Manuka Honey Chesty Cough Relief

Manuka is a food first, so most of these questions are about choosing well, and about the one group who must never have it. It's the same conversation our naturopaths have in store.

A good fit if

• You're an adult buying honey as a food and want to understand what the grade on the jar measures
• You're comparing MGO, UMF and 'active' and want a straight comparison
• You're weighing up Australian Leptospermum honey against New Zealand manuka and want the facts rather than the marketing
• You enjoy it as a food and count its sugars the same way you'd count any other sugar
• You want a graded honey with the testing method printed on the jar, not just a word

Check with us first if

• You have diabetes, prediabetes or any condition where you manage your blood sugar. Manuka is about four-fifths sugar and isn't a low-sugar swap for sugar.
• You have fructose malabsorption or IBS, or you follow a low-FODMAP diet. Honey is high in fructose and is often limited on those plans.
• You're thinking of using it on a skin problem or a slow-healing wound. That's a decision for a doctor or wound nurse, and the products studied are sterilised medical-grade honey, not food.
• You're buying it for a child over twelve months. The baby restriction ends at twelve months, but the sugar and dental concerns don't, so it's worth a chat.
• You have a weakened immune system, are having chemotherapy, or have any condition where you avoid raw and unpasteurised foods. Check with your treating team, because honey isn't sterile.
• You're choosing a high grade and aren't sure it's been verified. Bring the jar in and we'll read the label with you.
• If you take prescription medicine, check with your doctor, pharmacist or our naturopaths before you start.

• MGO (methylglyoxal, stated in mg/kg). Best known for: The single number most Australian shelves lead with, and the easiest to compare across brands. Absorption: A direct chemical measurement of methylglyoxal, the compound that activity follows. It's honest and it's meaningful. Typical use: Meaningful. Its one gap is that it says nothing about whether the honey is really manuka. A high number and a genuine floral source are two separate questions.
• UMF (Unique Mānuka Factor). Best known for: The most informative label on the shelf, because it's four tests reported as one number. Absorption: Tests methylglyoxal for strength, leptosperin for authenticity, dihydroxyacetone (which predicts how the honey will keep), and HMF to show the honey hasn't been overheated or stored too long. Typical use: Meaningful, and the only common grade that checks the honey is manuka as well as how strong it is. It's licensed by a New Zealand industry association, so Australian honey generally can't carry it.
• NPA (Non-Peroxide Activity). Best known for: The original method the UMF number was built on, still used on some Australian jars. Absorption: A biological test rather than a chemical one: how well the honey stops bacteria growing in a dish is compared with phenol solutions and reported as an equivalent phenol percentage. Typical use: Meaningful but older. NPA 10 roughly lines up with UMF 10. Because it's a biological test, results vary more between laboratories than measuring a molecule directly.
• MPI monofloral or multifloral classification. Best known for: The New Zealand government's scientific definition, and the reason honey with only a little manuka in it can still be sold as 'manuka'. Absorption: Five markers: four nectar chemicals plus manuka pollen DNA. Monofloral needs 2'-methoxyacetophenone at 5 mg/kg or more and 3-phenyllactic acid at 400 mg/kg or more; multifloral needs only 1 mg/kg and 20 mg/kg respectively. Typical use: Meaningful, but it answers a different question: whether the honey is manuka and how pure, not how strong it is. It's required for New Zealand exports, not for honey sold within New Zealand.
• 'K Factor'. Best known for: Looking like a strength rating on the shelf while being a system owned by a single brand. Absorption: Based on pollen count and general quality markers. It doesn't measure methylglyoxal and doesn't convert to MGO, UMF or NPA. Typical use: Marketing. A K Factor number can't be compared with an MGO or UMF number, and a jar with only a K Factor tells you nothing about activity.
• 'Active', 'Bio-Active' or 'Total Activity (TA)'. Best known for: The vaguest wording on the shelf, and the one most often mistaken for a grade. Absorption: Total Activity usually includes hydrogen peroxide activity, which most honeys have and which doesn't survive dilution or storage the way methylglyoxal does. Typical use: Mostly marketing. Treat 'active' with no defined method behind it as a word rather than a number, and look for the MGO, UMF or NPA figure instead.

Reference values. None. Honey is a food, not an essential nutrient, so the NHMRC doesn't set a recommended intake for it or for methylglyoxal.

Typical supplemental range. Australian labels suggest servings rather than doses, usually around 10 g, which is a heaped teaspoon to a level tablespoon. Nutrition panels on manuka jars are usually based on a 21 g tablespoon. Food labels don't tell you to have a set amount each day, and no Australian source sets an amount at which the graded activity does anything measurable once you swallow it.

Upper level. There's no NHMRC upper limit and no cap in Australia's permitted ingredients rules. The thing to watch is sugar, not regulation. Manuka honey is about four-fifths sugar, and a 21 g tablespoon has about 17 g of sugars and 268 kJ. That's the number to keep in mind if you have it every day, and it's the same whatever the grade.

Worth knowing. Knowing how to choose matters more here than how much to have, because the grade is what sets jars apart on the shelf. A higher grade isn't a stronger food; it's honey with more of one measured compound in it. What you need depends on your age, diet and health, so talk to one of our naturopaths.

Food first, where the diet allows it.

• Monofloral manuka honey (New Zealand, Leptospermum scoparium): the classic product; commonly graded from around MGO 100 up to MGO 800 and beyond
• Multifloral manuka honey and manuka blends: lower activity at a lower price; blends may declare a percentage of graded manuka rather than a grade of their own
• Australian Leptospermum, sold as jelly bush or Australian manuka: mainly Leptospermum polygalifolium from New South Wales and Queensland; research samples reached 1,100 mg/kg methylglyoxal
• Jarrah honey (Western Australia, Eucalyptus marginata): an Australian honey with high peroxide activity and no methylglyoxal grade: a different marker entirely
• Ordinary blossom, clover or bush honey: peroxide activity only, which does not persist; nutritionally close to manuka and a fraction of the price
• Honeycomb and raw honey: unheated, unfiltered forms of the same food; the infant restriction applies to these identically

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• Babies under twelve months. Never give it. Australian medicines containing honey must say 'Not suitable for infants under the age of twelve months'; healthdirect advises against honey for babies under 12 months because of the risk of botulism.
• This applies to all honey at any grade, including honey mixed into food or put on a dummy.
• If a baby who has been given honey becomes constipated, feeds poorly, has a weak cry or seems floppy, get urgent medical attention.
• You're allergic to honey, bee products or pollen. Don't take it.
• You have diabetes or prediabetes, or are managing your blood glucose. Honey is roughly four-fifths sugars.
• You have fructose malabsorption or IBS, or eat low-FODMAP. Honey is high in fructose and commonly restricted.
• You have a weakened immune system or are having chemotherapy. Honey isn't a sterile food, so check with your treating team.
• You want to treat a wound, burn or infection. These aren't for self-treatment; the honey studied on skin is a sterilised medical-grade product used under medical supervision.
• Your teeth. Honey affects them like any sugar, at any grade.
• 'Active', 'bio-active' and 'K Factor' on a jar aren't methylglyoxal grades and shouldn't be treated as though they were.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before starting.