Raise your hand if you know the difference between a Nutritionist, Health Coach, Dietitian, Registered Dietitian, Registered Dietitian Nutritionist, and Dietetic Technician? If that just looks like a big word salad to you, we’ll help clear things up in this month’s blog. In honor of National Nutrition Month, we’re giving you the skinny on the nutrition professions, what these titles mean, and why you need to learn the difference as a consumer.
Why Keep Reading?
Did you know that in nearly all states it is illegal to receive prescribed nutrition recommendations that treat a diagnosable medical problem (like diabetes) or its symptoms from anyone who is not a Registered Dietitian? The ins and outs of nutrition legalities are not widely known by the general public. But, there are very important legal protections in place for consumers so that they don’t find themselves victims of nutrition advice that improperly treats, or worse, exacerbates, a medical issue.
Different nutrition and health-related professionals receive different types of education, receive different degrees, and complete different kinds of qualification requirements to be approved to practice in these areas. These requirements ensure that a baseline minimum of understanding and capability are met. It’s important to understand who does what, so that depending on what you’re looking to accomplish, you seek out the appropriate person to help you.
Image by Laurel Dix, RDN, LD (on instagram @nutritious_epicurean)
Registered Dietitian (Dietitian for short, AKA Registered Dietitian Nutritionist)
These titles are all interchangeable for the same type of professional. While every dietitian is a nutritionist, not every nutritionist is a dietitian. These professionals will have an “RD” or “RDN” in their credentials. To carry this credential, the person has to complete a bachelors or masters program approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND), complete a required number of clinical hours, and pass a credentialing exam. That person must then apply for licensure through the Commission on Dietetic Registration (CDR), and usually the state they practice within as well. To maintain their RD credential, they must submit a career portfolio every 5 years detailing their professional plan, along with evidence of 75 hours of continuing education credits.
RDs are educated on providing medical nutrition therapy (MNT), or nutrition recommendations that treat diagnosable medical conditions. They are not allowed to prescribe medications or diagnose disease.
Due to less legal regulation of this term, it can mean a lot of things. Some nutritionists have completed several years of high level nutrition related education, while others have completed none. Sometimes this education covers medical related nutrition therapies, other times it does not. Some have passed a certification exam to carry a credential in the nutrition field. Others have not. Many nutrition certifications exist, some more reputable than others, and while generalized nutritionist credentials are provided to qualifying professionals, they are often implemented by state rather than nationally. There is no regulated baseline guarantee of education or capability with the “nutritionist” label.
Nutrition and Dietetic Technician, Registered
“NDTRs” attend education programs and obtain licensure through the same governing bodies as RDs. They help to obtain information needed by RDs to design MNT, and help deliver those plans to patients and clients.
Health Coach, Macro Coach, Diet Coach, Wellness Coach, etc.
These hold no legal regulation, less than “nutritionists.” This means that anyone can use these titles without penalty. Zero qualifications are required by law to carry these titles. The title can mean whatever the person carrying it wants it to mean.
Not all States are Created Equal
The legal side of things is where this issue gets complicated. Nationally, to carry the “RD” or “RDN” credential, you must be licensed with CDR. However, each state can decide how specifically they want to enforce that through licensure and regulation. In states with the strictest laws, ONLY RDs can practice medical nutrition therapy (MNT), or the treatment of diagnosable diseases with nutrition. This is stated and outlined specifically in the state’s legislature with regard to scope of practice. In those same states, usually an additional state-specific licensure is required to practice and ensure adequate qualifications.
In other states, there is less regulation on this topic in the sense that those with the label “nutritionists” do not have a designated professional scope (in other words, what they can and cannot do). In stricter regulated states, there is clear legislation defining, for example, that only RDs can practice medical nutrition therapy, only licensed nutritionists may call themselves “nutritionists,” and only those licensed in nutrition professions may practice within those fields. As mentioned above, some states have a “nutritionist” or similar certification that comes with a regulated baseline of competencies, often requiring those professionals to pass an exam to obtain licensure to help better define scope of practice for these professions. The only way to know the details for sure is to dig into your state’s Department of Health legal documents.
As you can see, things get complicated…
If you’d like to see if your state requires nutrition licensure, check out the link below:
What do I Need to Know to Protect Myself as a Consumer?
First of all, it’s not your job as a consumer to be reading through state legal documentation to figure out whether or not the nutrition service you’re receiving is legal. It’s the job of nutrition and health professionals to ensure that the right pathways are set up for you to receive quality services. However, because right now those pathways can get murky, let’s talk about a couple things you can do to put yourself in the most successful position.
What Kind of Service am I Looking for?
The Academy of Nutrition and Dietetics defines medical nutrition therapy (MNT) as, ‘"Nutritional diagnostic, therapy, and counseling services for the purpose of disease management which are furnished by a registered dietitian or nutrition professional…" (source Medicare MNT legislation, 2000). MNT is a specific application of the Nutrition Care Process in clinical settings that is focused on the management of diseases. MNT involves in-depth individualized nutrition assessment and a duration and frequency of care using the Nutrition Care Process to manage disease.’
In other words, if someone is giving you a specific nutrition-related instruction, and that instruction is meant to directly address a diagnosable disease, they are conducting medical nutrition therapy. This includes overweight and obesity. Most often, your physician will be able to refer you to a nutrition professional for any MNT. This person will most often be a Registered Dietitian, as MNT is the basis for this profession’s education, and nearly all states legally require this. In some cases, a specialist might be warranted. Still, this specialist will often be a Registered Dietitian who has obtained additional education and certifications to further their knowledge in a particular area of nutrition.
If you are NOT seeking MNT, you have a wider set of options at your disposal. For example, if you are an otherwise healthy individual seeking weight loss or generally healthy eating tips, this can be accomplished by a variety of nutrition professionals. The key in this scenario, since you are exposing yourself to services with fewer quality regulations, is to do your research and make sure that the professional you choose is a reputable one. Because of the wide education base and certification requirements, an RD is still often your best bet, even if you don’t need MNT. Many nutrition professionals wishing to work in wellness and weight management choose to become RDs, specifically so they have a broader knowledge base that will better equip them to provide quality care for their patients and clients. If you need specialized nutrition advice, be sure to research what specific certifications and qualifications are recommended to get the information you’ll need.
To find a registered dietitian in your area, check out this RD finder: