What is a "registered" dietician or "certified" nutritionist?

Searching the web for advice on how to eat “good” is, um, helpful - but there is high noise to signal ratio.

I would love to benefit from evidence based advice from an expert. I am, perhaps unfairly, skeptical of the terms “registered” and “certified” when it comes to dieticians or nutritionists. You see these terms everywhere. Any blog on why food X is bad for you is signed by a registered certificationist. Never do you see who issued the certificate, or with what institution the author is registered. The local grocery store advertises the services of a registered dietician on staff to help me buy the right groceries.

Who issues these certificates? Where are these practitioners registered? Is there a way to assess their qualifications and hopefully hire someone who can actually provide real (i.e. evidence based) advice?

I almost asked this in GQ because I am seeking facts on the qualification process, not on diet advice (oh, please - no more diet advice from the internets :smile: ), But I guess I’m really after opinions on the validity of these professions - either by learning these qualifications are indeed valuable, or by hearing your anecdotes of idiots claiming to be experts.

For a registered dietitian nutritionist, it seems to be a fairly rigorous process:

Here’s the credentialing agency:
https://www.cdrnet.org/certifications/registered-dietitian-rd-certification

Thanks both to nofloyd and to kenobi for nudging my research laziness.

I had assumed “dietician” was a term similar to “beautician”. Turns out no, at least not in Canada:

Dietitian is a protected title across Canada, just like physician, nurse and pharmacist. Nutritionist is also a protected title in Alberta, Quebec and Nova Scotia.
(https://www.dietitians.ca/About/Learn-About-Dietitians/The-difference-between-a-dietitian-and-nutritionis)

Ignorance fought!

Note that just because someone is a registered dietician does not mean they still can’t give flaky advice or recommendations that are not evidence based, just as there are quack physicians who will offer bad medical advice and treatments that are not well-proven. I say this because I’ve known several registered dieticians who were enthusiastic at endorsing “cleansing” diets, exclusive raw food, colonics, and other ostensibly nutritional advice that is unproven at best and may carry medical risks. For the most part, dietitians deal with correcting nutritional pathologies (e.g. making sure people are eating healthy foods) or making balanced diet plans for people with significant dietary restrictions, and while they can certainly make recommendations on what is considered improvements to a ‘normal’ diet, they are also working from guidelines that have changed significantly over the past few decades, e.g. that all fats should be restricted in favor of ‘low-fat’ varieties of foods, or that dietary cholesterol is the cause of high cholesterol levels in patients.

So, regardless of qualifications you should still seek a second or even third opinion on anything that sounds sketchy, and of course ask for primary sources if they make a claim that some particular food is a “superfood” or is uniquely harmful. For most people, the general guidance to cut out or minimize ‘white carbs’ (refined sugars, corn syrup, white rice, et cetera), moderate alcohol intake, eat a good quantity of fruits and leafy green vegetables to get vitamins and minerals, avoid too much of anything fried or baked, get adequate insoluble fiber, and make sure you are eating a moderate amount of lean animal protein and/or getting a good balance of plant proteins is sufficient, along with supplementation with Vitamin D and Omega-3 fats if you don’t get enough of that from sunlight and diet. Unless you have an actual nutritional deficiency, there is no magic food you absolutely need or something you have to totally exclude.

Stranger

My niece is a dietician. She works at a hospital, and her job is to make sure each patient receives a “nutritious” tray that also conforms with a doctor’s specific instructions. Once I asked my doc how much of his medical training concerned nutrition – “Maybe an hour”. No doctor has ever asked me about my diet.

Now I’m hungry.

How about some Jello?

Here’s yer diet advice from the internets!

Stranger_On_A_Train raises a couple of good points

For most people, the general guidance…

I heard an interview with the author of some diet book. He said, “After years of research, I’ve found that the answer to healthy eating is to eat real food, mostly plants, and probably a bit less than you currently are. Which sucks as an author because that doesn’t fill up a whole book.” What I’m seeking advice on are some specifics, tailor-made to my goals and situation. Someone who knows how to navigate the sometimes ambiguous and contradictory findings of nutritional studies would be helpful.

Note that just because someone is a registered dietician does not mean they still can’t give flaky advice

How sad but true. But I’ve avoided even seeking out a dietician because until I learned the term is protected I thought anyone’s aunt can call themself such. I wonder if a dietician is subject to malpractice action if they provide flaky advice that causes adverse affects? Not that I would even go there - your suggestions to get multiple opinions and insist on primary sources are spot on. I take full responsibility for what I put into my body. Just would like some information to help with my decisions.

