You’re reading this blog so obviously you’ve got some interest in nutrition. But if you had a really big question about nutrition or wanted to overhaul your diet, who would you turn to? Today we are taking a look at the qualifications of various “nutrition people” who you may read articles by, and hopefully providing a little consumer protection.
I’m going to break this post into four categories: RD/RDNs, PhD Nutritionists, MDs, and “other nutritionists”
Registered Dietitian (RD) or Registered Dietitian/Nutritionist (RDN)
What they do: These are the only people licensed to give nutrition advice in a medical setting. That being said, many RDs and RDNs do other stuff. There are dietitians in private practice, that work with sports teams, RDs in food service operations. Dietitians help devise menus for long term care facilities, coordinate government programs dealing with food provisions (like WIC), and you may even speak to one over the phone who works as a health coach. Often dietitians are found in wellness roles, working at gyms or supermarkets, and more and more frequently RDs are entrepreneurs.
How they’re trained:
RDs and RDNs have undergone extensive nutrition education:
1. An accredited program of study at a four-year college that includes physics, chemistry, A&P, food science, biology, microbiology, biochemistry, psychology, counseling and behavior change, and (of course) many nutrition classes. This thorough background gives all the knowledge to not only understand what is “good” and what is “bad”, but to understand why all the way down to the molecular level.
2. The Dietetic Internship comes next. Candidates apply to be matched to an internship, which is much like a residency for medical students. These internships cover community, clinical, and food service nutrition in different rotations. Some are combined with Masters degrees, some are stand-alone DIs. The match rate for dietetic internships has been hovering between 55-50% for the past 8 years – only the best and brightest of aspiring dietitians are admitted.
3. The Dietetic Registration Exam is the final step to become an RD or RDN. Once the dietetic internship is complete, a candidate is eligible to sit for this exam, GRE style in a computerized testing facility.
The difference between these two distinctions is choice – RD was the original credential, but in an effort to keep pace with the public’s recognition of the term “nutritionist”, RDN became an official credential as well. I personally am designated as an RD, but I can switch to RDN officially today if I wanted to.
How to find one: Right here, my pretties! Though it’s by no means an exhaustive list.
What they do: PhDs often do research and teach. A PhD in nutrition can approach nutrition from a lot of perspectives that you may not originally think of. For example: researching the economic factors that play a role in undernutrition in India, looking at the effect of prostitution on nutrition outcomes in Tanzania, examining effects of Vitamin D on epithelial cell function and proliferation, or building a childhood nutrition education program to be instituted at Head Start centers. This is for the super duper smarty pants. PhDs can teach you SO much about some very specific things (and often a lot of very specific things). Do you want to ask them for dietary counseling? Maybe not, if you’re looking for an overall assessment and ways to help. Oftentimes, research is very singularly focused – so if you’re looking for information about foot strike hemolysis, or the effect of calcium supplementation on performance of anemic runners, an article written by a PhD who has studied that specific topic would be so awesome.
How they’re trained: In order to earn a PhD, a person must take required coursework, do a BUNCH of their own original research, write it all up into a dissertation, and defend. I know “defend” sounds super scary, and it is, but what that means in short is answer a bunch of questions about it from a bunch of really smart people.
How to find one: Pubmed search the topic you’re looking for. If you’re not in the market for scientific journal articles, google the topic and check the credentials of the author. If you want to take it a step further, look up his/her CV. You could even email them. The cool thing for us nerds is that when you find a professor who has done some super amazing work, you can email them and they normally email you back! “Hey, I would love to discuss the research you did on building a framework for positive youth development through sport, wanna grab a coffee??” – sets my heart aflutter.
What they do: We’ve all been to a doctor. They do a lot of different stuff! If you’re getting nutrition advice from one, it’s probably your GP at your annual exam counseling you about your high cholesterol.
How they’re trained: According to a survey of medical schools, MDs receive an average of 19.6 contact hours of nutrition education. Only about 1/4 of the schools surveyed required an actual nutrition course. Of course, there are certain specialties where nutrition plays a more prominent role in education (think GI docs) than others, so this does not apply to all doctors everywhere. Now, the next time your GP gives you nutrition advice, are you going to take it or are you going to ask for an RD referral?
