It was with utter devastation that I, and the rest of our SMHP Board members, learned of the passing of Dr. Adele Hite a few days ago.  I’ve been wanting to write this since it happened but I have been, and still am, struggling to find the words.  I was introduced to Adele back in mid 2018 by Gary Taubes as we were planning a special session for the LowCarbUSA® San Diego event in July 2018.  He suggested she would be a great moderator for this session aimed at soliciting feedback from clinicians who were implementing carbohydrate reduction as a therapeutic intervention in their practices.

I think Gary secretly knew Adele had a lot more on her mind than this but he didn’t say so.  I reached out to her and her response was a 2-page document which I often say made me weak at the knees.  Her vision was so impossibly enormous that I just couldn’t get my head around it in a way that made me feel like it was even vaguely doable.  Her vision was that the concept of Therapeutic Carbohydrate Reduction would be established as Standard of Care (SoC) and would be offered as an option to all patients for whom it was appropriate in all practices.  In this response document she sent me, she led with the legal definition of Standard of Care which she had learned when she served on the jury of a medical malpractice lawsuit:

From a legal perspective, “standard of care” is defined as “providing health care in accordance with the standards of practice among members of the same health care profession with similar training and experience situated in the same or similar communities at the time the health care is rendered.  In other words, “standard of care” does not come from what is taught in professional training, from public health policy, or even from clinical care guidelines established by professional organizations, although all of these can inform and help define a standard of care. Rather, “standard of care” comes from what a community of clinicians do in the actual provision of care.

Even though I felt totally overwhelmed, we kept talking and she kept pointing to parts of this legal definition and showing me that I had already started to get some of these things in place.  She had this amazing knack of showing me how much more I could do if I just got out of my own way.  We were totally focused on building the community and we were providing tons of education and training so we had those parts covered already.  Then she suggested we produce a Clinical Guidelines document.  Even though it is not, in and of itself, SoC it would be the perfect place to start cultivating the conversations that would eventually establish a consensus.  We needed a panel of advisors to audit the content of the document and a place to publish the document once it was ready.  So, as a starting point, we could publish it on the LowCarbUSA® website and I had access to many of the greatest minds in the field. I put a panel of 12 of these great minds together consisting of David Cavan, MD, FRCP;  Mark Cucuzzella MD, FAAFP;  Robert Cywes, MD, PhD;  Georgia Ede, MD;  Gary Fettke, MB, BS, FRACS, FAOrthA;  Brian Lenzkes, MD;  Timothy D. Noakes, MD, DSc;  Bret Scher, MD;  Franziska Spritzler, RD, CDE;  David Unwin, FRCGP;  Eric C. Westman, MD, MHS; and  William S. Yancy, Jr., MD, MSH.

Then it was all up to Adele. First thing she did was kick me out of the kitchen!  “You’re not a clinician” she said to me, “you can’t have anything to do with the content of this document”. Those of you who knew her well can just imagine her saying that to me, I’m sure. She then set about putting the document together.  Once she was done she bounced it off the advisors over and over, constantly feeding all the recommendations back into the document until they were all happy that it was ready to go.  The Clinical Guidelines for Carbohydrate Reduction as a Therapeutic Intervention was first published in the May of 2019, just 9 months after she started on the project. It has 133 total references, a link to a deprescribing document, links to patient education documents and many other resources.  I found out subsequently that at the same time that she was doing this she was working her regular job AND defending her PhD thesis. By the time we published the guidelines, she had just become Dr. Adele Hite!

Although the Clinical Guidelines document was initially published on the LowCarbUSA® website, we always knew that was not the ideal place for it in the long run. Discussions with Adele and Dr. Tro Kalayjian and others made us realize that a special nonprofit needed to be established as an umbrella for all practitioners who were open to this conversation.  Metabolic medicine was a term that started to get bandied about and so ‘The Society of Metabolic Health Practitioners‘ (The SMHP) was born. We moved the guidelines document over to this new site so that it now had a real home and to date it has been translated into 8 other languages. When I let Adele know that this had all happened I know she was thrilled. Her vision was starting to come together.