Senegoid: is there a Chick tract for every occasion?

jtur88: That is surprising, but I sympathize. I’m a software developer. How many times have I heard, “Oh, you do computers - can you fix my printer?” With fields of knowledge as wide as computers and as medicine, no one person can know it all. (and sure, I’ll fix your printer: did you reboot?)

When I was in culinary school, one of the programs we could work towards was registered dietician. It required another 2 years, 4 years total, and involved quite a bit of biology and chemistry requirements.

I wouldn’t say that achieving the degree means you know everything about diet and food, but you probably are pretty well versed, and your knowledge and advice is worth more than some random individual who read the Adtkin’s Diet book.

Most of those who get the degree go to work in hospitals, retirement communities, and long term care facilities. Those actually pay really well. If someone is not working in one of those environments, then my speculation is that they were at the bottom of their class and while they may be more knowledgeable than your average foodie, they may not have a completely firm grasp of the material. I don’t think that most people would become a private diet coach if they had more lucrative options available to them.

I do know that I’ve met a couple registered dieticians who had some interesting thoughts about food.

Side note there, the problem is that when it comes to printers, you don’t need someone who “does computers”, you need someone who does exorcisms.

An RD should have a good grounding in nutritional biochemistry, but how well that sticks varies from person to person; certainly, a dietician is not referencing mitochondrial function or regulation of protein catabolism, but predominately concerned with constructing a diet plan that addresses any nutritional deficiencies and that regulates insulin response to maintain blood glucose levels. Much of the work the typical registered dietician does today deals specifically with dealing with incipient or active Type 2 diabetes mellitus because of the epidemic of that syndrome, which is almost entirely due to diets in modern industrialized countries having shifted to highly processed and sugar-enriched foods (including those ‘fat-free’ foods that were so heavily promoted as being ‘healthy’), or else making meal plans and dietary recommendations for people undergoing chemotherapy or other treatments that make it challenging just to maintain basic nutritional requirements.

For the o.p., you haven’t mentioned your specific intent in seeking nutritional advice, but if it is a fitness-based goal you may want to talk with an exercise physiologist who specializes in nutrition, or an RD that works in sports nutrition. Nutrition is a key aspect in obtaining peak athletic conditioning, and one that is often overlooked by amateur athletes, and there is of course much flaky advice in ‘health’ magazines and on the internet regarding ‘paleo’ diets, intermittent fasting, et cetera. Someone who is knowledgable in sports nutrition can give diet recommendations for training in a specific sport or athletic activity that can dramatically improve performance and recovery.

Stranger

My general rule when encountering controversial/potentially dubious advice on any medically-related subject is to focus on the advice itself (at least initially), rather than the credentials of whoever is offering it.

Red flags include use of words like “integrative”, “functional”, “holistic”, “detoxification” etc.

It’s helpful to build up a network of reliable sources, which in this case might include Science-Based Medicine, USDA, the World Health Organization and professional groups like the Academy of Nutrition and Dietetics*. PubMed is valuable for searching the scientific literature, with many papers available for free (others only as abstracts).

*this organization of diet professionals emphasizes evidence-based practices and promoting research, which sounds good. However one of the first articles I pulled up on their site, while generally offering good advice, was written by a person whose title and descriptors included every one of the red flag designations mentioned previously. No matter what the title and impressive degrees someone has, it’s still possible they are promoting useless and/or potentially harmful woo.

I work at a research university in the same college as a Foods and Nutrition department (that has a registered dietician track that they are very serious about), and they use “integrative,” “functional” and “holistic” in many of their marketing materials and on their website. I wouldn’t totally discount them, as they seem pretty common even in this research environment. I’ve never seen them talk about detox, however.

But I totally agree that the nutritional expert arena attracts a lot of nuts, even nuts with Ph.Ds.

You need new doctors. Ones who actually care about what their patients eat.

I can pull up what my patients order from the prison canteen. so I can tell pretty quick if they eat wisely or not. No canteen purchases means they’re eating from the cafeteria trays, which are reasonably nutritious, though if they swap foods with others, etc they can overload on carbs and fats.

Everything useful I learned about nutrition I learned from registered dieticians. I’m on a first name basis with our system’s dietician.

And it saddens me how often educated folks like physicians, scientists, pharmacists, etc. can fall for woo and end up down the rabbit hole.

Where do we find these amazing “new doctors” who are accepting new patients?

At “these” magical mystery castles “full” of wonder and amazement that “some” call “hospitals”. It’s “where” I, through some “divine” mysticism, found my “new doctor” three weeks ago “.”

You’re lucky then. Most of the country suffers from a primary care practitioner shortage.

…through some “divine” mysticism, found my “new doctor” three weeks ago “.”

The quotes around the period just slayed me :smiley: