (Molan and Allen,

1996) that the ancient people believed. Research is showing

a number of other health-related benefits, including a

laxative effect, beneficial effects on blood glucose levels

(Cortes et al., 2011), anti-inflammatory and immune

stimulating properties and potentially a cancer-preventative

action (Manyi-Loh et al., 2011).

Production of Honey

The honey bee (Apis mellifera) is of great importance for

humans as a pollinator of both commercial and domestic

crops and provider of honey, a high-value nutritional

commodity (Potts et al., 2010, Ratnieks and Carreck, 2010).

Honey bee loss due to the interacting drivers of pests and

diseases, exposure to agrochemicals, apicultural

mismanagement and lack of genetic diversity have led to

widespread concern about the future potential of honey

bees to provide these services (Ratnieks and Carreck, 2010,

Potts et al., 2010). The quality and composition of honey

produced is affected by many factors including flower

composition, geographical position of the hive, bee health

and annual changes in local flora and flowering phenology

(Galimberti et al., 2014). Various physical types of honey are

also commercially available (comb, chunk, crystallized or

granulated, creamed) with many different levels of

processing (pressed, centrifuged, drained, heat processed)

(Anklam, 1998). Within a honey bee hive there are three

castes–queen (alpha), worker (beta) and drone (gamma)

bees (Havenhand, 2010), a collective effort allows for the

production of honey. Honey is produced by honey bees

using nectar from flowering plants, nectar is a sugar-rich

liquid that is produced in glands called nectaries.

Nectar is collected by worker bees, travelling up to 9 km in

one trip (Havenhand, 2010). Sucrose in nectar is hydrolyzed

to produce glucose and fructose (Kubota et al., 2004). Upon

return to the hive the nectar is swallowed and regurgitated

by thousands of worker bees within the honey comb. The

regurgitation process and wing fanning causes evaporation

and the water content is reduced, the honey is ripened over

time. Honey bees keep the honey as food stores for the

winter period when no nectar or pollen is available. Any

excess honey can be extracted for human consumption

(Havenhand, 2010). Kubota et al. (2004) described how

glucosidase III is produced in the hypopharyngeal gland of

European honey bees. This enzyme is secreted into the

nectar and is responsible for the production of hydrogen

peroxide (Bucekova et al., 2014). Pollen grains are collected

by honey bees as they visit flowering plants to feed honey

bee larvae (Galimberti et al., 2014). Dense pollen pellets are

produced from these grains using a nectar-saliva mixture.

Honey bees collect the exudate from sap-sucking insects as

an alternative to nectar. Honeydew collection is often

recorded from sap feeding insects feeding on conifers and

other anemophilous species (Oddo et al., 2004). Tree resin

is also actively collected from a range of species and

combined with wax to make propolis that is deposited

within the hive as it has antimicrobial properties (Wilson

et al., 2013).

Composition of Honey

Honey contains an array of minor constituents including

carbohydrates, volatiles and phenolic compounds including

flavonoids and non-flavonoid phenolic compounds (Baroni

et al., 2006). These compounds originate from plants

foraged upon by the bees and from the bees themselves.

Phenolic compounds are affected by the storage and

processing of the honey, microbial or environmental

contamination, geographical distribution and botanical

source of nectar and pollen. Although, honey is a unique

saturated complex solution all honeys are not the same

since they vary depending on the variation in their botanical

source, geographical location, bee species, storage

condition, beekeeping as well as the year and time of

collection during the year all could affect the chemical

profile of the honey (Manyi-Loh et al., 2011).

Osmalarity

Due to the high sugar content of honey, the osmotic

pressure of honey is usually high leading to low water

activity (aw) reported range = 0.562–0.62 (Bogdanov et al.,

1997), which gives the osmolarity an essential role in the

antimicrobial activity of undiluted honeys; since, the growth

of many bacterial species, for example, is completely

inhibited when the (aw) is in the range of 0.94 - 0.99 (Molan,

1992).

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Water content

Honey water content is an important quality parameter,

which must be determined in order to prevent the spoilage

of honey due to fermentation. The honey moisture content

is not like other parameters which are optionally accepted,

since it affects the quality as well as the shelf life of the

honey (Bogdanov et al., 2004). The International Honey

Commission (IHC) has set a maximum limit of 20g

water/100g of honey for any honey sample to be accepted

for honey trade. The moisture content has a direct effect on

other honey properties such as glucose crystallization and

viscosity of the honey (Bogdanov et al., 2004). The honey

moisture content is evaluated by either refractive index,

gravimetric technique or Karl Fischer titration (Sanchez

et al., 2010).

Acidity

Acidity is another factor which contributes to the

antimicrobial activity of honey. Although it was thought to

have a major role, more recent studies have demonstrated

that acidity actually plays a minor role in the antibacterial

activity of honey (Molan, 1992). There are about 30 organic

acids in honey (Mato et al., 2003); however, gluconic acid

which is produced due to the activity the enzyme glucose

oxidase is main organic acid present in the honey in the

range of 0.23-0.98% (White, 1975).

Sugar content (Carbohydrates)

Honey is a complex saturated or super saturated solution

which mainly made up of two components sugars and

water. The sugars or carbohydrates make up more than

90% of the honey’s total dry matter (Anklam, 1998). It has

been reported that honey is made up of more than 180

substances (Jones, 2009) which Bogdanov has estimated to

be actually even closer to 600 substances (Bogdanov et al.,

2004). The carbohydrates content of honeys includes a

variety of sugars such as the monosaccharides fructose

(levulose) as well as glucose (dextrose), sucrose and

maltose and disaccharides oligosaccharides which seem

to differ according to the floral source of the honey

(Molan and Allen, 1996). Sugars (saccharides) comprise the

major portion of honey approximately 85-95% (w/v) of the

total honey. Honey consists mostly of the monosaccharides

fructose and glucose. Twenty five other oligosaccharides

(di, tri and tetrasaccharides) have also been described.

Invert syrup (IS), conventional corn syrup (CCS) and high

fructose corn syrup (HFCS) is also used in honey

adulteration (Anklam, 1998). Honey is a variable and

complex mixture of sugars and other components. At its

very basic level, honey consists of a mixture of simple

carbohydrates which create a highly osmotic environment.

The combination of low levels of water (~18%) and high

levels of sugar (~80%) are enough in themselves to prevent

the spoilage of honey by microorganisms (Kwakman et al.,

2010). Disruption of the bacterial cell wall occurs due to the

osmotic effect. The osmotic effect has been shown to be an

important parameter for killing Helicobacter pylori, however

honey has other antibacterial factors beyond the osmotic

effect (Kwakman and Zaat, 2012). An artificial honey

solution is used to distinguish between the osmotic effects

of sugars and antibacterial activity in a study by Cooper et

al. (2002).

