Manuka Honey - History, Uses, and Benefits
Most of us apply antibacterial and antibiotic ointments like Neosporin to our scrapes and wounds. What if we replaced those infection-fighting and wound-healing ingredients with honey?
Honey is not new to the medical field and health foods scene. Documentation from the ancient Sumerians and Egyptians nearly 4000 years ago detail their multitude of uses for honey. [1] Furthermore the ancient Assyrians, Chinese, Greeks, and Romans also used honey to speed wound healing and alleviate intestinal issues. [2]
Related: Top 5 Health Benefits Of Local Honey - Allergies, Wounds & More
it's been well-established that honey offers antibacterial properties and is a favorable alternative to processed cane sugar, but not all honeys are created equal.
Enter, manuka honey.
Manuka honey results from bees feeding on the flowers of the manuka bush (Leptospermum scoparium), also known as the tea tree, a plant native to New Zealand and Australia. [3] Unlike the generic honey you buy at the grocery store, manuka honey is dark cream to dark brown in color, has a damp earth and aromatic aroma, as well as a mineral and slightly bitter flavor. [4]
Like all other honey varieties, manuka honey is rich in sugar and carbohydrates but provides virtually no fat or carbohydrates. 100 grams of manuka honey contains approximately 331 calories, 82 grams of carbohydrates, zero grams of fat, less than one gram of protein, and 17 grams of water. [2]
Almost all the carbohydrates in honey are in the form of sugar. Most of this sugar is in the form of fructose and glucose, which are quickly absorbed by the body, but honey also contains the fructooligosaccharides. [2]
Oligosaccharides are not readily absorbed by the body and act as beneficial probiotics in the intestines. In addition, honey contains trace amounts of potassium, iron, copper, zinc, manganese, vitamins C, B1, B2, riboflavin, nicotinic acid, B6, and pantothenic acid. [2] Manuka honey is like cane sugar on steroids.
The antimicrobial properties of manuka honey make it particularly unique. These health-promoting properties vary based on the floral source, geographic location, weather conditions, time, temperature, and additional treatments of the honey. [5] This means the quality of your honey is influenced not only by the region from which it's produced but could also vary year-to-year despite purchasing from the same supplier.
To standardize the quality of manuka honey produced in New Zealand and Australia, manufacturers and regulators have created the unique manuka factor (UMF), a measurement of the honey antibacterial properties. [6] The higher the UMF value, the stronger the antibacterial strength.
The minimum recognized rating is UMF5 but the antibacterial effects of manuka honey are not truly noticed unless you used products with a UMF greater than 10. [7] Ideally the product should have a UMF of at least 15. [8] The highest possible UMF rating is 26 per the Unique Manuka Factor Honey Association. [9] High quality and high potency manuka honey products will place the UMF value in a prominent location on the label.
In fact, two products, Medihoney. and Active Honey Absorbent Dressing, API-MED are approved in Europe and Australia for the clinical treatments of infected wounds. [10] Clinical evidence also exists for the use of manuka honey to treat ulcers, allergies, and gastrointestinal infection. [11][12][2] Anecdotal evidence supports the use of manuka honey to: [11][7]
One popular site popular in the naturopathic and homeopathic community recommends the consumption of one to two tablespoons of manuka honey per day. [7] If you choose to apply manuka honey to your skin then consider starting with a very small amount to determine your body?s response before applying large quantities.
A small study of twenty healthy individuals between 42 and 64 years old found that 20 grams of manuka honey consumption per day for four weeks did not cause an allergic response nor did it negatively impact gut bacteria. [13] Otherwise healthy individuals should moderate their manuka honey consumption; it's a calorie-dense food high in carbohydrates and sugar. Consuming significantly more calories than you burn will lead to excess fat gain which negatively impacts many aspects of life.
While manuka honey is highly safe and non-carcinogenic, select populations may notice undesirable side effects from excessive manuka honey consumption or application on the skin. While rare, some individuals may experience an allergic reaction to the pollen or bee proteins found in honey upon topical application or consumption. Those with a sensitivity may notice a slight and short-lived stinging sensation if applied to the skin.
Excessive topical application may also cause slight dehydration of the skin. Those with diabetes should be careful applying excessive amounts of manuka honey to open wounds as it may increase blood sugar. [2] If you experience any unwanted side effects then discontinue manuka honey use immediately and consult your healthcare professional.
