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The Best Dried Fruit for Osteoporosis

“We are in an epidemic of osteoporosis. There can be no doubt about that.” Ten million Americans have it, and one in three older women will get it. “We urgently need public health strategies to maintain bone health throughout the life cycle and to prevent osteoporosis in later life.” Might fruits and vegetables be the unexpected natural answer to the question of osteoporosis prevention? My video Prunes for Osteoporosis sought to find out.

Evidence from a variety of studies “strongly points to a positive link between fruit and vegetable consumption and indexes of bone health,” such as bone mineral density, and the “size of the effect in the older women [is] impressive: doubling the fruit intake” is associated with a 5 percent higher spine mineralization. The same relationship exists with young women, too. And, eating lots of fruit in childhood may protect bones throughout life—something that was not found for milk intake, as I’ve explored before in my video Is Milk Good For Our Bones?

Bone health isn’t just about calcium. There are several key nutrients found in vegetables, fruits, and beans that are associated with better bone mineral density, but does that translate into lower hip fracture risk? The Singapore Chinese Health Study found that a “diet rich in plant-based foods, namely vegetables, fruit, and legumes such as soy, may reduce the risk of hip fracture.” But, why?

“The underlying mechanism in postmenopausal osteoporosis (PO) is an imbalance between bone resorption [disappearance] and formation,” and oxidative stress may play a role in this balance.

There are two types of bone cells: “the bone-forming osteoblasts and the bone-dismantling osteoclasts.” Osteoblasts are continually laying down new bone, while osteoclasts chisel away old bone, using free radicals as the molecular chisel to chip away our bone. Too many free radicals in our system, though, may lead to excessive bone breakdown. Antioxidant defenses appear “markedly decreased in osteoporotic women,” and “elderly osteoporotic women had consistently lower levels of all natural antioxidants tested than controls.”

“Because excessive [free radicals] may contribute to bone loss, it is important to elucidate the potential role antioxidant-rich fruits play in mitigating bone loss that leads to the development of osteoporosis.” The thought is that fruits up-regulate the bone building cells, and down-regulate the bone-eating cells, tipping the balance towards greater bone mass. So, let’s put a fruit to the test. Which one do we pick? Dried plums were chosen because they have among the highest antioxidant ranking among commonly consumed fruits and vegetables—and because the researchers received a grant from the California Dried Plum Board!

When you think of prunes, you think of bowels, not bones, but, over a decade ago, researchers at Oklahoma State tried giving a dozen prunes a day to a group of postmenopausal women, using a dozen dried apple rings as a control. After three months, only the subjects who consumed the prunes had significant elevations in an enzyme marker of bone formation, although prunes didn’t seem to affect markers of bone breakdown. So, prunes may help more with building bones than preventing bone loss. However, the reverse was found with almonds, so maybe a little prune-and-almond trail mix is in order. 

With this bump in bone formation indices, one might expect that if they did a longer study, we would actually see an impact on bone mineral density. And nine years later, just such a study was done: 12 months on dried plums versus apples. Both dried fruit regimens appeared to have “bone-protective effects,” though the prunes seemed to work better in the arm bone and spine.

So, the dried plum marketing board wants everyone to know that dried plums are “the most effective fruit in both preventing and reversing bone loss,” but only two fruits have ever been tested: plums and apples. If this pans out for other plants, though, “a ‘fruit and vegetables’ approach may provide a very sensible (and natural) alternative therapy for osteoporosis treatment, one that is likely to have numerous additional health-related benefits.” All we have to do is convince people to actually do it.


For more on bone health, see:

What else can prunes do for us? Check out Prunes vs. Metamucil vs. Vegan Diet.

Apple rings have their own benefits. See Dried Apples vs. Cholesterol.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


61 responses to “The Best Dried Fruit for Osteoporosis

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  1. In addition to all the other fruits I eat every day, I’m not about to scarf down 12 prunes too! (Well, maybe just one.)

