RECLAIMING HEALTH: INTRODUCTION

‘The voice of nutrition in New Zealand is alarmingly quiet’.[1]

PSGRNZ advances this Report as a catalyst for informed discussion and constructive debate on the health-reform responses required to address New Zealand’s metabolic and mental-health challenges. The Report has two central aims: first, to synthesise the evidence identifying the key drivers of the global surge in metabolic and mental-health disorders; and second, to outline evidence-based pathways capable of restoring individuals, families, and communities to health.

A substantial body of scientific research now demonstrates that much of today’s chronic disease burden is preventable and, in many cases, reversible. This is a consequential finding. It restores agency to individuals and communities and offers clinicians renewed purpose at a time when health systems remain heavily oriented toward symptom management rather than causal prevention.

Yet despite medical advances and increasing health system investment, public agencies and medical practitioners have been unable to reduce the burden of metabolic and mental illness. These conditions are now most commonly expressed as multimorbidity, the co-existence of multiple, interacting conditions. Legacy approaches, and the ‘best international evidence’ routinely relied upon by government, are increasingly contradicted by contemporary scientific literature that integrates nutrition, metabolism, inflammation, and neurobiology. This disconnect has material consequences for health outcomes, workforce participation, and public expenditure.

Nutrition is foundational to protecting metabolic and mental health, and nutrition plays a key role in recovery from common conditions. Both functions remain marginal in government health strategy. This Report examines the evidence showing that cumulative carbohydrate burdens, high intakes of ultra-processed foods, and widespread micronutrient insufficiencies play an outsized role in promoting New Zealand’s chronic-disease epidemic. These factors contribute directly to hyperglycaemia, hypertension, systemic inflammation, and impaired brain function, operating upstream of many commonly diagnosed conditions.

The cumulative carbohydrate burden emphasises daily exposures to rapidly digestible starches, often in the form of processed carbohydrates, which affects not only the body but also the brain. A consistent body of evidence shows that reducing blood glucose and triglyceride levels, primarily through lowering carbohydrate intake, reduces risk not only of type 2 diabetes and cardiovascular disease, as well as many psychiatric and neurocognitive conditions. This evidence remains largely absent from official dietary policy.

Current dietary guidelines place disproportionate emphasis on carbohydrate intake while understating the physiological importance of fat and protein. As a result, many officials and members of Parliament remain insufficiently aware of the extent to which high-carbohydrate dietary patterns drive insulin spikes, hyperinsulinemia, and chronic inflammation. This omission persists despite clear evidence that insulin resistance and inflammatory pathways sit upstream of type 2 diabetes, hypertension, cardiovascular disease, periodontal disease, and many mental-health conditions, often concurrently.

Multimorbidity is the defining crisis. More New Zealanders now live with multiple chronic conditions than with any single diagnosis, and the associated costs, clinical, social, and economic, are super-additive. As metabolic and neurobiological dysfunction has intensified, prescribing rates have risen sharply. Yet polypharmacy is rarely associated with improved health or wellbeing and frequently compounds harm where medications address symptoms without resolving underlying dysfunction.

New Zealand’s health system is increasingly out of step with the evidence base. Laws, policies, institutional cultures, and regulatory frameworks have not been systematically updated to reflect advances in metabolic and nutritional science. Officials have frequently relied on offshore ‘consensus’ positions that stabilise existing approaches rather than interrogate them. Independent, comprehensive reviews of the scientific literature have not occurred at scale, while science-policy and funding frameworks have created barriers to public-good research capable of addressing these gaps.

There is, however, significant scope for reform. One purpose of this Report is to contrast the breadth of evidence in the scientific literature with current Ministry of Health approaches. While health targets emphasise service access and utilisation, performance indicators increasingly focus on wellbeing. This policy-indicator misalignment leaves upstream prevention, particularly nutrition, largely out of scope. This is visible across white papers, ministerial briefings, consultation documents, and official responses to public inquiry.

PSGRNZ, as a New Zealand charitable trust, lays down a challenge:

New Zealand can reverse its metabolic and mental-health crisis, but doing so requires rewiring health policy, general practice, and research systems.

Reform cannot occur if problems are acknowledged abstractly, without understanding how existing systems perpetuate them. Human biology is fundamentally dependent on vitamins and minerals, and officials have the discretion and responsibility to identify obstructive legislation and evaluate contemporary nutritional evidence. Accordingly, this Report identifies outdated scientific assumptions that no longer serve New Zealanders; highlights the absence of targeted biomarker screening that limits clinicians’ ability to assess metabolic dysfunction, nutrient deficiency, or toxicity; and examines legislative settings that automatically classify nutrients as drugs once biochemical pathways are identified, an approach that can impede health-promoting interventions.

Reform is already underway in homes, clinics, and communities. The burden imposed by carbohydrate-rich diets has been scientifically and politically difficult to address, yet clinicians, health coaches, researchers, and patients have developed practical strategies for adopting nutrient-dense whole-food diets that are not burdensome, do not spike glucose or insulin and frequently reverse insulin resistance.

Effective reform must be multifaceted.

Health coaches provide personalised dietary support, recognising that individuals vary in their metabolic response to carbohydrates. Daily dietary decisions can mitigate, and often reverse, conditions long considered permanent, including type 2 diabetes. As glucose and insulin stabilise, a wide range of symptoms frequently subside, challenging the orthodoxy of ‘one medication per symptom’. Health coaches can be integrated into clinical, hospital, and community settings, supporting individuals to navigate addictive food patterns that undermine health.

A broader reform agenda also requires the restoration and protection of academic and research freedom public good research for human and environmental health, alongside a willingness to challenge entrenched assumptions. Contemporary, interdisciplinary evidence from nutrition, metabolism, and neurobiology must be permitted to inform public policy. Biological and health-science curricula at primary, secondary, and tertiary levels require updating to reflect the central role of diet and metabolic health.

This Report concludes with recommendations for reform, including paradigm-shifting changes in how New Zealand approaches carbohydrate-heavy diets, insulin resistance, and hyperinsulinemia. The Reform section is structured in four parts: (1) diet-first approaches in local communities; (2) educational reform; (3) institutional and regulatory reform and (4) science-system reform.

RECLAIMING HEALTH PDF

REFERENCES

[1] Coad J and Pedley K. (2020). Nutrition in New Zealand: Can the Past Offer Lessons for the Present and Guidance for the Future? Nutrients, 12:3433; DOI:10.3390/nu12113433

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RECLAIMING HEALTH: INTRODUCTION

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