OPEN LETTER: NZ Report Calling for Urgent Reset of New Zealand Health Policy.

January 21st, 2026. Open Letter (original as a PDF).

Dear Members of Parliament, Ministry of Health officials, Auditor General and the Mental Health and Wellbeing Commission leadership team and board,

We respectfully submit our paper Reclaiming Health, and its reform recommendations for your consideration.

PSGRNZ (2026) Reclaiming Health: Reversal, Remission & Rewiring. Understanding & Addressing the Primary Drivers of New Zealand’s Metabolic & Mental Health Crisis. ISBN 978-1-0670678-2-3. 3 page summary + Chapter 12: Recommendations for Reform.

Reclaiming Health challenges the foundations of New Zealand’s health policy and dietary guidance, arguing that the country’s escalating burden of chronic metabolic and mental illness is not inevitable and can be reversed. For several decades, dietary guidance has been developed with the stated aim of preventing obesity and cardiovascular disease. These objectives have not been achieved. Deference to the status quo is untenable when the evidence from mechanistic studies, clinical evidence, and cohort data are considered, as Reclaiming Health shows. Instead, New Zealand, in line with other high-income countries, has experienced a sustained and accelerating rise in chronic metabolic and mental illnesses.

Insulin resistance and chronic inflammation are consistently present across the conditions grouped as metabolic syndrome. These conditions include hypertension, dyslipidaemia, type 2 diabetes, and obesity. Insulin resistance is the defining biomarker of cardiometabolic risk. By contrast, the continued emphasis on saturated fat as inherently harmful rests on the assumption that cholesterol is the primary causal driver of cardiovascular disease. Past and current published evidence does not support this position. A strong and coherent body of evidence identifies elevated blood glucose, hyperinsulinaemia, insulin resistance, and inflammation as more drivers of cardiometabolic disease.

KEY POINTS: THE METABOLIC PATHWAY TO CHRONIC ILLNESS:

A single systemic metabolic & mental health crisis reframes many diseases as one metabolic failure.
Glycaemic and insulin stability underpin metabolic health & reflect core physiological regulation.
Insulin & inflammation as metabolic mediators. Displacing the single disease-specific approach.
Multimorbidity as signal, not just coincidence. Conditions share common upstream drivers.
Cumulative processed & refined carbohydrate exposure. Not just sugar, not just calories.
Nutrition & diet guidelines developed to avoid deficiency, not assure functional sufficiency.
Macronutrient hierarchy inverted. Carbohydrates structurally privileged over fat and protein groups.
Insulin as primary risk biomarker overturns cholesterol primacy.

Critically, elevated glucose and insulin are driven not only by added sugars, but by sustained exposure to processed and refined carbohydrates. Individual tolerance varies considerably. These upstream metabolic disturbances give rise to multimorbidity rather than isolated disease. It is now more common for individuals to present with multiple metabolic and brain-related diagnoses, often at younger ages. People with metabolic syndrome also carry a significantly higher risk of mental illness and other brain-related disorders.

Despite this, dietary guidelines and the processes used to sustain them have remained largely unchanged. Clinicians, meanwhile, continue to report difficulty achieving adherence to low-fat, high-carbohydrate dietary guidance.

At its core, the problem is straightforward. Change has been stalled by entrenched high-carbohydrate dietary patterns, governance frameworks focused on preventing frank deficiency rather than restoring health, and institutional inertia. These frameworks do not adequately account for the role of protein, fat, and micronutrients in metabolic resilience or recovery from chronic illness.

Dietary non-adherence may therefore reflect guidance that is unfit for purpose. Fibre alone cannot substitute for the satiety provided by adequate protein and fat. In fractionated industrial foods, added fibre does not prevent rapid carbohydrate absorption, repeated glucose and insulin spikes, or dopamine-mediated reward activation. The result is persistent hunger, increased snacking, and loss of appetite regulation even when caloric intake is sufficient.

While ultra-processed foods receive increasing attention, regulating them as a single category is unlikely to succeed, as risk varies widely within the group and industry lobbies will contest and slow any pace of change. What can be tracked clinically is the cumulative metabolic impact of diets high in rapidly absorbed carbohydrates, as reflected in glucose, insulin, and triglyceride markers.