Proteins and Amino acids

Honey normally contains between 0.1-0.5% proteins (Won

et al., 2009). Eighteen amino acids are found in honey;

proline represents 50–85% of the total amino acid profile.

Arginine, tryptophan, and cystine are characteristic amino

acids in some honey types (Anklam, 1998). Enzymes make

up a small fraction of these proteins. Enzymes found in

honey which originate from both nectar and the bees are

common (Weston, 2000). Predominant enzymes are

diastase (amylase), which breaks down starch into smaller

units; invertase (glucosidase) which converts glucose to

fructose and glucose oxidase which catalyses the reaction

of glucose to gluconolactone, resulting in the production of

gluconic acid and hydrogen peroxide (Bucekova et al.,

2014). Catalase occurs naturally in some pollen grains,

catalase neutralizes hydrogen peroxide (Assia and Ali, 2015).

Vitamins and Minerals

Trace amounts of B vitamins (riboflavin, niacin, folic acid,

pantothenic acid and vitamin B6) and C vitamins (ascorbic

acid) are found in honey. Many different minerals (calcium,

iron, zinc, potassium, chromium, phosphorous, magnesium

and manganese) are found in unprocessed honey.

Volatile compounds

More than 600 volatile organic compounds (VOCs) have

been identified in honey. Volatiles are organic chemicals

that have a high vapour pressure at standard room

temperature. Seven major groups have been previously

characterised in honey; aldehydes, ketones, acids, alcohols,

esters, hydrocarbons and cyclic compounds (Kaskonienė

and Venskutonis, 2010; Manyi-Loh et al., 2011). Honey

contains numerous VOCs in low concentration however,

VOCs affect the sensory characteristic of honey; flavour,

aroma, colour and texture are all affected by the type of

plants and flowers bees visit (Manyi-Loh et al., 2011). Some

VOCs originate from the plants or nectar source whereas

others are created during the processing or storage of

honey (Jerkovic et al., 2006, Castro-Vazquez et al., 2008;

Jerkovic et al., 2011). The Maillard reaction occurs when

honey is heat treated; a non-enzymatic browning reaction

occurs between sugars and amino acids resulting in the

production or transformation of VOCs (Castro-Vazquez

et al., 2008).

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Microbial and environmental contamination can also

contribute to the number of VOCs (Manyi-Loh et al., 2011).

Hydroxymethylfurfuraldehyde (HMF)

Hydroxymethylfurfuraldehyde (HMF) is also present in

minor quantities. HMF which could be formed in the

presence of acid due the breakdown of fructose has been

considered as evidence for the adulteration of honey;

however, it has been proved that even fresh honeys do

contain minor amounts of HMF (Zappala et al., 2005) which

could easily be elevated if the honey is stored in moderate

or high temperatures; hence, it is necessary to store honey

in a refrigerator or a cool place (White, 1975) so as to keep

the levels of HMF to the minimum since, HMF is one of the

main factors which are considered for the quality and

marketing of honey.

Enzymes

Moreover, honey contains a number of enzymes including

glucose oxidase, invertase, and amylase, which appear to

originate from honeybees (Molan, 1992). Glucose oxidase

plays an essential role in the antibacterial activity of honeys

as well as the generation of gluconic acid. The enzyme

Invertase catalyses the conversion of sucrose obtained from

the nectar and into the monosaccharides fructose and

glucose in a ratio of 1.2:1 between glucose and fructose

(Anklam, 1998). There are other enzymes such as catalase

and acid phosphatase (White, 1975) which are also present

in some honeys but these are likely to be derived from the

pollens and nectar of plants.

Phenolic compounds

The major phenolic compounds identified in honey are

flavonoids: quercetin, pinocembrin, pinobanksin, chrysin,

galangin, kaempferol and luteolin (Pyrzynska and Biesaga,

2009; Kaskonienė and Venskutonis, 2010; Dong et al., 2013).

Aromatic acids contain an aromatic ring and an organic acid

function (C6-C1 skeleton). Phenolic compounds are an

example of aromatic acids as they containing a phenolic ring

and an organic carboxylic acid function. Phenolic acids can

be found in many plant species (Lin and Harnly, 2007; Cai

et al., 2004; Pinho et al., 2014). Flavonoids are plant

specialized metabolites which fulfill many functions and are

important for plant pigmentation, UV filtration and

symbiotic nitrogen fixation (Dixon and Pasinetti, 2010).

Flavonoids are widely distributed in plants and their basic

molecular structure is 2-phenyl-1,4-benzopyrone. Plant

derived phenolic acids include benzoic, ferulic, gallic,

chlorogenic, caffeic, p-coumaric, ellagic and syringic acids.

Phenolic compounds have antibacterial, anti-inflammatory

and antioxidant activities. The composition of

phytochemicals has an effect on the bioactivity of honey

(Kaskonienė and Venskutonis, 2010).

Pollen, Propolis and Royal jelly

Honey bees collect pollen and nectar from flowering plants,

supplying the hive with protein for nourishment. Pollen is

commonly found in honey. Wind pollinated pollen from

trees and plants also frequently feature within honey

(Bruni et al., 2015). Pollen contains contain carbohydrates,

amino acids, DNA, nucleic acids, proteins, lipids, vitamins,

minerals, phenolic compounds and flavonoids (Morais et al.,

2011). Propolis is produced from the exudates of plants;

bees seal the hive with the resinous substance creating a

protective barrier against intruders (Viuda-Martos et al.,

2008). Propolis is comprised of resin (50%), wax (30%),

essential oils (10%), pollen (5%), and other organic

compounds (5%) (Viuda - Martos et al., 2008). More than

300 compounds including phenolic compounds, esters,

flavonoids, terpenes and anthraquinones have been found

in propolis (Kalogeropoulos et al., 2009; Bertrams et al.,

2013). Royal jelly is a proteinous liquid secreted by glands in

the hypopharynx of worker bees; it is produced exclusively

for the adult queen bees, it is a vital nutritional source

(Viuda - Martos et al., 2008). More than 50 % of the dry mass

of royal jelly is proteins, major royal jelly proteins (MRJPs)

have been researched and analysed (Won et al., 2009).

Royal jelly is used as a dietary supplement for the treatment

of many conditions including asthma, high cholesterol and

seasonal allergies.