Honey also dehydrates bacteria by drawing moisture out of the environment, maintains a relatively low pH to discourage bacterial growth, and has several phytochemical factors to further fight against bad bacteria. [2] A number of lab studies verify manuka honey's ability to hinder the growth of numerous bacteria strains.
Manuka honey fights against multiple strains of Staphylococcus aureus (MRSA), Streptococcus pyogenes, Streptococcus mutans, Proteus mirabilis, Pseudomonas aeruginosa, Enterobacter cloacae (E. coli), and Helicobacter pylori (H. pylori). [5][14] Furthermore, these bacteria did not mutate and build resistance to manuka honey despite repeated exposure. [15] Unfortunately, these studies were carried out using cells in petri dishes, but the results are promising.
One study on twelve patients infected with H.pylori examined the consumption of one tablespoon of manuka honey four times per day for 14 days. Four weeks after the study concluded researchers measured the presence of H. pylori using a 14C urea breath test.
Unfortunately, the manuka honey did not eradicate H. pylori. [16] This contrasts with lab studies indicating manuka honey?s ability to hinder the growth of and eradicate H. pylori, a bacteria that can cause stomach ulcers in the stomach and small intestine.
A meta-analysis of five studies found that application of manuka honey to an open wound is significantly more effective in decreasing the healing time compared to polyurethane, amniotic membrane, boiled potato peel, silver sulfadiazine, and saline. [11] Across wound adhesives with manuka honey, those with UMF values greater than 18 were significantly more effective at inhibiting the growth of three different strains of C. difficile compared to placebo. [17]
Additional human studies confirm manuka honey?s ability to kill multiple strains 'of MRSA as well as its ability to encourage the growth of blood capillaries, fibroblast, and epithelial cells when applied to wounds. [18][3] Manuka honey stacks also extremely well with antibiotic compounds like oxacillin, tetracycline, imipenem, and mupirocin. [15] That sweet viscous liquid you put in your tea and coffee could also save you from life-threatening infections.
The consumption of manuka honey offers of several positive benefits as found in human and animal studies. A liquid solution comprised of 5% honey can significantly decrease the duration of diarrhea compared to sugar placebo, rehydrate the body, decrease inflammation, and help rebuild damaged mucosa in the intestine. [2]
Honey can also significantly increase nitric oxide production in the blood while simultaneously decreasing prostaglandin levels. [11] High prostaglandins levels correlate to high levels of inflammation in the body. A sizable consumption of 1.2 to 1.5 grams of manuka honey per kilogram of body weight can significantly boost immune system function as well as raise antioxidants levels in the blood. [11][19]
For reference, a 180lb individual would need to consume between 98 and 123 grams of honey per day to obtain these observed benefits. For most this would be a majority of both sugar and carbohydrate daily requirements.
Believe it or not, manuka honey as improves teeth and gum health. 30 individuals chewed on manuka honey leather or chewed sugarless gum for ten minutes three times per day after each meal.
After three weeks those chewing the manuka honey leather significantly reduced their mean plaque scores and percentage of bleeding sites compared to the sugarless gum placebo. [20] While it may seem too good to be true, manuka honey might be just what you need to ensure a cavity-free diagnosis at your next dental checkup.
Manuka honey may also be part of a proprietary blend found in high-end cosmetic and beauty products. Many pharmacies and medical supplies stores sell sterile adhesive pads lined with medical-grade manuka honey.
Do you use manuka honey? Does it live up to its claims? Let me know in the comments below.
2) Eteraf-Oskouei, Tahereh, and Moslem Najafi. ?Traditional and Modern Uses of Natural Honey in Human Diseases: A Review.? Iranian Journal of Basic Medical Sciences 16.6 (2013): 731?742. Print.
3) "Manuka Honey." NCI Drug Dictionary, National Cancer Institute, 2016, Accessed Nov. 2016.
4) Stephens, Jonathan McD C. "The factors responsible for the varying levels of UMF® in m?nuka (Leptospermum scoparium) honey." Research Commons, University of Waikato, Feb. 2006, Accessed Nov. 2016.
5) Lu, Jing et al. ?Manuka-Type Honeys Can Eradicate Biofilms Produced by Staphylococcus Aureus Strains with Different Biofilm-Forming Abilities.? Ed. Siouxsie Wiles. PeerJ 2 (2014): e326. PMC. Web. Nov. 2016.
