Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Nov 19;15(1):48.
doi: 10.1038/s41387-025-00403-9.

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

Mostafa Norouzzadeh  1   2   3 , Sanaz Barazandeh  1   3 , Minoo Hasan Rashedi  1   3 , Sanaz Jamshidi  4 , Fatemeh Hatamifar  1   3 , Zohreh Maghsoomi  5 , Farshad Teymoori  6 , Mojtaba Malek  7
Affiliations
Meta-Analysis

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

Mostafa Norouzzadeh et al. Nutr Diabetes. .

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The study followed the Declaration of Helsinki and received approval from the Ethics Committee of the Iran University of Medical Sciences (IR.IUMS.REC.1404.036). The review followed the Cochrane Handbook for Systematic Reviews of Interventions and adhered to the PRIOR and PRISMA guidelines, as detailed in Supplementary Tables 1 and 2.

Figures

Fig. 1
Fig. 1
The PRISMA flow diagram for the selection of studies and participants.
Fig. 2
Fig. 2. Pairwise analysis for the effects of honey, royal jelly, and propolis on cardiometabolic biom arkers.
Pairwise analysis for the effects of honey, royal jelly, and propolis on a anthropometric indices, b blood pressure, c glycemic profile, d liver enzymes, and e lipid profile.
Fig. 3
Fig. 3. Non-linear dose–response analysis of honey and its derivatives on cardiometabolic outcomes.
Shown are the effects of a honey on SBP, b honey on AST, c honey on FBG, d royal jelly on TG, e royal jelly on LDL-C, and f propolis on MDA.
Fig. 4
Fig. 4
Linear dose-response analysis for each 1gr increase in propolis intake on ALT, AST, FBG, HbA1C, HOMA-IR, Insulin, IL-6, TAC, TNF-α.
See this image and copyright information in PMC

References

    1. WHO. Noncommunicable Diseases. 2024. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
    1. CDC. CfDCaP. Heart Disease Facts. 2025. https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html.
    1. WHO. WHO global report on traditional and complementary medicine 2019. 2019. https://www.who.int/publications/i/item/978924151536.
    1. Farhadnejad H, Saber N, Neshatbini Tehrani A, Kazemi Jahromi M, Mokhtari E, Norouzzadeh M, et al. Herbal products as complementary or alternative medicine for the management of hyperglycemia and dyslipidemia in patients with type 2 diabetes: current evidence based on findings of interventional studies. J Nutr Metab. 2024;2024:8300428. 10.1155/2024/8300428. - DOI - PMC - PubMed
    1. Mahmoud AM, Hernández Bautista RJ, Sandhu MA, Hussein OE. Beneficial effects of citrus flavonoids on cardiovascular and metabolic health. Oxid Med Cell Longev. 2019;2019:5484138. 10.1155/2019/5484138. - DOI - PMC - PubMed

LinkOut - more resources