Fooducate Blog - Should Nutrition Counseling be Provided Solely by Registered Dietitians?

Should Nutrition Counseling be Provided Solely by Registered Dietitians?

Posted: 08 Jun 2012 05:04 AM PDT

photo: Western Kentucky University

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Several months ago, we came across an interesting article in Forbes, describing what seems like an attempt by the Academy of Nutrition and Dietetics (formerly American Dietetic Association) to unfairly limit competition through legislation and other regulatory actions.

The laws around licensure and the practice of dietetics vary from state to state. That’s why dietitians have different appendages to their title: LD, CD, etc…

The Academy is pushing for strict :

The licensure bills vary state-by-state, but Illinois SB2936, the "Dietitian Nutritionist Practice Act," an amendment to and extension of an already-existing licensure law, facing vote soon, is typical. The bill states that "Any person who practices, offers to practice, or holds oneself out as being able to provide dietetics and nutrition services without being licensed under this Act shall. . . pay a civil penalty to the Department [of Financial and Professional Regulation] in an amount not to exceed $10,000." Similar bills in other states include sanctions of up to six months in prison. Read more from Forbes…

Why, you may ask, is this an issue?

There are many people making a living from counseling people on nutrition and health – naturopaths, physicians, and other nutritionists that studied in alternative programs. There are people with PhDs in nutrition that simply never joined the AND. Additionally, there are the many dietitians who refuse to pay their member dues to AND because they disagree with the organization’s acceptance of sponsorship from the likes of Coca Cola and Mars. (Side note: we know quite a few registered dietitians, and several confided with us that the only reason they continue to pay their annual membership dues to AND is to stay licensed.)

Organizations such as Alliance for Natural Health, the American Nutrition Association, and the Weston A. Price Foundation, have mobilized their members to fight what they deem as a monopolization of the field.

We wanted the get AND’s take on the matter. Here is a written response we received a few days ago from Jeanne Blankenship, MS, RD, CLE, vice president, policy initiatives and advocacy, at AND to questions we posed.

Fooducate: Why use legislation when the Academy's efforts should be placed on marketing the RD as a brand?

Blankenship: There's no reason why we can't or shouldn't do both. We are health-care professionals, just like doctors and nurses, that provide services that should be regulated for the protection of the public; this isn't just a marketing issue.

The Academy remains dedicated to empowering our members to be the nation’s food and nutrition leaders. This ties in directly with the Academy's vision of optimizing the nation’s health through food and nutrition. On one hand we continue to ensure the public that when seeking food and nutrition information, registered dietitians have the comprehensive education, training and experience they need to develop personalized, science-based eating plans that fit consumers' specific needs. And we have been successful in these efforts, as registered dietitians' expertise has been recognized by Congress as well as federal health agencies like the Centers for Medicare and Medicaid Services.

On the other hand, it is vital when consumers are seeking medical nutrition therapy (nutritional diagnostic, therapy and counseling services for the purpose of disease management, which are furnished by a registered dietitian or a nutrition professional) for the prevention and treatment of diseases like diabetes, heart disease, cancer and other serious medical chronic diseases, that the provider has met rigorous educational and experiential requirements and that he or she is dedicated to what is in the best interest of the consumer. When unqualified individuals provide medical nutrition therapy, serious harm can be done. Licensure is about ensuring the safety of the American public.

Fooducate: Why not win in an open market by causing people to relate the term RD with the best possible advice they can get?

Blankenship: This isn't about winning. It's about protecting the public from harm.

Registered dietitians are widely-recognized as the food and nutrition leaders. However, when it comes to medical nutrition therapy, there must be assurances that a person is qualified. There is a big difference between providing general nutrition guidance and providing medical nutrition therapy (MNT). Contrary to rumors and misinformation, licensure does still allow the consumer a choice. Whether one has to hold RD credential to administer MNT varies state by state. However, in those states where licensure has been enacted and enforced, consumers can know the information they are receiving is coming from a qualified professional and not someone with a few weeks of education, or worse, no education at all. And in the cases where someone is practicing outside of a consumer's best interest or using quackery, licensure allows for them to be removed from practicing through an established process.

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What do you think?

Should nutrition services be limited to professionals licensed unders the auspices of AND?

Is there room for more than one licensing organization?

Should there be a distinction made between licensure for general nutrition advice (weight loss) and medical nutrition therapy (diabetes, renal, etc..)?

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