6) Fernandez-Cabezudo, Maria J. et al. ?Intravenous Administration of Manuka Honey Inhibits Tumor Growth and Improves Host Survival When Used in Combination with Chemotherapy in a Melanoma Mouse Model.? Ed. Antonio Facchiano. PLoS ONE 8.2 (2013): e55993. PMC. Web. Nov. 2016.
7) Axe, Josh. "10 Proven Manuka Honey Uses & Benefits." Dr. Axe, 2016, Accessed Nov. 2016.
8) Schmidlin, P. R., et al. "Antibacterial Potential of Manuka Honey Against Three Oral Bacteria in Vitro." National Center for Biotechnology Information, Swiss Dent J, 2014, Accessed Nov. 2016.
9) "Grading System Explained." Unique Manuka Factor Honey Association, 2016, Accessed Nov. 2016.
10) Brudzynski, Katrina, and Robert Lannigan. ?Mechanism of Honey Bacteriostatic Action Against MRSA and VRE Involves Hydroxyl Radicals Generated from Honey?s Hydrogen Peroxide.? Frontiers in Microbiology 3 (2012): 36. PMC. Web. Nov. 2016.
11) Yaghoobi, Reza, Afshin Kazerouni, and Ory kazerouni. ?Evidence for Clinical Use of Honey in Wound Healing as an Anti-Bacterial, Anti-Inflammatory Anti-Oxidant and Anti-Viral Agent: A Review.? Jundishapur Journal of Natural Pharmaceutical Products 8.3 (2013): 100?104. Print.
12) Thamboo, A., et al. "Single-blind Study of Manuka Honey in Allergic Fungal Rhinosinusitis." National Center for Biotechnology Information, J Otolaryngol Head Neck Surg, June 2011, Accessed Nov. 2016.
13) Wallace, A., et al. "Demonstrating the Safety of Manuka Honey UMF 20+in a Human Clinical Trial with Healthy Individuals." National Center for Biotechnology Information, Br J Nutr, Apr. 2010, Accessed Nov. 2016.
14) Al Somal, N et al. ?Susceptibility of Helicobacter Pylori to the Antibacterial Activity of Manuka Honey.? Journal of the Royal Society of Medicine 87.1 (1994): 9?12. Print.
15) Carter, Dee A. et al. ?Therapeutic Manuka Honey: No Longer So Alternative.? Frontiers in Microbiology 7 (2016): 569. PMC. Web. Nov. 2016.
16) McGovern, D P et al. ?Manuka Honey against Helicobacter Pylori.? Journal of the Royal Society of Medicine 92.8 (1999): 439. Print.
17) Hammond, Eric N, and Eric S Donkor. ?Antibacterial Effect of Manuka Honey on Clostridium Difficile.? BMC Research Notes 6 (2013): 188. PMC. Web. Nov. 2016.
18) Jenkins, R., et al. "Effect of Manuka Honey on the Expression of Universal Stress Protein A in Meticillin-resistant Staphylococcus Aureus." National Center for Biotechnology Information, Int J Antimicrob Agents, Apr. 2011, Accessed Nov. 2016.
19) Ahmed, Sarfraz, and Nor Hayati Othman. ?Honey as a Potential Natural Anticancer Agent: A Review of Its Mechanisms.? Evidence-based Complementary and Alternative Medicine?: eCAM 2013 (2013): 829070. PMC. Web. Nov. 2016.
20) English, H. K., et al. "The Effects of Manuka Honey on Plaque and Gingivitis: a Pilot Study." National Center for Biotechnology Information, J Int Acad Periodontol, Apr. 2004, Accessed Nov. 2016.
Honey is not new to the medical field and health foods scene. Documentation from the ancient Sumerians and Egyptians nearly 4000 years ago detail their multitude of uses for honey. [1] Furthermore the ancient Assyrians, Chinese, Greeks, and Romans also used honey to speed wound healing and alleviate intestinal issues. [2]
Related: Top 5 Health Benefits Of Local Honey - Allergies, Wounds & More
it's been well-established that honey offers antibacterial properties and is a favorable alternative to processed cane sugar, but not all honeys are created equal.
Enter, manuka honey.
