I'm a Nutritionist! You're a Nutritionist! We're All Nutritionists!
Many cancer patients and survivors are interested in finding nutrition information to promote a healthy lifestyle that can improve treatment outcomes, recovery, and reduce the risk of recurrence. However, they may be hesitant to trust information from sources other than health professionals. Rightfully so. The health and wellness industry is a multi-billion dollar industry that is experiencing exponential growth, and many opportunists are touting themselves as experts to try to get a piece of the pie. The goal of this post is to teach you why you should be a little more skeptical about the credentials of people providing nutrition information.
In my last post, I mentioned that registered dietitians are qualified nutrition experts that you should try to seek out for nutrition information, especially for personalized dietary counseling. What does it take to become a registered dietitian (RD)? Just a few simple steps…
1. Complete a bachelor’s degree and receive a verification statement from an Accreditation Council for Education in Nutrition and Dietetics-accredited program. Some people may have a bachelor’s degree in a different field, but they had come back to school to complete the required courses for the verification statement. These courses include biology, biochemistry, organic chemistry, anatomy & physiology, food science, counseling, nutrition assessment, medical nutrition therapy, and the list goes on. Point is, there’s A LOT of science and the study of nutritional needs across the lifespan and for different diseases and disorders.
2. Complete at least 1200 hours of supervised practice in an accredited dietetic internship. These internships range from 8 months to 2 years and are extremely competitive. Only ~50% of students that completed the above step get matched to an internship.
3. Pass the Commission on Dietetic Registration’s dietetic exam.
4. Maintain continuing education (CEU) which is currently 75 hours over 5 years. These CEUs are primarily obtained from attending conferences, seminars, webinars, and workshops or publishing research. Some states have additional licensure requirements that also have CEU requirements.
5. Coming soon – a requirement for a master’s degree.
Oh wait, those aren’t easy steps. Mad respect for these experts.
Here are the steps it takes to become a nutritionist:
1. Call yourself a nutritionist
Seriously. That’s it. No formal education or training in nutrition. The term nutritionist is not regulated, and the problem doesn’t end there. There are plenty of people who don’t call themselves a nutritionist that are still out selling books, supplements, diet plans, magic pills and powders, etc. It’s madness!
Are dietitians the only people that should provide nutrition information? Not necessarily. I don’t believe a dietitian automatically deserves a stamp of approval because they have the credential, and I’ve heard about some shoddy advice that came from dietitians. I also know many people with graduate degrees in nutrition, but aren’t an RD, who would be a tremendously better resource for the latest evidence than dietitians who haven’t kept up with the science. However, if you need medical nutrition therapy, which I’ll describe a little later, you should stick to an RD.
Take away point – Be critical of the experience, knowledge, and intentions of those providing nutrition information.
Wait, you made me read this far along and you still haven’t told me where to go for help?! I am hesitant about saying who or what is ok to utilize because there is quite a range of quality, and I can’t possibly evaluate them all. One diet book may actually provide science-based info while another may be so extreme that it could result in nutrient deficiencies. One health coach may be promoting a well-rounded plant-based diet, while another may tell you that a juice cleanse and their $150/month supplement package is the way to wellness. For generally healthy people, following a fad diet or other bad nutrition advice is probably not going to seriously harm them; although, I think the miserable eating experience and the time and money wasted can still be considered harmful. I become much more concerned about the risks posed to populations with disease or elevated risk for disease such as cancer patients and survivors. There are additional considerations when working with clinical populations such as potential drug interactions, medication and treatment side effects, and alterations in metabolism, organ function, or immune function. Dietitians will be best equipped to handle this more complicated scenario and provide individualized medical nutrition therapy and counseling.
Will any dietitian do? Nutrition is a VERY broad field. Dietitians work across multiple industries including community, public health, clinical, research, food service, and food industry and with a wide range of populations across the lifespan. Since there are so many diseases and conditions that can be prevented and/or managed with diet, it is extremely challenging for a dietitian to be up-to-date on the nutritional needs and issues across all possible health conditions and populations. I’ll admit that I know the basics, but not all of the nuances, on nutritional needs during pregnancy, infancy and early childhood. One can’t possibly know it all! Therefore, it’s important to find a dietitian that has experience with your health conditions and needs.
For general guidance on healthy eating, most consulting dietitians will be able to help cancer patients and survivors. For more specialized cases, such as dealing with acute or late side-effects of treatment, tube feeding (enteral nutrition), cancer-related muscle wasting/weight loss, or weakened immune system, it is best to find a dietitian that is specialized in oncology or has additional education and experience in oncology. There is a board certification credential (CSO) for Registered Dietitians in Oncology Nutrition. This specialty certification requires 2000 practice hours in oncology over 5 years and passing a specialized exam. Recertification must be renewed every 5 years, and the RD must complete the requirements of 2000 hours and the exam each time! It's intense, and these are going to be a top-notch resource. They are pretty rare, but worth seeking out if you have more complicated health issues related to your cancer and cancer treatment.
Did I convince you to seek a registered dietitian (RD)? You can find a local dietitian at https://www.eatright.org/find-an-expert. In your search you can also use filters for specialties, like oncology, and whether they accept insurance. I am a Registered Dietitian, with expertise in nutrition and cancer. I am currently accepting clients, providing individualized, in-person consulting at Cancer Rehab Austin. I am also available virtually through Skype. You can learn more about my services here.
Have a question or a topic you’d like me to cover? Email me at DrZNutrition@gmail.com