Dietary guidelines that downplay protein and fat, and restrict saturated fats, may therefore be contributing to harm at the population level. The health system is structured around avoiding deficiencies rather than restoration and resilience. In such a system, nutrition cannot be deployed as a therapeutic or preventative intervention, and legacy dietary and nutrition guidelines likely sustain the conditions it seeks to prevent.

Multimorbidity and polypharmacy, now common outcomes of these dietary patterns, remain poorly studied and insufficiently funded. Reclaiming Health documents how government agencies have been unable or unwilling to reassess prevailing assumptions or create pathways for independent evaluation. Vote Health does not ring-fence funding for interdisciplinary research to assess whether current macronutrient and micronutrient recommendations remain fit for purpose.

The paper further identifies the absence of a policy mandate to assess diet and nutrition by age, sex, developmental stage, ethnicity, or metabolic vulnerability across key health strategies, including those for children, Māori, Pasifika, pregnant women, and mental health. As a result, susceptibility to elevated blood glucose and insulin levels, insulin resistance, and early metabolic disease is systematically overlooked.

Notably, Kia Manawanui Aotearoa: the Long-term Pathway to Mental Wellbeing excludes diet and nutrition, despite strong evidence that nutritional status is foundational to brain health. Current Ministry of Health-funded health coaching scopes do not include education, or invest in research to examine the contribution of inadequate diets, from conception onwards, that increase psychiatric risk.

There is currently no funding dedicated to the evaluation of improved metabolic screening, access to essential nutrients, or the adequacy of nutrition education across primary, secondary, and tertiary education systems. Health targets remain decoupled from the biological drivers of disease.

Reclaiming Health is a three-part paper of approximately 40,000 words, supported by over 600 citations. Chapters 11 and 12 provide evidence and proposals for reform which are practical and evidence-based. International experts have welcomed the report’s synthesis, these are quoted below.

The costs of rising multimorbidity and polypharmacy are no longer defensible. Reform is both necessary and achievable. This correspondence is directed to those with the authority to initiate reform. We ask that you give this paper serious consideration.

Yours sincerely,

The Physicians and Scientists for Global Responsibility New Zealand Charitable Trust.

The above Open Letter was sent with the following attachments:

To:

[1] All current New Zealand members of Parliament (MPs), as a group email by political party.

[2] New Zealand’s Auditor General Grant Taylor. For the attention of (via generic contact email).

The Mental Health & Wellbeing Commission. (via generic contact email).

Board: Hayden Wano, Chair, Dr Barbara Disley, Deputy chair, Josiah Tualamali’I, Rae Lamb, Professor Sunny Collings, Tuari Potiki, Wayne Langford
Leadership team: Karen Orsborn, Chief Executive, Ella Cullen, Maraea Johns, Sonya Russell, Stuart Allan

Senior Ministry of Health Officials.

The Executive Leadership Team:

Director-General of Health and Chief Executive Audrey Sonerson
Chief Financial Officer Fergus Welsh
Deputy Director-General, Corporate Services Celia Wellington
Deputy Director-General, Māori Health John Whaanga
Deputy Director-General, Performance and Governance Brent Johnston
Deputy Director-General, Public Health Agency Andrew Old
Acting Deputy Director-General, Regulatory Services Jennie Kerr
Deputy Director-General, Strategy and Policy Ruth Isaac

Chief Clinical Officers

Chief Allied Health Professions Officer Martin Chadwick
Chief Medical Officer Dr Joe Bourne
Chief Nursing Officer Lorraine Hetaraka
Chief Maternity Officer Heather Muriwai

Chief Advisors

Chief Science Advisor Professor Ian Town
Chief Economist Bronwyn Croxson
Chief Advisor Horizon Scanning (ERI) Vickie Saunders
Chief Advisor Precision Health (SPL) James Oughton

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OPEN LETTER: NZ Report Calling for Urgent Reset of New Zealand Health Policy.

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