The effects, contraindications, and sugar content of honey (honey).

Honey has been considered a beneficial substance since ancient times, and in recent years, "honey water" and "honey lemon water" have been touted online as having health benefits and even anti-cancer properties. Some of these claims are unfounded, but some are indeed supported by research—the problem is that few people mention the most fundamental thing about honey:Its main component is sugar.。

This article clarifies three key points: the nutritional composition of honey, its proven uses (and who should absolutely avoid it), and how to calculate daily sugar and calorie intake. The "honey" commonly referred to in Hong Kong is the same honey discussed in this article.

I. What is honey? Let's first understand its composition.

Honey is a thick liquid produced by bees from nectar collected from flowers, processed and dehydrated. Its main components are sugar and water, with other ingredients making up a very small percentage. According to the USDA database, approximately 100 grams of honey contains the following:

A quick look at the numbers makes it clear: approximately [amount of honey].Eighty percent of the ingredients are sugar.The rest is water. The mineral content is only tens of milligrams per 100 grams, which is a trace amount compared to daily needs; honey does contain small amounts of phenols, flavonoids and other components, but the amount that can be ingested in a typical serving is quite limited.

Therefore, the statement that "honey is a natural food and doesn't count as sugar" is incorrect. It is a natural food, and it is also sugar—the two are not contradictory. What's truly important is how much of your daily sugar intake it represents.

2. What are the differences between the sugar in honey and regular sugar?

The sweetness of honey mainly comes from monosaccharides: fructose (approximately 381 TP4T) and glucose (approximately 311 TP4T), with small amounts of maltose and sucrose. Because of its high monosaccharide content, honey has a different sweetness and texture than sugar, and is therefore often described as a "more natural source of sweetness."

However, when it comes to glycemic response, honey is actually similar to regular sugar—the values vary greatly depending on the honey's floral source, making it not a consistently "low-glycemic" food. For people who need to monitor their blood sugar, considering honey as a "safer sugar" is a potentially problematic idea.

III. WHO's 10% and 5%: Does honey count as "sugar"?

The World Health Organization's recommendations on sugar are divided into two levels, which is often confused:

• Key Recommendations (Strongly Recommended):Both children and adults shouldFree sugarsIntake reduced to a percentage of total daily energy Below 10%。
• Further suggestions (conditional suggestions):If it can drop further Below 5%This can bring additional health benefits. This is a "further reduction in recommendation," which is not the same level of recommendation as the former.

More importantly, the WHO's stance on "Free sugarsThe definition of "" - it clearly statesIncluding the sugars naturally present in honeyThis also includes sugars in syrups, fruit juices, and concentrated fruit juices. In other words, honey is not excluded from the WHO's calculation framework simply because it is "natural".

Taking 2000 kcal per day as an example, the WHO's own conversion method is: 10% is equivalent to 200 kcal, approximately 50 gramsSugar; 5% is equivalent to 100 kcal, approximately 25 gramsSugar. These limits refer to...The total amount of all free sugarsIt's not about "additional quotas for honey"—if beverages, sauces, and desserts already take up a portion, the space left for honey is even smaller.

IV. How much can I eat each day? (Honey water calorie conversion)

One tablespoon of honey is approximately 21 grams, and contains approximately [calorie content missing]. 64 kcalIt contains approximately 17 grams of sugar. Putting this number into the WHO framework, we can calculate the following reference values (honey is about 80% sugar):

The following conversion is a point that many people overlook.If you only drink honey water all day and never drink plain waterBased on a daily intake of 1500 to 2000 ml, approximately 150 to 200 grams of honey is needed—which translates to approximately [calorie count missing]. 456 to 608 kcal, equivalent to 1.7 to 2.4 bowls of white rice(Based on a bowl of white rice containing approximately 260 kcal), and all of it comes from sugar.

In practice, a common approach is to keep plain water as the primary source of hydration, and treat honey water as an occasional beverage, including it in your daily sugar intake. If you have diabetes or need to control your blood sugar, please discuss this with your doctor or registered dietitian.

If you are concerned about overall sugar intake and dietary planning, and not just honey, you can read more:6 Major Benefits of a Balanced Diet。

V. What are the empirically supported uses of honey?

Honey is not just about sugar. The following two uses are supported by relatively clear research or guidelines.

(1) Relieves upper respiratory symptoms such as cough (for people over 1 year old)

The guidelines, jointly developed by the UK's National Institute for Health and Care Excellence (NICE) and Public Health England, list honey as...People aged 1 year and aboveOne of the self-care options to try for acute cough is to reduce unnecessary antibiotic use.

A systematic review and meta-analysis published in *BMJ Evidence-Based Medicine* in 2020, including 14 studies, found that honey was more effective than standard care in improving overall symptom scores, cough frequency, and cough severity in upper respiratory tract infections. In some studies, the duration of symptoms was shortened by approximately 1 to 2 days. The researchers also noted that the quality of the evidence is still limited, and more high-quality placebo-controlled trials are needed.

It is important to distinguish that honey belongs to:Symptom reliefThis is not a way to treat the illness. If a cough persists for more than three to four weeks and is accompanied by fever, difficulty breathing, chest pain, or coughing up blood, you should seek medical attention as soon as possible instead of continuing to treat it yourself.

(2) Rapid carbohydrate sources before and after exercise

Honey is primarily composed of monosaccharides, which are quickly absorbed by the body, making it a common and convenient source of carbohydrates in sports nutrition. However, for people with average daily activity levels, this doesn't necessarily mean they "need to eat more honey"; it simply means that honey is one option when the body does need a quick replenishment of carbohydrates.

Other frequently mentioned statements

The antibacterial activity of honeyLaboratory researchWhile honey has indeed been widely discussed, laboratory results and actual effects on humans are two different things. Honey may offer slight relief for constipation, which is related to incomplete fructose absorption in some individuals, and individual differences are significant. As for claims such as "skin care" and "boosting immunity," there is currently no consistent clinical evidence to support these claims, and they are more suitable to be understood as traditional dietary therapy experiences rather than definitive efficacy claims.

6. Why should infants under 1 year old never eat honey?

This is the most important section of this article, and it also contains the most consistent recommendations from health agencies around the world.

Honey may contain contaminants during the collection and processing process.Clostridium botulinum sporesIn adults, the gut microbiota matures, and the spores are usually excreted in feces and do not germinate in the intestines; however...The intestinal environment of infants under 1 year old is not yet mature.The spores have the potential to germinate in the intestines, produce toxins, and cause...Infant botulism—This is a rare but potentially serious disease.

Therefore, the recommendations of the Hong Kong Centre for Health Protection, the Hong Kong Centre for Food Safety, the World Health Organization, the US CDC, and the UK NHS are consistent:Honey should not be given to infants under 12 months of age.The Centre for Food Safety also specifically reminds parents that honey should not be added to baby food or applied to pacifiers to soothe babies.

Parents should pay attention to these warning signs: persistent constipation, lethargy or significantly decreased activity, weak cry, poor sucking ability, limp and weak head, neck and limbs, and feeding difficulties. If the infant has been exposed to honey and exhibits the above symptoms, seek medical attention immediately.

After a child turns one year old, their gut microbiota gradually matures, and the risk is greatly reduced. At that time, small amounts can be tried, but it should still be counted as part of the sugar content. Honey is also added sugar for young children and should not be used as a daily source of sweetness, as there is also the risk of tooth decay.

7. Who else should we be wary of?

Apart from infants under 1 year old, the considerations for other ethnic groups are different from those for infants and need to be explained separately.

