Bee products consumption and cardiovascular diseases risk factors: a systematic review of interventional studies

Figures & data

Table 1. Search terms

Medline (PubMed)
(“honey” or “propolis” or “bee glue” or “bee bread” or “royal jelly” OR “RJ”) AND (“diabetes mellitus” OR diabetes OR pre-diabetes OR diabetic OR “abnormal glucose homeostasis” OR “abnormal glucose tolerance” OR “glucose tolerance” OR “glucose homeostasis” OR “glucose intolerance” OR hyperglycemia OR “glycemic control” OR “insulin resistance” OR “blood glucose” OR “blood sugar” OR “fasting blood glucose” OR “fasting plasma glucose” OR “body weight” OR overweight OR obesity OR “body mass index” OR BMI OR “abdominal obesity” OR “morbid obesity” OR “Waist Circumference” OR “LDL cholesterol” OR LDL OR “HDL cholesterol” OR HDL OR “VLDL cholesterol” OR VLDL OR triglyceride OR TG OR “total cholesterol” OR cholesterol OR hyperlipidemia OR “abnormal lipid profile” OR “lipid profile” OR “blood pressure” OR hypertension OR “abnormal blood pressure” OR “high blood pressure”)
Scopus
(“honey” or “propolis” or “bee glue” or “bee bread” or “royal jelly” OR “RJ”) AND (“diabetes mellitus” OR diabetes OR pre-diabetes OR diabetic OR “abnormal glucose homeostasis” OR “abnormal glucose tolerance” OR “glucose tolerance” OR “glucose homeostasis” OR “glucose intolerance” OR hyperglycemia OR “glycemic control” OR “insulin resistance” OR “blood glucose” OR “blood sugar” OR “fasting blood glucose” OR “fasting plasma glucose” OR “body weight” OR overweight OR obesity OR “body mass index” OR BMI OR “abdominal obesity” OR “morbid obesity” OR “Waist Circumference” OR “LDL cholesterol” OR LDL OR “HDL cholesterol” OR HDL OR “VLDL cholesterol” OR VLDL OR triglyceride OR TG OR “total cholesterol” OR cholesterol OR hyperlipidemia OR “abnormal lipid profile” OR “lipid profile” OR “blood pressure” OR hypertension OR “abnormal blood pressure” OR “high blood pressure”): ti,ab,kw
Web of Science
#1. TS = (“honey” or “propolis” or “bee glue” or “bee bread” or “royal jelly” OR “RJ”) #2. TS = (“diabetes mellitus” OR diabetes OR pre-diabetes OR diabetic OR “abnormal glucose homeostasis” OR “abnormal glucose tolerance” OR “glucose tolerance” OR “glucose homeostasis” OR “glucose intolerance” OR hyperglycemia OR “glycemic control” OR “insulin resistance” OR “blood glucose” OR “blood sugar” OR “fasting blood glucose” OR “fasting plasma glucose” OR “body weight” OR overweight OR obesity OR “body mass index” OR BMI OR “abdominal obesity” OR “morbid obesity” OR “Waist Circumference” OR “LDL cholesterol” OR LDL OR “HDL cholesterol” OR HDL OR “VLDL cholesterol” OR VLDL OR triglyceride OR TG OR “total cholesterol” OR cholesterol OR hyperlipidemia OR “abnormal lipid profile” OR “lipid profile” OR “blood pressure” OR hypertension OR “abnormal blood pressure” OR “high blood pressure”) #3. #1 AND #2
Cochrane Library
#1 (“honey” or “propolis” or “bee glue” or “bee bread” or “royal jelly” OR “RJ”): ti, ab, kw #2 (“diabetes mellitus” OR diabetes OR pre-diabetes OR diabetic OR “abnormal glucose homeostasis” OR “abnormal glucose tolerance” OR “glucose tolerance” OR “glucose homeostasis” OR “glucose intolerance” OR hyperglycemia OR “glycemic control” OR “insulin resistance” OR “blood glucose” OR “blood sugar” OR “fasting blood glucose” OR “fasting plasma glucose” OR “body weight” OR overweight OR obesity OR “body mass index” OR BMI OR “abdominal obesity” OR “morbid obesity” OR “Waist Circumference” OR “LDL cholesterol” OR LDL OR “HDL cholesterol” OR HDL OR “VLDL cholesterol” OR VLDL OR triglyceride OR TG OR “total cholesterol” OR cholesterol OR hyperlipidemia OR “abnormal lipid profile” OR “lipid profile” OR “blood pressure” OR hypertension OR “abnormal blood pressure” OR “high blood pressure”):ti, ab, kw

