INTRODUCTION: This study investigated the effects of Acacia honey drink on glucose metabolism, total antioxidant status, and running performance in the heat and compared it with a commercial sports drink. MATERIALS AND METHODS: In this randomised cross -over study, ten participants completed two endurance running trials in the heat (31°C, 70% relative humidity) with either the honey drink (H) or sports drink (SPD) consumption with a one-week interval between trials. The participants warmed up for 5 min at 50% of their respective maximum oxygen consumption (VO2max) and subsequently ran at 60% of VO2max for 1 hour, immediately followed by a 20-min time trial running performance. During the 20-min time trial, each participant’s furthest running distance was recorded to determine the participants’ running performance. Blood samples were analysed for glucose, insulin, cortisol, and total antioxidant status. RESULTS: There was no difference in running performance during the honey and sports drink trials. In addition, plasma glucose, insulin, and cortisol were also not statistically different at any time points between H and SPD trials. However, the total antioxidant status was significantly higher (p<0.01) than the resting value in the H trial. CONCLUSION: Our findings indicate that H and SPD consumed before and during exercise elicited similar effects on running performance, glucose metabolism and total antioxidant status during prolonged running in the heat. Therefore, Acacia honey can be used as an alternative ergogenic aid for athletes who train and compete in a hot and humid environment. [ABSTRACT FROM AUTHOR]