Abstract
Honey is a natural substance with many medicinal properties, including antibacterial, hepatoprotective, hypoglycemic, antioxidant and antihypertensive effects. It reduces hyperglycemia in diabetic rats and humans. However, the mechanism(s) of its hypoglycemic effect remain(s) unknown. Honey comprises many constituents, making it difficult to ascertain which component(s) contribute(s) to its hypoglycemic effect. Nevertheless, available evidence indicates that honey consists of predominantly fructose and glucose. The objective of this review is to summarize findings which indicate that fructose exerts a hypoglycemic effect. The data show that glucose and fructose exert a synergistic effect in the gastrointestinal tract and pancreas. This synergistic effect might enhance intestinal fructose absorption and/or stimulate insulin secretion. The results indicate that fructose enhances hepatic glucose uptake and glycogen synthesis and storage via activation of hepatic glucokinase and glycogen synthase, respectively. The data also demonstrate the beneficial effects of fructose on glycemic control, glucose- and appetite-regulating hormones, body weight, food intake, oxidation of carbohydrate and energy expenditure. In view of the similarities of these effects of fructose with those of honey, the evidence may support the role of fructose in honey in mediating the hypoglycemic effect of honey.
Highlights
Honey is a natural substance with various medicinal properties which include antibacterial [1], antihypertensive [2], hepatoprotective [3], hypoglycemic and antioxidant effects [4]
The findings indicate that glucose and fructose might exert a synergistic effect in the intestine and pancreas
The glucose-lowering effect of fructose is attributed to increased expression or activation of some enzymes such as glucose6-phosphate dehydrogenase, aldolase B, phosphofructokinase-1 and glycogen synthase and inhibition of glucose 6-phosphatase and phosphorylase [32,33,34,38,39,42]. This results in increased hepatic glycogen synthesis and storage [32,33,34,38,39,42]. These findings indicate that small amounts or catalytic doses of fructose are capable of markedly increasing hepatic glucose uptake and glycogen synthesis and deposition via activation of glucokinase and other enzymes or inhibition of some enzymes [31,32,33,34,38,39,42]
Summary
Honey is a natural substance with various medicinal properties which include antibacterial [1], antihypertensive [2], hepatoprotective [3], hypoglycemic and antioxidant effects [4]. All these catalytic reactions occur independently of insulin and the rate-limiting steps are bypassed in fructose metabolism [22,29] These differences in metabolism result in about 50% to 70% of the absorbed fructose being metabolized in the liver [29], compared to only about 20% to 30% of the absorbed glucose [30]. Honey supplementation (via its fructose) might enhance glucose uptake, synthesis and storage of glycogen in the liver of diabetic rodents or humans. This would result in improved glycemic control in diabetes mellitus. These effects might improve liver efficiency in metabolizing honey fructose and thereby contribute to hypoglycemic effect of honey via improved hepatic enzymes involved in glucose metabolism
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