    Prunes, prunes, the musical fruit; the more you eat, the more you do a helluva lot more than toot. :-)

    1. YR, I started eating prunes after watching the video about osteoporosis — which I have. Four a day. I LOVE them!! And would probably eat more if I didn’t limit myself. They are a great snack, especially with fresh fruit.

      1. Dr J, I give no credence to prunes after reading the study referenced by Dr Greger. Participants were also given 500 mg Ca and vit D. https://www.ncbi.nlm.nih.gov/pubmed/21736808

        I eat 2 apples a day or more for the supposed cholesterol lowering effect which Dr Greger did a video about. They may have used people eating the SAD in the trial because my cholesterol did not budge.

        1. All of the participants were given Ca and Vit D and the prune group still came out ahead. There may have been benefit from the supplements but it seems as though the prunes provided further improvement. A study without the supplements would be interesting.

    2. Heh, I remember that old saying as well.

      But personally I’m just a regular kind of guy whether I eat my prunes (3 in the morning, 3 in the afternoon) or not.

      As for tooting, I notice a little squeaker or two after eating a small chunk of unsweetened bitter chocolate accompanied by a few semi-sweet chocolate chips.

    3. It’s not just prunes that help osteoporosis. Studies done focusing on the Scarborough diet had an effect on markers of bone resorption. Diet included 6 servings a day of vegetables, green leafy, onions, broccoli, tomatoes, cucumbers, leeks, green beans.
      Fruit was citrus, prunes and one other (not banana or apple).
      2 servings of greens were included.
      Also herbs were included, including garlic, parsley, sage, thyme.
      Portion size was 80 grams per serving. The chart says that is 1/2 cup of cooked, or 1 cup raw. That isn’t correct. Measure out 80 grams of leafy greens, it is a lot more, probably equal to 1 cup cooked.
      The group on the most effective diet got the required 4700mg. of potassium per day.
      According to the study, most people reduced their servings of grains by 1-2, and added the vegetables and fruit instead.

      https://saveourbones.com/scarborough-fair-study-reconfirms-the-save-our-bones-program-diets-rich-in-fruits-vegetables-and-herbs-reduce-bone-turnover-helping-to-prevent-and-reverse-osteoporosis-and-osteopenia/

      https://res.mdpi.com/nutrients/nutrients-07-02499/article_deploy/nutrients-07-02499-v2.pdf?filename=&attachment=1

        1. Barbara, they got it, according to the study, by eating these plant foods in large amounts.
          In fact, the study participants were people eating in their own homes. So they were monitored by urine samples to verify potassium content. They were eating enough of the required fruits and veggies and herbs.
          With my patients who struggle to get more potassium, I recommend adding no-salt added, or low salt tomato juice. Depending on the brand, 1 cup can add 600-900 grams of potassium without a lot of calories.

          1. Here is a food chart with high potassium foods. Keep in mind the way you prepare them matters. For instance, if you cook potatoes, or most veggies in water, a lot of the potassium ends up being washed out. So steaming, or baking a potato, for instance, is a better choice.
            In fact, kidney patients who must limit potassium in their diets, are instructed to cut up and soak potatoes before cooking.
            Also, magnesium helps potassium absorption.

            https://www.myfooddata.com/articles/high-potassium-vegetables.php

  2. I did some searching around for how many prunes to eat daily.
    It looks like 5-6 prunes a day have a positive effect protecting against bone loss.
    That’s not bad, and prunes are a go-to for me when my sweet tooth acts up :D

    1. Thank you for sharing this. My mother is 89 and is suffering severe back and knee pain due to osteoporosis. Will try to give her some prunes and almonds.
      Are there any other studies on different fruits and vegetables to see if there are more such bone building ones out there?

      1. Is she Whole Food Plant Based, low saturated fat, too?

        (Thinking about the pain videos)

        I am trying to stay WFPB, low saturated fat, no oil.

        I use a device called, Micropulse ICES, which is excellent with pain.

        Before I went WFPB, I used that to get rid of foot and ankle pain from an injury and knee pain also from an injury and chronic lower back and shoulder pain.

