Dietitian

A dietitian (sometimes spelled dietician) is an expert in food and nutrition. Dietitians help promote good health through proper eating. They also supervise the preparation and service of food, develop modified diets, participate in research, and educate individuals and groups on good nutritional habits. The goals of the dietary department are to obtain, prepare, and serve flavorsome, attractive, and nutritious food to patients, family members, and health care providers.

In the US nutrition professionals include the registered dietitian (RD) and the dietetic technician, registered (DTR). Some RDs or DTRs call themselves nutritionists. However, some people who may call themselves a nutritionist are not registered dietitians. Dietetic technicians are not the same as dietitians in terms of responsibilities and qualifications. Different professional terms are used in other countries.

These designations apply principally to the US although the generic classifications are likely to be applicable elsewhere.

Types of dietitian

The majority of dietitians are clinical, or therapeutic, dietitians. Clinical dietitians review medical charts and talk with patients' families. They work with other health care professionals and community groups to provide nourishment, nutritional programs, and instructional presentations to benefit people of all ages, and with a variety of health conditions. This is accomplished by developing individual plans to meet nutritional needs. These plans include nourishment, tube feedings (called enteral nutrition), intravenous feedings (called parenteral nutrition) such as total parenteral nutrition (TPN), diets, and education. Clinical dietitians provide individual and group educational programs for patients and family members about their nutrition and health.

Clinical dietitians

Clinical dietitians work in hospitals to provide medical nutrition therapy to patients according to the disease processes, provides individual inpatient and outpatient dietary consultations to patients and their family members and also conduct group educations for other health workers, patients and the public. They work as a team with the physicians, physical therapists, occupational therapists, speech therapists, social workers and nurses to provide care to the patients.

Community dietitians

Community dietitians work with wellness programs and international health organizations. These dietitians apply and distribute knowledge about food and nutrition to specific life-styles and geographic areas. They coordinate nutritional programs in public health agencies, daycare centers, health clubs, and recreational camps and resorts. Some community dietitians carry out clinical based patient care in the form of home visits for patients who are too ill to physically attend consultation in health facilities.

Foodservice dietitians

Foodservice 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, prisons, cafeterias, and restaurants. They direct and manages the operational and nutrition services staffs such as kitchen staffs, delivery staffs and dietary assistants or diet aides.

Research dietitians

Research dietitians are mostly involved with dietary related research in the clinical aspect of nutrition in disease states, public aspect on primary, secondary and sometimes tertiary health prevention and foodservice aspect in issues involving the food prepared for patients. Research Dietitians normally work in a hospital or research facilities. It should be noted that some Clinical dietitian's roles also involve research other than the normal clinical workload. Quality improvement in dietetics services is also one area of research.

Administrative dietitians

Administrative, or management or Director of Dietetics Department or Nutrition Services, sometimes also known as Manager instead of Director depending on the size, number of dietitians in the department and also the organisational structure adopted by the Health facilities or Hospital. Director or Manager act as head of the dietitians. They also hire, train, direct, supervise employees and manage dietary departments

Business dietitians

Business dietitians serve as resource people for the media. They work as sales representatives for food manufacturing companies that provide nutritional supplements and tube feeding supplies.

Consultant dietitians

Consultant dietitians work under private practice. They contract independently to provide nutrition services and educational programs to individuals, nursing homes, and in health care facilities.

Other nutrition workers

These designations apply principally to the US although the generic classifications are likely to be applicable elsewhere.

Dietary assistants

Dietary assistants or dietary aides are responsible for assisting and carrying out the medical nutrition therapy prescribed by the Dietitians and to ensure that food for the patients as instructed by the Dietitians are carried out correctly by checking menus against recent diet orders before tray assembly begins and being physically present in the kitchen plating-lines at meal hours. Dietary aides in some countries might also carry out a simple initial health screening for newly admitted patients and only inform the Dietitians if any screened patients requires a dietitian's expertise for further assessments or interventions.

Dietary clerks

Dietary clerks perform clerical tasks such as entry and maintenance of dietary requirements to a database. They also track financial information, such as the number of meals served each day.

Dietary managers

Dietary managers are responsible for retail, catering, and tray lines. If an operation is large, there may be one or more managers to help in directing the dietary workers.

Dietary workers

Dietary workers prepare the food and meal trays in the kitchen. They check for accuracy and completeness. They also maintain the storage area for food supplies and ensure practice of sanitary procedures. Dietary workers are trained on the job and can work in any commercial kitchen.

Dietary hosts

Dietary hosts or hostesses deliver and bring back the meal trays to patients. They distribute and collect menus and help the patients to make complete selections.

