Mostafa Norouzzadeh, Sanaz Barazandeh, Minoo Hasan Rashedi, Sanaz Jamshidi, Fatemeh Hatamifar, Zohreh Maghsoomi, Farshad Teymoori, Mojtaba Malek
Journal: Nutrition & diabetes 2025;15(1):48
PMID: 41261111
Heart disease and type 2 diabetes are major causes of illness and death worldwide. Many people use natural products such as honey, royal jelly, and propolis in the hope that they may improve heart and metabolic health. However, research findings have been inconsistent, and it is unclear how much of these products might be beneficial. This umbrella review aimed to compare the effectiness of bee-related products on cardiometabolic health.
The results showed mixed effects for honey. Consuming about 10 g of honey per day was linked to a small improvement in long-term blood sugar. However, it was also associated with small negative effects on blood pressure, triglycerides, fasting blood sugar, liver enzymes, and inflammation markers. Royal jelly and propolis showed more consistent benefits for blood sugar control, blood fats, and other markers at specific doses (around 2200 mg for royal jelly and 1700–1900 mg for propolis).
In conclusion, honey and some of its derivatives may have small benefits for heart and metabolic health when used in specific moderate amounts, but honey may also have some unwanted effects. The certainty of evidence ranged from low to moderate for many outcomes, meaning that further high-quality trials are still needed. They should not replace established medical treatments. Healthcare professionals may consider these findings when advising patients who are interested in natural dietary approaches, while emphasising overall diet quality and evidence-based care.
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• Replacing simple sugar with 10g of good quality honey per day may positively influence HbA1c levels. However, caution is advised for long-term use due to potential adverse effects lipid profiles, blood pressure and inflammatory markers.
Introduction:
A systematic review was conducted to examine the effects of honey, Royal Jelly (RJ) and propolis on cardiometabolic health markers.
Method:
The analysis included 69 randomised controlled trials (RCTs), involving 3544 male and female participants (50.2%), sourced from PubMed, Scopus, and Web of Science.
The primary outcomes focused on assessment of cardiometabolic biomarkers: glycaemic control, lipid profiles, and blood pressure.
Honey dose and outcomes
• 10g Honey was associated with a reduction in HbA1C (WMD: −0.25, 95% CI: −0.45 to −0.05; I²: 58.6%).
• Conversely, honey increased triglyceride (TG) levels (WMD: 8.09 mg/dL, 95% CI:1.22 to 14.9; I²: 7.78%, CoE: Low) and systolic blood pressure (SBP) (WMD:4.24 mmHg, 95% CI: 2.03–6.45; I²: 0.00%) and diastolic blood pressure (DBP) (WMD: 1.94 mmHg, 95% CI: 0.40 to 3.48; I²: 0.00%)
Royal Jelly, dose and outcomes
• Royal Jelly demonstrated a lowering effect on insulin (INS) levels (WMD: −3.63 μU/mL, 95% CI: −6.77 to −0.49; I²: 27.8%) and reduced total cholesterol (WMD: −11.0 mg/dL, 95% CI: −18.0 to −3.96; I²: 13.4%, CoE: Moderate).
Propolis, dose and outcomes
• Propolis supplementation showed an improvement in glycaemic control by reducing fasting blood glucose (FBG) (WMD:−10.9 mg/dL, 95% CI: −17.3 to −4.51; I²: 94.4%), Insulin (WMD: −1.55 μU/mL, 95% CI: −2.47 to −0.63; I²:88.4%), and HbA1C (WMD: −0.49, 95% CI: −0.76 to −0.21; I²: 85.2%).
• Propolis supplementation improved lipid markers by lowering LDL-C/HDL-C ratio (WMD: −0.20, 95% CI −0.36 to −0.05; I²: 25.2%, CoE: Very Low)
Conclusion:
This review concluded that honey consumption was associated with adverse effects on blood pressure. In contrast, Royal Jelly (RJ) demonstrated beneficial effects on both lipid, and glycaemic profiles, while propolis supplementation improved lipid metabolism, and glycaemic control.
• This review found that a daily intake of 10g of honey significantly reduced HbA1C levels (WMD: −0.37; 95% CI: −0.56 to −0.18). However, these beneficial effects diminished at doses exceeding 50g per day.
• The findings also demonstrated that honey increased blood pressure, highlighting the need for healthcare practitioners to exercise caution when recommending honey to hypertensive patients. In such cases, the anti-hypertensive effects associated with Royal Jelly (RJ) may offer a more suitable alternative.
• A dose-response analysis revealed that approximately 2,200 mg of RJ is required to achieve a minimal clinically important difference (MCID) of 4 mg/dL in LDL-C levels, while a dose of 500 mg daily significantly reduced triglyceride levels beyond the MCID threshold (10.5 vs. 8 mg/dL).
• The greatest reduction in triglyceride levels was observed with a daily
propolis dose of 500 mg, resulting in a weighted mean difference (WMD) of −10.5 mg/dl (95% CI: −18.7 to−2.37).
• Given the concerns surrounding honey’s effects on blood pressure and inflammatory markers, further high-quality clinical trials are needed to clarify its long-term safety and cardiometabolic impact.
• Although Royal Jelly (RJ) has demonstrated beneficial effects on lipoprotein metabolism, the precise biological mechanisms underlying these effects remain poorly understood and require further investigation.
• Future research exploring combination therapies involving honey, RJ and propolis may reveal synergistic benefits, particularly within high-risk cardiometabolic populations.
• In addition, many commercially available formulations lack quality control, and optimal concentrations of bioactive compounds required to achieve therapeutic efficacy. Future studies should prioritize standardisation, safety and reproducibility across formulations.
• Further investigations focusing on population-specific responses and optimised dosing strategies are also warranted to better guide clinical applications.
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 21ST 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.
© 2025. The Author(s).
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