Recently the practice of nutrition therapy by Registered Dietitians has come under a bit of fire. One senator wrote in an article. “Rather than genuine health and safety concerns, licensed dietitians are mostly just worried about protecting their monopoly status as the only group that can provide nutritional services in states like Missouri.”¹ This quote was then spread through Cross Fit’s social media and made its way to many social media platforms. 

I hope to shed some light on why credentialing and licensure is incredibly important. 

There is credentialing for many health professionals such as speech therapists, physical and occupational therapists, and doctors. Every health care provider is credentialed to practice within their scope. Every provider must recognize where their scope of practice falls so that they can give the best, most appropriate care possible. 

Registered Dietitians hope to protect the practice of Medical Nutrition Therapy because it is what we are trained and educated to do. We prescribe nutrition interventions based on a number of personal considerations including past medical history, personal food preferences and restrictions, and current health state. We are taught to counsel appropriately and provide evidence-based nutrition advice. 

So why do we feel we are the most qualified? We go through extensive training including completing a bachelor’s degree (soon to be a required master’s degree), complete at least 1200 hours of supervised practice in a very competitive Dietetic Internship, and pass a national licensing exam. All of this education takes on average 5 years, sometimes more depending on additional degrees that students earn and the length of their internship. 

Unfortunately there is a lot of bad advice on the internet and the truth is, the ability to eat and prepare food doesn’t make a person an expert on nutrition. People get hurt from poor nutrition advice. A recent study done by Glasgow University found that about 90% of nutrition advice given by popular bloggers online is wrong. The nutrition advice was graded on using 12 indicators in 3 groups: transparency, trustworthiness, and bias.² If you ask me, these indicators should all be a given when we are getting any sort of health advice. 

Here are a few examples of the poor nutrition advice I have seen on the internet: 

If you need to cut calories, just skip a meal! 

Instead of teaching people to over-restrict calories and cut out an entire meal, why don’t we just help them build healthier meals? Eating inadequate calories can result in micronutrient deficiencies and often causes people to overeat in a meal later. 

Take herbal and dietary supplements for weight loss. 

Unless someone has a vitamin or mineral deficiency or a specific condition that calls for supplementation, people who are eating enough food and variety of food do not need supplements. Supplements can even cause damage when used in excess; 20% of cases of drug induced liver toxicity are related to herbal and dietary supplements.³ Supplements are not required by the FDA to prove their effectiveness like medications are; therefore, it is important that people are careful when taking them and should not take them without a physician’s recommendation. 

Weight loss always means improved health. 

Weight loss can have many benefits such as improved glucose sensitivity in diabetics, less pressure on joints, and improved cardiovascular health. However, these benefits only come when we make good lifestyle changes. There can be unhealthy ways to lose weight including diets that cut out an entire food group (I’m looking at you keto diet). For example, whole grain bread or oatmeal which is extremely limited in the ketogenic diet while sausage is still allowed. Extreme diets having nothing on moderation when it comes to improving overall health.

Anybody can call themselves a nutritionist, only a credentialed professional can call themselves a Registered Dietitian. We don’t care about creating a monopoly, we care about protecting the safety of our patients. 

For signs to look out for when someone is giving you nutrition advice, check out this article from the Cleveland Clinic: https://health.clevelandclinic.org/5-signs-of-bad-nutrition-advice/

Citations: 

1. It’s Time for Missouri to Legalize Diet Advice. (2019, May 01). Retrieved from https://www.rstreet.org/2019/05/01/its-time-for-missouri-to-legalize-diet-advice/
2. Davenport, L. (2019, April 30). Avoid Food Bloggers When Looking for Nutritional Advice. Retrieved from https://www.medscape.com/viewarticle/912360#vp_2
3. Navarro, V. J., Khan, I., Björnsson, E., Seeff, L. B., Serrano, J., & Hoofnagle, J. H. (2017, November 17). Liver injury from herbal and dietary supplements. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502701/