This is a guest post from registered dietician and nutritionist Kelly Jones, MS, RD, CSSD, LDN.

From sports drinks to energy gels and “honey” waffles to sport jelly beans, there’s no shortage of options on the shelves (or your online cart) to fuel your exercise. Still, while new products continue to flood the sports nutrition market, a classic single ingredient food may be your best option to fuel fitness. The human body was designed to be active, so wouldn’t it make sense that the energy needed for this active body already naturally exists?  

This article discusses the energy obtained from raw honey and the research supporting a variety of its benefits to the active population. Not only is there a lower likelihood of gastrointestinal discomfort while ingesting honey versus some other forms of carbohydrate, but research shows its effectiveness for fueling endurance exercise while being more economical than modern sports gels, blocks, beans, and beverages. 

Gastrointestinal Discomfort in Athletes 

Since it isn’t very pleasant to talk about, most people are unaware of how common gastrointestinal (GI) disorders are. Roughly one-third of American adults report some level of GI upset with 12% meeting the criteria for Irritable Bowel Syndrome (IBS), according to studies.¹ Rates of discomfort are even higher in athletes, particularly endurance athletes, with some studies reporting that up to 74% of runners experience some level of distress during or after exercise.²  

Foods consumed, as well as timing of consumption, may impact GI symptoms, even in those who don’t meet the criteria for digestive disorders. While carbohydrates are important prior to exercise, it is recommended to limit protein, fat, and fiber to moderate amounts before activity as these three nutrients slow gastric emptying.³ On top of this, there is additional reduced stomach emptying during endurance exercise.⁴ Slowed emptying leaves food in the digestive tract and limits energy release into the bloodstream for use during exercise. Discomfort may also be from high amounts of single source sugar, sugar alcohols, or artificial sweeteners. The acidity of foods and beverages may also play a role.³ 

Since GI discomfort often isn’t discussed or may be thought of as normal in endurance sports, athletes may not be aware of how to alter fuel intake and timing to limit stress to the gut and improve performance. Ultimately, this may cause some individuals to forego eating prior to exercise at all or lead to underfueling for many.

Need for Energy before and during Exercise 

Carbohydrate is the most efficient energy source to fuel the muscles during exercise and along with dehydration, depletion of stored muscle carbohydrate (glycogen) is the limiting factor in intensity and duration of endurance exercise.² Intake of carbohydrates throughout the entire day is important, but consumption of this energy source prior to activity and during exercise lasting longer than an hour is recommended. 

In the short term, underfueling during exercise simply results in early fatigue and reductions in intensity. However, in the long-term, these energy deficits add up and may contribute to decreased muscle strength and performance, increased injury risk, decreased coordination, and even irritability and depression, among other symptoms.⁵ Understanding energy and carbohydrate needs not only allows for increased fitness and performance but also allows for improved long-term health outcomes. 

Carbohydrate recommendations range from 3-12 g/kg/day depending on the sport and position of the athlete or athletic individual.⁶ The range of 3-5 g/kg is for those with low-intensity exercise or skill-based exercise routines. 5-7 g/kg is suggested for those engaging in moderate-intensity training programs of 60 minutes per day. Those engaging in moderate- to high-intensity exercise for 1-3 hours per day should ingest between 6-10 g/kg, and the rare athlete engaging in over 4 hours per day of moderate- to high-intensity exercise should consume up to 12g/kg per day.  

Before exercise, general recommendations suggest carbohydrate intake should be 1g/kg per hour prior to endurance activity.⁶  This would be 1 g/kg of weight in carbohydrate one hour before the start of exercise and up to 4 g/kg four hours prior to exercise. This may not always be feasible which is when ingestion of roughly 30 grams of easily digestible carbohydrate 5-10 minutes prior to exercise can be beneficial.⁶ 

While ingestion of carbohydrate in exercise lasting 2 hours or more has been shown to prevent hypoglycemia, maintain high rates of energy production, and support endurance, intake during high-intensity exercise lasting one hour or more has been shown to be beneficial.⁶  Studies on high-intensity intermittent sports such as soccer, basketball and hockey also have shown benefits to intake of carbohydrate during training and competition, by increasing time to exhaustion. For these instances, 30 grams of carbohydrate per hour is recommended.  