Qualification

UK

How to train as a UK dietitian

The minimum qualification of all UK dietitians is a 4-year, university awarded BSc (Batchelor of Science) Honours degree in Dietetics. Dietitians can also enter the profession through a first degree in a related subject (such as a BSc Nutrition, or BSc Biochemistry degree) after completing a two-year post-graduate degree (MSc - Master of Science) in Dietetics or a post-graduate Diploma in Dietetics from a recognised university. Both courses are full-time, university based, with clinical experience being gained under the tutelage of hospital dietetic departments recognised for the training of dietetic students. This practical training in a clinical situation takes a minimum of 28 weeks.

Successful completion of a recognised course allows registration with the Dietitians Board of the Health Professions Council(www.hpc-uk.org). This is the regulatory body of 13 Registered Health Professionals, including Dietitians. Set up by UK Statute in 2002 (the Health Professions Act, 2002), this replaced the former regulatory body, the Council for the Professions Supplementary to Medicine (CPSM), itself a body set up by Act of Parliament (Professions Supplementary to Medicine Act, 1983). As such, members of the public are protected by law should any healthcare professional give personal or professional cause for concern.

The terms 'dietitian/ dietician' and 'registered dietitian' are protected by law. It is illegal for anyone to claim to be a dietitian or registered dietitian who is not entitled to do so. Most dietitians can be recognised by the suffix 'RD', for Registered Dietitian, after their name.

Conversely, self-styled nutritionists have a variety of regulatory bodies, although these are not covered by legal statute and are monitored and managed by their own members. The most well known of these is BANT, which adopts the code of Practice followed by the Nutrition Therapy Council - an alternative health body not recognised by law. Recently, the NTC has issued 'codes of conduct for nutritional practioners' lifted almost verbatim from the Dietitian Code of Conduct on the Health Professions Council website. Those wishing to pursue nutritional advice from a non-HPC accredited therapist should be aware that there is no legal redress other than that covered by common law for such therapists. There is no record at the current time of any self-styled nutritional therapist being chastised for poor practice by the NTC.

Details of how to train as a dietitian and the courses recognised as acceptable for the Health Professions Council Dietitians Board are available from the website of The British Dietetic Association (www.bda.uk.com), the professional body for all Registered Dietitians in the UK.

USA

A dietitian's education in health science involves significant scientific based knowledge in anatomy, chemistry, biochemistry, biology, physiology, nutrition, medical science. It is these strong foundations in advanced scientific knowledge equipped with counseling skills and aspects of psychology which enables a Dietitian to assess, analyse, intervene, and educate a patient in relation to the diet and disease.

It can be said that in an interdisciplinary team (consisting of the physician, dietitian, speech therapist, physiotherapist, occupational therapist, social worker, and nurses), the physician and the dietitian are the two health professionals with the most well-rounded knowledge on human biochemistry and physiology.^{[citation needed]}

There are a few different academic routes to becoming a fully qualified registrable dietitian:

A professional bachelor degree in Dietetics which requires four years of studies

or

A bachelor of science degree and a postgraduate diploma in Dietetics

or

A bachelor of science degree and a master's degree in Dietetics

Besides academic education, registered dietitians must complete up to a year long dietetic internship before they can sit for the registration examination. The dietetic internship requires the intern 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 dietitian is able to work in a variety of professional settings. Most states require additional licensure to work in most settings. To maintain, the RD credential, professionals must participate in and earn continuing education units on a yearly basis.

Canada

To be completed.

Australia

To be completed.

New Zealand

To be completed.

Professional associations

UK

In Britain, a registered dietitian (RD) must be trained to degree level and have kept up-to-date in their studies; as a result, the term registered dietitian is a protected term. The professional association for dietitians in the UK is the The British Dietetic Association. Although nutritionists in the UK also have a trade organisation, the Nutrition Society, the term nutritionist is not a protected term. Therefore, anyone can use the title nutritionist in the UK.

USA & Canada

In the United States and Canada, the Dietitian, Registered Dietitian (RD), etc. are similarly protected titles. The professional association in Canada is the Dietitians of Canada. The US equivalent of it is The American Dietetic Association.

Australia

In Australia, a dietitian who participated in the continuing professional development program are permitted to use the term "Accredited Practicing Dietitian" (APD). The Association in Australia introduced a Advanced Practitioner program for experienced dietitians, upon satisfying the program requirement these dietitians are permitted to use the term "Advanced Accredited Practicing Dietitian" (advAPD). The professional association for dietitians in Australia is the Dietitians Association of Australia.

New Zealand

The professional body for dietitians in New Zealand is the New Zealand Dietetic Association.

External links