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.
psgr.org.nz/2-uncategori...

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

psgr.org.nz/2-uncategori...

10. Chapter 9. Type 2 Diabetes: Remission is Real.
Type 2 diabetes is often reversible. Low-carb whole-food approaches repeatedly show improvements in blood sugar, weight, blood pressure & mental health, & reduced medication use

Wider benefits extend to people with T1DM psgr.org.nz/2-uncategori...

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...