One of the most common questions that you get asked as a dietitian is ‘what is the difference between a dietitian and a nutritionist? Admittedly it is confusing – if anything the term nutritionist sounds far more user friendly compared to the term ‘dietitian’ which tends to conjure up images of a practitioner in a white coat dictating what you should and should not be eating. This is as opposed to nutritionist in which case we tend to imagine holistic health imagery filled with fresh fruit, vegetables and wellbeing.
While a dietitian is always also a nutritionist, this is not the case for a nutritionist. A dietitian is someone who has completed tertiary training, usually with a Master’s Degree at university in the area of nutrition and dietetics – the applied science of nutrition and its application to dietary change in people. To be called an Accredited Practising Dietitian (similar to an accredited accountant) you not only need to have completed this university training but annually complete a certain number of continuing education activities to ensure that your practice is current and up to date with the latest scientific research and its application to humans. The scientific training of a dietitian involves studying biochemistry, physiology, disease states, psychology, supervised nutritional counseling and statistical analysis. Such in depth training not only takes many years but teaches dietitians to be able to interpret scientific data and medical results in order to develop individual client dietary prescriptions based on scientifically proven data ad research. On the whole, the profession is highly regulated to ensure that best practice is ensured for our clients.
Nutritionists on the other hand are managed a little less rigidly – actually anyone can call themselves a nutritionist, and while some people may have studied nutrition at a tertiary level and earned various qualifications, others may simply have completed a course at a private college or via an online course. And for this reason, it is imperative that consumers check the credentials of the health professional that they are seeing. Recommending that those consumers wanting dietary advice or weight loss advice see a dietitian is given not because a nutritionist is not likely to improve the diet quality of any client that they see, but rather because dietary intervention can be a little more complicated.
To demonstrate this, a client story of mine that I will share with you;
A couple of years ago I saw a 32 year old female for weight loss. The female was roughly 90kg and had been feeling exceptionally tired. She has already seen a GP and an endocrinologist who had blamed the fatigue on a poor diet and her insulin resistance. Since these consults, my patient’s symptoms had not improved and she had also see a nutritionist at her gym who suggested she stop consuming wheat and dairy. Initially my client had felt better with this advice but she was still not losing weight and a month later she was still tired. When I first saw her, I simply changed her macronutrient ratios (her carb, protein and fat levels) slightly but had that practitioner sixth sense that all was not well with this girl. I have seen too many other women for weight loss, over many years to know when something is not right. My client appeared grey, low in energy and mood and even with insulin resistance her fatigue was extreme. When I went home I discussed the patient online with some dietitian colleagues – as a profession there is support available from other practitioners online when you are a dietitian. One of my colleagues suggested another endocrinologist simply as this one specialist had much experience with clients presenting with fatigue. While I continued to see the client and managed to help her lose 3kg, she finally got into the new specialist and was diagnosed with thyroid cancer. She has since had it removed and is in full remission.
Now I do not share this story to show off or claim glory but rather to show that simple dietary presentations whether they are fatigue, bloating, irritable bowel, bad skin or unexplained weight gain can be masking significant health issues, health issues which do need practitioners with a certain level of training to deal with. If I was not a dietitian I would not be in close contact with other medical professionals, nor would I have access to a 2000 other practitioners to reflect and discuss cases and refer on when necessary. Luckily in this case we were able to have a patient diagnosed with cancer thanks to these professional interactions and as a result ultimately saved her life. In my 12 years of practice I have seen 5 cancer diagnoses, numerous cases of insulin resistance and PCOS, more than 20 pregnancies and 12 coeliacs diagnosed – and I can guarantee that it was my training as a dietitian that resulted in these outcomes.
Telling someone to eat more fresh fruit and vegetables is unlikely to do any harm but it is always useful to be aware of ones limitations in this space, and when it comes to many dietary issues and weight loss, a dietitian is the best practitioner to manage these.