        It was originally being developed for NASA as part of dealing with bone loss in astronauts, but they tried to throw the inventor under the bus and take his product and not give him credit and they were doing things with studies, which he wasn’t comfortable with. He left NASA, they tried to take ownership of his product and he won the court case. He is the person who found out that when certain waveforms were used there was a biological effect and also that most waveforms didn’t work. That has resulted in a whole worthless PEMF community, many not using viable waveforms at all. Anyway, the fake guys often sell their products for $20,000. The real guy, if you are just using it for pain, he has one which is in the $450 range. I got the one in the $650 range because it also has low-level TMS, which is safer than the TMS used for things like depression and stroke and it has settings, which can be used for sleep and others for brain health. It is an experimental device, not a medical device, but it can do things like grow back cartilage in knees and hips and grow back bone. Though the cartilage takes a long time – in studies with PEMF it took up to 2 years. The man who invented it successfully healed one of his hips, but the other hip is taking much longer. He has learned that there is a lot of variability in things like that.

        Anyway, pain is the thing it helped with the best.

        1. There is also a $1500 product, which can do multiple sites at once if she has bad back and knees and hips.

          Not doing a sales pitch for him.

          He doesn’t do any advertising or marketing at all and is anti-sales-pitch oriented.

          The inventor used to a fire chief, until he was injured. He used the technology he invented to heal his back pain from that injury.

          He had a stroke and TMS and PEMF are being used for stroke recovery, but he is so against sales pitches that when he wrote his book on his experience with brain plasticity, he didn’t want to include his device at all.

          You can’t get much more integrity than that.

          He has helped other PEMF selling companies to make their PEMF’s actually do something and has helped companies which seriously ripped off his designs. He said that he helped them because he didn’t want them injuring people.

          The fact that his device is one of the least expensive out there and he answers every email and every comment on his site, he is so accessible and has so much integrity. That is why I mention his device.

          The device I have came out of the self-hacking community wanting access to things like Schumann and gamma wavelengths and TMS. He gave the community every single wavelength they wanted to experiment with and when I was looking at the studies on PEMF, he gave the way to try the studies myself with one small device, which is about the size of a tape measure with a few coils attached.

      2. I found several studies in MedlinePlus indicating that fruits and vegetables in general were associated with building bone density, especially those that contain high levels of beta carotene, Vitamin C and Potassium. While Prunes may have “wont the prize” most fruits and vegetables have the nutrients to help with buildling bones. And we know they often work in concert, so having a fruit salad plus lots of fruits daily will be good for your mother–and you too!
        To your health!

    2. ~ 6 was my understanding as well. Not worried about my bones or my bowels… I just like that it is sweet, easy to access, and helps get a big spoonful of almond butter chewed up and swallowed.

  3. the aspect of redox control of osteoporosis is under control of radical formation and ph ..stem cell differentiation of osteoclasts is favored by an alkaline ph.. olive oil extracts are shown to also favor bone growth ..I will add prunes to my diet now after reading the blog ..the more people that can change their diet to an alkaline vegetable rich organic if possible the better for a number of health related issues

  4. Are there any studies done specific to bone loss in the teeth? I am going to assume for now that prunes and almonds should help with building bone in the teeth and preventing bone loss in the teeth.

    1. Loss of supporting bone around the teeth is caused by bacteria (and possibly viruses) and called periodontitis. You can have the densest bone in the world and it won’t protect you from this type of bone loss. The only way this can be diagnosed is by “periodontal probing”, not xrays. The only person qualified to do this is a licensed dentist that is very familiar with the diagnosis and treatment. Not all dentists are. Hygienists can do the probing but they cannot make the diagnosis. When in doubt, make an appointment with a periodontist, the dental specialist trained specifically to diagnose and treat this disease. It’s 3 years of additional full time training after graduation from dental school.

    2. Are there any studies done specific to bone loss in the teeth? I am going to assume for now that prunes and almonds should help with building bone in the teeth and preventing bone loss in the teeth.
      —————————————————————————————–
      I’m not aware of any studies, but like you it just seems intuitive if that protects bone in other parts of the body it would do the same for jaw bone.

