Guest Columnist
Should You See a Dietitian or a Nutritionist?
By
May 17, 2009 - 8:11:19 AM

Do any of the following sound familiar?

You’re trying to lose weight.
Your doctor told you your cholesterol is high and it needs to come down.
You found out you have diabetes, high blood pressure or cancer and you really need nutrition and diet information but don’t know where to turn.
You’ve had a heart attack and don’t want another one.
You’re tired of reading conflicting news stories about nutrition and don’t know who to trust for the straight story about about what you should or shouldn’t eat.

If you’ve said or thought any of these, then you probably need to see a nutrition professional, but what kind? Should you see a registered dietitian or a nutritionist? Is there a difference? Actually, there’s a big difference. Read on.

(HealthNewsDigest.com) - Registered dietitians and nutritionists have both been around for decades, but to help determine which is most qualified to help you, first ask yourself which of the following qualities would give you confidence in the credibility of a nutrition professional who evaluates and counsels you:

1.National credentialing by a recognized and trusted health professional organization.
2.A guarantee of at least a bachelor’s degree in a nutrition related field.
3.Successful performance in an internship.
4.Passing a national credentialing exam.
5.A requirement of at least 75 hours of continuing education every five years in order to stay current and maintain the credential.
6.Advice and recommendations that are based on sound, evidence-based science.
7.All of the above.

If any or all of the above are important to you, then your choice is clear: see a registered dietitian. Only registered dietitians – not nutritionists – meet ALL of the above criteria. Many registered dietitians, easily recognized by the initials “RD” after their name, have considerably more advanced education. Indeed, nowadays most RDs have a Master’s degree in a nutrition-related field and some have doctoral degrees. Don’t be surprised to see someone with “MS, RD” or “PhD, RD” following their name.

Nutritionists, on the other hand, have no nationally recognized credentialing body like the Commission on Dietetic Registration, which credentials registered dietitians. Some states require dietitians and nutritionists to be licensed or certified in the state before they can identify themselves as dietitians or nutritionist, but many states have no such requirements.

It’s shocking that in some states, anyone can hang out a shingle, call himself or herself a “nutritionist” and start dispensing nutrition advice. What’s even more ironic is that you may need a license to cut hair, but not to counsel someone about managing their diabetes.

They’re not in the kitchen anymore

Many people used to think of a “dietitian” as someone who wore a hair net and stayed in the hospital kitchen stirring the big soup kettle. Those days are long gone. They are now very respected members of the health care team playing a vital role in the treatment and prevention of our most life-threatening diseases.

Many RDs are in private practice and accept referrals from a wide variety of physician specialists, including internists, endocrinologists, cardiologists, and others. What RDs practice is medical nutrition therapy and physicians are quite willing to refer their patients to RDs for medical nutrition therapy. Physicians have come to realize that RDs possess unique skills that they themselves never received in medical school. I have been involved in training developmental pediatricians and other physicians for many years and they will frequently tell me that they received little or no training in the nutrition arena.

Insurance coverage for medical nutrition therapy

It’s happening, slowly but surely. For people receiving Medicare, there is mandated coverage for medical nutrition therapy services from an RD for two diseases: diabetes and kidney disease. Congress may broaden the range of conditions covered and it would certainly be appropriate. It’s ridiculous that the biggest killer – heart disease – is diet related (as are 8 of the 10 leading causes of death) yet there is no coverage for medical nutrition therapy that could prevent or delay these conditions.

Fortunately, many insurance plans have realized that covering medical nutrition therapy visits is highly desirable by customers and hugely cost-effective at the same time. Why would an insurer agree to cover the cost of amputating the foot of a diabetic, but not the cost of seeing an RD who could help prevent the amputation (and the subsequent rehab, discomfort, and reduced quality of life) in the first place? Makes no sense and insurers around the country are beginning to get it.

Ask if your health plan allows you to see an RD and if not, speak up. It’s a win-win – savings for your plan and better health for you. Doesn’t get better than that.

Consumers TRUST RDs but where are they?

Surveys by the American Dietetic Association have shown that consumers trust registered dietitians as high or higher than physicians as trusted sources for nutrition information. Unfortunately, consumers GET their nutrition information from less trusted sources: gyms, health food stores, magazines, and such.

To find an RD in your area, the American Dietetic Association maintains a nationwide list of registered dietitians. Just log on to their website at: www.eatright.org and click “Find a Nutrition Professional” in the box at the top of the web page. You’ll plug in your zip code and get a list of RDs in your area, by specialty. Or just call them at: 1-800-877-1600.

Perhaps you’ve already invested hundreds of dollars on supplements purchased from the salesperson at the “health food store” (which no longer even sells food, only pills and powders). Perhaps you have health issues or even just nutrition questions about you or your family that you need answered.

Look no further, stop your confusion and ask a registered dietitian. It’s that simple.

Keith-Thomas Ayoob, EdD, RD, is a registered dietitian and associate clinical professor of pediatrics at the Albert Einstein College of Medicine in New York City.

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