Hydrogen peroxide

In the 1960s, hydrogen peroxide (H2O2) was identified as a

major antibacterial compound in honey. Hydrogen peroxide

is commonly used in cleaning products such as bleach but it

is also produced naturally during glucose oxidation of honey

(Brudzynski et al., 2011). Hydrogen peroxide is also a

contributing factor to a honeys acidity and sterility.

Hydrogen peroxide and honey phenolics with pro-oxidant

activities are involved in oxidative damage resulting in

bacterial growth inhibition and DNA degradation

(Brudzynski et al., 2011, Brudzynski et al., 2012). Brudzynski

et al. (2012) concluded that hydrogen peroxide is involved in

oxidative damage, which causes bacterial DNA degradation

and growth inhibition. Further studies revealed the

bacteriostatic effect was directly related to the generation,

and therefore concentration of hydroxyl radicals generated

from the hydrogen peroxide (Brudzynski and Lannigan,

2012). It is believed that the hydrogen peroxide effects are

modulated by other honey components (Brudzynski et al.,

2011).

Bee derived antimicrobial peptides

Bee derived defensins are cysteine-rich cationic peptides

produced in the salivary glands and fat body cells and are

involved in social and individual immunity (Klaudiny et al.,

2005). Two defensins have been characterized, royalisin

(from royal jelly) and defensin (from the haemolymph),

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which are both encoded by Defensin-1. The Defensin-2

which shows 55% similarity to Defensin-1, has also been

identified (Ilyasov et al., 2013). Defensin-1 (5.5 KDa) has been

shown to possess potent antibacterial activity against Gram

positive microorganisms including Staphylococcus aureus

and Bacillus subtilis (Kwakman et al., 2010; Bucekova et al.,

2014) and Paenibacillus larvae. This is the causative agent of

American Foulbrood (AFB) which is a major pathogen of

bees (Katarina et al., 2002). The honey is not registered as

an antimicrobial but as a wound healing stimulant where it

is claimed to stimulate tissue regeneration and reduce

inflammation. The in vitro bactericidal activity against

Bacillus subtilis, Staphylococcus aureus, Streptococcus

epidermidis, Escherichia coli and Pseudomonas aeruginosa

was assessed and a bactericidal effect was seen within

24 h by 10-40% (v/v) honey (Kwakman et al., 2010).

The peptide (defensin-1) and the other factors contributing

to this bactericidal effect were also characterized

(Kwakman et al., 2010). Other proteinaceous antibacterial

compounds have previously been reported in six of twenty

six honeys, but identification of these proteins was not

performed (Mundo et al., 2004).

Plant derived antimicrobial phytochemicals

Plant derived phytochemicals play an important role in the

antibacterial activity of honey; methylglyoxal (MGO) from

Manuka honey is an example of honey which attributes its

activity to plant derived chemicals. Non-peroxide activity

has been described in investigations of bactericidal factors

within honey (Manyi-Loh et al., 2012; Pinho et al., 2014),

particular attention has been paid to Manuka honey (Adams

et al., 2009). Plant derived phenolic compounds isolated

from honey have been investigated and identified by

different research groups, but the contribution to the

overall activity remains unclear (Isla et al., 2011; Manyi-Loh

et al., 2012; Kwakman and Zaat, 2012; Liu et al., 2013) It has

been suggested that the contribution of plant derived

components to the antibacterial activity of honey is too low

to detect (Kwakman et al., 2010), but when extracted

phenolics and flavonoids are regarded as a very promising

source of natural medicinal therapeutics. Solid phase

extraction (SPE) and HPLC analysis was used to extract

phenolic compounds and antimicrobial agents from Rubus

honey (Escuredo et al., 2012). The phenolics caffeic,

p-coumaric and ellagic acids and the flavonoids chrysin,

galangin, pinocembrin, kaempferol and tectochrysin were

isolated (Escuredo et al., 2012). The phenolic fraction

samples showed antimicrobial activity against various

organisms including Salmonella typhimurium, Proteus

mirabilis and Pseudomonas aeruginosa. The most susceptible

species were Proteus mirabilis and Bacillus cereus (Escuredo

et al., 2012). The antioxidant and antimicrobial activities of

phenolics extracted from Rhododendron honeys from the

Black Sea region of Turkey have also been studied (Silici

et al., 2010). High levels of antimicrobial activity were

described against Pseudomonas aeruginosa and Proteus

mirabilis (Silici et al., 2010). The combination of different

phenolics, instead of individual compounds may contribute

to the activity of honey, but further investigations are

required in order to assess these interactions (Manyi-Loh

et al., 2012). The minor constituents in honey have high

levels of antimicrobial activity due to a combination of these

factors, often working in unison. These plant derived

compounds have high potential to be used as therapeutics

in human health. It has been shown that the flavonoids,

phenolic and organic acids in honey may act in various

processes including hydrogen donating, oxygen quenching,

radical scavenging and metal ion chelation resulting in

bacterial growth inhibition (Manyi-Loh et al., 2012).

The antibacterial activity of phenolic compounds should not

be dismissed; phytochemicals have an influence on the

antimicrobial activity of honey (Molan, 2011). Peroxide and

non-peroxide factors may also be working in synergy and

inhibiting bacterial growth (Manyi-Loh et al., 2011). In order

to analyze these compounds, the sugars which are the

major components in honey must be removed. Various

analytical techniques can be used to identify

these components (Cuevas-Glory et al., 2007, Pontes et al.,

2007). Thin Layer Chromatography (TLC) and Gas

Chromatography-Mass Spectrometry (GC-MS) have been

used to extract the phenolic compounds which have

demonstrated antibacterial activity against Helicobacter

pylori (Manyi-Loh et al., 2012). The Helicobacter pylori, which

cause chronic active gastritis and peptic ulcers, showed

susceptibility to various fractions of South African honey

(Manyi-Loh et al., 2012; Manyi-Loh et al., 2013). The activity

was attributed to the combination or separate action of

volatile compounds including acetic acid (Manyi-Loh et al.,

2012). Other VOCs have been identified in honey; (±)-3-

Hydroxy-4-phenyl-2-butanone and (+)-8-hydroxylinalool

show high levels of antimicrobial activity against bacteria

including Staphylococcus aureus, Escherichia coli, Klebsiella

pneumoniae and human pathogen fungi Candida albicans

(Melliou and Chinou, 2011). Despite only being present in

low concentrations the VOCs may contribute to the overall

antimicrobial activity and have the potential to be used as

natural therapeutics to treat a range of pathogenic

microbial organisms.

