Honey

Honey is sugar with extras: about 80% sugar by weight, plus a small fraction of plant compounds. Pooled short trials suggest it slightly lowers fasting blood sugar and cholesterol, but the same analysis found two inflammation markers going up, and the blood-sugar benefit fades once missing studies are accounted for.

A tablespoon (about 20 g) of raw honey now and then is fine and probably slightly better than the same amount of refined sugar, but treat it as sugar, not a health food. Never give honey, raw or processed, to a baby under 12 months.

What is in it

Honey is made by bees from flower nectar. By weight it is about 80% simple sugars. Raw, unfiltered honey is a mixture of roughly 200 identified constituents, most of them ordinary components such as sugars, water and minerals; a minority are the compounds of interest — flavonoids, phenolic acids and the enzymes glucose oxidase and catalase.^[1]

Pasteurised, ultrafiltered supermarket honey loses a quarter to two-thirds of its phenolic content to heat, depending on the compound and the method.

For the sugar limits, honey counts in full. The World Health Organization (WHO) counts the sugar in honey as "free sugars", which it recommends keeping below 10% of daily energy.^[2] How that limit and the others compare is covered under Sweeteners.

Small benefits in trials, with a catch

The best summary of the evidence pooled 18 controlled trials in 1,105 people, who ate a median of about 40 g of honey a day for about eight weeks. Compared with the control diets, honey lowered fasting glucose by 0.20 mmol/L and total cholesterol by 0.18 mmol/L — both small changes, and both graded low certainty. The effects were clearest with raw honey and with single-flower honeys such as robinia and clover.^[3]

Two findings in the same review cut against reading this as a health endorsement:

Inflammation markers went up, not down. Honey raised interleukin-6 by 0.37 pg/mL and tumour necrosis factor alpha by 1.44 pg/mL, two signals of inflammation. Both were graded moderate certainty, a higher grade than either benefit.
The blood-sugar benefit may be inflated. The fasting-glucose result showed signs of publication bias — small positive studies being more likely to appear in print. Corrected for it, the effect halved to 0.10 mmol/L and could no longer be told apart from no effect.

The trials were mostly short and the effects clinically modest. Two of the review's authors have received research support from the US National Honey Board, though the review itself was publicly funded.^[4]

Raw against supermarket honey: untested

The heat-processing loss sounds as if it should matter, but nobody has shown that it does. A three-way head-to-head trial gave people honey, table sugar or high-fructose corn syrup for two weeks and found similar effects on blood sugar, blood fats and inflammation.^[5] The advantage of raw honey in the pooled analysis rests on a subgroup drawn from only five raw-honey trial comparisons in the whole review, within results graded low certainty. Raw is a reasonable preference, not a proven one.

Manuka and the anti-ageing claims

Manuka honey, a high-methylglyoxal honey made from the nectar of Leptospermum scoparium, has well-established antibacterial activity when applied to the skin, which is why it is used on wounds. Its claimed whole-body anti-inflammatory and anti-ageing effects rest on test-tube work with immune cells and small animal studies.

The same goes for the wider claim that honey's polyphenols switch on the longevity pathways run by the enzymes AMPK (AMP-activated protein kinase) and SIRT1 (sirtuin-1): it is preclinical, never shown in people.

Who should be careful

Babies under 12 months. Honey, raw or processed, must never be given to an infant: it is the one identified dietary source of infant botulism.
Anyone counting sugar. Honey is still about 80% sugar; how much you eat matters more than where it came from.

What to do

Count honey as sugar within your daily limit, not as a supplement.
If you use it, keep it to about a tablespoon now and then, raw if you can get it.
Don't buy manuka honey to eat for health. Its established use is on wounds.
Never give honey to a baby under one year old.