Dietitian
Encyclopedia
Dietitians supervise the preparation and service of food
, develop modified diet
s, participate in research
, and educate individuals and groups on good nutritional habits. The goals of dietitians are to provide medical nutritional intervention, and to obtain, safely prepare
, serve and advise on flavorsome, attractive, and nutritious food for patients, groups and communities. Dietary modification to address medical issues involving dietary intake is a major part of dietetics (the study of nutrition as it relates to health). For example, working in consultation with physician
s and other health care providers, a dietitian may provide specific artificial nutritional needs to patients unable to consume food normally. Professional dietitians may also provide specialist services such as in diabetes
, obesity
, oncology
, osteoporosis
, pediatrics, renal disease, and micronutrient
research.
Different professional terms are used in different countries and employment settings, for example, clinical dietitian, community dietitian, dietetic educator, foodservice dietitian, registered dietitian, public health dietitian, therapeutic dietitian, or research dietitian. In many countries, only people who have specified educational credentials and other professional requirements
can call themselves "dietitians" — the title is legally protected. The term "nutritionist
" is also widely used; however, the terms "dietitian" and "nutritionist" should not be considered interchangeable — the training, regulation and scope of practice
of the two professional titles can be very different across individuals and jurisdictions.
In many countries, the majority of dietitians are clinical or therapeutic dietitians, such as the case of the United States, the United Kingdom, and much of Africa. In other countries they are mostly foodservice dietitians, such as in Japan and many European countries.
s, nursing care facilities
and other health care facilities to provide nutrition therapy to patient
s with a variety of health conditions, and provide dietary consultations to patients and their families. They confer with other health care professionals to review patients' medical charts
and develop individual plans to meet nutritional requirements. Some clinical dietitians will also create or deliver outpatient or public education programs in health and nutrition. Clinical dietitians may provide specialized services in areas of nourishment and diet
s, tube feedings (called enteral nutrition
), and intravenous feedings (called parenteral nutrition) such as total parenteral nutrition
(TPN) or peripheral parenteral nutrition (PPN). They work as a team with the physicians, physician assistants, physical therapists, occupational therapists, pharmacists, speech therapists, social workers, nurses, dietetic technicians, and other career
s to provide care to patients. Some clinical dietitians have dual responsibilities with patient nutrition therapy and in foodservice or research (described below).
dietitians work with wellness programs, public health
agencies, home care
agencies, and health maintenance organizations. These dietitians apply and distribute knowledge about food and nutrition to individuals and groups of specific categories, life-styles and geographic areas in order to promote health
. They often focus on the needs of the elderly, children, or other individuals with special needs or limited access to healthy food. Some community dietitians conduct home visits for patients who are too physically ill to attend consultations in health facilities in order to provide care and instruction on grocery shopping and food preparation.
dietitians or managers are responsible for large-scale food planning and service. They coordinate, assess and plan foodservice processes in health care
facilities, school
food service programs, prison
s, restaurant
s, and company cafeteria
s. These dietitians may perform audits of their departments to ensure quality control and food safety standards, and launch new menus and various programs within their institution to meet health and nutritional requirements. They train and supervise other food service workers such as kitchen staff, delivery staff, and dietary assistants or aides.
(the study of aging).
, clinics, hospitals and government agencies, in developing and implementing treatment plans for children with eating disorders, food allergies, or any condition where a child’s diet factors into the equation, such as childhood obesity
.
dietitians are involved with dietetics-related research conducted in hospitals, universities, government agencies, food and beverage companies, and the pharmaceutical industry. They may conduct research in clinical aspects of nutrition, for example, the effects of diet on cancer treatment. They may focus on social sciences
or health services research
, for example, investigate the impact of health policies or behaviour change, or evaluate program effectiveness. They may survey foodservice systems management in order to guide quality improvement. Some research dietitians study the biochemical aspects of nutrient interaction within the body. In universities, they also may have teaching responsibilities. Some clinical dietitians' roles involve research in addition to their patients care workload
.
dietitians oversee and direct all aspects of food policy and large-scale meal service operations in hospitals, government agencies, company cafeterias, prisons, and schools. They recruit, train and supervise employees of dietetics departments including dietitians and other personnel. They set department goals, policies and procedures; purchase food, equipment and supplies; maintain safety and sanitation standards in food preparation and storage; and keep records to monitor areas such as budget control and client information.
dietitians serve as resource people in food and nutrition through business, marketing and communications. Dietitians' expertise in nutrition is often solicited in the media
— for example providing expert guest opinion on television and radio news or cooking shows, columnist for a newspaper or magazine, or resource for restaurants on recipe development and critique. Business dietitians may author books or corporate newsletters on nutrition and wellness. They also work as sales representatives for food manufacturing companies that provide nutritional supplements and tube feeding supplies.
dietitian is a term sometimes used to describe dietitians who work under contract with health care facilities or in private practice
, such as used in Canada and the United States. The term 'consultant' in this case should not be confused with the identical title reserved for certain medical doctor
s in countries such as the United Kingdom
and Ireland
. Consultant dietitians contract
independently to provide nutrition services and educational programs to individuals and health care facilities as well as sports teams, fitness clubs, supermarkets, and other health and nutrition-related businesses.
, chemistry
, biochemistry
, biology
, and physiology
.
While the specific academic and professional requirements
to becoming a fully qualified dietitian differ across countries and jurisdictions, as these are adapted to the needs of the individual countries and the opportunities available, common academic routes include:
In addition, dietitians may be required to undergo an intern
ship to learn counseling skills and aspects of psychology
. The internship process differs across countries and jurisdictions.
Associations for dietetics professionals exist in many countries on every continent.
system or private health insurance, APD status is required. APDs are Dietitians engaged in the Continuing Professional Development program offered by the DAA and commit to uphold the DAA Code of Professional Conduct and Code of Ethics.
Dietitians who are not members of the DAA may participate in the DAA's Continuing Professional Development Program and in this way can still hold APD status. However, under new rules (which commenced 1 July 2009), health care providers must either have statutory registration or be members of their national professional association to obtain a provider number. This means all private health funds will require private practitioners applying for provider numbers to be DAA members (not just ‘eligible’ for membership).
, 'Dietitian' and 'Registered Dietitian' are protected professional titles. Each province has an independent professional college (for example, The College of Dietitians of Ontario) which is responsible for protecting the public and regulating the profession. The colleges are entirely funded from licensing fees collected from dietitians. Each college must have both public and professional members, and is empowered to investigate and censure (when malpractice/negligence is found) members of the profession who breach either their scope of practice
or harm/endanger the health of a patient/client, and receive a complaint against them from a member of the public or another health care professional. To practice as a registered dietitian within a province, a dietitian must register with the college and obtain a license. The activities of the college are governed by legislation passed by the provincial government. It is the presence of this regulatory body which distinguishes registered dietitians from nutritionist
s in Canada, the regulations for which vary by province.
The colleges also set the minimum entry requirements for admission into practice as a registered dietitian. Requirements to entry into practice
as a dietitian include a four year undergraduate degree from an accredited university (which includes courses in science, foods, nutrition, management, communication and psychology/sociology, among others), a 10-12 month supervised practice period (called an internship), and successfully passing a board exam in nutrition and dietetics.
The national professional association in Canada is the Dietitians of Canada
.
Against the backdrop of the HIV/AIDS epidemic in South Africa
, there remains high demand for greater numbers of practicing dietitians, along with other health care staff, in order to expand public sector health care services.
Academic programs, professional associations, and credentialing requirements do not exist for dietitians in most other African countries, where the number of professionals in dietetics is very low.
(HPC) in order to be able to work for the National Health Service
. The education requirements include obtaining either a BSc in dietetics or a postgraduate qualification approved by the HPC.
(ADA) which registers and confers professional credentials. The ADA also recognizes and certifies certain specialty areas, such as in Gerontological Nutrition.
Dietitians are registered with the Commission on Dietetic Registration (the certifying agency of the ADA) and are only able to use the label "Registered Dietitian" when they have met specific educational and professional prerequisites and passed a national registration examination. Besides academic education, dietitians must complete at least 1200 hours of practical, supervised experience through an accredited program before they can sit for the registration examination. In a coordinated program, students acquire internship hours concurrently with their coursework. In a didactic program, these hours are obtained through a dietetic internship that is completed after obtaining a degree. In both programs the student is required to complete several areas of competency including rotations in clinical, community, long-term care nutrition as well as food service, public health
and a variety of other worksites.
Once the degree is earned, the internship completed, and registration examination passed, the individual can now use the nationally recognized legal title, "Registered Dietitian", and is able to work in a variety of professional settings. To maintain the RD credential, professionals must participate in and earn continuing education units (often 75 hours every 5 years).
In addition, many states require specific licensure to work in most settings. For instance, the California Business and Professions Code Section 2585-2586.8, states that:
Any person representing himself or herself as a registered dietitian shall meet one of the following qualifications:
In addition: It is a misdemeanor for any person not meeting the criteria... in connection with his or her name or place of business, the words "dietetic technician, registered," "dietitian," "dietician," "registered dietitian," "registered dietician," or the letters "RD," "DTR," or any other words, letters, abbreviations, or insignia indicating or implying that the person is a dietitian, or dietetic technician, registered or registered dietitian, or to represent, in any way, orally, in writing, in print or by sign, directly or by implication, that he or she is a dietitian or a dietetic technician, registered or a registered dietitian.
As recent studies have shown the importance of diet in both disease prevention
and management, many US states have moved towards covering medical nutrition therapy under the Medicaid
/Medicare
social insurance programs, making dietetics a much more lucrative profession due to insurance reimbursement.
The ICDA supports national dietetics associations and their members, beyond national and regional boundaries, by providing:
s, nursing homes and schools. They assist in education and assessment of clients' dietary needs, and may specialize in nutritional care or foodservice management. Dietetic technicians usually work with, and under the supervision of, a registered dietitian.
The training requirements and professional regulation of dietetic technicians vary across countries, but usually include some formal (postsecondary) training in dietetics and nutrition care. In jurisdictions where the profession is regulated, such as in the United States, the title "Dietetic Technician, Registered" (DTR) may be used.
offers the only diploma program with a clinical focus for dietetic technicians.
(ADA) confers the "Dietetic Technician, Registered" (DTR) credentials. Qualified DTRs possess a specialized Associate Degree from community college
programs which are accredited by the ADA's Commission on Accreditation of Dietetics Education (CADE). They must complete a dietetic internship with a minimum of 450 supervised practice hours in the areas of Food Service Theory and Management, Community Dietetics, and Clinical Dietetics. They must also successfully pass a national registration examination administered by the Commission on Dietetic Registration (CDR) of the ADA. The DTR is an ADA-credentialed nutrition practitioner who works independently in many nutrition settings; however, when performing clinical dietetics, they must work under the supervision of a Registered Dietitian. Some states have legislation specifying the scope of practice
for the DTR in medical nutrition therapy settings.
Effective June 1, 2009, a new pathway to becoming a Registered Dietetic Technician has been made available by the Commission on Dietetic Registration. Students may take the DTR examination without attending an internship after completion of a Baccalaureate degree granted by a US regionally accredited college/university, or foreign equivalent, and completion of a CADE Didactic Program in Dietetics or Coordinated Program in Dietetics. Applicants must take and pass the CDR Dietetic Technician Registration Exam to qualify for the DTR credential.
As for Registered Dietitians, in many cases the title "Dietetic Technician" is regulated by individual states. For instance, according to the California Business and Professions Code Section 2585-2586.8:
Any person representing himself or herself as a dietetic technician, registered shall possess all of the following qualifications: Be 18 years of age or older. Satisfactory completion of appropriate academic requirements and receipt of an associate's degree
or higher from a college or university accredited by the Western Association of Schools and Colleges
or other regional accreditation agency. Satisfactory completion of the dietetic technician program requirements by an accredited public or private agency or institution recognized by the State Department of Health Services including not less than 450 hours of supervised practice. Satisfactory completion of an examination administered by a public or private agency or institution recognized by the State Department of Health Services to administer the examination. Satisfactory completion of continuing education requirements established by a public or private agency or institution recognized by the State Department of Health Services to establish the requirements.
Dietary aides in some countries might also carry out a simple initial health screening for newly admitted patients in medical facilities, and inform the dietitian if any screened patients requires a dietitian's expertise for further assessments or intervention
s.
s, such as hospitals, nursing homes, school and college cafeterias, restaurants, correction facilities and catering
services. They assure their department is compliant with food safety
regulations, and that the food served meets dietary requirements established by a dietitian.
Training requirements vary across jurisdictions and employment settings. Dietary management is not usually subject to professional regulation, although voluntary certification is preferred by many employers.
Foodservice
Food Service or catering industry defines those businesses, institutions, and companies responsible for any meal prepared outside the home...
, develop modified diet
Diet (nutrition)
In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...
s, participate in research
Research
Research can be defined as the scientific search for knowledge, or as any systematic investigation, to establish novel facts, solve new or existing problems, prove new ideas, or develop new theories, usually using a scientific method...
, and educate individuals and groups on good nutritional habits. The goals of dietitians are to provide medical nutritional intervention, and to obtain, safely prepare
Food safety
Food safety is a scientific discipline describing handling, preparation, and storage of food in ways that prevent foodborne illness. This includes a number of routines that should be followed to avoid potentially severe health hazards....
, serve and advise on flavorsome, attractive, and nutritious food for patients, groups and communities. Dietary modification to address medical issues involving dietary intake is a major part of dietetics (the study of nutrition as it relates to health). For example, working in consultation with physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s and other health care providers, a dietitian may provide specific artificial nutritional needs to patients unable to consume food normally. Professional dietitians may also provide specialist services such as in diabetes
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
, obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
, oncology
Oncology
Oncology is a branch of medicine that deals with cancer...
, osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
, pediatrics, renal disease, and micronutrient
Micronutrient
Micronutrients are nutrients required by humans and other living things throughout life in small quantities to orchestrate a whole range of physiological functions, but which the organism itself cannot produce. For people, they include dietary trace minerals in amounts generally less than 100...
research.
Different professional terms are used in different countries and employment settings, for example, clinical dietitian, community dietitian, dietetic educator, foodservice dietitian, registered dietitian, public health dietitian, therapeutic dietitian, or research dietitian. In many countries, only people who have specified educational credentials and other professional requirements
Healthcare provider requisites
Healthcare provider requisites refer to the regulations used by countries to control the quality of individual healthcare workers practicing in their jurisdictions and to control the size of the health labour market...
can call themselves "dietitians" — the title is legally protected. The term "nutritionist
Nutritionist
A nutritionist is a person who advises on matters of food and nutrition impacts on health. Different professional terms are used in different countries, employment settings and contexts — some examples include: nutrition scientist, public health nutritionist, dietitian-nutritionist, clinical...
" is also widely used; however, the terms "dietitian" and "nutritionist" should not be considered interchangeable — the training, regulation and scope of practice
Scope of Practice
Scope of Practice is a terminology used by national and state/provincial licensing boards for various professions that defines the procedures, actions, and processes that are permitted for the licensed individual. The scope of practice is limited to that which the law allows for specific education...
of the two professional titles can be very different across individuals and jurisdictions.
In many countries, the majority of dietitians are clinical or therapeutic dietitians, such as the case of the United States, the United Kingdom, and much of Africa. In other countries they are mostly foodservice dietitians, such as in Japan and many European countries.