Other minor components

Furthermore, honey is rich with other components although

in minor amount. These include amino acids (mainly

proline), vitamins including vitamin A, B-vitamins (riboflavin,

niacin, pyridoxine, panthothenic acid, and folic

acid),vitamin-C (ascorbic acid), vitamin D, and vitamin E,

Honey also contains a significant number of minerals,

including calcium, phosphorous, iron, zinc, selenium,

chromium, potassium, magnesium, and manganese and

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organic acids (Bobis et al., 2008). Other components

present in honeys also include flavonoids, antioxidant

substances and unidentified plant-derived elements

(phytochemical components) (Sato and Miyata, 2000).

Antimicrobial efficiency of Honey

The antibacterial effect of honey, mostly against Gram

positive bacteria, both bacteriostatic and bactericidal

effects have been reported, against many strains, many of

which are pathogenic. Honey glucose oxidase produces the

antibacterial agent hydrogen peroxide, while another

enzyme, catalase breaks it down. Honey with a high

catalase activity has a low antibacterial peroxide activity.

Honey has both peroxide and non-peroxide antibacterial

action, with different non-peroxide antibacterial

substances involved: acidic, basic or neutral (Bogdanov,

2006). Antimicrobial effect of honey is thus due to different

substances e.g. aromatic acids and compounds with

different chemical properties and depends on the botanical

origin of honey. The high sugar concentration of honey, and

also the low honey pH is also responsible for the

antibacterial activity. Most experiments report on stop of

bacterial growth after a certain time of honey action.

The higher the concentration the longer is the period of

growth inhibition. Complete inhibition of growth is

important for controlling infections. Honey has also antiviral

activity Rubella, Herpes virus (Al-Waili, 2004). Honey has

also fungicide activity against different dermatophytes.

Honey has been shown to have a prebiotic effect, i.e. its

ingestion stimulates the growth of healthy specific Bifidus

and Lactobacillus bacteria in the gut. Sour-wood, alfalfa,

sage and clover honeys have been shown to have prebiotic

activity. The prebiotic activity of chestnut honey is bigger

than that of acacia honey. Oligosaccharides from honeydew

honey have prebiotic activity. Theoretically honeydew

honeys, containing more oligosaccharides should have a

stronger prebiotic activity than blossom honeys (Stefan

Bogdanov, 2011).

Antibacterial activity

The antibacterial properties of honey includes, the release

of low lives of hydrogen peroxide, some honey have an

additional phytochemical antibacterial compounds. The

antibacterial property of honey is also due to osmotic effect

of its high sugar content as it has an osmolarity sufficient to

inhibit the microbial growth (Rakhi et al., 2010). Hydrogen

peroxide was responsible for the antibacterial activity of

honey since both the antibacterial activity of honey and

hydrogen peroxide was destroyed by light (Miki Fukuda,

2011). White and Subers reported that hydrogen peroxidase

which is produced by the glucose oxidase of honey could be

the inhibitory substance against bacteria. However, it is

known that honey as well as bacteria produces a catalase

that eliminates hydrogen peroxide.

But although catalase is active with high concentration of

hydrogen peroxide, it is of low activity with physiological

levels (Osho and Bello, 2010). Lavie found an additional

group of light sensitive, heat-stable antibacterial factors in

honey which inhibited the growth of Bacillus subtilis, Bacillus

alvei, Escherichia coli, Pseudomonas pyocyanes,

Salmonella typhi and Staphylococcus aureus (Boukraa, 2008).

A comparison was made by Cortopassi–Laurino and Gelli

between the physico-chemical properties and antibacterial

activity of honey produced by Africanized honey bees

(Aphis mellifera) and Melliponinae (stingless bees) in Brasil.

For both types of honey at a concentration of 5-25%, Bacillus

stearothermophilus was found to be the most susceptible

and Escherichia coli the least susceptible of the seven

bacterial isolates tested (the other five being, Bacillus

subtilis, Staphylococcus aureus, Klebsiella pneumoniae and

Pseudomonas aeruginosa). Melipona subnitida honey

produced from Mimosa bimucronata and Plebia sp. honey

produced from Borreria/Mimosa exhibited the

greatest antibacterial activities (White and Subers, 2013).

Antibacterial activities of the two honey samples, produced

by the honeybee (Aphis mellifera), were assayed using

standard Well diffusion method. Both honey samples were

tested at four concentrations (5%, 25%, 50% and 100% w/v)

against Staphylococcus aureus, Pseudomonas aeruginosa,

Klebsiella pneumoniae, Bacillus subtilis and Escherichia coli.

There are many reports of bactericidal as well as

bacteriostatic activity of honey and the antibacterial

properties of honey may be particularly useful against

bacteria, which have developed resistance to many

antibiotics (Osho and Bello, 2010).

Antifungal activity

The synergistic action of starch on the antifungal activity of

honey, a comparative method of adding honey with and

without starch to culture media was used. Candida albicans

has been used to determine the minimum inhibitory

concentration (MIC) of five varieties of honey (Conti, 2000).

The antifungal action of three single samples of South

African honey (wasbessie, bluegum and fynbos) against

Candida albicans and found honey to inhibit on the growth

of Candida albicans, while the control, bluegum and fynbos

honey produced only partial inhibition (Terrab et al., 2004).

Antiviral activity

Honey had good anti-Rubella activity, while thyme did not.

These results may justify the continuing use of honey in

traditional medicines from different ethnic communities

worldwide and in some modem medications such as cough

syrups (Golob et al., 2005).

Antioxidant activity of Honey

Honey contains a variety of phytochemicals (as well as

other substances such as organic acids, vitamins, and

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enzymes) that may serve as sources of dietary antioxidants

(Gheldof and Engeseth, 2002). The amount and type of

these antioxidant compounds depends largely upon the

floral source/variety of the honey. In general, darker honeys

have been shown to be higher in antioxidant content than

lighter honeys. Researchers at the University of Illinois

Champaign/Urbana examined the antioxidant content

(using an assessment technique known as Oxygen Radical

Absorbance Capacity or ORAC) of 14 unifl oral honeys

compared to a sugar analogue. ORAC values for the honeys

ranged from 3.0 μ mol TE/g for acacia honey to 17.0 μ mol

TE/g for Illinois buckwheat honey. The sugar analogue

displayed no antioxidant activity (Swellam et al., 2013).

