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The Globe and Mail, Tuesday, May 22, 2001

Sweet relief
  Researchers are discovering that honey, that age-old sweetener, has potent antiseptic and anti-inflammatory properties
By Pippa Wysong and Heather Lea-Brown


Once again, Mom was right. Clear tea with lemon and honey for that sore throat can do wonders, though it turns out the lemon and tea are optional. It's the honey that does the trick.

In fact, honey has powerful antimicrobial and anti-inflammatory properties which are stirring up a lot of excitement among medical researchers. The sticky, sweet solution that's the favourite of Winnie the Pooh (who, by the way, seems to have impeccably good health) is proving to be a worthy opponent of bacteria with nasty names such as Viridans streptococci, Staphylococcus aureus and E.coli.

Even more exciting is the finding that unlike the arsenal of sophisticated antibiotics that have hit a wall against antibiotic-resistant superbugs, honey is able to do battle with at least some of them when it comes to infected wounds.

Honey has shown the most promise in treating wounds. Evidence has shown it helps promote the healing of burns and surgical incisions. It is purported to help cleanse wounds and has anti-inflammatory and antimicrobial properties as well. "Randomized trials have shown that honey is more effective in controlling infection in burn wounds than silver sulphadiazine, the antibacterial ointment most widely used on burns in hospitals," says Dr. Peter Molan, Professor of Biochemistry at Waikato University in New Zealand. In fact, he says, "the most important role for honey in wound care will prove to be in the treatment of wounds infected with antibiotic resistant bacteria, like MRSA [methicillin-resistant Staphylacoccus aureus.]"

Indeed, there have been numerous reports of the dramatic effects of honey on infected wounds. There was the British teen whose legs were amputated because of an infection. He suffered for months with sores that refused to heal, and when all else failed, dressings impregnated with sterilized honey were used. Within 10 weeks the wounds were healed.

Numerous studies have compared honey with standard medical treatments. In a study of women with infected abdominal wounds after cesarean delivery, 15 had the infected wound treated with honey, and 19 underwent conventional therapy. The honey-treated women spent an average of 4.5 days in hospital while the wound healed, compared with 11.5 days for those who got standard treatment.

Researchers writing for the British Journal of Plastic Surgery reported a study of two groups of 46 burn patients. One group had gauze pads impregnated with honey placed on their wounds, while the other group had a standard dressing. Burns treated with honey healed significantly more quickly.

So, what's so special about honey? There are several characteristics about this liquid gold that can affect wound healing, said Dr. Gard Otis (PhD), a bee researcher who has lectured on the benefits of honey. He is a professor in the department of environmental biology at the University of Guelph.

A thin layer of honey provides a moist environment that protects the skin and prevents a hard scab from forming. Honey stimulates the growth and formation of new blood capillaries and triggers the cells that produce new skin to grow. As well, anti-oxidants in the honey possess an anti-inflammatory action that help reduce swelling, improve circulation and keep the wound from "weeping."

But the uses of honey are not restricted to the hospital. Dr. Molan recently addressed the University of Illinois College of Dentistry on the effects of honey on dental cavities. His research showed that honey not only halts the growth of plaque bacteria, but stops them from sticking to the teeth in the first place. "If you made candy out of selected honey instead of sugar, you wouldn't have to add anything to it to make it antiseptic," he said.

One study out of Hebrew University-Hadassah found a spoonful of honey indeed makes the bacteria go down. In the American Journal of Dentistry, researchers reported that the amount of total bacteria in people's mouths dropped dramatically for an hour after they ate generous doses of honey. Small amounts, though, seemed to encourage bacterial growth.

The evidence for honey having healing powers for wounds and the skin are generally stronger than anything related to the ingestion of honey. The compounds in honey are quickly diluted when swallowed, making them ineffective for internal infections, although some studies of specific types of honey have demonstrated improvements in patients with peptic ulcers -- again, a wound-healing effect.

Honey holds other secrets related to its ability to affect healing. Just ask the bees. Worker bees gather nectar from flowers, and essentially chew it for a period of time. While doing this, they add enzymes and concentrate the sugars. They then regurgitate the resulting liquid into the honeycomb.

Bee saliva contains glucose-oxidase, a key enzyme that breaks down the glucose in the nectar, and plays a big role in honey's healing powers. Once on a wound, the honey is somewhat diluted by the body's fluids, and this decreases the natural acidity of honey. The less acidic environment allows glucose-oxidase to go into action. The enzyme breaks down sugars (the glucose) in the honey and a by-product of this activity is hydrogen peroxide -- traditionally used to cleanse and disinfect wounds.