      I’ve known people who have lost their teeth and in later years decided to have permanent false teeth pegged into their jaw. One person I knew had a break in his jaw when inserting the pegs because he had lost so much bone over the years.

      I’ve been doing the prune thing for quite a number of years now and in the past 2 or 3 years have included daily almond butter. I’ve lost many of my teeth over the years but I often check my jaws by feel.

      They seem quite sturdy.

      1. While there are several well-designed studies on nutrition and dental health in general (with whole food plant based diet) strongly correlated with dental health, I could not find one spelling out relationship of nutrition and bone loss. However the wise comment that whatever protects bones throughout the body also protects against bone loss in the teeth. You might also consider the importance of calcium and these videos will help you understand the importance of as both calcium intake and absorption for bone growth (and how a whole food plant based diet will help ensure adequate calcium to avoid bone loss through your body from toes to teeth:
        https://www.ncbi.nlm.nih.gov/pubmed/12088515
        https://nutritionfacts.org/video/alkaline-diets-animal-protein-and-calcium-loss/
        .

  5. I wonder what quantities and consumption frequency is required or suggested to benefit from eating dried prunes. I eat two per day (although I would happily eat more!) Because of the iodine benefit since sea salt has little or no iodine. I have the same question regarding flax seeds. I don’t seem to have the opportunity to fit 1/4 cup per day into my menu. Thank you for whatever suggestions you can provide!

    1. The studies are linked in the blue/green colored font in the article. Dr Greger mentioned several studies, but the longer term one is here:

      https://www.ncbi.nlm.nih.gov/pubmed/21736808

      They used 100gm / day of prunes (equating to 10 prunes!) plus calcium and vitamin D supplements. Here is the nutrient info on prunes… looks like it came out to an extra 220 cal per day.

      https://nutritiondata.self.com/facts/fruits-and-fruit-juices/2043/2

      Re the ground flax, Dr Greger recommends 1 tbsp of ground flax per day in his Daily Dozen. If you are trying to use it to lower blood pressure, there are flax muffins available in some areas that might help. I lowered blood pressure successfully with getting some sleep (finally) and increasing exercise, plus wfpb diet.

  6. Why not ear fresh plums instead of dried?
    I fill a pan of water, bring to a slightly warm temp, drop all the dried prunes in, let them rehydrate, then drain (drink) the liquid, place the prunes in a mini blender and use it as a very nice tasting ‘jam’. I even add lemon (fresh) juice. It’s wonderful. Must be kept in refrigerator

    1. Blair, just a couple of days ago something prompted me to buy prunes when I was shopping at Stop&Shop.

      I bought pitted D’Noir Prunes 100% Preservative Free (Sunsweet in California). I cut one of them up and cooked it in my gruel this morning. And then I saw Dr. G’s latest blog.

    2. Hi, Blair.
      If you’re talking about possibly naturally-occurring sulfites, I wouldn’t worry about it.
      If you make sure to get organic prunes, there are no preservatives or added sulfites.
      Organic prunes are not preserved with sulfites.
      I stopped eating prunes, too, till I found I could easily get Newman’s Own organic ones.

  7. On osteoporosis, I would like to hear what the science tells you about the effects vitamin K2-mk7 have. A search shows nothing has been said on this at NutrutionFacts.org

    thanks so much
    ed

  8. I had osteopenia and now it has developed into osteoarthritis. My doctor had a handout with tips from the book “The Healthy Bones Nutrition Plan and Cookbook” by Dr. Laura Kelly and Helen Bryman Kelly. Much of it doesn’t apply to a vegan diet but there are several great tips.

    I make a bone building vinegar that absorbs the calcium from greens. One tablespoon per day of this vinegar has 350-400 mg of calcium. I also make a nettle tea infusion that supplies calcium, magnesium and other vitamins and minerals.