Free radicals and reactive oxygen species (ROS) have been

implicated in contributing to the processes of aging and

disease. Humans protect themselves from these damaging

compounds, in part, by absorbing antioxidants from

high-antioxidant foods. This report describes the effects of

consuming 1.5 g/kg body weight of corn syrup or buckwheat

honey on the antioxidant and reducing capacities of plasma

in healthy human adults. It can be speculated that these

compounds may augment defenses against oxidative stress

and that they might be able to protect humans from

oxidative stress. Given that the average sweetener intake

by humans is estimated to be in excess of 70 kg per year,

the substitution of honey in some foods for traditional

sweeteners could result in an enhanced antioxidant defense

system in healthy adults (Derek et al., 2013). Antioxidant

properties shown by volatile oil of propolis (VOP) from India

were investigated by spectrophotometric methods and a

photochemi-luminescence method and it was found that

from IC50 values it could be concluded that the efficiency of

scavenging ABTS radicals by the VOP was more pronounced

as compared to scavenging other radicals (Orsolic et al.,

2013).

Other medicinal uses of honey

Honey as antibiotics

Manuka honey has potent antibacterial properties, making

it especially beneficial for preventing and treating wound

infections by drug-resistant bacteria, according to physician

Robert Frykberg of the Veterans Affairs Medical Center in

Phoenix, Ariz.

Antidiabetic activity

Frykberg noted that the FDA-approved manuka honey

product, Medihoney, has proven beneficial for healing foot

ulcers in diabetic patients. Diabetics with foot ulcers that do

not heal sometimes require foot amputation.

Arthritis

Take one part honey to two parts of luke warm water and

add a small teaspoon of cinnamon powder, make a paste

and massage it on the itching part of the body. It is noticed

that the pain recedes within a minute or two. Or for arthritis

patients daily morning and night take one cup of hot water

with two spoons of honey and one small teaspoon of

cinnamon powder. If drunk regularly even chronic arthritis

can be cured. In a recent research done at the Coppen

Hagen University, it was found that when the doctors

treated their patients with a mixture of one tablespoon

honey and half teaspoon cinnamon powder before

breakfast, they found that within a week out of the 200

people so treated practically 73 patients were totally

relieved of pain and within a month, mostly all the patients

who could not walk or move around because of arthritis

started walking without pain.

Hair loss

Those suffering from hair loss or baldness may apply a paste

of hot olive oil, one tablespoon or honey, one teaspoon

cinnamon powder before bath and keep it for

approximately 15 min. And then wash the hair. It was found

very effective even if kept for 5 min.

Bladder infections

Take two tablespoons of cinnamon powder and one

teaspoon of honey in a glass of luke warm water and drink

it. It destroys the germs of the bladder.

Toothache

Make a paste of one teaspoon of cinnamon powder and five

teaspoons of honey and apply on the aching tooth. This may

be done 3 times a day daily till such time that the tooth has

stopped aching.

Cholesterol

Two tablespoons of honey and three teaspoons of

cinnamon powder mixed in 16 ounces of tea water if given

to a cholesterol patient; it reduces the level of cholesterol in

the body by 10% within 2 h. As mentioned for arthritic

patients, if taken 3 times a day any chronic cholesterol

cured. As per the information received in the said journal,

pure honey taken with food daily relieves complains of

cholesterol.

Colds

Those suffering from common or severe colds should take

one tablespoon Luke warm honey with 1/4 teaspoon

cinnamon powder daily for 3 days. This process will cure

most chronic cough, cold and clear the sinuses.

Stomach upset

Honey taken with cinnamon powder cures stomachache

and also clears stomach ulcers from the root. Gas: according

to the studies done in India and Japan, it is revealed that if

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honey is taken with cinnamon powder the stomach is

relieved of gas.

Heart diseases

Make a paste of honey and cinnamon powder, apply on

bread or chapatti instead of jelly and jam and eat it regularly

for breakfast. It reduces the cholesterol in the arteries and

saves the patient from heart attack. Also those who have

already had an attack, if they do this process daily, are kept

miles away from the next attack, regular use of the above

process relieves loss of breath and strengthens the heart

beat in America and Canada, various nursing homes have

treated patients successfully and have found that due to the

increasing age the arteries and veins, which lose their

flexibility and get clogged, are revitalized.

Immune system

Daily use of honey and cinnamon powder strengthens the

immune system and protects the body from bacterial and

viral attacks. Scientists have found that honey has various

vitamins and iron in large amounts. Constants use of honey

strengthens the white blood corpuscles to fight bacterial

and viral diseases.

Indigestion

Cinnamon powder sprinkled on two tablespoons of honey

taken before food, relieves acidity and digests the heaviest

of meals.

Influenza

A scientist in Spain has proved that honey contains a natural

ingredient, which kills the influenza germs and saves the

patient from flu.

Longevity

Tea made with honey and cinnamon powder, when taken

regularly arrests the ravages of old age. Take 4 spoons of

honey 1 spoon of cinnamon powder and 3 cups of water and

boil to make like tea. Drink 1/4 cup, 3 to 4 times a day. It

keeps the skin fresh and soft and arrests old age. Life spans

also increases and even if a person is 100 years old.

Pimples

Three tablespoons of honey and one teaspoon of cinnamon

powder paste. Apply this paste on the pimples before

sleeping and wash it next morning with warm water.

If done daily for two weeks. It removes pimples from the

roots.

Skin infections

Applying honey and cinnamon powder in equal parts on the

affected parts cures eczema, ringworm and all types of skin

infections.

Weight loss

Daily in the morning 1/2 h before breakfast on an empty

stomach and at night before sleeping, drink honey and

cinnamon powder boiled in one cup water. If taken

regularly it reduces the weight of even the most obese

person. Also drinking of this mixture regularly does not

allow the fat to accumulate in the body even though the

person may eat a high calorie diet.

Cancer

Recent research in Japan and Australia has revealed that

advanced cancer of the stomach and bones have been

cured successfully. Patients suffering from these kinds of

cancer should daily take one tablespoon of honey with one

teaspoon of cinnamon powder for one month 3 times a day.

Fatigue

Recent studies have shown that the sugar content of honey

is more helpful than detrimental to the body strength.

Senior citizens who take honey and cinnamon powder in

equal parts are more alert and flexible. Dr. Milton who has

done research says that half tablespoon honey taken in one

glass of water and sprinkled with cinnamon powder, taken

daily after brushing and in the afternoon at about 3.00 p.m.

Bad breath

People of South America, first thing in the morning gargle

with one teaspoon of honey and cinnamon powder mixed in

hot water. So, their breath stays fresh throughout the day.

Hearing loss

Daily morning and night honey and cinnamon powder taken

in equal parts restores hearing.

Conclusion

Honey is one of the oldest known medicines that have

continued to be used up to present times in folk-medicine.