People with diabetes or who need to control their blood sugar

Honey is about 80% sugar, which can affect blood sugar levels, so it shouldn't be considered a source of sweetness that can be consumed "at will." This doesn't mean you can't eat it at all, but rather that you need to include it in your daily sugar and carbohydrate intake and monitor your individual blood sugar response. For specific portion sizes and arrangements, please discuss with your doctor or registered dietitian.

People with weakened immune systems or those undergoing treatment

The common online claim that "people with weakened immune systems and patients undergoing chemotherapy should strictly avoid eating honey" actually extends the guidelines for infants. Health agencies in various countries have clearly defined guidelines against consuming honey.For infants under 1 year old onlyFor individuals with weakened immune systems, a more reasonable approach is...Consult the attending physician firstThe doctor should make a judgment based on your specific situation, rather than applying the rules for infants to yourself.

People with sensitive intestines or irritable bowel syndrome

Honey has a high fructose content, which some people may not fully absorb, potentially causing bloating or discomfort. If this occurs, it is recommended to control the amount consumed and observe your own reaction.

People allergic to bee products

People who have had allergic reactions to pollen or bee products should consult a doctor before consuming honey.

8. What are some of the claims about pairing honey with other ingredients that are supported by evidence?

Claims such as "pear and honey soothe the throat and nourish the lungs," "ginger and honey provide warming and nourishing effects," and "honey and rice porridge nourish the spleen and stomach" have been circulating for a long time. While some of the ingredients have a basis in research, descriptions like "nourishing the lungs," "warming and nourishing," and "nourishing the spleen and stomach" belong to traditional dietary therapy concepts, not directly correlated with modern research. The following will provide a straightforward explanation; the methods can be retained, but the effects should not be exaggerated.

pear + honey

The supported evidence includes: honey's viscous texture can temporarily coat the throat, providing a soothing sensation for a dry and itchy throat; pears provide moisture and dietary fiber. Hollowing out a pear, adding a small amount of honey, and stewing it is a common and gentle way to soothe a sore throat. As for its "lung-nourishing" properties, there is currently no research to support this claim.

Milk + Honey

Milk provides protein and calcium, while honey provides sugar. A glass of warm milk before bed is a relaxing habit for many, but "soothing emotions" is a subjective feeling and not a specific effect of honey or milk.

Ginger + Honey

This is the combination with the most research support among the four: ginger has been shown to help with nausea and cough in some studies, and honey provides guidance for cough (in children over 1 year old). It should be noted that ginger is quite irritating, and those prone to stomach upset should not consume excessive amounts.

Honey Rice Porridge

Porridge is easy to digest and is suitable for providing calories when you have a poor appetite or gastrointestinal discomfort; adding honey mainly increases sweetness and sugar content. It's a palatable dish, but there's no modern research to support its claim of "nourishing the spleen and stomach."

9. Selection and Storage: Hong Kong Local Reminder

Purchase

The Hong Kong Centre for Food Safety recommends that honey be purchased from reliable sources or bee farms. Local reports have previously linked honey from overseas to [unspecified sources].Crazy honey poisoning"Case Study—The cause is that bees collect nectar from plants in the Ericaceae family (such as rhododendrons), thus the honey contains..."ToxinSymptoms of poisoning include dizziness, weakness, excessive sweating, excessive salivation, paresthesia, nausea and vomiting. In severe cases, low blood pressure or even shock may occur.

Here's how to tell: honey containing gentian violet toxin will cause a burning sensation in the throat when ingested; honey with a distinctly bitter or astringent taste should be discarded. Extra caution should be exercised when purchasing honey when traveling to known risk areas such as the Black Sea region of Turkey.

Storage

• Sealing is key.Honey has a low water content (approximately 171 TP4T), making it difficult for microorganisms to grow, but it is highly hygroscopic. After opening, it should be sealed and stored in a cool, dry place to avoid moisture and absorbing odors.
• Crystallization is a normal phenomenon.The glucose in honey will crystallize naturally at low temperatures. This does not mean that it has spoiled or been adulterated with sugar. Simply warm it up in warm water.
• No need to refrigerate, but prevent contamination.Use clean, dry utensils when taking out the product to avoid bringing moisture or food residue into the bottle.
• Honey should not be added to any food for infants under 1 year old.This includes complementary foods, drinking water, and pacifiers.

