Regular consumption of sugar is considered harmful to our health, including increasing the risk of diabetes, obesity, and cardiovascular disease. However, there is one natural sugar that is an exception. It has even been found to benefit cardiovascular health and blood sugar control, and it is honey.
According to the World Health Organization, cardiovascular diseases account for 32 percent of all deaths worldwide. Sugar, which is present in many processed foods, is thought to be one of the causes of cardiovascular diseases. Regular intake of excessive free sugar, such as white sugar, rock sugar, granulated sugar, and high-fructose corn syrup, increases the risk of chronic inflammation, obesity, Type 2 diabetes, and cardiovascular diseases.
However, many studies have found that honey, which is also classified as “free sugar”, contains multiple healthy nutrients that are beneficial for cardiovascular health. A new study pointed out that eating the right honey can improve blood lipid levels and control blood sugar.
This meta-analysis from the University of Toronto showed that honey reduces fasting blood sugar levels, total and LDL cholesterol (bad cholesterol), fasting triglycerides, and fatty liver markers (ALT); honey also significantly increases HDL cholesterol (good cholesterol).
Although honey is made up of approximately 80 percent sugar and 20 percent water, it contains about 180 healthy substances, including amino acids, vitamins, minerals, probiotics, and polyphenols.
Yi Fang Tsai, a nutritionist at the Koii Nutrition Consulting Center in Taiwan, said that the benefits of honey on the cardiovascular system are primarily related to polyphenols.
Polyphenols are common substances found in nature; polyphenols in honey include quercetin, caffeic acid phenethyl ester (CAPE), acacetin, kaempferol, galangin, chrysin, etc., all of which are good for cardiovascular health. These substances can prevent thrombosis, prevent the oxidation of bad cholesterol, and enhance vasodilation, all of which help reduce the risk of heart disease.
Quercetin: Quercetin can lower blood pressure, improve endothelial function, and reduce the risk of coronary heart disease, and stroke. In addition, it also has a preventive effect on angiotensin II-induced vascular smooth muscle cell hypertrophy, and vascular smooth muscle cells are one of the important components that regulate atherosclerosis and vascular restenosis.
Caffeic acid phenethyl ester: The CAPE is one of the main components of propolis; it helps with vasodilation, lowers blood pressure, and is anti-atherosclerotic.
Acacetin: Clinically, acacetin can be used as a drug for the prevention and treatment of atrial fibrillation. 
Kaempferol: Kaempferol can prevent cardiac dysfunction induced by myocardial ischemia-reperfusion.
Galangin: Its antioxidant properties protect endothelial tissues.
Chrysin: It has a protective effect on myocardial structure; it can alleviate myocardial damage and has the function of regulating blood pressure.
The types and contents of polyphenols in honey from different floral sources are slightly different, but the protective effect of honey on the cardiovascular system comes from the synergistic effect of these phenolic compounds.
Honey also provides cardiovascular health benefits in obese patients with cardiovascular risk factors. In a controlled trial, obese patients were assigned into 2 groups: one group received 70 grams of sucrose per day, and the other group received 70 grams of natural honey.
After 30 days, the group that received honey experienced the following changes: a 3.3 percent reduction in total cholesterol, a 4.3 percent reduction in LDL cholesterol, and a 19 percent reduction in triglycerides. In addition, these people experienced a mild reduction in body weight. As for the people in the sucrose group, their LDL cholesterol (bad cholesterol) increased significantly by 9 percent, and their body weight also increased slightly. 
Many people who are concerned about blood sugar levels are afraid of eating sugar, but a meta-analysis by the University of Toronto shows that honey can lower fasting blood glucose. This is because, in addition to antioxidants such as polyphenols, honey also contains rare sugars.
Rare sugars account for about 14 percent of the sugar content in honey, and are monosaccharides and their derivatives with limited availability in nature. They can inhibit certain enzymes or down-regulate glucose transporters, thus having short-term and long-term positive effects on blood sugar levels.
Yi Fang Tsai added that honey also contains oligosaccharides, which prompt a more gradual rise in blood sugar. Furthermore, oligosaccharides can serve as prebiotics and become food for gut bacteria.
Honey enhances insulin sensitivity, which further stabilizes blood glucose levels. This is related to the fact that honey can increase the level of adiponectin. Adiponectin, a hormone secreted by adipose tissue, can regulate glucose and lipid metabolism, and diabetic patients have low levels of adiponectin. Increased levels of adiponectin in the body help reduce systemic inflammation and improve insulin sensitivity.
The cardiovascular benefits of honey are also reflected in diabetic patients. Long-term consumption of honey by patients with Type 2 diabetes can improve cardiovascular conditions. Some studies suggest that honey may reduce cardiovascular complications in diabetic patients.
Besides, a study of more than 18,000 people found that people who regularly consumed honey were less likely to develop prediabetes, and people who ate honey four to six times a week were 23 percent less likely to develop prediabetes than those who did not.
Honey is beneficial for both cardiovascular health and blood sugar control. So how do we maximize the health benefits of honey? There are a few ways:
1.) Replace added sugar with honey
White sugar and granulated sugar that people often use, as well as high fructose corn syrup commonly used in processed foods, are not conducive to blood sugar control. If you are used to adding sugar to your breakfast, snacks, coffee, or tea, replace it with honey.
2.) Control the amount of honey
Honey has many nutrients but is still a type of sugar, so be sure to limit the amount you consume.
The WHO recommends reducing sugar intake to less than 10 percent of total energy intake. The recommended daily intake per person is calculated on the basis of 2,000 calories a day, so a 10 percent serving is about 40 grams of honey (2 tablespoons).
Yi Fang Tsai pointed out that honey is good for people only when consumed in moderation. The amount of honey must be limited if you have eaten other sugary foods during the day.
This is especially important for diabetic patients, as excessive consumption of honey is still bad for blood sugar control.
3.) Single-Origin Raw Honey Is Better Than Processed Honey
The difference between raw honey and processed honey is that the latter has been sterilized at high temperatures, and its nutritional value has been destroyed to some extent. Raw honey does not go through this process and therefore retains most of its nutrients.
Raw honey contains probiotics such as Lactobacillus, which can boost the immune system, lower blood lipid levels, and supply short-chain fatty acids (SCFA). SCFAs can prevent inflammatory diseases and enhance intestinal barrier function. In addition, the amylase in raw honey can help digest starch.
However, probiotics and amylase are sensitive to heat; hence, the composition and biological activity of processed honey after short-time heating at 60 to 65 degrees Celsius will inevitably change, and the health benefits will also be affected to a certain extent.
Studies have also shown that eating raw honey, especially single-origin raw honey (e.g. clover honey and acacia honey), is more beneficial to cardiovascular health.
It is worth noting that both raw honey and processed honey should not be eaten by children younger than 1, especially raw honey, as it may contain clostridium botulinum (that causes botulism).
4.) Diabetic patients should pair honey with other foods
Healthy individuals can eat honey on an empty stomach, but it is not recommended for people with insulin resistance and diabetes. This is because the main component of honey is fructose, and eating honey alone will affect blood sugar levels.
Yi Fang Tsai suggested that these patients can pair honey with other non-sugar foods, like sugar-free yogurt with honey, or eggs with honey water.

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