Dosage exploration of the effects of honey and its derivatives on cardiometabolic outcomes: an overview of systematic reviews and GRADE-assessed updated meta-analysis.

2025-11-19
Nutrition & diabetes 15(1)
- Mostafa Norouzzadeh
- Sanaz Barazandeh
- Minoo Hasan Rashedi
- Sanaz Jamshidi
- Fatemeh Hatamifar
- Zohreh Maghsoomi
- Farshad Teymoori
- Mojtaba Malek

PubMed: 41261111
DOI: 10.1038/s41387-025-00403-9

Study Design

Type: Meta-Analysis
Sample size: n = 3,544
Population: 69 RCTs with 3544 participants
Methods: Systematic search of PubMed, Scopus, and Web of Science from inception through 21st October 2024; random-effect pairwise analysis, dose-response and influence analyses

Cardiovascular diseases and diabetes are associated with significant mortality, morbidity, and economic burden, highlighting the need for alternative preventive strategies. Honey bee products, including honey, royal jelly, and propolis, are considered potential interventions for managing cardiometabolic risk factors. This umbrella review aimed to compare the effectiveness of these products in cardiometabolic health. PubMed, Scopus, and Web of Science databases were systematically searched from inception through 21^ST October 2024 to identify eligible meta-analyses and primary randomized controlled trials (RCTs). Random-effect pairwise analysis combined trial findings, while dose-response and influence analyses assessed result robustness. Evidence quality and certainty were evaluated using AMSTAR-II, ROB, GRADE, and ICEMAN criteria. Analysis of 69 RCTs with 3544 participants revealed that 10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein. Royal jelly improved blood pressure, lipid profiles, glycemic indices, and total antioxidant capacity. Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers. While long-term or high-dose honey consumption in individuals with health concerns warrants caution, RJ and propolis demonstrated dose-dependent benefits for cardiometabolic health with proper certainty. Future research should focus on population-specific characteristics and optimized dosages.

Research Insights

Honey→Increased Aspartate Transferase Level
10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein.
Effect
Harmful
Effect size
Small
Dose
10 g daily
Honey→Increased Blood Glucose Levels
10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein.
Effect
Harmful
Effect size
Small
Dose
10 g daily
Honey→Increased C-Reactive Protein Level
10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein.
Effect
Harmful
Effect size
Small
Dose
10 g daily
Honey→Increased Systolic Blood Pressure
10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein.
Effect
Harmful
Effect size
Small
Dose
10 g daily
Honey→Reduced Hemoglobin A1C Level
10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein.
Effect
Beneficial
Effect size
Small
Dose
10 g daily
Honey→Reduced Triglyceride Level
10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein.
Effect
Harmful
Effect size
Small
Dose
10 g daily
Propolis→Improved Blood Lipid Profile
Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers.
Effect
Beneficial
Effect size
Moderate
Propolis→Improved Glycemia
Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers.
Effect
Beneficial
Effect size
Moderate
Propolis→Improved Liver Enzyme Activity
Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers.
Effect
Beneficial
Effect size
Moderate
Propolis→Reduced Anthropometric Measure
Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers.
Effect
Beneficial
Effect size
Moderate
Propolis→Reduced Inflammatory Markers
Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers.
Effect
Beneficial
Effect size
Moderate
Propolis→Reduced Oxidative Stress Marker
Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers.
Effect
Beneficial
Effect size
Moderate