How to find one: Go through your health insurance’s website, and SET UP YOUR OWN ACCOUNT to make sure that doctor is in your specific network. Just because your doctor accepts the insurance that you’ve got doesn’t necessarily mean they’re in network for you. I could get into it deeper, but if you haven’t already stopped reading this post you would then. Trust me, I used to work for Cigna.
Who they are: Adding another category here. This group includes people who self-identify as “nutritionists” – which is an unregulated term. This group includes people who write nutrition articles and provide nutrition counseling or services but who have not had formal education on the topic. Whether they’ve gone through a program like the Institute for Integrative Nutrition (IIN), a nutrition psychology course, a certificate program from an academic institution like Tufts or Cornell, they do not have the legal right to practice nutrition in a medical setting. Depending on the state, they may not be legally allowed to discuss nutrition at all.
What they do: This varies significantly. With the smaller independent “certifying” institutions, I find that the typical participant has gone to school for something different and decided that they want to change their path. Instead of going back to the beginning to become an RD/RDN, they look to one of these less money and time-intensive options. The issue is, they then take this limited education (more to come on that) and apply it in ways that an RD or RDN would: private counseling, nutrition seminars, and other modes through which one can speak authoritatively and capture the full attention of the interested public. As for the certificate programs from academic institutions, they are more geared towards professionals who work in fields where their practice would be enhanced by a better understanding of nutrition. Think MDs, international aid workers, community organizers (especially those working with food/sustainable agriculture), etc. These people rarely position themselves as “nutrition experts” – they approach nutrition from different perspectives and have taken it upon themselves to gain further education for the benefit of the work that they are passionate about.
How they’re trained: Training varies depending on the organization. OR, a person may be self-taught and still call themselves a “nutritionist” in many states. Some academic certificates may require prerequisite courses, some may not. These academic institutions have well-defined course sequences that you can find online if you are interested. For example, the Tufts certificate in Nutrition Science for Communications Professionals includes things like Interpreting Nutrition Evidence, and Nutrition-Related Consumer Marketing. The course sequence clearly provides a skillset that allows a student to apply them immediately to a nutrition focused communications job immediately upon completion. It’s about adding nutrition competency to a different field.
Often, independent organizations or “schools” that cater solely to crankin’ out certifications in some sort of nutrition do not have prerequisites, do not list their courses online, and often the education is distance learning for less than 200 hours. Compare that to a full undergraduate education and 1200 hours of supervised practice (dietetic internship). Not at all the same. Content often varies as well: these short-and-sweet certifications often do not explore the underlying causes of nutrition issues, are heavy on education surrounding food fads and fad diets, and may cater to whatever the public deems as “trendy” (think gluten-free, paleo, etc.). Upon completion of these courses, a person should be able to discuss a generally good diet, and will probably be able to comment upon the differences between popular nutrition trends. Without the background in health sciences, commenting about how nutrition can affect specific disease states is not advisable, though I’m sure it happens.
How to find one: Step outside! People are preachin’ nutrition info EVERYWHERE these days, I dare you to check the credentials on the next 5 nutrition articles you come across. Let me know how many of these were written by PhDs, RDs or RDNs. If we get over 50% the next round is on me.
Which should I choose? Clearly I’m beyond biased, as I’ve gone through the
pain and suffering amazing educational experience that is required to become a dietitian, BUT having done that I understand just how much I pull from every bit of education that I have ever had. Yeah, organic chem may have sucked, but yeah, it totally enhanced my understanding of nutrition. In fact, I needed the first year of orgo in order to get to the second year which actually helped me to make a lot of connections. Honestly, I feel like a newbie and like there are always areas of nutrition that I could totally go take some more classes on, and I spent a huge chunk of my life to get to where I am. If I feel that way, why should someone who took a 3-month certification course be allowed to counsel?
So why is this allowed?? It all comes down to the money. When I lived in Louisiana, there was a law that unless you were a Registered Dietitian and have paid your licensure fees, you CANNOT call yourself a “nutritionist”, “dietitian”, or any other iteration of those terms. This is super rare, because a bunch of people are making a bunch of money by telling other people how to eat. Think GNC, personal trainers, etc. Registered Dietitians and the Academy of Nutrition and Dietetics (our governing body) don’t have that kinda money. Trust me. You can see my paycheck.
So, if you’re in the market for nutrition counseling or reading an article that you’re not so sure of, CHECK CREDENTIALS! Now you know!