Reiko in the greenhouse with daughter Lucille in 2013

The other day I had a good chuckle when my 6 year old daughter showed me a “book” she had created while I was busy working. She proudly read what she had written about me, “My mom is a dietitianer nutritioner and she helps people with their food issues.” What she had actually written was this: “My mom is a diutrish unr noothishur …” which looked even sillier to me than it sounded. Even though it was cute and funny hearing this new take on my job title, it was a good reminder that there is a lot of confusion about nutrition professionals. And let’s face it,“registered dietitian nutritionist” is a mouthful even for people who have made it beyond a kindergarten education! So let’s dive in a little and try to make some sense of it all.

What’s in a Name?

In the United States, many healthcare practitioners are regulated at the state level. This means that the scope of practice and regulations are determined individually by each state. This inconsistency leads to a lot of confusion, particularly when it comes to nutrition. It turns out that the terms “dietitian” and “nutritionist” are not the same, even though we often use them interchangeably.

In some states — such as Arizona, California, Michigan and New Jersey (as of 2016) — there is no regulation on nutrition practice so just about anybody can call themselves a “nutritionist” regardless of education or experience. At the same time, other states such as North Carolina and Ohio have very strict regulations and have shut down businesses operating in their state who do not meet their criteria. Many states fall somewhere in between, with most having some regulations in place but not much enforcement going on to ensure that businesses are complying with them.

The end result is that, unfortunately, the title of “nutritionist” or anything similar does not have a consistent meaning in the United States. This is not to say that there aren’t many highly qualified and talented nutrition practitioners out there who call themselves a nutritionist, but you won’t be able to tell by just looking at their title.

So What Is a Dietitian (AKA “Dietitianer”)?

While the term “nutritionist” isn’t consistent in the U.S., the term “dietitian” is a protected title. The Academy of Nutrition and Dietetics and most states assert that only people who meet the criteria to be a registered dietitian can use the word “dietitian” in their title. What this means is that anybody using the title “Dietitian”, “Registered Dietitian”, “Registered Dietitian Nutritionist” or even the alternative spelling of “Dietician” must have obtained at least a four year degree granted by a U.S. regionally accredited college/university, completed a 1,200 hour internship which includes supervised patient interaction and passed a national registration exam. Additionally, in order to maintain their license, dietitians must adhere to professional and ethical standards and complete extra education on an ongoing basis to remain current in their field. Because this title includes a minimum standard of professional education and experience, dietitians are considered healthcare practitioners and their services can be covered by insurance. 

The great thing about working with a dietitian is that you know they are qualified to provide evidence-based advice and can help you sort through all the misinformation that is so pervasive nowadays. If you do decide to work with another type of nutrition professional, make sure to check their education and background so you know what you’re getting.

One Final Note

In addition to confusion about titles, there is a nagging misperception about the difference between “nutritionists” and “dietitians” regarding focus on integrative and functional medicine. All healthcare practitioners who want to take a more integrative and holistic approach with their patients can train for this in a variety of ways. Some of the accredited universities for registered dietitians (such as Bastyr University, my alma mater) incorporate integrative and functional medicine into their curriculum, but there are other training options available regardless of educational background for those wanting skills in this area. The point is that if you are looking for this type of approach, you have to seek it out specifically because it is not unique to any one type of practitioner. If you have a preference for working with a more holistic practitioner, don’t rely on their title to find out their training, look for specific education or emphasis on solving problems at the root level and addressing the whole person in their marketing language.

I hope this brings a little bit of clarity to the difference between “dietitianers” and “nutritioners”, but please feel free to contact me directly if you’d like to learn more!