    I’ve been vegetarian and vegan and health conscious for most of my adult life and unfortunately, my regular large intake of fruits and vegetables didn’t protect me from bone loss. I hope that my greater effort to include these bone building foods (and K2, which is important), will help rebuild my bones or protect again more loss. I also have always been an exerciser. I know that weight bearing exercise is important for bone health.

    http://thehealthybonesbook.com/make-your-own-bone-building-calcium-rich-vinegar/

    1. Connie, you are right to pay attention to leafy greens, magnesium and vitamin K2. Boron, and vitamin D also important.

      1. Marilyn,

        I tried eating dried natto powder daily, as it is the only plant-based source of K2. The taste was unpleasant to me so I ended up mixing it with vegetable/tomato juice to be able to get it down. But, I don’t love that routine so since then I have been taking K2 as a supplement along with vitamin D, the bone building vinegar, a small dose of a calcium supplement and the nettle tea. I hope that my next dexa scan in 1 1/2 years shows an improvement in my bone density.

        The is on the handout I got from my doctor, taken from the book I referenced:

        “Nettle tea provides nearly everything you need to strengthen bones:
        calcium (125 mg per cup), magnesium (75 mg per cup), vitamins A, B, C, D,
        K potassium, zinc, sulfur, boron, iron and trace minerals

        Fill a jar with dried nettle( can be stalks and leaves) 1 oz per 1 quart
        of water, then fill jar with boiling water, other dried or fresh herbs like mint
        or stevia leaf can be added for improved taste and flavor.”

        1. I realize that I left off part of the instructions. Let the tea brew overnight and in the morning strain out the herbs. Drink a cup or two per day.

        1. Lida, as you can see, I’m not Marilyn, but I for one would rather get vitamins/minerals via food, when possible. Am not fond of swallowing pills of any kind.

          “To ensure you have enough boron in your diet consume a variety from among the following food sources: almonds, walnuts, avocados, broccoli, potatoes, pears, prunes, honey, oranges, onions, chick peas, carrots, beans, bananas, red grapes, red apples and raisins. According to Medline Plus, boron is beneficial for regulating hormones, preventing osteoarthritis, reducing symptoms of menopause, preventing blood clots, reducing psoriasis and increasing testosterone.”

          https://www.livestrong.com/article/242015-foods-high-in-boron-vitamins/

          1. YR,
            Thanks for responding. The thing is that I do already eat many of those foods you mentioned but I am trying to prevent my osteopenia from becoming osteoporosis and I have read that Boron taken in conjunction with magnesium and D will work synergistically to strengthen bones..
            Boron supplements have been used in trials with good results. I am not as fortunate as you in avoiding health issues and food choices seem not to have the positive effects on their own.

    2. Looking at your post, I went back to his bone blog and it said that we need to shake our soy milk because the calcium settles at the bottom.

      I wonder how many little details like that I have glossed over.

      Grains and beans and nuts are on his list. Phytates.

    1. If dried plums can do it. With summer coming, can we assume that eating fresh plums as often; will also help.
      ——————————————————–
      Mary, I have no idea if just any plum is as healthy as the plums prunes are made from. This statement found on google suggests a difference:

      “Prunes are varieties of European plum (Prunus domestica). While all prunes are plums, not all plums can be dried into prunes.”

      The picture opening this video shows what is probably a Damson plum that is a very good prune maker.

      Not saying fresh plums are lacking in good nutrition, but I’m more excited about the health benefit of prunes.

      Below is not a study link, but if you trust Whole Foods, you may find their information comparing plums and prunes useful.

      http://www.whfoods.com/genpage.php?tname=foodspice&dbid=35

  9. Can we drink prune juice instead? I know if we juice a fruit that it isn’t as healthy as eating the actual fruit, but is it the same of different with prune juice? It’s easier to chug a can of prune juice than to eat that any plumes. I have so much other healthy stuff I have to eat in a day.

    1. Wendy, though I don’t mind the taste of plums and prunes, I am not in a rush to buy either … Dr Greger mentions in the last paragraph that ONLY two fruits have ever been tested, and the prune industry would like us to believe prunes are IT. He adds that taking a ‘fruit and vegetables approach’ may provide a sensible alternative to osteoporosis treatment. Marilyn Kay posted some great information above which might be more helpful as well.

