Food For Thought: What is a Registered Dietitian Nutritionist?
Today is Registered Dietitian Nutritionist (RDN) Day, which honors the nation’s food and nutrition experts. Today marks the tenth year we celebrate RDNs on their own commemorative day and the work they do to promote healthy living throughout our communities. With over 100,000 registered dietitians in the United States, many people still do not understand the many roles a RDN assumes to help improve the health of individuals.
The term “nutritionist,” by itself, is not exclusive to registered dietitians. Anyone with any type of training in nutrition can deem themselves a nutritionist. On the other hand, the credential of Registered Dietitian Nutritionist indicates a recognized healthcare professional who has met specific, intensive education requirements and experiences to practice medical nutrition therapy, whereby the dietitian counsels individuals with specific medical conditions (e.g., diabetes, kidney disease, heart disease, eating disorders, food allergies, etc.). To become qualified, the RDN must obtain a four-year degree through an accredited program in nutrition and dietetics. As the industry moves towards higher standards of professional development, a Master’s degree will also be required starting in 2024 to earn the RDN credential. Upon completion of an undergraduate and/or graduate program, a 1200-hour supervised practice (internship) program must also be completed. The intern works in foodservice, clinical, and community settings with established RDNs in hospitals, private practice, and community settings; the intern must demonstrate proficiency in specific competencies, in all areas of practice. Once the terms of the internship are met, the final step requires passing a national Registered Examination for Dietitians, covering principles of dietetics, nutritional care for individuals and groups, management of food and nutrition programs and services, and foodservice systems.
Finally, 46 states require registered dietitians to simultaneously be licensed. State certification is completely separate and distinct from registration by the Commission on Dietetic Registration, with its own set of requirements varying by state. State licensure grants further security in the interest of the public that the dietitian is qualified to practice as a healthcare professional. The RDN is responsible for maintaining a certain number and type of continuing education credit hours to maintain both his/her registration and state license. This ensures all education materials and suggestions are up to date, in accordance with current scientific research and standards of care; continuing education also keeps the RDN well informed in all areas of practice, regardless of his/her specialty. Recently in the state of Florida, state licensure for the practice of dietetics was challenged, with a bill presented in Tallahassee that would allow any nutritionist to provide nutrition advice to all individuals, including those with chronic diseases, with no specific requirements for education and training. Marilyn and Jen joined dozens of other dietitians in the state of Florida on "Legislative Day" last month to advocate for both our profession and the safety of all Florida residents. This change could potentially jeopardize the health and/or progress of any individual with a medical condition who might unsuspectingly pay a nutritionist with no formal training to manage his or her meals. Even a cosmetologist is required to maintain a state license in order to receive compensation for cutting hair. Likewise, registered dietitians are licensed in most states in order to protect the general public from potential harm.
Now let’s dig a little deeper into what a RDN is…and what a RDN is not!
A Registered Dietitian Nutritionist can be…
- A Clinical Dietitian – Dietitians are an important part of the healthcare team in acute care settings, such as hospitals, long term care facilities, nursing homes, and outpatient centers. In these settings, RDNs assess patients and offer nutrition education or counseling to meet their individualized needs, with the intent of managing various medical conditions. One of the most critical roles of the clinical dietitian is in the initiation and management of nutrition support for patients in critical care. The RDN is responsible for calculating the patient’s daily energy needs and determines how much nutrition the patient is to receive through tube feedings. The RDN coordinates with other members of the healthcare team—doctors, nurses, occupational therapists, and speech therapists—to provide adequate care.
- A Nutrition Counselor/ Health Coach – One-on-one nutrition counseling helps you set short- and long-term goals, with ongoing support from your dietitian to help you identify and overcome specific challenges. Clients often dig deeper with nutrition counseling because the RDN not only provides necessary tools and expertise, but guides clients to become more self-sufficient and learn how to trust their bodies again.
- A Food & Nutrition Manager – These RDNs oversee the production and service of food. Management in food and nutrition might involve school nutrition programs, clinical nutrition management, food service in acute or long-term care facilities, or directing retail and hospitality food service establishments. They require strong leadership qualities, including skills in management and human resources.
- A Community Dietitian – Community nutrition professionals work in public health, many times in federal, state, or local agencies. Many RDNs in this area work for the Supplemental Nutrition Program for Women, Infants, and Children (WIC), where they provide nutrition education and counseling, provide supplemental food and infant formula to women and children up to age five, and provide breastfeeding support for optimum nutrition and health in early childhood. Other areas might include programs for the aging, cooperative extension, or agencies dealing with chronic disease.
- A Healthcare Consultant – Some RDNs become nutrition entrepreneurs and develop private practices or business consulting firms, working in nutrition care planning, group training/presentations, marketing, health coaching, or staff training. Services are often contracted by the RDN or a firm.
- An Educator – Many RDNs hold advanced degrees and work in academia, teaching courses in nutrition, food science, metabolism, and medical nutrition therapy, among many other subjects. Some RDNs teach and work in private practice, while others may pursue research projects.
- A Researcher – Nutrition is a very young science, compared to chemistry or biology. We have only just begun to understand the impact of nutrition on overall health, as well as concepts in metabolism, in the past few decades; so, research is absolutely crucial to our constantly-evolving field. Researchers throughout the world perform clinical trials and epidemiological studies so that we may continue to advance and optimize recommendations related to food, medicine, and chronic disease.
While the above list is not inclusive, it includes the most common roles of a RDN. No matter where one’s career path may lead, a Registered Dietitian Nutritionist is NOT…
- An Advocate for the Diet Industry – Despite the “diet” in “dietitian,” RDNs believe every individual is unique, and certain approaches to food and nutrition that benefit one person may not necessarily help someone else. The RDN can identify and explain the (many) flaws in fad diets, which exist to keep individuals in a continuous loop of shame and restriction. The term “diet” is better recognized as the various foods one habitually eats to a RDN, not a particular plan that values weight loss over health and balance.
- The Food Police – One of the most common concerns clients express at their initial visit is the fear that a dietitian will “take away” their favorite foods. Believe it or not, the dietitian’s primary function is not to tell you what to eat or do. Nor should a dietitian judge a client’s choices. In our evidence-based practice, we provide nutrition education based on current research, assess your medical history and food behaviors, and help guide you towards lifestyle changes that suit your individual needs. Except with extreme medical conditions, such as end-stage kidney failure, it is very rare that you should have to completely eliminate foods that you enjoy.
- A Medical Doctor – A RDN cannot diagnose any medical condition. Nor can he/she prescribe medications. However, a RDN receives thorough education and training to assess or evaluate your labs and medication list and identify any contraindications in your meal pattern(s) and/or herbal supplement use. The RDN has the authority to prescribe supplements but will often coordinate with your doctor for consistency in care.
- A Physical Therapist – While he/she can share general guidelines for physical activity, a RDN cannot prescribe an exercise plan under our credential. Because exercise is such an important part of overall health, however, many RDNs become certified personal trainers in order to offer a full range of services. Always check with your primary care physician before starting an exercise program.
Keep in mind that the most important advocate for your health is you. Nobody knows your body better than you do, and everyone deserves access to quality healthcare. Do not hesitate to ask questions when considering a new practitioner, including insight into his/her qualifications. Consider the level of training and experience that matters to you, and choose a nutrition counselor who can meet all of your needs. We are always open to answer any questions you may have, whether you want to know more about any member of our staff, or the services we can provide. If you are already working with a registered dietitian, acknowledge them on this special day and let them know how they've helped you on your journey. There is no greater satisfaction for a RDN than knowing he/she made a significant contribution to someone's life!