Its use has been "rediscovered" in later times by the

medical profession, especially for dressing wounds. The

numerous reports of the effectiveness of honey in wound

management, including reports of several randomized

controlled trials, have recently been reviewed, rapid

clearance of infection from the treated wounds being a

commonly recorded observation. In almost all of these

reports honey is referred to generically, there being no

indication given of any awareness of the variability that

generally is found in natural products. Yet the ancient

physicians were aware of differences in the therapeutic

value of the honeys available to them: Aristotle (384-322

BC), discussing differences in honeys, referred to pale

honey being "good as a salve for sore eyes and wounds";

and Dioscorides (50 AD) stated that a pale yellow honey

from Attica was the best, being "good for all rotten and

hollow ulcers".

Journal of Academia and Industrial Research (JAIR)

Volume 6, Issue 10, March 2018 177

*Corresponding author

©Youth Education and Research Trust (YERT) jairjp.com Saranraj & Sivasakthi, 2018

Any honey can be expected to suppress infection in wounds

because of its high sugar content, but dressings of sugar on

a wound have to be changed more frequently than honey

dressings do to maintain an osmolarity that is inhibitory to

bacteria, as honey has additional antibacterial components.

Since microbiological studies have shown more than one

hundred-fold differences in the potency of the antibacterial

activity of various honeys, best results would be expected if

a honey with a high level of antibacterial activity were used

in the management of infected wounds. Other therapeutic

properties of honey besides its antibacterial activity are also

likely to vary. An anti-inflammatory action and a stimulatory

effect on angiogenesis and on the growth of granulation

tissue and epithelial cells have been observed clinically and

in histological studies. The components responsible for

these effects have not been identified, but the

anti-inflammatory action may be due to antioxidants, the

level of which varies in honey. The stimulation of tissue

growth may be a trophic effect, as nutrification of wounds

is known to hasten the healing process: the level of the

wide range of micronutrients that occur in honey also

varies. Until research is carried out to ascertain the

components of honey responsible for all of its therapeutic

effects it will not be possible to fully standardize honey to

obtain optimal effectiveness in wound management.

However, where an antiseptic wound dressing is required

then standardization for this effect is possible. Several

brands of honey with standardized levels of antibacterial

activity are commercially available in Australia and New

Zealand, but even where these are not available it is

possible to assay the level of antibacterial activity of locally

available honey by a simple procedure in a microbiology

laboratory.

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Honey-induced expression of glutathione-encoding genes (gshA and gshB) in clinical Pseudomonas aeruginosa isolates may reduce the antibacterial potency of honey

Article

Full-text available

Jan 2025

Background: It has been reported in Nigeria that honey has low antibacterial properties against Pseudomonas aeruginosa. Hydrogen peroxide (H2O2) is the major contributor to the antimicrobial activity of honey. This research sought to determine whether stress protective glutathione biosynthesis genes (gshA and gshB) present in pathogenic Pseudomonas aeruginosa are associated with its anti-honey resistant nature Methodology: The susceptibility of 5 P. aeruginosa clinical strains obtained from Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital Ogbomoso, Nigeria to antibiotics and honey were assessed using disc and agar well diffusion techniques. Detection and expression of P. aeruginosa gshA and gshB genes in the presence of varying dilutions of sweet and bitter Nigerian honey (100%-undiluted, 50%, 25%) and untreated controls, were done using conventional and real-time qPCR, with 16S rRNA gene used as internal control and reference gene to normalize the cDNA samples. Results: The gshA and gshB genes were detected and expressed in 3 of the 5 selected isolates of P aeruginosa in the controls (untreated), and in 50% and 25% honey dilutions where they showed down regulation, but in the 100%, the genes were not expressed. Conclusion: The presence and expression of the glutathione producing genes (gshA and gshB) in P. aeruginosa may reduce the potency of honey as an antibacterial agent by interfering with antibacterial action of H2O2 component of honey. Further studies are needed to confirm these genes as hinderances against the successful treatment of bacterial infections caused by P. aeruginosa using honey.

Efficacy of honey against clinical isolates of Staphylococcus aureus and Pseudomonas aeruginosa

Article

Feb 2025

Skin serves as the first line of defense of the body against invading microorganisms. When it becomes compromised due to a cut or a burn, infections may set into the wound. Honey produced by bees can serve as an alternative treatment to available antibiotics to which microorganisms are already becoming resistant to. This study was undertaken to evaluate the efficacy of honey sold in Samaru, Zaria against bacterial wound isolates. Proximate compositions of two honey samples were determined. Pure isolates of P. aeruginosa and S. aureus were challenged against a pool of the two honey samples that passed sterility test using agar well diffusion method. The MIC and MBC of the honey were determined using tube dilution method. The honey samples had a mean pH of 4.93, with composition of 76.23% carbohydrate, 0.16% ash, 2.23% lipid and 3.45% protein. The honey demonstrated its highest activity against P. aeruginosa (20.0 mm), than S. aureus (16.0 mm) at a concentration of 100%v/v. Activity of the honey reduced with reducing concentration, until no activity was recorded at a concentration of 25%v/v. The MIC of the honey was 25%v/v against S. aureus and 12.5%v/v against P. aeruginosa. However, the MBC of the honey against S. aureus and P. aeruginosa was 25%v/v each. This study confirms that honey sold in Zaria possess antibacterial activity against wound pathogens.

Spectroscopic, Chromatographic, and Mass Spectrometry Methodologies for Honey Geographical Production and Botanical Origin Characterization and Authentication

Chapter

Feb 2025

Honey is a traditional food sweetener with a very complex composition, produced naturally by bees (Apis mellifera), highly consumed and appreciated by society not only because of its nutritional value and taste but also due to its beneficial properties on human health. Composed mainly of sugars, water, and proteins, it also contains other bioactive substances, such as vitamins, enzymes, organic acids, and polyphenols, that contribute to a greater or lesser extent to its organoleptic and physicochemical properties, being an important source of antioxidants, exhibiting also an immunomodulator effect in wound healing, as well as antitumoral, anti-inflammatory, antifungal, and antibacterial properties. These properties are influenced by the botanical origin, geographical production area, the environment, and floral and entomological sources, among other factors. Thus, the characterization of honey based on the different factors that influence its organoleptic and health characteristics, such as geographical origin, is of paramount importance to protect and enhance the beekeeping sector. The special and unique characteristics of honey have placed it as one of the products most vulnerable to manipulation for illicit purposes, with adulteration and mislabeling being the most common fraudulent practices. This issue is aggravated by the fact that the honey supply is frequently lower than the demand, a situation that has recently been further intensified by the drought environmental conditions in many honey-producing areas. Thus, honey authenticity today awakens the interest of all the actors involved, aiming to avoid economic losses in the beekeeping sector. Hence, among the most relevant honey authenticity issues, we can find the assessment of the botanical species and the geographical production region, especially for those products labelled with a protected designation of origin (PDO) or other equivalent quality attributes, due to the higher prizes they can reach in the market. Spectroscopic, chromatographic, and mass spectrometry methodologies are widely employed to characterize honey and to solve different honey authentication issues, including fraudulent practices based on adulteration and mislabeling. In this chapter, the role of chromatographic separation techniques, such as liquid chromatography (LC) and gas chromatography (GC), spectroscopy –including simple spectrophotometric assays, such as Folin Ciocalteu (FC) or ferric reducing antioxidant ability (FRAP) assays–, and mass spectrometry to characterize and assess honey botanical and geographical production origin will be addressed by means of relevant examples. An exhaustive review of the topic with coverage of all kinds of publications is beyond the scope of the present contribution, so we will focus on the most relevant applications published in the last five years.

Antimicrobial Analysis Methods of Bee Products

Chapter

Full-text available

Jun 2024

Serra Bilen

Bee products are used in many fields and consumed as food today. Unfortunately, it is known that bee products are unfortunately affected by counterfeiting activities and their contents are changed. Healing bee products become harmful with adulteration and dangerous chemicals. For this reason, analysis methods are developed to know the reliability and content of bee products. In this book titled Methods of Biochemıcal Analysis of Bee Products, how the current analysis methods are carried out and which analyses are included. Thus, with this book, scientists and related institutions and individuals who want to perform the analysis of bee products will be able to access many analysis methods collectively and learn the important points. This book will be an important source for the analyses of bee products. This book will be useful for scientists, beekeepers and related public and individuals.

Characterization of Antibiofilm and Antimicrobial Effects of Trigona Stingless Bee Honey Compared to Stinging Bee Centaurea hyalolepis and Citrus Honeys

Article

Full-text available

Aug 2024

The antibiofilm and antimicrobial properties of tropical honey types including Malaysian stingless bee honey remain explicitly unexplored when compared with Apies honey. The antibiofilm and antimicrobial activities of the Malaysian Trigona honey were characterized with two stinging bee honey types (Centaurea hyalolepis and Citrus honeys) from Jordan. The antibiofilm and antimicrobial investigations were conducted on a set of seven microbial strains; five bacterial species of Pseudomonas aeruginosa ATCC 10145, Streptococcus pyogenes ATCC 19615, Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Klebsiella pneumoniae ATCC 13883, and two fungal strains Candida albicans ATCC 10231 and Candida krusei ATCC 14243. The antimicrobial investigations revealed a broad spectrum activity for Trigona honey against Gram-positive, Gram-negative, and fungal strains over the two honey types. One-way ANOVA showed a significant difference (p < 0.001) in the zone of inhibition ranging from 9 to 25 mm and minimum inhibition activity (MIC) ranged from 9.4–29.6% (w/v) against the microbial strains. Moreover, the addition of honey to established biofilms has induced a degradation activity in the biofilm mass. Two-way ANOVA showed a significant biofilm degradation proportion (p < 0.001) ranging from 1.3% to 91.3% following treatment with Trigona honey and the other honey types in relevance to the concentration ranging from 10% to 50% (w/v). Moreover, the antibiofilm activity was highly consistent with MIC affecting bacterial growth inhibition. In conclusion, a robust antimicrobial and antibiofilm activity for Trigona stingless bee honey over the stinging bee Centaurea hyalolepis and Citrus honeys is noticed which endows the usage of Trigona honey in the antimicrobial industry.

Health benefits of honey: A critical review on the homology of medicine and food in traditional and modern contexts

Article

Mar 2025

Antimicrobial and antioxidant potential of Yemeni Sidr honey against multidrug-resistant pathogens – in vitro and in silico studies

Article

Full-text available

Feb 2025

Background Honey’s medical values have been extensively recorded in literature. Yemeni Sidr honey was reported to treat many ailments like stomach and respiratory disorders. ESKAPE and other multidrug-resistant pathogens are considered one of the top three risks to global public health, so alternative strategies become critical demand against such pathogens or their biofilms. The current study aimed to explore the antibacterial and antioxidant potential of the Yemeni Sidr honey extracts. The antibacterial activity of the two Yemeni Sidr honey extracts (ST and SM) was assessed against different pathogenic strains. The antioxidant activity was also evaluated using ORAC, ABST, 5-LOX, and DPPH. Furthermore, 2D HSQC data of both ST and SM honey extracts were collected uploaded to the SMART platform to identify the possible metabolites in these extracts. The identified metabolites were analyzed using docking and molecular dynamic simulations (MDS) to identify the key players in the antibacterial action. Results The antibacterial activity revealed that ST and SM extracts have similar activity against all tested pathogens . ST extract exhibited superior antibiofilm effect against P. aeruginosa and C. albicans by 68.2% and 62.6%, respectively, exceeding the reference standards. Moreover, ST extract displayed the highest antioxidant power against all assays except the DPPH assay. SMART dereplication of the HSQC data of ST extract revealed the annotations of five carbohydrates (fructose, glucose, mannose, maltose, and sucrose); while, SM extract showed three major phenolic compounds (chrysin, ellagic acid, and caffeic acid), in which chrysin and ellagic acid were likely the key players in the antibacterial action, based on MDS. Conclusions The study confirmed the effectiveness of Sidr honey against the tested multidrug-resistant pathogens. Additionally, our observations shed the light on the main secondary constituents in Yemini Sidr honey extracts, and their effective role in multidrug-resistant pathogens growth inhibition.

Antimicrobial Properties of Hive Products and Their Potential Applications in Human and Veterinary Medicine

Article

Full-text available

Feb 2025

Hive products, encompassing honey, propolis, bee venom, royal jelly, and pollen, are recognized for their antimicrobial and therapeutic properties. This review examines their chemical composition, explores their mechanisms of action, and discusses their potential applications in both human and veterinary medicine, particularly in addressing the challenge of antimicrobial resistance. This study utilized a comprehensive literature search strategy, gathering data from Google Scholar, MEDLINE PubMed, SciELO, and SCOPUS databases. Relevant search terms were employed to ensure a thorough retrieval of the pertinent literature. Honey, rich in bioactive compounds such as hydrogen peroxide and methylglyoxal, effectively disrupts biofilms and combats multi-drug-resistant pathogens, showing promise in treating a range of infections. Propolis, with its flavonoids and phenolic acids, demonstrates synergistic effects when used in conjunction with antibiotics. Bee venom, particularly its component melittin, exhibits antibacterial and immunomodulatory properties, although further research is needed to address toxicity concerns. Pollen and royal jelly demonstrate broad-spectrum antimicrobial activity, which is particularly relevant to animal health. Existing pre-clinical and clinical data support the therapeutic potential of these hive products. Hive products represent a vast and largely untapped natural resource for combating antimicrobial resistance and developing sustainable therapies, particularly in the field of veterinary medicine. However, challenges remain due to the inherent variability in their composition and the lack of standardized protocols for their preparation and application. Further research is essential to fully elucidate their mechanisms of action, optimize formulations for enhanced efficacy, and establish standardized protocols to ensure their safe and effective clinical use.

