Sugar is increasingly being seen as a cause of Western lifestyle diseases, particularly obesity. As obesity develops the risk of other lifestyle diseases such as type 2 diabetes, cardiovascular disease and cancer also increase. Refined crystalline sugar, also called sucrose or table sugar, is damaging because it contains fructose. Fructose in itself is not damaging to the health because most fruit contains fructose. However, when consumed in high concentrations and in the absence of fibre, in its crystalline or processed state, fructose becomes a metabolic poison. Fructose can flood the liver with energy and stimulate flux through a chemical pathway called the de novo lipogenesis pathway. This pathway then converts carbohydrate to fatty acids, and these fatty acids accumulate in skeletal muscle and the liver where they induce insulin resistance. The fructose in fruit is not damaging because fruit has a high water content that minimises the fructose intake and also because the fibre in the fruit slows the absorption of the fructose and thus reduces the flood of energy reaching the liver.
Honey is composed mainly of fructose and glucose. As sucrose is also composed of fructose and glucose, chemically the two substances are similar. The sweet taste of honey is because of the presence of these sugars, particularly fructose which is much sweeter than glucose. However, honey does not appear to have as many adverse health effects as sucrose. The main reason for the discrepancy is the fact that honey just simply not eaten in as high amounts a sucrose. Sucrose is everywhere, and nearly all sweetened processed foods, soft drinks and confectionary contain large amounts of sucrose. Historically humans were prevented from eating large quantities of honey by angry bees. Another factor that makes honey a healthier alternative is that it is much harder to add to foods due to its consistency, which inhibits dissolution in liquids and can be messy. Another factor to consider is the fact that honey contains many healthy substances from the plants from which it originated, including antioxidant phytochemicals. These plant chemicals make honey a viable and healthy alternative to sucrose, if used in moderation.