Normally, the effect of hydrogen peroxide is short-lived when placed on a wound and breaks down quickly. Because of the slow breakdown of the sugar in honey, there is a constant, "slow-release" of hydrogen peroxide in amounts that are big enough to kill local bacteria, but too small to adversely affect the surrounding healthy tissue.

Some honeys may help with wound healing because of other antibacterial compounds derived from specific floral sources, such as antioxidants and aromatic acids, said Dr. Molan.

Still, should you use honey from the jar on your kitchen shelf the next time you get a paper cut? "I use honey all the time for cuts," said Dr. Otis. He adds, though, there can be big differences between different types of honey.

Active compounds can vary, depending on the types of flowers from which the bees get the nectar. One U.S. study found that on average, darker honeys have slightly higher levels of anti-oxidants than the lighter or clear honeys. "It's not a perfect correlation, it depends on the floral source," he said. Plus, there is a difference between honeys that are heat-treated and those that aren't.

Honeys don't undergo a true pasteurization, like milk, and the temperatures aren't high enough to kill any bacteria that might be present. They are heat-treated to reduce the crystallization of honey, giving them a longer shelf life and making it easier for consumers to dribble into tea or on to toast.

Many commercial honeys are also filtered for the same reason. The heat destroys some of the enzymes, making it less effective as a wound treatment, Dr. Otis said.

Manuka, a dark, strong-flavoured honey from New Zealand, was once considered by many consumers to be undesirable. Now, because of its ability to destroy Heliobater pylori (the bacterium linked to peptic ulcers), it sells at about $15 a pound in health food stores.

One New Zealand company is already capitalizing on the antiseptic properties of honey and produces honey-laced surgical bandages and dressings. The bandages, produced by ApiMed, are impregnated with manuka honey and are used in both surgical and burn units in New Zealand.

A project has started to investigate honeys produced in North America. Samples are all being sent to Dr. Molan for study.

Honey isn't for everybody, however. In fact, it is considered unsafe for infants, and both Health Canada and pediatrics societies advise against giving it to children under one year of age. The problem is botulism. It is estimated that Clostridium botulinum is present in up to 5 per cent of honey. While this is not a problem for most consumers, infants are an exception.

Infants have not yet developed sufficient intestinal microflora to protect them from the bacterium, said John Austin, chairman of Health Canada's Botulism Reference Service. "If an infant eats honey that has spores of C. Botulinum there's a possibility that the spores, when they get into the gut or colon, will germinate and grow," he said. They produce a neurotoxin. The problem is rare, with only 19 cases having occurred in Canada since 1976, and no deaths have been reported.

Health Canada and the Canadian Honey Council are investigating just how the bacterial spores get into honey. The spores "are very common in the environment, are common in dust and soil. It could be that bees brings it back to the hive," he said.

Still, for the most part, researchers are sweet on the idea of investigating honey further. 

    The science of stings 

  

    Bumblebees are noisily trying to escape from a glass jar. Deftly, a set of tweezers grabs one by the head and places it gently on an ice-cooled spot close to the navel of its captor. The bee stings in retaliation.

This scene is common for practitioners of apitherapy, also called bee-sting therapy. For thousands of years, honey-bee stings have been used in an attempt to relieve numerous human ailments. In recent years, it is purported to treat such diseases as arthritis, rheumatism and multiple sclerosis (MS).

According to the American Apitherapy Society, bee venom contains mellitin, an allergen that causes the "ouch" and itch of a bee sting. Mellitin stimulates the adrenal glands to produce cortisol, a natural steroid that plays a role in reducing inflammation and is chemically related to drugs such as cortisone, used to treat MS and rheumatoid arthritis.

Other parts of the immune system also kick into action in response to a sting, causing the release of various other chemicals including histamine. This chemical soup not only acts to protect the body from the sting toxins and repair the wound, but is believed to have an overall healing effect on certain other disorders.

But does it really work?

Like many alternative therapies, bee venom has its proponents, but there is little generally accepted data that justifies or supports its use.

In 1998, a study sponsored the U.S. National Multiple Sclerosis Society concluded that bee venom had no beneficial effect on mice that had a multiple sclerosis-like disease.

However, it found that bee venom is a mixture of active compounds, some of which might have potential benefits. They say more research is needed.

Still, the general medical consensus is that "there is no scientific evidence that bee-venom therapy is of any value in multiple sclerosis," said Dr. William J. McIlroy, national medical advisor for the Multiple Sclerosis Society of Canada.

The most dangerous side effect of this type of therapy is the severe, sometimes fatal, anaphylactic reactions that people can experience with bee stings. Even if there is no initial allergic reaction, allergic sensitivity can develop over time.



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