Manuka honey results from bees feeding on the flowers of the manuka bush (Leptospermum scoparium), also known as the tea tree, a plant native to New Zealand and Australia. [3] Unlike the generic honey you buy at the grocery store, manuka honey is dark cream to dark brown in color, has a damp earth and aromatic aroma, as well as a mineral and slightly bitter flavor. [4]
Like all other honey varieties, manuka honey is rich in sugar and carbohydrates but provides virtually no fat or carbohydrates. 100 grams of manuka honey contains approximately 331 calories, 82 grams of carbohydrates, zero grams of fat, less than one gram of protein, and 17 grams of water. [2]
Almost all the carbohydrates in honey are in the form of sugar. Most of this sugar is in the form of fructose and glucose, which are quickly absorbed by the body, but honey also contains the fructooligosaccharides. [2]
Oligosaccharides are not readily absorbed by the body and act as beneficial probiotics in the intestines. In addition, honey contains trace amounts of potassium, iron, copper, zinc, manganese, vitamins C, B1, B2, riboflavin, nicotinic acid, B6, and pantothenic acid. [2] Manuka honey is like cane sugar on steroids.
The antimicrobial properties of manuka honey make it particularly unique. These health-promoting properties vary based on the floral source, geographic location, weather conditions, time, temperature, and additional treatments of the honey. [5] This means the quality of your honey is influenced not only by the region from which it's produced but could also vary year-to-year despite purchasing from the same supplier.To standardize the quality of manuka honey produced in New Zealand and Australia, manufacturers and regulators have created the unique manuka factor (UMF), a measurement of the honey antibacterial properties. [6] The higher the UMF value, the stronger the antibacterial strength.
The minimum recognized rating is UMF5 but the antibacterial effects of manuka honey are not truly noticed unless you used products with a UMF greater than 10. [7] Ideally the product should have a UMF of at least 15. [8] The highest possible UMF rating is 26 per the Unique Manuka Factor Honey Association. [9] High quality and high potency manuka honey products will place the UMF value in a prominent location on the label.
Manuka Honey Uses
Manuka honey has several clinically studied uses because of its powerful antimicrobial and antibacterial properties. In the medical community, manuka honey may be applied to wounds to jumpstart the healing process, cleanse the wound, prevent or reverse infection, and reduce inflammation. [2]In fact, two products, Medihoney. and Active Honey Absorbent Dressing, API-MED are approved in Europe and Australia for the clinical treatments of infected wounds. [10] Clinical evidence also exists for the use of manuka honey to treat ulcers, allergies, and gastrointestinal infection. [11][12][2] Anecdotal evidence supports the use of manuka honey to: [11][7]
- Improve digestion
- Alleviate cough
- Maintain teeth and gum health
- Decrease cardiac pain and palpitation
- Improve eyesight and prevent cataracts
- Regulation and rebalance lung function and iron levels in the blood
- Treat bacterial overgrowth, low stomach acid, and acid reflux
- Improve sleep quality
- Exfoliate the skin and increase hair shine
- Provide relief from digestive issues like irritable bowel syndrome (IBS) and irritable bowel disease (IBS)
- Boost immune function
- Treat skin conditions like acne and eczema
One popular site popular in the naturopathic and homeopathic community recommends the consumption of one to two tablespoons of manuka honey per day. [7] If you choose to apply manuka honey to your skin then consider starting with a very small amount to determine your body?s response before applying large quantities.
A small study of twenty healthy individuals between 42 and 64 years old found that 20 grams of manuka honey consumption per day for four weeks did not cause an allergic response nor did it negatively impact gut bacteria. [13] Otherwise healthy individuals should moderate their manuka honey consumption; it's a calorie-dense food high in carbohydrates and sugar. Consuming significantly more calories than you burn will lead to excess fat gain which negatively impacts many aspects of life.
While manuka honey is highly safe and non-carcinogenic, select populations may notice undesirable side effects from excessive manuka honey consumption or application on the skin. While rare, some individuals may experience an allergic reaction to the pollen or bee proteins found in honey upon topical application or consumption. Those with a sensitivity may notice a slight and short-lived stinging sensation if applied to the skin.
Excessive topical application may also cause slight dehydration of the skin. Those with diabetes should be careful applying excessive amounts of manuka honey to open wounds as it may increase blood sugar. [2] If you experience any unwanted side effects then discontinue manuka honey use immediately and consult your healthcare professional.
Manuka Honey Benefits
Manuka honey's strong antibacterial properties make it useful for cleaning wounds and fighting infection. Researchers believe its high concentration of 1,2-dicarbonyl methylglyoxal which releases small amounts of hydrogen peroxide, is largely responsible for its ability to fight bacteria. [3]Honey also dehydrates bacteria by drawing moisture out of the environment, maintains a relatively low pH to discourage bacterial growth, and has several phytochemical factors to further fight against bad bacteria. [2] A number of lab studies verify manuka honey's ability to hinder the growth of numerous bacteria strains.
Manuka honey fights against multiple strains of Staphylococcus aureus (MRSA), Streptococcus pyogenes, Streptococcus mutans, Proteus mirabilis, Pseudomonas aeruginosa, Enterobacter cloacae (E. coli), and Helicobacter pylori (H. pylori). [5][14] Furthermore, these bacteria did not mutate and build resistance to manuka honey despite repeated exposure. [15] Unfortunately, these studies were carried out using cells in petri dishes, but the results are promising.
One study on twelve patients infected with H.pylori examined the consumption of one tablespoon of manuka honey four times per day for 14 days. Four weeks after the study concluded researchers measured the presence of H. pylori using a 14C urea breath test.
Unfortunately, the manuka honey did not eradicate H. pylori. [16] This contrasts with lab studies indicating manuka honey?s ability to hinder the growth of and eradicate H. pylori, a bacteria that can cause stomach ulcers in the stomach and small intestine.
A meta-analysis of five studies found that application of manuka honey to an open wound is significantly more effective in decreasing the healing time compared to polyurethane, amniotic membrane, boiled potato peel, silver sulfadiazine, and saline. [11] Across wound adhesives with manuka honey, those with UMF values greater than 18 were significantly more effective at inhibiting the growth of three different strains of C. difficile compared to placebo. [17]
Additional human studies confirm manuka honey?s ability to kill multiple strains 'of MRSA as well as its ability to encourage the growth of blood capillaries, fibroblast, and epithelial cells when applied to wounds. [18][3] Manuka honey stacks also extremely well with antibiotic compounds like oxacillin, tetracycline, imipenem, and mupirocin. [15] That sweet viscous liquid you put in your tea and coffee could also save you from life-threatening infections.
The consumption of manuka honey offers of several positive benefits as found in human and animal studies. A liquid solution comprised of 5% honey can significantly decrease the duration of diarrhea compared to sugar placebo, rehydrate the body, decrease inflammation, and help rebuild damaged mucosa in the intestine. [2]
Honey can also significantly increase nitric oxide production in the blood while simultaneously decreasing prostaglandin levels. [11] High prostaglandins levels correlate to high levels of inflammation in the body. A sizable consumption of 1.2 to 1.5 grams of manuka honey per kilogram of body weight can significantly boost immune system function as well as raise antioxidants levels in the blood. [11][19]
For reference, a 180lb individual would need to consume between 98 and 123 grams of honey per day to obtain these observed benefits. For most this would be a majority of both sugar and carbohydrate daily requirements.
Believe it or not, manuka honey as improves teeth and gum health. 30 individuals chewed on manuka honey leather or chewed sugarless gum for ten minutes three times per day after each meal.
After three weeks those chewing the manuka honey leather significantly reduced their mean plaque scores and percentage of bleeding sites compared to the sugarless gum placebo. [20] While it may seem too good to be true, manuka honey might be just what you need to ensure a cavity-free diagnosis at your next dental checkup.
Where Can I Find Manuka Honey?
Manuka honey is most commonly packaged in a glass jar or plastic container and sold by online supplement retailers and health foods stores as a standalone ingredient designed to be orally consumed. Supplement manufacturers do not include manuka honey as a part of pre-workout, intra-workout, post-workout, or general wellness supplement blends.Manuka honey may also be part of a proprietary blend found in high-end cosmetic and beauty products. Many pharmacies and medical supplies stores sell sterile adhesive pads lined with medical-grade manuka honey.
Do you use manuka honey? Does it live up to its claims? Let me know in the comments below.
References
1) Nzeako, Basil C, and Faiza Al-Namaani. ?The Antibacterial Activity of Honey on Helicobacter Pylori.? Sultan Qaboos University Medical Journal 6.2 (2006): 71?76. Print.2) Eteraf-Oskouei, Tahereh, and Moslem Najafi. ?Traditional and Modern Uses of Natural Honey in Human Diseases: A Review.? Iranian Journal of Basic Medical Sciences 16.6 (2013): 731?742. Print.