Clinical dietitians
Clinical dietitians work in hospitalHospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
s, nursing care facilities
Nursing home
A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...
and other health care facilities to provide nutrition therapy to patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
s with a variety of health conditions, and provide dietary consultations to patients and their families. They confer with other health care professionals to review patients' medical charts
Medical record
The terms medical record, health record, and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction....
and develop individual plans to meet nutritional requirements. Some clinical dietitians will also create or deliver outpatient or public education programs in health and nutrition. Clinical dietitians may provide specialized services in areas of nourishment and diet
Diet
Diet, in relation to food, might mean:*Diet , the sum of the food consumed by an organism or group*Dieting, the deliberate selection of food to control body weight or nutrient intake*Diet food, foods that aid in dieting...
s, tube feedings (called enteral nutrition
Nasogastric intubation
Nasogastric intubation is a medical process involving the insertion of a plastic tube through the nose, past the throat, and down into the stomach.-Uses:...
), and intravenous feedings (called parenteral nutrition) such as total parenteral nutrition
Total parenteral nutrition
Parenteral nutrition is feeding a person intravenously, bypassing the usual process of eating and digestion. The person receives nutritional formulae that contain nutrients such as glucose, amino acids, lipids and added vitamins and dietary minerals...
(TPN) or peripheral parenteral nutrition (PPN). They work as a team with the physicians, physician assistants, physical therapists, occupational therapists, pharmacists, speech therapists, social workers, nurses, dietetic technicians, and other career
Career
Career is defined by the Oxford English Dictionary as a person's "course or progress through life ". It is usually considered to pertain to remunerative work ....
s to provide care to patients. Some clinical dietitians have dual responsibilities with patient nutrition therapy and in foodservice or research (described below).
Community dietitians
CommunityCommunity
The term community has two distinct meanings:*a group of interacting people, possibly living in close proximity, and often refers to a group that shares some common values, and is attributed with social cohesion within a shared geographical location, generally in social units larger than a household...
dietitians work with wellness programs, public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
agencies, home care
Home care
Home Care, , is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as...
agencies, and health maintenance organizations. These dietitians apply and distribute knowledge about food and nutrition to individuals and groups of specific categories, life-styles and geographic areas in order to promote health
Health promotion
Health promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"...
. They often focus on the needs of the elderly, children, or other individuals with special needs or limited access to healthy food. Some community dietitians conduct home visits for patients who are too physically ill to attend consultations in health facilities in order to provide care and instruction on grocery shopping and food preparation.
Foodservice dietitians
FoodserviceFoodservice
Food Service or catering industry defines those businesses, institutions, and companies responsible for any meal prepared outside the home...
dietitians or managers are responsible for large-scale food planning and service. They coordinate, assess and plan foodservice processes in health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
facilities, school
School
A school is an institution designed for the teaching of students under the direction of teachers. Most countries have systems of formal education, which is commonly compulsory. In these systems, students progress through a series of schools...
food service programs, prison
Prison
A prison is a place in which people are physically confined and, usually, deprived of a range of personal freedoms. Imprisonment or incarceration is a legal penalty that may be imposed by the state for the commission of a crime...
s, restaurant
Restaurant
A restaurant is an establishment which prepares and serves food and drink to customers in return for money. Meals are generally served and eaten on premises, but many restaurants also offer take-out and food delivery services...
s, and company cafeteria
Cafeteria
A cafeteria is a type of food service location in which there is little or no waiting staff table service, whether a restaurant or within an institution such as a large office building or school; a school dining location is also referred to as a dining hall or canteen...
s. These dietitians may perform audits of their departments to ensure quality control and food safety standards, and launch new menus and various programs within their institution to meet health and nutritional requirements. They train and supervise other food service workers such as kitchen staff, delivery staff, and dietary assistants or aides.
Gerontological dietitians
Gerontological dietitians are specialist in nutrition and aging. They work in nursing homes, community-based aged care agencies, government agencies in aging policy, and in higher education in the field of gerontologyGerontology
Gerontology is the study of the social, psychological and biological aspects of aging...
(the study of aging).
Pediatric dietitians
Pediatric dietitians provide nutrition and health advice for infants, children, and adolescents. They focus on early nutritional needs, and often work closely with doctors, school health servicesSchool health services
School health services are services from medical, teaching and other professionals applied in or out of school to improve the health and well-being of children and in some cases whole families...
, clinics, hospitals and government agencies, in developing and implementing treatment plans for children with eating disorders, food allergies, or any condition where a child’s diet factors into the equation, such as childhood obesity
Childhood obesity
Childhood obesity is a condition where excess body fat negatively affects a child's health or wellbeing. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of obesity in children and its many adverse health effects...
.
Research dietitians
ResearchResearch
Research can be defined as the scientific search for knowledge, or as any systematic investigation, to establish novel facts, solve new or existing problems, prove new ideas, or develop new theories, usually using a scientific method...
dietitians are involved with dietetics-related research conducted in hospitals, universities, government agencies, food and beverage companies, and the pharmaceutical industry. They may conduct research in clinical aspects of nutrition, for example, the effects of diet on cancer treatment. They may focus on social sciences
Social sciences
Social science is the field of study concerned with society. "Social science" is commonly used as an umbrella term to refer to a plurality of fields outside of the natural sciences usually exclusive of the administrative or managerial sciences...
or health services research
Health services research
Health services research is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care...
, for example, investigate the impact of health policies or behaviour change, or evaluate program effectiveness. They may survey foodservice systems management in order to guide quality improvement. Some research dietitians study the biochemical aspects of nutrient interaction within the body. In universities, they also may have teaching responsibilities. Some clinical dietitians' roles involve research in addition to their patients care workload
Workload
-An amount of labor:While a precise definition of a workload is elusive, a commonly accepted definition is the hypothetical relationship between a group or individual human operator and task demands....
.
Administrative dietitians
Administrative or managementManagement
Management in all business and organizational activities is the act of getting people together to accomplish desired goals and objectives using available resources efficiently and effectively...
dietitians oversee and direct all aspects of food policy and large-scale meal service operations in hospitals, government agencies, company cafeterias, prisons, and schools. They recruit, train and supervise employees of dietetics departments including dietitians and other personnel. They set department goals, policies and procedures; purchase food, equipment and supplies; maintain safety and sanitation standards in food preparation and storage; and keep records to monitor areas such as budget control and client information.
Business dietitians
BusinessBusiness
A business is an organization engaged in the trade of goods, services, or both to consumers. Businesses are predominant in capitalist economies, where most of them are privately owned and administered to earn profit to increase the wealth of their owners. Businesses may also be not-for-profit...
dietitians serve as resource people in food and nutrition through business, marketing and communications. Dietitians' expertise in nutrition is often solicited in the media
Mass media
Mass media refers collectively to all media technologies which are intended to reach a large audience via mass communication. Broadcast media transmit their information electronically and comprise of television, film and radio, movies, CDs, DVDs and some other gadgets like cameras or video consoles...
— for example providing expert guest opinion on television and radio news or cooking shows, columnist for a newspaper or magazine, or resource for restaurants on recipe development and critique. Business dietitians may author books or corporate newsletters on nutrition and wellness. They also work as sales representatives for food manufacturing companies that provide nutritional supplements and tube feeding supplies.
Consultant dietitians
ConsultantConsultant
A consultant is a professional who provides professional or expert advice in a particular area such as management, accountancy, the environment, entertainment, technology, law , human resources, marketing, emergency management, food production, medicine, finance, life management, economics, public...
dietitian is a term sometimes used to describe dietitians who work under contract with health care facilities or in private practice
Private practice
Private practice may refer to:*Practice of law*Medical practice*Private Practice , released in 1978 by Dr. Feelgood*Private Practice , a U.S.-produced medical drama...
, such as used in Canada and the United States. The term 'consultant' in this case should not be confused with the identical title reserved for certain medical doctor
Consultant (medicine)
In the United Kingdom, Republic of Ireland, and parts of the Commonwealth, consultant is the title of a senior doctor who has completed all of his or her specialist training and been placed on the specialist register in their chosen specialty...
s in countries such as the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and Ireland
Ireland
Ireland is an island to the northwest of continental Europe. It is the third-largest island in Europe and the twentieth-largest island on Earth...
. Consultant dietitians contract
Contract
A contract is an agreement entered into by two parties or more with the intention of creating a legal obligation, which may have elements in writing. Contracts can be made orally. The remedy for breach of contract can be "damages" or compensation of money. In equity, the remedy can be specific...
independently to provide nutrition services and educational programs to individuals and health care facilities as well as sports teams, fitness clubs, supermarkets, and other health and nutrition-related businesses.
Required qualifications and professional associations
In most countries, competent performance as a dietitian requires formal training at a higher educational institution in food and nutritional science, nutrition education, dietetics, or a related field. Their education in health science involves scientific based knowledge in anatomyAnatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
, chemistry
Chemistry
Chemistry is the science of matter, especially its chemical reactions, but also its composition, structure and properties. Chemistry is concerned with atoms and their interactions with other atoms, and particularly with the properties of chemical bonds....
, biochemistry
Biochemistry
Biochemistry, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...
, biology
Biology
Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy. Biology is a vast subject containing many subdivisions, topics, and disciplines...
, and physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
.
While the specific academic and professional requirements
Healthcare provider requisites
Healthcare provider requisites refer to the regulations used by countries to control the quality of individual healthcare workers practicing in their jurisdictions and to control the size of the health labour market...
to becoming a fully qualified dietitian differ across countries and jurisdictions, as these are adapted to the needs of the individual countries and the opportunities available, common academic routes include:
- A bachelor degree in Dietetics which typically requires four years of postsecondary studies; or
- A bachelor of science degree and a postgraduate diplomaDiplomaA diploma is a certificate or deed issued by an educational institution, such as a university, that testifies that the recipient has successfully completed a particular course of study or confers an academic degree. In countries such as the United Kingdom and Australia, the word diploma refers to...
or master's degreeMaster's degreeA master's is an academic degree granted to individuals who have undergone study demonstrating a mastery or high-order overview of a specific field of study or area of professional practice...
in Dietetics.
In addition, dietitians may be required to undergo an intern
Intern
Internship is a system of onthejob training for white-collar jobs, similar to an apprenticeship. Interns are usually college or university students, but they can also be high school students or post graduate adults seeking skills for a new career. They may also be as young as middle school or in...
ship to learn counseling skills and aspects of psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
. The internship process differs across countries and jurisdictions.
Associations for dietetics professionals exist in many countries on every continent.
Australia
Accredited Practising Dietitians (APDs) in Australia gain their qualifications through university courses accredited by the Dietitians Association of Australia (DAA). In order for patients to receive a rebate from the national MedicareMedicare (Australia)
Medicare is Australia's publicly funded universal health care system, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all resident citizens and permanent residents except for those on Norfolk Island...
system or private health insurance, APD status is required. APDs are Dietitians engaged in the Continuing Professional Development program offered by the DAA and commit to uphold the DAA Code of Professional Conduct and Code of Ethics.
