Conclusion: Reversing Surging Multimorbidity with 'Fantastically Cheerful' Medicine.

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PSGRNZ (2026) Reclaiming Health: Reversal, Remission & Rewiring. Understanding & Addressing the Primary Drivers of New Zealand’s Metabolic & Mental Health Crisis. Bruning, J.R., Physicians & Scientists for Global Responsibility New Zealand. ISBN 978-1-0670678-2-3

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In conclusion, substantial evidence indicates that current dietary guidelines have not stemmed rising rates of metabolic and mental disorders and, in several respects, may be contributing to the progression of illness. Health is complex, multifactorial, and dynamic. As defined by the World Health Organization:

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.[1]

The onset of multimorbidity at earlier ages is strongly associated with poorer long-term outcomes. Rising rates of multimorbidity, alongside equity in medication prescribing, are not proxies for improved wellbeing or quality of life.

This Report demonstrates that New Zealand’s health policy has rested on outdated assumptions while nutritional and metabolic science has advanced. Current Ministry of Health positions, echoed by government-aligned organisations, stand in sharp contrast to an expanding body of evidence showing that foundational dietary and supplementary approaches can reverse or mitigate many metabolic and neurological conditions, improving functionality, wellbeing, and quality of life.

Encouragingly, change is already underway. Case and cohort studies consistently show that substantial reductions in refined carbohydrate intake are associated with improvement, remission, and in some cases reversal across a wide range of metabolic and brain-related conditions.[2] [3] There is increasing consensus that compulsive overconsumption of refined carbohydrates, particularly in the form of ultra-processed foods, constitutes a form of substance-use disorder. Health coaching, peer support, and community-based programmes can facilitate dietary change and, in doing so, reduce the burden of metabolic and neurological disorders as well as pharmaceutical dependence.

Dr Jen Unwin, co-partner of the UK clinic that has pioneered approaches to reversing metabolic syndrome, reducing prescribing rates, and improving mental health outcomes, has described counselling, coaching, and support as ‘fantastically cheerful medicine’. Yet conventional therapeutic frameworks do not treat long-term dietary change as a clinical intervention in the same way pharmaceutical treatments are regarded.

The protection and promotion of health require officials to remain abreast of contemporary science concerning the central role of diet and nutrition in metabolic regulation, hormonal balance, and homeostasis. Vulnerable groups, including infants, children and adolescents, pregnant women, and those with elevated metabolic risk, have received insufficient attention. Indeed, agencies currently lack a clear understanding of what constitutes optimal nutrition by age and life stage. Government bodies have consistently failed to examine the relationships between diet quality, nutrient insufficiency, and the physiological demands imposed by age, sex, ethnicity, genetic variability, socioeconomic context, pregnancy, and inflammatory status.

Historic alignment with international dietary frameworks used in Australia, the United States, and Nordic countries has not succeeded in halting or reversing the rise of prediabetes, diabetes, metabolic syndrome, or mental illness. In the decades following the adoption of current guidelines, multimorbidity in younger age groups has increased markedly. Current policy frameworks emphasise the LDL cholesterol marker, minimise the importance of key macronutrients, fat and protein, and fail to link micronutrient sufficiency with optimal physiological function and resilience.

Public-good research in nutrition science, including the investment required to update regulations and policies through transparent reviews of the scientific literature, has been neglected, deprioritised, and underfunded. As a result, independent scientists that can challenge current assumptions are rare, and government policy remains largely silent on the carbohydrate–insulin pathway and insufficiently responsive to individual metabolic risk.

The technology to detect elevated risk for prediabetes is readily available, and the capacity to screen for nutrient deficiencies in people presenting with mental-health conditions is well established. Yet these interventions remain underutilised, restricted, or unrecognised. Over the same period, funding for pharmaceutical access has expanded, while research into drug risks and adverse effects has been comparatively underfunded. Drug trial data are difficult to access, if not opaque, and governments have not provided adequate funding to independently evaluate industry claims or to systematically assess harms alongside benefits.

In these knowledge gaps, officials appear disproportionately focused on potential risks associated with nutritional supplements, despite long histories of safe use and contradictory evidence, while adverse drug risks are largely left to voluntary disclosure by manufacturers. This reflects a deeper contradiction: the Ministry of Health has the authority to set clinical limits for nutrients, yet is not positioned as an authority on optimal nutrition or its role in sustaining metabolic and mental health.

Suboptimal diets and nutrient insufficiencies amplify risk across a broad spectrum of chronic conditions, including metabolic syndrome and complex multimorbidity, yet when knowledge is absent or incomplete, clinicians, families, and patients are denied meaningful choice. Informed consent cannot be achieved when upstream dietary options are neither explained nor endorsed.

This Report, together with the forthcoming companion report on micronutrients and mental health, demonstrates that a longstanding governance culture has placed carbohydrate science, the carbohydrate–insulin model, and nutritional sufficiency outside the scope of formal health policy for decades. Without system-wide correction, continued institutional reticence and gaps in nutritional understanding will perpetuate poor policy and poor outcomes.

There is, however, strong cause for optimism. Current metabolic and mental-health trends are not inevitable. They are reversible. With evidence-based, nutrition-centred health policy, the trajectory of chronic disease in New Zealand can be changed, and health reclaimed. This Report sets out practical pathways to address the primary drivers of the metabolic and mental-health crisis and to reclaim health.

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REFERENCES

NB: Number order differs from the original Reclaiming Health publication (PDF).

[1] World Health Organization. Health and Well-being. https://www.who.int/Data/Gho/Data/Major-Themes/Health-and-Well-Being

[2] Zheng, Q., Gao, X., Ruan, X. et al. (2025) Are low-carbohydrate diet interventions beneficial for metabolic syndrome and its components? A systematic review and meta-analysis of randomized controlled trials. Int J Obes DOI:10.1038/s41366-025-01822-5

[3] Athinarayanan SJ, Roberts CGP, Phinney SD et al. (2025). Effects of a continuous remote care intervention including nutritional ketosis on kidney function and inflammation in adults with type 2 diabetes: a post-hoc latent class trajectory analysis. Front. Nutr. Sec. Nutrition and Metabolism, Vol 12 – 2025, DOI: 10.3389/fnut.2025.1609737