To Your Health

What's the difference between a dietitian and a nutritionist?

Q. What's the difference between a dietitian and a nutritionist? How do I decide which one to consult for a specific problem, and how do I find a good one?

A. Both dietitians and nutritionists are health care specialists who advise people on the relationship between food and health. The titles "dietitian" or "nutritionist" alone may not give you enough information to make your decision because, although there are some generally recognized differences, there are many similarities in the two professions. To make your best choice, you will want to know the professional philosophy of the practitioner you consult. Generally, if you want advice about food choices, you would consult a dietitian, and if you want advice about the use of food supplements, you could consult a nutritionist, after carefully examining his or her credentials.

Historically, dietitians concentrated on food choices and meal planning while nutritionists emphasized the use of food supplements to optimize intake of the 50 or more known nutrients. Today, this distinction is blurred. Clinical nutritionists are increasingly aware that some nutrients are best supplied by food rather than food supplements, and dietitians are likewise increasingly coming to the conclusion that food supplements are necessary, given the ever-worsening dietary habits of the American population. For example, a practice group within the American Dietetic Association, known as Nutrition in Complementary Care, specializes in advice about dietary supplements.

Registered Dieticians have "RD" after their names and have met certain professional requirements. This is a national registration. Some states also license dietitians, so you may see credentials such as "RD, LD." Generally, for the LD credential, there are additional requirements beyond the RD.

Many people with the RD after their names also use the term "nutritionist." There are no qualifications required for a person to call him or herself a nutritionist, as there is for the RD. There are, however, several titles using the word nutritionist that require some level of training and expertise plus a passing grade on a challenging exam. The three most selective are:

• Certified Clinical Nutritionist, requiring a B.S. degree in science and post-graduate training in clinical nutrition. CCNs usually have a private practice of individualized nutrition counseling.

• Certified Nutrition Specialist, requiring a post-graduate degree in nutrition. CNSs are usually found in the academic arena.

• Diplomate American Chiropractic Board of Nutrition, requiring a DC degree with additional training. DACBNs typically incorporate nutrition into their chiropractic practice.

In addition to these, there are literally hundreds of organizations that offer a nutritionist credential of some sort, sometimes only requiring payment of a nominal fee for a diploma. There is immense variation in the skills of these practitioners. If you can't find a friend who knows personally a good nutritionist or dietitian, check for membership in one of the four organizations mentioned above.

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