Dietitians who are not members of the DAA may participate in the DAA's Continuing Professional Development Program and in this way can still hold APD status. However, under new rules (which commenced 1 July 2009), health care providers must either have statutory registration or be members of their national professional association to obtain a provider number. This means all private health funds will require private practitioners applying for provider numbers to be DAA members (not just ‘eligible’ for membership).
Canada
In CanadaCanada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
, 'Dietitian' and 'Registered Dietitian' are protected professional titles. Each province has an independent professional college (for example, The College of Dietitians of Ontario) which is responsible for protecting the public and regulating the profession. The colleges are entirely funded from licensing fees collected from dietitians. Each college must have both public and professional members, and is empowered to investigate and censure (when malpractice/negligence is found) members of the profession who breach either their scope of practice
Scope of Practice
Scope of Practice is a terminology used by national and state/provincial licensing boards for various professions that defines the procedures, actions, and processes that are permitted for the licensed individual. The scope of practice is limited to that which the law allows for specific education...
or harm/endanger the health of a patient/client, and receive a complaint against them from a member of the public or another health care professional. To practice as a registered dietitian within a province, a dietitian must register with the college and obtain a license. The activities of the college are governed by legislation passed by the provincial government. It is the presence of this regulatory body which distinguishes registered dietitians from nutritionist
Nutritionist
A nutritionist is a person who advises on matters of food and nutrition impacts on health. Different professional terms are used in different countries, employment settings and contexts — some examples include: nutrition scientist, public health nutritionist, dietitian-nutritionist, clinical...
s in Canada, the regulations for which vary by province.
The colleges also set the minimum entry requirements for admission into practice as a registered dietitian. Requirements to entry into practice
Healthcare provider requisites
Healthcare provider requisites refer to the regulations used by countries to control the quality of individual healthcare workers practicing in their jurisdictions and to control the size of the health labour market...
as a dietitian include a four year undergraduate degree from an accredited university (which includes courses in science, foods, nutrition, management, communication and psychology/sociology, among others), a 10-12 month supervised practice period (called an internship), and successfully passing a board exam in nutrition and dietetics.
The national professional association in Canada is the Dietitians of Canada
Dietitians of Canada
Dietitians of Canada is the professional organization and "nation-wide voice of dietitians in Canada". They claim to be the most trusted source of information on food and nutrition for Canadians. DC brings brings the knowledge and skills of its members together to informdecisions that affect...
.
South Africa
In South Africa, dietitians must be registered with the Health Professions Council of South Africa. The council regulates the following professional titles: Dietitians, Supplementary Dietitians, and Student Dietitians, as well as Nutritionists, Supplementary Nutritionists, and Student nutritionists. Requirements for eligibility for registration include a recognised Bachelors degree in dietetics or nutrition from an accredited educational institution. The undergraduate training should include the three practice areas of therapeutic nutrition, community nutrition, and food service management.Against the backdrop of the HIV/AIDS epidemic in South Africa
HIV/AIDS in South Africa
HIV/AIDS in South Africa is a prominent health concern because South Africa is believed to have more people with HIV/AIDS than any other country....
, there remains high demand for greater numbers of practicing dietitians, along with other health care staff, in order to expand public sector health care services.
Academic programs, professional associations, and credentialing requirements do not exist for dietitians in most other African countries, where the number of professionals in dietetics is very low.
United Kingdom
In the United Kingdom, dietitians must be registered with the Health Professions CouncilHealth Professions Council
The Health Professions Council is a statutory regulator of 210,000 health professionals from 15 professions in the United Kingdom. It was set up in 2003 under the National Health Service Reform and Health Care Professions Act 2002, to replace the Council for Professions Supplementary to Medicine ....
(HPC) in order to be able to work for the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
. The education requirements include obtaining either a BSc in dietetics or a postgraduate qualification approved by the HPC.
United States
In the United States, nutrition professionals include the dietitian or registered dietitian (RD), as well as "dietetic technician" or "dietetic technician, registered" (DTR) (see below). These terms are legally protected, regulated by the American Dietetic AssociationAmerican Dietetic Association
The American Dietetic Association is the United States' largest organization of food and nutrition professionals, with nearly 72,000 members. The American Dietetic Association is officially changing its name to the Academy of Nutrition and Dietetics. The announcement was made Saturday, September...
(ADA) which registers and confers professional credentials. The ADA also recognizes and certifies certain specialty areas, such as in Gerontological Nutrition.
Dietitians are registered with the Commission on Dietetic Registration (the certifying agency of the ADA) and are only able to use the label "Registered Dietitian" when they have met specific educational and professional prerequisites and passed a national registration examination. Besides academic education, dietitians must complete at least 1200 hours of practical, supervised experience through an accredited program before they can sit for the registration examination. In a coordinated program, students acquire internship hours concurrently with their coursework. In a didactic program, these hours are obtained through a dietetic internship that is completed after obtaining a degree. In both programs the student is required to complete several areas of competency including rotations in clinical, community, long-term care nutrition as well as food service, public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
and a variety of other worksites.
Once the degree is earned, the internship completed, and registration examination passed, the individual can now use the nationally recognized legal title, "Registered Dietitian", and is able to work in a variety of professional settings. To maintain the RD credential, professionals must participate in and earn continuing education units (often 75 hours every 5 years).
In addition, many states require specific licensure to work in most settings. For instance, the California Business and Professions Code Section 2585-2586.8, states that:
Any person representing himself or herself as a registered dietitian shall meet one of the following qualifications:
- Been granted, prior to January 1, 1981, the right to use the term "registered dietitian" by a public or private agency or institution recognized by the State Department of Health Services as qualified to grant the title, provided that person continues to meet all requirements and qualifications periodically prescribed by the agency or institution for the maintenance of that title.
- Possess all of the following qualifications:
-
- (A) Be 18 years of age or older.
- (B) Satisfactory completion of appropriate academic requirements for the field of dietetics and related disciplines and receipt of a baccalaureate or higher degree from a college or university accredited by the Western Association of Schools and CollegesWestern Association of Schools and CollegesThe Western Association of Schools and Colleges is one of six official academic bodies responsible for the accreditation of public and private universities, colleges, secondary and elementary schools in the United States and foreign institutions of American origin. The Western Association of...
or other regional accreditation agency. - (C) Satisfactory completion of a program of supervised practice for a minimum of 900 hours that is designed to prepare entry level practitioners through instruction and assignments in a clinical setting. Supervisors of the program shall meet minimum qualifications established by public or private agencies or institutions recognized by the State Department of Health Services to establish those qualifications.
- (D) Satisfactory completion of an examination administered by a public or private agency or institution recognized by the State Department of Health Services as qualified to administer the examinations.
- (E) Satisfactory completion of continuing education requirements established by a public or private agency or institution recognized by the State Department of Health Services to establish the requirements.
In addition: It is a misdemeanor for any person not meeting the criteria... in connection with his or her name or place of business, the words "dietetic technician, registered," "dietitian," "dietician," "registered dietitian," "registered dietician," or the letters "RD," "DTR," or any other words, letters, abbreviations, or insignia indicating or implying that the person is a dietitian, or dietetic technician, registered or registered dietitian, or to represent, in any way, orally, in writing, in print or by sign, directly or by implication, that he or she is a dietitian or a dietetic technician, registered or a registered dietitian.
As recent studies have shown the importance of diet in both disease prevention
Preventive medicine
Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...
and management, many US states have moved towards covering medical nutrition therapy under the Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
/Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
social insurance programs, making dietetics a much more lucrative profession due to insurance reimbursement.
International Confederation of Dietetic Associations (ICDA)
The International Confederation of Dietetic Associations (ICDA) is a membership organization of over 40 national associations of Dietitians and Nutritionists. Dietetics associations are professional societies whose members have education qualifications in food, nutrition and dietetics recognized by a national authority.The ICDA supports national dietetics associations and their members, beyond national and regional boundaries, by providing:
- An integrated communications system
- An enhanced image for the profession
- Increased awareness of standards of education, training and practice in dietetics.
Other nutrition personnel
These titles are general designations of nutrition personnel; specific titles may vary across countries, jurisdictions and employment settings.Dietetic technicians
Dietetic technicians are involved in planning, implementing and monitoring nutritional programs and services in facilities such as hospitalHospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
s, nursing homes and schools. They assist in education and assessment of clients' dietary needs, and may specialize in nutritional care or foodservice management. Dietetic technicians usually work with, and under the supervision of, a registered dietitian.
The training requirements and professional regulation of dietetic technicians vary across countries, but usually include some formal (postsecondary) training in dietetics and nutrition care. In jurisdictions where the profession is regulated, such as in the United States, the title "Dietetic Technician, Registered" (DTR) may be used.
Canada
In Canada, there are no national standards for academic training and qualifications for dietetic technicians, although many employers require a diploma in human nutrition or foodservices management. In Ontario, Conestoga CollegeConestoga College
The Conestoga College Institute of Technology and Advanced Learning is a public college based in Kitchener, Ontario in Canada.-History:The College was founded in 1967 as the Conestoga College of Applied Arts and Technology, one of many such institutions established in that time by the Ontario...
offers the only diploma program with a clinical focus for dietetic technicians.
United States
In the United States, the American Dietetic AssociationAmerican Dietetic Association
The American Dietetic Association is the United States' largest organization of food and nutrition professionals, with nearly 72,000 members. The American Dietetic Association is officially changing its name to the Academy of Nutrition and Dietetics. The announcement was made Saturday, September...
(ADA) confers the "Dietetic Technician, Registered" (DTR) credentials. Qualified DTRs possess a specialized Associate Degree from community college
Community college
A community college is a type of educational institution. The term can have different meanings in different countries.-Australia:Community colleges carry on the tradition of adult education, which was established in Australia around mid 19th century when evening classes were held to help adults...
programs which are accredited by the ADA's Commission on Accreditation of Dietetics Education (CADE). They must complete a dietetic internship with a minimum of 450 supervised practice hours in the areas of Food Service Theory and Management, Community Dietetics, and Clinical Dietetics. They must also successfully pass a national registration examination administered by the Commission on Dietetic Registration (CDR) of the ADA. The DTR is an ADA-credentialed nutrition practitioner who works independently in many nutrition settings; however, when performing clinical dietetics, they must work under the supervision of a Registered Dietitian. Some states have legislation specifying the scope of practice
Scope of Practice
Scope of Practice is a terminology used by national and state/provincial licensing boards for various professions that defines the procedures, actions, and processes that are permitted for the licensed individual. The scope of practice is limited to that which the law allows for specific education...
for the DTR in medical nutrition therapy settings.
Effective June 1, 2009, a new pathway to becoming a Registered Dietetic Technician has been made available by the Commission on Dietetic Registration. Students may take the DTR examination without attending an internship after completion of a Baccalaureate degree granted by a US regionally accredited college/university, or foreign equivalent, and completion of a CADE Didactic Program in Dietetics or Coordinated Program in Dietetics. Applicants must take and pass the CDR Dietetic Technician Registration Exam to qualify for the DTR credential.
As for Registered Dietitians, in many cases the title "Dietetic Technician" is regulated by individual states. For instance, according to the California Business and Professions Code Section 2585-2586.8:
Any person representing himself or herself as a dietetic technician, registered shall possess all of the following qualifications: Be 18 years of age or older. Satisfactory completion of appropriate academic requirements and receipt of an associate's degree
Associate's degree
An associate degree is an undergraduate academic degree awarded by community colleges, junior colleges, technical colleges, and bachelor's degree-granting colleges and universities upon completion of a course of study usually lasting two years...
or higher from a college or university accredited by the Western Association of Schools and Colleges
Western Association of Schools and Colleges
The Western Association of Schools and Colleges is one of six official academic bodies responsible for the accreditation of public and private universities, colleges, secondary and elementary schools in the United States and foreign institutions of American origin. The Western Association of...
or other regional accreditation agency. Satisfactory completion of the dietetic technician program requirements by an accredited public or private agency or institution recognized by the State Department of Health Services including not less than 450 hours of supervised practice. Satisfactory completion of an examination administered by a public or private agency or institution recognized by the State Department of Health Services to administer the examination. Satisfactory completion of continuing education requirements established by a public or private agency or institution recognized by the State Department of Health Services to establish the requirements.
Dietary assistants
Dietary assistants, also known as “nutrition assistants” or “dietary aides”, assist dietitians and other nutrition professionals to maintain nutritional care for patients and groups with special dietary needs. They assist in preparing food in hospitals, childcare centres, and aged care facilities.Dietary aides in some countries might also carry out a simple initial health screening for newly admitted patients in medical facilities, and inform the dietitian if any screened patients requires a dietitian's expertise for further assessments or intervention
Health intervention
A health intervention is an effort to promote good health behaviour such as physical exercise or to prevent bad health behaviours, e.g. promoting tobacco smoking cessation or discouraging the use of illicit drugs or excessive drinking....
s.
Dietary clerks
Dietary clerks, also sometimes known as “medical diet clerks” or “dietary workers”, prepare dietary information for use by kitchen personnel in preparation of foods for hospital patients following standards established by a dietitian. They examine diet orders, prepare meal trays, maintain the storage area for food supplies, and ensure practice of sanitary procedures. They may operate computers to enter and retrieve data on patients' caloric requirements and intake, or to track financial information. Dietary workers are typically trained on the job.Dietary managers
Dietary managers supervise the production and distribution of meals, as well as the budgeting and purchasing of food and the hiring, training and scheduling of support staff in various types of workplaces offering larger scale foodserviceFoodservice
Food Service or catering industry defines those businesses, institutions, and companies responsible for any meal prepared outside the home...
s, such as hospitals, nursing homes, school and college cafeterias, restaurants, correction facilities and catering
Catering
Catering is the business of providing foodservice at a remote site or a site such as a hotel, public house , or other location.-Mobile catering:A mobile caterer serves food directly from a vehicle or cart that is designed for the purpose...
services. They assure their department is compliant with food safety
Food safety
Food safety is a scientific discipline describing handling, preparation, and storage of food in ways that prevent foodborne illness. This includes a number of routines that should be followed to avoid potentially severe health hazards....
regulations, and that the food served meets dietary requirements established by a dietitian.
Training requirements vary across jurisdictions and employment settings. Dietary management is not usually subject to professional regulation, although voluntary certification is preferred by many employers.
- In Canada, dietary managers with recognized training in areas such as diet therapy, menu planning, food safety and food production may become members of the Canadian Society of Nutrition Management (CSNM).
- In the United States, “Certified Dietary Managers” are certified by the credentialing agency known as the "Dietary Managers Association" (DMA). This agency also certifies a professional known as a “Certified Food Protection Professional”. The DMA certifies specific programs to meet its educational requirements, including courses in culinary management, clinical nutrition, and food safety. In addition, there are supervised practice requirements and a certification exam that must be passed.
Dietary hosts
Dietary hosts/hostesses, also known as “food service aides”, assist in patient tray services in hospitals and other health care settings, usually under the supervision of the dietary manager. They distribute menus, and prepare, deliver and bring back meal trays. Usually no specific training is required for workers in this category.See also
- Health care providerHealth care providerA health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
s - Allied health professionsAllied health professionsAllied health professions are clinical health care professions distinct from dentistry, nursing and medicine. One estimate reported allied health professionals make up 60 percent of the total health workforce...
- NutritionistNutritionistA nutritionist is a person who advises on matters of food and nutrition impacts on health. Different professional terms are used in different countries, employment settings and contexts — some examples include: nutrition scientist, public health nutritionist, dietitian-nutritionist, clinical...
- NutritionNutritionNutrition is the provision, to cells and organisms, of the materials necessary to support life. Many common health problems can be prevented or alleviated with a healthy diet....
- Food scienceFood scienceFood science is a study concerned with all technical aspects of foods, beginning with harvesting or slaughtering, and ending with its cooking and consumption, an ideology commonly referred to as "from field to fork"...