Now we have a Clinical Guidelines document available in 9 languages; training in place and pathways defined where practitioners interested in metabolic medicine can get accredited; a list of practitioners who are open to this conversation who can help clients and patients get healthy again; a place where practitioners can go and add their names to a support for these guidelines; and a community of practitioners who are discussing cases and these guidelines and arriving at a consensus. And all of this is a reality because of one person, Adele Hite. We are quite a long way off from having this intervention ‘offered as an option to all patients for whom it is appropriate in all practices’ but the day will come, I am sure of that.

Recently, the SMHP presented Adele with a special Achievement Award for her exceptional work in getting this all done. You can read more about that here.

I think the thing that impacted me most about Adele, and that will stay with me always, was her insistence that ‘words matter’.  “When you say something,” she would say, “make sure that the words you use reflect what you are trying to say accurately and truthfully and without potential ambiguity!”

Rest in peace my friend!  Know that your work, and most especially the Clinical Guidelines document, will live on forever and we will all do our best to continue your work from where you left off.

Adele has named the ‘Reversing T2: A Dr. Sarah Hallberg Legacy Project‘ charity for those wishing to contribute to her legacy.  This group has ambitions to become a big tent, to promote the work of the many people who devoted themselves to furthering education on this important topic.


  1. Adda Ramos on April 28, 2022 at 3:48 pm

    I still cannot believe she is gone. She was a speaker at my very first Low Carb USA conference and I was so impressed by her straight forwardness, no tolerance for exaggeration of data and just stating the facts! The Clinical Guidelines have been so helpful that I cannot imagine not having that resource to our disposal. A great loss to our community.

  2. Kendrick Murphy on April 28, 2022 at 4:16 pm

    Great tribute, Doug! I had the pleasure of being on a few zoom calls with Adele and even in those brief moments she made an impact on me as a practitioner. She will be missed but the mission remains!

  3. Franziska Spritzler on April 29, 2022 at 3:07 am

    Doug, What a beautiful, moving tribute to my amazing colleague and friend. Adele was one of a kind, and I too am deeply shaken by her loss. However, I’m so proud of all that she did to advance low-carb acceptance over the years and, of course, her creation of the Clinical Guidelines for Therapeutic Carbohydrate Restriction. What an honor it has been to have known and worked closely with this incredible woman. RIP, Adele. You have truly made a difference in the lives of countless people.

  4. Molly Rutherford on April 29, 2022 at 4:33 am

    I’m sad and shocked to hear this news. Praying for everyone who will miss her.

  5. David Crutchfield M.D. on April 30, 2022 at 9:35 am

    When I became enlightened to the LCHF sphere of influence and began researching metabolic health to incorporate it into my life and practice, I found Adele Hite. Rather, she found me. Tweeting that there were opportunities to help within the space and soliciting volunteers to contribute, I answered her call to action. I got to know her a little via Zoom and she was always able to keep these conversations and sessions focused and on task. I was stunned to hear of her passing, much too soon. She will be missed personally and professionally. My heart goes out to her family and friends. RIP Adele.

    Doug, that was a succinct and heartfelt tribute. The SMHP will go on with her in remembrance.

  6. Sandy Parkington on April 30, 2022 at 2:23 pm

    Although I am devastated by the loss of such a beautiful and intelligent soul, I will always treasure and honor the brief time I worked with Adele on a project on behalf of the SMHP. She was laser focused on defining the term “Metabolic Health” in clear, concrete terms that could be understood by many differing clinicians, non-clinicians as well as lay people. We shared a love for Public Health Nutrition, both wanting to share the definition and focus on Metabolic Health in an annual International Public Health conference.
    On a personal note, Adele was so welcoming to me in my move this year to Durham, NC. I will always regret not being able to work with her on projects in future years. She made an impact and will be missed by so many. May her memory be a blessing to her loved ones and to those who were fortunate to know her.

  7. Shashikant Iyengar on April 30, 2022 at 6:53 pm

    A big loss to the low carb world..

Leave a Comment

You must be logged in to post a comment.