Professional Documents
Culture Documents
2011
www.rcia.uc.cl
human health
literature review
Abstract
M.E. Corts, P. Vigil, and G. Montenegro. 2011. The medicinal value of honey: a review
on its benefits to human health, with a special focus on its effects on glycemic regulation.
Cien. Inv. Agr. 38(2): 303-317. 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.
Key words: Diabetes, flavonoids, glycemic regulation, honey, insulin resistance, nutraceuticals,
nutrition.
Introduction
Honey is a natural substance of sweet flavor
and viscous consistency produced by honeybees, especially by the species Apis mellifera.
Received March 12, 2010. Accepted March 23, 2011.
Corresponding author: manuelcortes@uc.cl
Honey was probably the first sweetener discovered by man, and its use dates back to the
origins of mankind itself (Havsteen, 2002); in
fact, honey reportedly constituted a component of the Paleolithic diet (Eaton and Eaton,
2000). There is evidence of the development of
beekeeping in the Neolithic, as shown in cave
paintings found in Cueva de la Araa, near
Bicorp, Valencia, Spain, which depict honey
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also been suggested that the presence of variable amounts of heavy metals can be related to
the geographical and botanical origin of this
product (Fredes, 2004; Fredes and Montenegro,
2006).
In natural honey, as well as in propolis and royal
jelly, most of the phenolic compounds are present in the form of flavonoids (Viuda-Martos et
al., 2008), a vast family of phytochemicals comprising chalcones, flavandiols, flavonols, anthocyanins and proanthocyanidins. Flavonoid biosynthesis is derived from the phenylpropanoid
pathway, one of the most widely studied secondary metabolic routes in plant systems. Several phenolic compounds, especially flavonoids,
are associated with multiple benefits on human
health, including anti-inflammatory, antioxidant, antiallergic, antithrombotic, antidiabetogenic, hypoglycemic, normolipidemic, hepatoprotective, antiviral and anticarcinogenic activities (Havsteen, 2002; Middleton et al., 2000;
Prez-Trueba, 2003). Due to these properties,
flavonoids have been recognized as nutraceutical compounds (Tapas et al., 2008). Regarding
the flavonoids identified in Chilean honeys, it is
important to highlight specific compounds, such
as chrysin, galangin, isorhamnetin, kaempferol,
myricetin, naringenin, pinobanksin, pinocembrin, quercetin, and rutin (Muoz et al., 2007;
Montenegro et al., 2009). The specific effects of
these compounds on glucidic metabolism will
be described further below.
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mechanisms of antioxidant activity of the phenolic compounds present in honey and related
beehive products are not yet fully understood.
However, the most probable ones include free
radical scavenging, hydrogen donation, the interference with propagation reactions or inhibition of enzymatic systems involved in initiation
reactions, metallic ion chelation, and acting as
a substrate for diverse free radicals, especially
ROS (van Acker et al., 1996; Al-Mamary et al.,
2002; Havsteen, 2002; Middleton et al., 2000;
Viuda-Martos et al., 2008).
Effects on the immune system
It has been suggested that the consumption of
honey can exert several beneficial effects on the
human immune response and on its associated
mechanisms. In fact, honey has been reported
to promote the multiplication of human peripheral blood B- and T-lymphocytes and the activation of neutrophils under conditions of cell culture (Abuharfeil et al., 1999). In monocytic cell
line culture, honey has been shown to stimulate
the release of inflammatory cytokines, such as
tumor necrosis factor-alpha, interleukin-1 and
interleukin-6 (Tonks et al., 2003), which are
involved in triggering a number of functions
of the immune response to infection (Molan,
2001). Moreover, in mice, it has been found
that the intake of a honey-supplemented diet
stimulates the production of antibodies during
the primary and secondary immune responses
against thymus-dependent and -independent antigens (Al-Waili and Haq, 2004). A recent study
reported an immuno-modulatory potential of
honey in the course of phagocytosis, mainly by
modifying the oxidative burst process through
the inhibition of phagocytic myeloperoxidase
activity and an inhibitory effect exerted by the
major sugar constituents of honey on exocytosis-associated ROS formation catalyzed by myeloperoxidase (Mesaik et al., 2008).
