Nutritionists, Dietitians and Diets, Oh My!

By Julie Humphreys, Step UP Director
Courtesy of Spokane Coeur d’Alene Living Magazine March 2012

We really don’t like the word “diet.” Even in its purest form as a noun, it means “food and drink regularly provided or consumed” and “habitual nourishment.” Nothing wrong there. But drop a couple rungs down the ladder in Webster’s definition of diet and you find “a regimen of eating and drinking sparingly so as to reduce one’s weight going on a diet.” Yikes, eat and drink sparingly? Now we’re facing restrictions, and the truth is we don’t like to be restricted.

That is part of the reason for a name change in the nearly century- old organization,
the American Dietetic Association. In September the association voted to change its name to the Academy of Nutrition and Dietetics. Bringing the word nutrition into the fold was very intentional for reasons best explained by Spokane dietitian Heather Gabbert who did an informal poll last summer. When she asked, “What do you think of when you hear the words dietitian and nutritionist?” One response stood out: “When I hear dietitian I think of someone who is going to tell me what I can’t do. When I hear nutritionist I think of someone who is going to help me do what I need to do to get better.” Touché, that’s exactly what the well-meaning, educated, helpful dietitians of the world face.

So bring on the name change, but in doing so, you bring up a major point of clarification on the professions of dietitians and nutritionists. And this is information you, the consumer need to know. Dietitians are attempting to convey their modern day mission of who they are, what they do, and how they can help you improve your health and prevent serious diseases down the road.

Around the time of World War I, dietitians were diet planners or cooks. What they did was geared toward the medical treatment of disease, now called medical nutrition therapy. In the 21st century we know that nutrition affects your total health and quality of life in a variety of ways every day. Just like doctors, dietitians today have many and varied areas of expertise: sports nutrition, diabetes, pediatric, long term care, etc. And most of all what they have and always have had is a science background. “Nutrition is a science, not a philosophy or a feeling,” says Kim Larson, Registered Dietician (RD), and Director of Communications for the Washington State Academy of Nutrition and Dietetics.

The biggest distinction between a dietitian and a nutritionist is a science-based nutrition education and training that includes at least a four-year degree, along with passing a national board exam to become a Registered Dietitian. But Larson says the term nutritionist is not regulated and anyone can call themselves a nutritionist. She points out that nutrition is about the physiology of how food is used in the body and that involves a lot of chemistry to learn how the components of food are digested, absorbed and metabolized. Again, nutrition is science, so nutritionists should know science.

Still the word nutritionist is hot right now. There’s a big trend of people calling themselves nutritionists. With the Internet we have unlimited nutrition information at our fingertips and not all sources of that information are credible. It is wise to take a “consumer beware” stance when seeking out nutrition and health information and make sure it comes from people and organizations with credentials, a qualified background and formal education. Note that the former Dietetic Association added the word nutrition to its new title, not the word nutritionist. Larson says, healthcare professionals, like RD’s, need to change with the times and let consumers know they offer quality nutrition information and services they can count on to be safe and accurate. Elizabeth Abbey, a dietitian who teaches nutrition at Whitworth University says there are nutritionists out there who are qualified, it’s just a matter finding out if they have credentials, and if so, what kind. Abbey points out you can take an online class over the Internet on a weekend and be a nutritionist with a certification by Monday. She says there’s a booming interest in nutrition as a career and there are expanding opportunities in the field, which is bound to attract people who want to jump on the nutrition bandwagon. A major red flag, she says is a nutritionist who is tied to a product. The supplement business is a 28 billion dollar business and Americans spend 40 billion a year on weight loss programs and products. Beware of someone who stands to see a monetary gain through products with his or her nutrition advice. Larson reminds us, “Nutrition is big business, big money.”

What can a dietitian do for you? In general they teach, support and help motivate you to develop lifestyle, food, eating and exercise behaviors that are right for you and that will improve your health and performance as well as prevent and treat diseases. The dietitian can help you make changes, but that’s just one part of a bigger picture. “Good nutrition is multi-factorial in that it not only involves a conscious personal choice to eat better and get enough physical activity and exercise,” says Abbey, “but it also addresses the psychological, social and environmental aspects (access to quality food) of eating.”

Why we eat what we eat has a lot to do with our culture, so changing our bad eating habits involves not only personal change but change in the culture and the food industry. Larson says all these things have to be integrated so healthy food is readily available. She says we are making progress but it’s an uphill battle with so many new foods coming out that literally put us on the path to heart attack and disease. Foods high in sugar and fat sell. We want them; companies provide them. According to Larson, “Behavior changes are hard and once someone makes them, they have to be supported by their environment.”