Brewing method

Simply mix it with warm water; there's no need to deliberately pursue "high-temperature sterilization"—honey itself is not a food that needs to be boiled, and high temperatures will actually destroy some of its active ingredients. As for the saying that "honey cannot be used with a metal spoon," this is an old myth. In reality, short-term contact has limited impact, but using dry and clean utensils is still the key, and the focus should still be on avoiding moisture and contamination.

10. Frequently Asked Questions (FAQ)

Is it okay to drink honey lemon water every day?

You can drink it, but you should treat it as a sugary beverage. Replacing plain water with 1500 to 2000 ml of honey water daily equates to an extra 456 to 608 kcal, equivalent to 1.7 to 2.4 bowls of white rice, all from sugar. A more reasonable approach is to primarily drink plain water, with honey water as an occasional beverage, and include it in your daily free sugar intake.

Can honey or honey lemon water fight cancer?

Currently, no human studies have confirmed that honey or honey lemon water has anti-cancer effects. Any claims made using "anti-cancer" as a selling point should not be believed, and should not be used to delay proper medical treatment. If you have any questions about your health, please consult a doctor.

Is honey healthier than sugar?

Both are sugars and have similar effects on blood sugar. Honey does contain small amounts of minerals and phenolic compounds, but in a tablespoon serving, these components make a very limited contribution, while the sugar content is firmly included in your daily intake. The WHO's definition of free sugars also includes the natural sugars in honey. You can choose honey for its flavor or texture, but it shouldn't be interpreted as "healthier sugar."

Is it safe to give boiled or roasted honey to babies under 1 year old?

No. High temperatures can destroy botulinum toxin, but they are unlikely to kill heat-resistant spores. Boiling and baking temperatures are generally insufficient to eliminate the risk, so honey cakes, honey cookies, and honey water are also unsafe for infants under one year old. The risk only significantly decreases after one year of age.

Is it still okay to eat crystallized honey?

Yes. Crystallization is a natural physical phenomenon of glucose precipitation and is unrelated to quality or spoilage. It can be restored to its fluid state by slowly warming it in warm water. Avoid heating at high temperatures or boiling directly.

Is Manuka honey better?

Honey from different floral sources does vary in flavor, color, and some components. When purchasing, pay attention to the labeling and ensure the source is clearly stated. However, remember that regardless of the type of honey, its main component is still sugar, and it should not be consumed by infants under 1 year old. If you have specific health needs, consult a healthcare professional first, rather than relying solely on honey.

Source of information

1. World Health Organization. Healthy diet – Recommendations and definitions for free sugar intake. WHO
2. World Health Organization. Guideline: Sugars intake for adults and children. WHO
3. Hong Kong Centre for Health Protection – Botulinum Toxin Poisoning (including prevention advice for infant botulism). Centre for Health Protection
4. Hong Kong Centre for Food Safety — Botulinum poisoning and honey. Food Safety Centre
5. Hong Kong Centre for Food Safety – Case of “Honey Poisoning”. Food Safety Centre
6. National Institute for Health and Care Excellence (NICE). Cough (acute): antimicrobial prescribing (NG120). NICE
7. Abuelgasim H, Albury C, Lee J. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ Evidence-Based Medicine 2021;26(2):57-64. PubMed
8. NHS. Cough — Self-care and when to seek medical attention. NHS
9. NHS Foods to avoid giving honey to babies and young children (Honey and infant botulism). NHS
10. NHS. Botulism. NHS
11. USDA FoodData Central — Honey (Nutritional Information on Honey). USDA

Note: The calories and tablespoons cited on this page are approximate and may vary depending on the type of honey, water content, and actual quantity; please refer to the product label for actual values.