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I have been inspired by the work of so many pioneers in the field, but I would like to take the opportunity to remember the work of Dr Sarah Hallberg and Adele Hite, PhD, who are sadly no longer with us. Their work laid critical foundations for the advancement of therapeutic carbohydrate reduction and patient-centred metabolic care. I am sure they would be pleased to see how far we have come and yet equally sure they would urge us to press on and work together in addressing the systemic challenges that continue to hamper widespread improvements in population health.