Figure 1. The flow diagram of study selection

Table 2. The characteristics of included studies

First author (publication year)	Year	Country	Sample size (intervention/control)	Sex	Mean age (year)	Mean BMI (kg/m^2)	RCT design (blinding)	Duration (weeks)	Subject type	Dose and type of intervention	Comparison group	Outcome measures	ROB
Bahrami et al.	2009	Iran	25/23	Both	57	NR	Parallel (No)	8	T2DM	3.5 g/kg/day honey	Nothing	BW, FBS, HbA1c, TC, TG, LDL-c, HDL-c	Poor
Rasad et al.	2014	Iran	30/30	Male	23	23	Parallel (Yes)	6	Healthy	70 g/day honey	70 g/day sucrose	FBS, SBP, DBP	Fair
Rasad et al.	2018	Iran	30/30	Male	23	23	Parallel (Yes)	6	Healthy	70 g/day honey	70 g/day sucrose	BW, BMI, TC, TG, LDL-c, HDL-c	Fair
Sadeghi et al.	2019	Iran	18/24	Both	57	28	Crossover (No)	8	T2DM	weight maintenance diet +50 g/day honey	weight maintenance diet	BW, BMI, WC, FBS, HbA1c, Insulin, HOMA-IR	Fair
Yaghoobi et al.	2008	Iran	38/17	Both	40	31	Parallel (No)	4	Overweight	70 g/day honey	70 g/day sucrose	BW, BMI, FBS, TC, TG, LDL-c, HDL-c	Fair
Sadeghi et al.	2020	Iran	22/21	Both	57	28	Crossover (No)	8	T2DM	weight maintenance diet +50 g/day honey	weight maintenance diet	TC, TG, LDL-c, HDL-c	Fair
Silveira et al.	2019	Brazil	18/14	Both	61	29	Parallel (Yes)	48	CKD	500 mg/day green propolis extract	Placebo	SBP, DBP	Good
Afsharpour et al.	2019	Iran	30/30	Both	50	26	Parallel (Yes)	8	T2DM	1500 mg/day propolis extract	Placebo	BW, BMI, FBS, HbA1c, Insulin, HOMA-I	Good
Mujica et al.	2017	Chile	35/32	Both	45	28	Parallel (Yes)	13	Healthy	15 drop/day propolis extract	Placebo	BW, BMI, WC, FBS, HbA1c, HOMA-IR,SBP, DBP, TC, TG, LDL-c, HDL-c	Fair
Samadi et al.	2017	Iran	30/27	Both	56	27	Parallel (Yes)	12	T2DM	900 mg/day propolis extract	Placebo	BW, BMI, WC, FBS, Insulin, HbA1c, HOMA-IR, TC, TG, LDL-c, HDL-c	Fair
Zakerkish et al.	2019	Iran	50/44	Both	55	30	Parallel (Yes)	13	T2DM	1000 mg/day propolis extract	Placebo	BW, BMI, FBS, Insulin, HbA1c, HOMA-IR, TC, TG, LDL-c, HDL-c	Good
Fukuda et al.	2015	Japan	41/39	Both	63	25	Parallel (Yes)	8	T2DM	226.8 mg/day propolis extract	Placebo	FBS, Insulin, HbA1c, HOMA-IR, TC, TG, LDL-c, HDL-c	Fair
Soleimani et al.	2020	Iran	27/27	Both	42	28.98	Parallel (Yes)	16	NAFLD	500 mg/day propolis tablet	Placebo	BW, FBS, Insulin, HOMA-IR, QUICKI, TC, TG, LDL-c, HDL-c	Good
Mobasseri et al.	2014	Iran	21/20	Female	51	28	Parallel (Yes)	8	T2DM	1000 mg/day royal jelly	Placebo	TC, TG, LDL-c, HDL-c	Fair
Pourmoradian et al.	2012	Iran	21/20	Female	51	28	Parallel (Yes)	8	T2DM	1000 mg/day royal jelly	Placebo	BW, BMI	Fair
Saritas et al.	2011	Turkey	30/10	Male	22	22	Parallel (Yes)	4	Healthy	500 mg/day royal jelly 1 g/day royal jelly 2 g/day royal jelly	Placebo	BW, BMI, FBS, TC, TG, LDL-c, HDL-c	Fair
Chiu et al.	2017	Taiwan	20/20	Both	NR	NR	Parallel (Yes)	13	healthy mild hypercholesterolemic	350 mg/day royal jelly	Placebo	BW, WC, TC, TG, LDL-c, HDL-c	Fair
Guo et al.	2007	Japan	7/8	Both	37	22	Parallel (No)	4	Healthy	6 g/day royal jelly	NR	BW, BMI, FBS, TC, TG, LDL-c, HDL-c	Poor
Morita et al.	2012	Japan	30/26	Both	62	22	Parallel (Yes)	26	Healthy	100 ml liquid/day royal jelly	Placebo	BMI, WC, FBS, HbA1c, HOMA-IR,SBP, DBP, TG, LDL-c, HDL-c	Fair
Khoshpey et al.	2016	Iran	23/23	Both	35	27	Parallel (Yes)	8	T2DM	1 g/day royal jelly	Placebo	BW, BMI, FBS	Fair
Mousavi et al.	2017	Iran	23/23	Both	35	27	Parallel (Yes)	8	T2DM	1 g/day royal jelly	Placebo	HbA1c,SBP, DBP	Fair
Inoue et al.	2017	Japan	19/22	Both	33	NR	Parallel (Yes)	8	Dry eye disease	1200 mg/day royal jelly	Placebo	FBS, HbA1c, TC, TG, LDL-c, HDL-c	Fair
Petelin et al.	2019	Slovenia	30/30	Both	NR	27	Parallel (Yes)	8	Overweight	2 g/day royal jelly	Placebo	BMI, TC, TG, LDL-c, HDL-c, glucose	Good

RCT, randomized controlled trial; BMI, body mass index; NR, not reported; T2DM, type 2 diabetes mellitus; CKD, chronic kidney disease; BW, body weight; FBS, fasting blood sugar; HbA1c glycated hemoglobin; TC, total cholesterol; TG, triglyceride; LDL-c, low density lipoprotein cholesterol; HDL-c, high density lipoprotein cholesterol; SBP, systolic blood pressure; DBP, diastolic blood pressure; NAFLD: nonalcoholic fatty liver disease; ROB: Risk of Bias