  10. I’m I stupid? Quote: ” So, prunes may help more with building bones than preventing bone loss. However, the reverse was found with almonds, so maybe a little prune-and-almond trail mix is in order.”

    Are you saying eat prunes to build bones and then eat almonds to reverse the effect and cause bone loss?? So a trail mix would be great for doing nothing for you?

    1. Gary, it just means you now have a higher level of activity, ergo, your bones are more active in both processes.

      To me anyway, that suggests a more youthful state.

  11. Your marketing machine is becoming more and more biased and this study is evidenced based “research” to prove it.
    You are no longer properly vetting your research staff’s article picks.
    This study was funded by vested interests- the PRUNE industry. Yes, you do point that out. However, you take every chance that you get to demonize and discredit a study funded by a non plant based industry. No mention of any possible shenanigans when popping up studies that support your “industry”. Let’s be fair.
    Additionally, the study also used calcium and magnesium supplements. The calcium tablets contained gelatin in the ingredients list, by the way.
    I’m a vegan and will remain health care provider and strong supporter for plant based diets. However, I am exponentially getting disillusioned by your over-commercialism and now convinced that I need to question most of your citations hence forth.

    1. I get a bit cynical about posts like this one from BC.

      There have been a number of occasions on YouTube when people have commented similarly and then revealed later that they weren’t actually ‘vegans’ but were just mischief making by sailing under false colours. I have no idea if BC is a vegan or not but personal attacks, and conspiracy theories, of this sort do seem to be a low carb troll MO.

      BTW, where is this ‘commercialisation’ that BC alleges? Has Dr Greger started selling prunes? Also, what is this marketing machine that BC writes of ? Is Dr Greger getting a percentage of the price consumers pay for broccoli and mung beans?

      The issue about industry funded studies is not that they deliberately falsify results (that is relatively rare) but that they game the results by making inappropriate comparisons, omit or downplay relevant factors or use an unsuitable study population. The saturated fat studies are an example

      https://nutritionfacts.org/2016/10/04/how-to-design-saturated-fat-studies-to-hide-the-truth/

      Nobody doubts the data in those studies. The problem is that the authors of the studies chose to interpret the data as meaning that saturated fat consumption has no adverse effects on human health (and simply ignore the mountains of experimental evidence to the contrary). The studies are useful though and might be better understood as showing that refined carbohydrate consumption is as bad as saturated fat consumption and that there is considerable interindividual variabilty in responses to consumption.

      The study cited by Greger is a bit different. For one thing, it is a randomised trial not an observational study. For another thing, he doesn’t actually conclude from this study that we should all start eating plums. He uses it as simply one more brick in the wall to support a WFPB diet. He writes/quotes

      ‘“a ‘fruit and vegetables’ approach may provide a very sensible (and natural) alternative therapy for osteoporosis treatment, one that is likely to have numerous additional health-related benefits.” All we have to do is convince people to actually do it.’

      Recommending fruits and vegetables instead of drugs sounds quite reasonable.

      He does also provide the links and citations for people to check and question his assessments for themselves, which is perhaps just as valuable as the assessments themselves.

      However, it is certainly true that Dr Greger and the NF team come at nutritional science from a WFPB diet perspective. Or perhaps more accurately a whole food plant (WFP) diet perspective. So, yes, there is some obvious ‘bias’ here if tha’s how you prefer to term it. On the other hand, even the US dietary guidelines recognise that a well-planned ‘vegan’ diet is healthful so it is not like he is torturing the evidence to fit his beliefs.

      https://health.gov/dietaryguidelines/2015/guidelines/appendix-5/

      I would however like to see him address the mainstream dietary belief that low fat dairy foods may be beneficial

      1. Oh, let’s not forget the use of ‘demonise’ – its use is often a signature of the saturated fat apologists who simply dismiss the scientific evidence that they do not like as ‘demonising’. Their life is much easier if they do not have to examine what the evidence actually shows.

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