With endurance training lasting over two hours, 60 grams of carbohydrate per hour is recommended, with benefits seen from intake of multiple carbohydrate sugars versus one. With exercise lasting over 2.5 hours though, only multiple carbohydrate sources are recommended as the rate of ingestion should be roughly 90 grams per hour.⁶   

Gastrointestinal Benefits of Honey

As alluded to, it has been found that when multiple carbohydrates are ingested, such as glucose and fructose, gastrointestinal symptoms seem to be reduced when compared with intake of the same amount of a single carbohydrate, such as glucose. This is because there are different transports in the gut to absorb different carbohydrates. If only one carbohydrate type is ingested, such as glucose, its transporters would be overwhelmed, leaving excess carbohydrates in the intestines. This might cause fluids to enter into the intestines, leaving many individuals more likely to experience gastrointestinal symptoms, especially cramping.³ 

Versus other naturally occurring liquid carbohydrate options, honey is unique in that it contains both glucose and fructose. This allows for absorption of glucose through its transporters and fructose through others. Furthermore, because fructose is absorbed more slowly,⁷ a more steady and longer delivery of energy into the blood is possible. While more research is warranted, the fructose composition may allow for more sustained energy over time versus a spike and decline.  

Studies have found honey ingestion during exercise to provide nearly identical benefits to that of popular sports drinks and gels.^8,9 This has been found for both endurance and resistance exercise. Honey is more cost-effective than sports gels, so with similar benefits and a single natural ingredient, it is an easy choice to opt for honey before a workout or during activities of longer duration (lasting over an hour).  

Other Potential Benefits of Honey for Exercise 

In addition to pre-workout and during exercise, a study showed a honey drink to improve running performance and carbohydrate metabolism compared to plain water in the heat. It showed that honey, in combination with water and sodium, can be recommended for rehydration for athletes who compete in warm environments.¹⁰ 

When it comes to immunity, endurance athletes can benefit from some extra nutrients and antioxidants. In ultra-marathoners especially, rates of upper respiratory tract infections remain high.¹¹ While vitamin C has been shown to reduce risk, it is known that honey also benefits the immune system. Five studies reported and increase in white blood cells and neutrophils after ingesting honey combined with resistance or aerobic exercises.¹² 

References

1. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. Journal of the American Medical Association. 2015;313(9):949–958. 
2. Jeukendrup, A. E. Nutrition for endurance sports: marathon, triathlon, and road cycling.” J Sports Sci 29 Suppl 1: S91-99, 2011. 
3. Oliveira E, Burini R, Jeukendrup A. Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations. Sports Med, 2014. 44(1);79-85. 
4. Jeukendrup A. Training the Gut for Athletes. Sports Med, 2017. 47(1); 101-110. 
5. Mountjoy M, et al. The IOC consensus statement: beyond the Female Athlete Triad – Relative Energy Deficiency in Sport (RED-S). 
6. Karpinski C, Rosenbloom C. Sports Nutrition: A Handbook for Professionals, 6th Edition. Academy of Nutrition and Dietetics, 2017.  
7. Riby JE, Fujisawa T, Kretchmer N. Fructose absorption. Am J Clin Nutr. 1993;58:748S-53S 
8. Earnest CP, Lancaster SL, Rasmussen CJ, Kerksick CM, Lucia A, Greenwood MC, Almada AL, Cowand PA, Kreider RB: Low versus high glycemic index meals carbohydrate gel ingestion during simulated 64 km cycling time trial performance. J Strength Cond Res. 2004, 18: 466-472. 
9. Lancaster, S, R.B. Kreider, C. Rasmussen, C. Kerksick, M. Greenwood, P. Milnor, A.L. Al- mada, and C.P. Earnest. Effects of honey supplementation on glucose, insulin and endurance cycling performance. FASEB J, 2001 15:LB315. 
10. Ahmad NS. Effects of Post-Exercise Honey Drink Ingestion on Blood Glucose and Subsequent Running Performance in the Heat. Asian J Sports Med, 2015. 6(3): e24044. 
11. Peters EM, et al. Upper respiratory tract infection symptoms in ultramarathon runners not related to immunoglobulin status. Clin J Sport Med. 2010 Jan;20(1):39-46. 
12. Yusof A, et al. Effects of honey on exercise performance and health components: A systematic review. Science and Sports, 2018: 267-281.