Health Benefits of Honey and Propolis

Chapter

Full-text available

Dec 2024

Honeybees are important for pollination and produce products including honey, propolis, royal jelly, pollen, beeswax, and bee venom. Honey is a sweet liquid substance prepared by honeybees, which collects nectar and pollen from different flowers, and propolis is a glue substance collected by bees from different plant parts. In this review aimed to provide comprehensive studies on honey and propolis composition, bioactive compounds contained. as well as the bioactive components that are present. The purpose of this paper is to provide an overview of the biological potential of honey and propolis for human health. This includes their capacity to suppress bacteria, improve wound healing, and impact specific disorders. Furthermore, it is important to emphasize the benefits of honey and propolis for various health conditions, including allergies, oral problems, dermatological issues, and gastrointestinal disorders, as well as their antimicrobial, anti-inflammatory, immunomodulatory, antioxidant, anti-tumor, and cardiovascular properties. However, we have not fully elucidated the mechanisms of action of propolis and honey on all the previously listed activities. To gain a fuller understanding of its mechanics and the potential uses of this phenomenon, additional research is required.

Methods of Biochemical Analysis of Bee Products

Book

Full-text available

Jul 2024

Antibacterial Activity of Natural and Commercial Honey-A Comparative Study

Article

Full-text available

Jan 2017

Honey forms part of the traditional medicine in many cultures. Honey has been extensively used as healing agent throughout the human history in addition to its widespread usage as popular food. Honey is a sweet substance produced as a food source mainly from the nectar and secretions of plants by honey bees. In the present research, the antimicrobial activity of three different Honey samples viz., Kombu Honey, Malan Honey and Commercial Honey were evaluated against pathogenic bacteria (Staphylococcus aureus, Micrococcus luteus, Bacillus cereus, Escherichia coli, Klebsiella pneumoniae, Salmonella typhi, Shigella flexneri, Proteus mirabilis, Pseudomonas aeruginosa and Acetobacter baumani). The Natural and Commercial honey samples selected for the present study was collected from Chetheri Malai, Harur, Tamil Nadu, India. The Kombu honey, Malan honey and Commercial honey showed maximum zone of inhibition against Staphylococcus aureus. In conclusion, Kombu honey exhibited more antimicrobial activity against bacterial pathogens when compared to the Malan honey and Commercial honey.

Antimicrobial effect of honey produced by on some common human pathogens Apis mellifera

Article

Full-text available

Jan 2010

Pharmacology of Honey: A Review

Article

Full-text available

Jan 2016

Honey has been extensively used as healing agent throughout the human history in addition to its widespread usage as popular food. Honey is a sweet substance produced as a food source mainly from the nectar and secretions of plants by honey bees. Honey is used to feed bees during the winter. For centuries, honey has been used as food and as natural medicine, being prescribed by physicians of many ancient cultures for the treatment of a wide variety of ailments. In most ancient cultures honey has been used for both domestic and medical purposes. The belief that honey is a nutrient, a drug and an ointment has been carried into our days and thus, an alternative medicine branch, called apitherapy has been developed in recent years, offering treatments based on honey and other bee products against many diseases including bacterial and fungal infections. The present review focused on the pharmacological properties of honey. The topics covered in this present review includes: History of honey as medicine, Composition of honey, Medicinal properties of honey, Antimicrobial activity of honey and Uses of honey.

Harmonised methods of the European Honey Commission

Article

Full-text available

Jan 1997

The medicinal value of honey: A review on its benefits to human health, with a special focus on its effects on glycemic regulation

Article

Full-text available

May 2011

Honey, a natural substance produced by honeybees, is composed of a complex mixture of carbohydrates, water, and a small amount of +proteins, vitamins, minerals, and phenolic compounds. Fructose, glucose and maltose are among the various types of sugars present in honey. Used for millennia as both food and medicine, honey has been associated with improved antioxidant capacity, modulation of the immune system, antimicrobial activities, influence on lipid values (through antihypercholesterolemic effects) and regulation of glycemic responses, among other benefits. The aim of this article was to review the effects of natural honey intake on human health, with particular reference to its influence on glycemic regulation. Several studies have focused on the potential use of honey as a nutritional supplement for healthy individuals and for those with impaired glucose tolerance, diabetes, and their related comorbidities. Such investigations have found that, compared to glucose and sucrose, the consumption of honey decreases glycemic levels and blood lipids in healthy, diabetic and hyperlipidemic individuals. Moreover, long periods of honey intake seem to reduce fasting glucose levels in humans, suggesting that honey consumption influences plasma glucose regulation, mainly through a normo-or hypoglycemic effect. Therefore, honey may be proposed as a nutritional dietary supplement for healthy individuals and for those suffering from alterations in glycemic regulation.

Honey - A Remedy Rediscovered

Article

Jul 1989

Honey: A comprehensive survey

Article

Jan 1975

Antimicrobial resistance: Global report on surveillance

Article

Jan 2014

Medicinal uses and health benefits of Honey: An Overview

Article

Jan 2010

A survey of non-manuka New Zealand honeys for antibacterial and antifungal activities

Article

Jan 2004

To assess the variation in antibacterial and antifungal activity of non-manuka honeys, a study was undertaken using 179 unifloral, unpasteurized honey samples obtained from commercial beekeepers throughout New Zealand. The honeys were tested against Staphylococcus aureus and Candida albicans, Escherichia coli and the dermatophyte Trichophyton mentagrophytes using agar well diffusion, measurement of minimum inhibitory concentration and modified agar well diffusion methods, respectively. Of the 179 non-manuka honey samples assessed, none showed non-peroxide or anti-yeast antimicrobial activities. By contrast, 50% of the samples tested showed antibacterial activity against S. aureus, with activity ranging from 5.0-27.9% phenol equivalent. Approximately 30% of the samples tested showed antibacterial activity against E. coli; however honey concentrations required for inhibition were, with one exception, in excess of 19%. Similarly, 35% of samples showed antifungal activity although the levels of activity measured were low.

Comprehensive Review on Honey: Biochemical and Medicinal Properties

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