Food, nutrition and exercise are all subject to trends just like most everything in life. Larson reminds us that fad diets are always a problem so we as consumers have to know how to evaluate them. Here are some things to look for in diet trends to which dietitians warn, “watch out!”
Following a low-fat diet to lose weight. This was popular in the 80s and 90s but actually resulted in people consuming more calories and gaining weight. Low-fat diets can also lead to not enough “healthy” fats from avocados, nuts, fish and oils.
Avoiding or limiting foods. If you take out most of or an entire food group you risk creating a nutrient shortfall. For example, eliminating all milk products can cause a shortage of important nutrients that help prevent bone fractures in children, and osteoporosis in adults.
Low-carbohydrate diets. This is probably the most current popular weight loss diet. But when you eliminate all carbs you are missing out on fruits, whole grains and fiber that protect against cancer, heart disease and diabetes. These diets also lead to bigger intakes of meat, cholesterol and fat, which can increase the risk of heart disease.
Weight-loss diets. They are now known to be linked to weight gain with up to two-thirds of dieters regaining more weight than they originally lost. This is in part because dieting predicts unhealthy eating behavior like binge eating.
Taking dietary supplements. Doing so may provide nutritional insurance but can pose some risk. Heavy supplement users may be getting too much of some nutrients and supplements don’t provide all the healthy components of foods.

Avoid super low calorie diets such as a 500-calorie diet. You will naturally lose weight if your intake is that low. You could eat 500 calories of chocolate cake for your daily intake and lose weight, but you won’t get essential nutrients your body needs and when your body doesn’t get enough and proper food it pulls from your muscle.

Another mandate from dietitians is to not skip meals, and there’s good reason. Meals are fully digested usually within about five hours, with carbohydrates within three to four hours. So you are out of fuel every three to five hours, and as soon as your body doesn’t have enough energy it starts breaking down lean muscle. And the cumulative effect is even worse as you continue to deny your body proper fuel at regular intervals.

Those are things to watch out for, but what about things to incorporate in your attempt to eat well and keep your weight in check? Dietitians support these tips:

• Use moderation, variety and balance in your food choices. It may not be flashy, but it’s tried and true.
• Consider taste, enjoyment and social and cultural factors in your food choices. Diets that don’t will not be successful in the long term.
• Select foods from all food groups. Each group provides important and unique nutrients.
• Most all food can be made part of a healthy diet.
• Try not to label foods as “good” or “bad” foods.
• Choose nutrient-rich foods that have a lot of vitamins, minerals and other nutrients.

Keep in mind it’s your diet over time, not individual foods or even single meals that will ultimately affect your health.

March is National Nutrition Month and this year the Academy of Nutrition and Dietetics is promoting “Get Your Plate in Shape.” In simple terms your meal plate should look like this: half fruits and vegetables, a quarter whole grains and a quarter protein.

Here’s  how:

Make half your plate fruits and vegetables: Eat a variety of vegetables, especially dark-green, red and orange varieties, as well as beans and peas. When buying canned vegetables choose “reduced sodium” or “no salt added” and rinse other canned goods like beans, corn and peas to reduce sodium levels.
Make at least half your grains whole: Choose brown rice, barley, and oats and other whole grains for your side dishes. Switch to 100% whole grain breads, cereals and crackers.
A quarter of your plate should be protein: Eat different protein foods like seafood, nuts and beans, lean meat, poultry and eggs. Eat more plant-based proteins like nuts and beans, and whole soy foods like tofu and edamame. At least twice a week, make fish and seafood the protein on your plate.

To find a dietitian in your area go to http://www.eatright.org and click on “find a dietitian.” While it appears ironic that dietitians are seeking to distinguish themselves from nutritionists yet they’ve added the word “nutrition” to their national title, it’s really not, they say. Because dietitians are all about nutrition; sound, studied, tested, true science based nutrition that translates to solid helpful information to you the consumer as you try to figure out how to eat right for your health.

Julie Humphreys is a health reporter and Director of Step UP Spokane, a community effort to encourage you to eat right and exercise. Visit http://www.stepupspokane.org for more nutrition information and to track your physical activity with free activity challenges.

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2 thoughts on “Nutritionists, Dietitians and Diets, Oh My!

  1. […] If you haven’t read the article read it on our blog!  https://stepupspokane.wordpress.com/2012/03/14/323/ […]

  2. There really is a lot of “noise” out there regarding what and how to eat. Thank you for providing some clarity.

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