Antimicrobial activity
Honey and beehive-related substances have
been used as antiseptic agents (e.g., propolis) since at least the time of Aristotle (Molan,
2001). Despite the evident antimicrobial capacity of honey, as determined by its effective inhibition of bacterial and fungal proliferation and
growth, there does not seem to be any clear-cut
cause, suggesting that it could correspond to a
combined or synergic effect of the antioxidant
compounds present (Viuda-Martos et al., 2008).
The following properties have been proposed
to explain the effect of honey against bacterial
growth: (i) the presence of hydrogen peroxide,
resulting from the action of the glucose-oxidase
enzyme on glucose in presence of oxygen (Garca et al., 1986; Wahdan, 1998; Molan, 1999a,
Khan et al., 2007), a compound whose activity
appears to decrease as honey remains in storage
(Montenegro et al., 2009); (ii) inherent physicochemical properties, such as its high sugar
content (~80% w/w) that can produce a high osmotic effect and its acid pH of 3 to 4.5 (Molan,
1992; Bogdanov et al., 1997); (iii) the presence
of diverse organic acids (Aparna and Rajalakshmj, 1999), including gluconic acid (also derived from glucose catalysis), which remarkably
creates an acidic microenvironment and whose
concentration varies considerably from one type
of honey to another (White et al., 1963; White,
1978); and (iv) non-peroxidic substances (Cabrera et al., 2006), such as polyphenols, which
possess antibacterial activity. These compounds
vary depending on the plant species from which
the bees gather their nectar (Cooper, 2007) and
seem to remain unaltered even after long periods of storage (Viuda-Martos et al., 2008). With
regard to the antibacterial activity, it has been
recently determined that extracts of unifloral
honeys from the endemic Chilean tree, Quillay (Quillaja saponaria), which contain several
natural phenolic compounds, show antibacterial
activity against Escherichia coli, Pseudomonas
aeruginosa, Staphylococcus aureus, Salmonella typhi, Streptococcus pneumoniae type , and
Vibrio cholerae, and antifungal activity against
Candida albicans (Montenegro et al., 2009).
Lastly, due to its antimicrobial properties, the use
of natural honey has also been recommended in
medical treatments for promoting wound disinfection and healing (Khan et al., 2007). Thus, some
physicians have also advised their patients to use
honey to improve the healing of surgical scars
(Molan, 1999b; Molan, 2001; Khan et al., 2007).
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Figure 2. One of the proposed hypothetical mechanisms through which several antioxidants (mainly flavonoids and
other phenolic compounds), which are present in natural honey, may act against the development of glycemic regulation
disorders by decreasing the oxidative stress caused by metabolic alterations, such as hyperglycemia, hyperinsulinemia
and dyslipidemia.
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Resumen
M.E. Corts, P. Vigil y G. Montenegro. 2011. Valor medicinal de la miel: beneficios en la
salud humana, con especial referencia en sus efectos sobre la regulacin glicmica. Cien.
Inv. Agr. 38(2): 309-323. La miel de abejas es una substancia natural constituida por una mezcla
compleja de carbohidratos, agua y una pequea proporcin de protenas, vitaminas, minerales
y compuestos fenlicos, entre otros constituyentes minoritarios. Utilizada por milenios como
alimento y medicina, se le atribuye un sinnmero de efectos beneficiosos, a saber: aumento
de la capacidad antioxidante, modulacin del sistema inmune, actividad antimicrobiana,
influencia sobre los niveles lipdicos mediante efectos antihipercolesterolmicos y regulacin
de las respuestas glicmicas, entre otros. Considerando lo anterior, nuestro objetivo es mostrar
los efectos de la ingesta de miel sobre la salud, con especial atencin en su influencia sobre
la regulacin glicmica. Diversos estudios han investigado si la miel puede constituir un
suplemento nutricional, tanto para individuos saludables como para aqullos con tolerancia
reducida a la glucosa, diabetes y comorbilidades asociadas. Estas investigaciones han
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