3) "Manuka Honey." NCI Drug Dictionary, National Cancer Institute, 2016, Accessed Nov. 2016.
4) Stephens, Jonathan McD C. "The factors responsible for the varying levels of UMF® in m?nuka (Leptospermum scoparium) honey." Research Commons, University of Waikato, Feb. 2006, Accessed Nov. 2016.
5) Lu, Jing et al. ?Manuka-Type Honeys Can Eradicate Biofilms Produced by Staphylococcus Aureus Strains with Different Biofilm-Forming Abilities.? Ed. Siouxsie Wiles. PeerJ 2 (2014): e326. PMC. Web. Nov. 2016.
6) Fernandez-Cabezudo, Maria J. et al. ?Intravenous Administration of Manuka Honey Inhibits Tumor Growth and Improves Host Survival When Used in Combination with Chemotherapy in a Melanoma Mouse Model.? Ed. Antonio Facchiano. PLoS ONE 8.2 (2013): e55993. PMC. Web. Nov. 2016.
7) Axe, Josh. "10 Proven Manuka Honey Uses & Benefits." Dr. Axe, 2016, Accessed Nov. 2016.
8) Schmidlin, P. R., et al. "Antibacterial Potential of Manuka Honey Against Three Oral Bacteria in Vitro." National Center for Biotechnology Information, Swiss Dent J, 2014, Accessed Nov. 2016.
9) "Grading System Explained." Unique Manuka Factor Honey Association, 2016, Accessed Nov. 2016.
10) Brudzynski, Katrina, and Robert Lannigan. ?Mechanism of Honey Bacteriostatic Action Against MRSA and VRE Involves Hydroxyl Radicals Generated from Honey?s Hydrogen Peroxide.? Frontiers in Microbiology 3 (2012): 36. PMC. Web. Nov. 2016.
11) Yaghoobi, Reza, Afshin Kazerouni, and Ory kazerouni. ?Evidence for Clinical Use of Honey in Wound Healing as an Anti-Bacterial, Anti-Inflammatory Anti-Oxidant and Anti-Viral Agent: A Review.? Jundishapur Journal of Natural Pharmaceutical Products 8.3 (2013): 100?104. Print.
12) Thamboo, A., et al. "Single-blind Study of Manuka Honey in Allergic Fungal Rhinosinusitis." National Center for Biotechnology Information, J Otolaryngol Head Neck Surg, June 2011, Accessed Nov. 2016.
13) Wallace, A., et al. "Demonstrating the Safety of Manuka Honey UMF 20+in a Human Clinical Trial with Healthy Individuals." National Center for Biotechnology Information, Br J Nutr, Apr. 2010, Accessed Nov. 2016.
14) Al Somal, N et al. ?Susceptibility of Helicobacter Pylori to the Antibacterial Activity of Manuka Honey.? Journal of the Royal Society of Medicine 87.1 (1994): 9?12. Print.
15) Carter, Dee A. et al. ?Therapeutic Manuka Honey: No Longer So Alternative.? Frontiers in Microbiology 7 (2016): 569. PMC. Web. Nov. 2016.
16) McGovern, D P et al. ?Manuka Honey against Helicobacter Pylori.? Journal of the Royal Society of Medicine 92.8 (1999): 439. Print.
17) Hammond, Eric N, and Eric S Donkor. ?Antibacterial Effect of Manuka Honey on Clostridium Difficile.? BMC Research Notes 6 (2013): 188. PMC. Web. Nov. 2016.
18) Jenkins, R., et al. "Effect of Manuka Honey on the Expression of Universal Stress Protein A in Meticillin-resistant Staphylococcus Aureus." National Center for Biotechnology Information, Int J Antimicrob Agents, Apr. 2011, Accessed Nov. 2016.
19) Ahmed, Sarfraz, and Nor Hayati Othman. ?Honey as a Potential Natural Anticancer Agent: A Review of Its Mechanisms.? Evidence-based Complementary and Alternative Medicine?: eCAM 2013 (2013): 829070. PMC. Web. Nov. 2016.
20) English, H. K., et al. "The Effects of Manuka Honey on Plaque and Gingivitis: a Pilot Study." National Center for Biotechnology Information, J Int Acad Periodontol, Apr. 2004, Accessed Nov. 2016.
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