You may have noticed that honey has made the headlines this week, ‘Use honey first for a cough, new guidelines say’ was the title of an article posted by the BBC. This is because new, draft guidelines have been released by Public Health England (PHE) which advise doctors on how to treat coughs in their patients. Let’s delve a little deeper into this headline and look at how much truth is behind it.

Why have the guidelines changed?

One of the reasons why the guidelines mentioned above have recently been reviewed and changed is to reduce the use of antibiotics. In the UK antibiotic resistance is a problem and reducing their use is imperative. Antibiotics are used to treat bacterial infections. Resistance occurs when bacteria evolve to become immune to antibiotics. Infections caused by resistant bacteria are very difficult to treat. For this reason, antibiotics should only be used when they are really needed as over-use will reduce their effectiveness.

The new guidelines apply to acute coughs associated with the common cold or acute infections of the airways. These are coughs which usually last for a short amount of time. Most acute coughs will get better on their own and are often caused by viruses rather than bacteria. Therefore, more often than not, antibiotic medication is not required.

What’s the evidence?

PHE have used the available evidence to construct these guidelines. A systematic review and meta-analysis was published in 2014 which looked into honey as a treatment for acute coughs in children. The effect of honey on cough frequency was compared with a placebo treatment, dextromethorphan (an ingredient found in cough medicine) and diphenhydramine (an antihistamine). The results from the study showed that:

  • Honey did not differ from dextromethorphan in reducing cough frequency.
  • Honey was better than the placebo and no treatment for reducing cough frequency.
  • Honey was slightly better than diphenhydramine in reducing cough frequency.

When compared to children who were given no treatment, children who were given honey coughed less often and had less severe coughs. This suggests that honey could potentially attenuate the symptoms of an acute cough and explains why the new guidelines suggest it’s use as a treatment. It is unclear how honey can actually make a cough better, but some possibilities include its antibacterial and anti-inflammatory properties as well as the sweetness leading to an increase roduction of saliva and mucus which sooths the throat. The antibiotic effect of honey is most likely due to the fact that it contains hydrogen peroxide.

What about Manuka honey?

You may have heard of Manuka honey, which many label a ‘superfood’. This term is really just a marketing ploy to attract health conscious consumers. Despite this, some evidence does show that Manuka honey may actually be a beneficial addition to your diet.

Manuka honey differs from other honey as the bees which make it only forage on the Manuka bush found in New Zealand. As a result of this, Manuka honey contains high levels of Methylglyoxal (MGO) which has been shown to have antimicrobial effects. The purity and quality of Manuka honey is identified by it’s UMF (see right), which stands for Unique Manuka Factor. The higher the UMF, the more MGO the honey will contain.

Although many studieshave shown that Manuka honey can kill a number of infection causing bacteria, there is no current evidence to support Manuka honey being beneficial to a cough. Manuka honey comes with a large price tag and so it may be more cost effective to stick to regular honey to relieve a nasty cough.

…So after all, your grandma’s old honey and lemon remedy for coughs and colds may not just an old wives tale! It should be noted that honey is unsuitable for those ages under 1.

Hannah is a Final Year Nutrition student at the University of Nottingham, who aspires to go on a study a Masters in Dietetics. Her interests include nutrition education and maternal and child health. Follow her on Twitter at @hlj_jones