Dear Ministry of Health,

Deficiency in key nutrients, the effect of ultraprocessed and high-carbohydrate diets and insulin resistance in driving many chronic conditions which are associated with chronic inflammation and depleted nutrient levels, is well described in the scientific literature. Dietary and nutritional advice in the context of the following questions includes advice to prevent chronic disease, reduce the symptoms of chronic disease and reverse chronic disease.

Excluding dietary and nutritional advice and failing to provide pathways to access for low-income groups perpetuates inequalities in health. Expanding access for medicine for 30 years has transparently failed to reduce inequities in health for low-income populations, which can include Māori and Pasifika.

1. Please direct me to the best practice Ministry of Health/Te Whatu Ora dietary and nutritional advice for clinicians/GPs for prevention and treatment of the following conditions:

a. Respiratory conditions including asthma
b. Childhood skin infections
c. Fibromyalgia
d. Chronic fatigue
e. Epstein-Barr virus/mononucleosis
f. Elevated HbA1c and triglyceride-rich lipoproteins (associated with neurological, ophthalmological and renal complications, as well as incident dementia, osteoporosis, peripheral vascular disease, ischemic heart disease, atrial fibrillation and heart failure).
g. Respiratory virus replication in lower/upper respiratory tract (influenza, Respiratory syncytial virus (RSV), common cold, COVID-19, pneumonia etc).
h. Depression and anxiety.

2. Please forward all memos/advice/documentation advising GPs on use and dosage of B group vitamins, vitamin C, D, selenium and zinc by age group; or weight; and dosage as general advice.

3. Please advise the name of the departments, and the head of that departments within the Ministry of Health and Health New Zealand who are collectively responsible for nutrition strategy and updating nutrition standards for New Zealand.

Yours faithfully,

J Bruning