13🧵Chapter 12. Whole of System Reform: In Brief

PSGRNZ 'offers a clear blueprint for progress'.

i. Diet first approaches in local communities
ii. Educational reform
iii. Institutional & Regulatory Reform
iv. Science System Reform.
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12🧵Chapter 11. Chapter 11. Whole of System Reform: Keys to Success.
Successful reform respects:
✅individual biology
✅health coaching & food addiction evidence
✅real-time feedback (CGMs, ketones)
✅practical tools
✅Common-sense Protein

Links to papers & info - Chapter 11:
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11🧵Chapter 10. Whole of System Reform: Health Coaching Central to Reversal & Remission of Metabolic & Mental Illness.
We highlight a recent paper (Zinn et al 2025) which used a three-pronged approach as a model of care to manage and potentially reverse prediabetes & T2DM

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9🧵Chapter 8. Health, Research & Academic Sector: No Pathways for Knowledge. Why doesn’t new science translate into policy? Is health governance failing? Research funding, academic incentives & agency work programmes quietly exclude nutrition, metabolism & brain health.
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8🧵Chapter 7: Health targets decoupled from policies.
😖Key indicators don't match health targets which concern expectations for service care & delivery.

🤫Primordial prevention revolves around building & sustaining a healthy metabolism from the outset to protect health psgr.org.nz/2-uncategori...

7🧵Chapter 6. New Zealand's Carbohydrate-Rich Guidelines.
Current New Zealand dietary guidelines for adults recommend 6 servings of grain foods a day & two servings of fruit a day while barely mentioning fat & downplaying animal protein.
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6🧵Chapter 5: The ethical burden on children & low-income groups. Deprived communities bear the brunt of metabolic & mental illness. Under 25's now develop prediabetes, obesity & mental illness at alarming rates. This is biology + environment.
Image: Pappachan et al 2024
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5🧵Chapter 4. Ultra-processed, refined carbohydrates don’t just affect metabolism, they affect reward pathways.
Highly palatable foods hijack dopamine signalling, driving addictive eating patterns that undermine “eat less, move more” advice. Reclaiming Health psgr.org.nz/2-uncategori...
#Craving

4🧵Chapter 3. Brain health is tightly linked to metabolic health, via dietary & nutrient intake, insulin levels, inflammation & mitochondrial health.

Nutritional psychiatry ✅micronutrients can improve resilience, mood and cognition including in vulnerable populations

Image Mayer et al 2022.

3🧵The total carbohydrate burden:
Foods labelled healthy can drive repeated blood sugar & insulin spikes. Over time, this fuels inflammation, fat storage, insulin resistance & disease
🔥 Guidelines focus on calories. Biology responds to insulin. Image Fazio 2025.
✅Ch2 psgr.org.nz/2-uncategori...

2🧵 Why do people have so many complex chronic & metabolic & brain-related conditions now?
Metabolic dysfunction (☝️blood glucose, insulin resistance, inflammation) = cascading failures across the body including the brain.
Ch1 Cascading Impairment Driving Multimorbidity. psgr.org.nz/2-uncategori...

1🧵New Zealand report: Reclaiming Health: Reversal, Remission & Rewiring. Understanding & Addressing the Primary Drivers of New Zealand’s Metabolic & Mental Health Crisis. starts from a confronting premise🔥:
😀most of New Zealand’s metabolic & mental health crisis is preventable & often reversible.

White Paper @PSGRNZ 'In closed-loop regulatory environments officials aren’t required to review the broader scientific literature and update their position on risk. The industry actors have the expertise, and the public sector is dependent on industry expertise.' psgr.org.nz/component/jd...