How the American Dietetic Association is Strengthening its Monopoly

ADAThe ADA is clever. It gets legislation passed under the radar, when no one is looking. And natural health nutritionists are getting a rotten deal.


As we reported a few weeks ago, the American Dietetic Association (ADA) has sponsored legislation in over 40 states. These bills usually lump dietitians and nutritionists into one licensing scheme, and require nutritionists to complete a dietitian program in order to practice nutritional therapy. Even if the nutritionist holds a Masters or a PhD in nutrition, the nutritionist is still required to complete registration through the ADA in order to keep practicing.

This is the organization that lists among its corporate sponsors soft drink giants Coca-Cola and PepsiCo, cereal manufacturers General Mills and Kellogg’s, candy maker Mars, and Unilever, the multinational corporation that owns many of the world’s consumer products brands in foods and beverages.

The ADA’s legislative manipulations are able to go undetected because it takes years for a bill to go through the regulatory phase and be implemented—so few people become aware of the full consequences of the law. Moreover, the ADA hasn’t yet “pulled the trigger” sending out cease-and-desist letters to nutritionists everywhere telling them they can no longer practice—but you can rest assured this will happen, as soon as the organization has its monopoly firmly established. In the meantime they go on to lobby for new legislation in other states.

Currently the ADA is pressing for bills in four states. They are have even organized a lobby day in New York state at the end of the month.

Take a look at what has been happening in North Carolina. It’s what will happen in all the states if the ADA monopoly grows.

There has been a dietetic monopoly law in NC since 1991. In 2003, Liz Lipski, PhD, CCN, CHN, a well-known and eminent nutritionist, applied for licensure. Just last month she was told by the North Carolina Board of Dietetics/Nutrition that she did not meet the minimum requirements for licensure.

As we have mentioned before, the “minimum requirements” fits the lower credentialing requirements of the dietitian model—so, for example, the NC dietitian board claimed that Liz did not meet the course requirement for organic chemistry, even though she has a doctoral level course in nutritional biochemistry—which is applied organic chemistry. Furthermore, Liz has a doctorate in clinical nutrition, has been board certified in holistic nutrition, and has been practicing for decades. But because she did not take the specific lower-level academic course as demanded by the ADA, she could no longer be licensed.

Liz has hired an attorney and is in the process of negotiating with the North Carolina Board of Dietetics/Nutrition. Her website has full details of her case, and if you can help with a donation toward her legal fees, it would be greatly appreciated.

Why does the the ADA, which claims to protect the consumer against poorly qualified nutritionists, reject nutritionists with advanced degrees from fully accredited institutions, like Liz Lipski? Could it be because they are more qualified than their own licensees?

We wanted to give you a follow-up on some of the bills the ADA we told you about previously. Remember, just because people are trying to get laws passed under the radar doesn’t mean we can’t stop them in their tracks!

Nevada AB 289: This bill is moving forward quickly. It has passed the Nevada House and is already in committee in its Senate. It is scheduled for a hearing tomorrow, May 11. This bad bill states that only ADA-licensed dietitians shall practice dietetics. “Dietetics” as defined in the bill encompasses a wide range of nutrition services including performing nutritional assessments and nutrition monitoring, counseling and evaluation, all of which fall under the scope of practice of any qualified and self-respecting nutritionist. Furthermore, the bill explicitly states that individuals cannot use the words “licensed nutritionist” or “LN” unless they complete the program for dietitians—which also requires completion of the ADA exam.

Nevada residents: If you have not done so already, please take action immediately, as the hearing will take place tomorrow!
There is also an online opinion poll on the Nevada legislative website. Nevada legislators use this opinion poll to get a sense of how their constituents feel about a certain bill. To let your legislator know how you feel about AB 289, fill this opinion poll by clicking here.


California AB 575: Victory! Due to a groundswell of opposition from our members, as well as the hard work of a coalition of activists, we were able to ensure that AB 575 was not heard in committee. We believe that AB 575 will not move anywhere this session but we are keeping eye open for the next session when it will almost certainly be reintroduced.

New York A.5666 and S.3556: As we noted in our previous article, this bill lumps dieticians and nutritionists together under one title, “Licensed Dietitian/Nutritionist” or “LDN,” and gives the ADA a majority membership on the new joint board—which means that the board will require that only the ADA exam be allowed, as they have done in other states. ADA-registered dietitians are planning a rally day on Friday, May 20, to lobby their legislators in support of this bill.

In response, we’re going to have an “online lobby day.” We’ll have a coordinated day of action tomorrow, on Wednesday, May 11—if you are a New York resident, please call your state representatives in opposition to the bill. Emails are great (and please continue to send them on our Action Alert page)—but real impact would be felt by calling representatives all on the same day.
New Jersey AB1987 and S809: No news here as yet. The Dietitian/Nutritionist Licensing Act lumps together “licensed dietitian/nutritionist,” and the terms are used interchangeably throughout the bill. Instead of noting and providing for the differences between the two, the bill creates a State Board of Dietitians/Nutritionists instead of a separate board for each. Furthermore, the Senate version of the bill requires the completion of a registered exam administered by the American Dietetic Association. If you are a New Jersey resident, please take action here.

95 comments

  1. As a certified nutritionist with a 14 year old private practice, I am supremely alarmed that the ADA is attempting to create health care monopoly, therein putting all legitimate complimentary health professionals out of business. There is nothing in the ADA’s curriculum that provides them the knowledge base to work with the public from a holistic base that helps heal the causes rather than the symptoms of dis-ease. Nutritionist and similar holistically-oriented practitioners are not a threat to ADA. We’re not competing – we’re just taking different approaches to the same end – health.
    Please do not deny us our rights to practice. Stay on your side and we will on ours. The fundamental right of the people to chose what kind of health professional they prefer is at stake here.
    Please play fair, not competitive. Thank you.

    1. This isn’t even competitive. It’d be like if the NFL and NFC teams got to the Super Bowl next year and the guys on the NFL team pulled out guns and shot the NFC team dead. There’d be no Super Bowl because there’d be no one to compete with.
      This is what the licensing agencies do every time. They kill the other team before the competition even begins. The AMA did it to midwives and homeopathic doctors and are still trying to do it to chiropractors. Now this. This, we do not need. If dieticians are so great then let them stand on their own merits rather than hiding behind the ADA’s bullying.

    2. I don’t know how and where you got your certification, however, I totally agree with ADA!!! I went through 6 years of rigorous training (coursework, and clinical ). The requirements for becoming an RD is strict on purpose, because the public can be harmed prescribing the wrong diet/food, and/or supplements, whether they are herbal or not! ADA also has a specialty group that is quite trained and experienced in Alternative Complementary Medicine. So for you to say that ADA has no background in this is incorrect! Many dietitians have specialties just like MD’s: Pediatrics, Sports Dietetics, Alternative medicine, Geriatrics, Culinary, Oncology, Geriatrics etc. So , yes, there may be some dietitians without the background in herbal/alternative nutrition, however, there are some of us that do. I totally agree with ADA, people calling themselves “nutritionists” , SHOULD be licensed in EVERY STATE, to ensure the public is SAFE from BAD INFORMATION.

      1. Really? How do you assess for different genetic needs? One size doesn’t fit all. Yet you practice the same treatment for every client that has a similar problem. There is no way you can argue that there is no such thing as biochemical individuality. That would be denying all of anthropology, all of genetics, all of natural selection. Metabolic Typing makes you look like the idiots you are. Name two more important homeostatic control systems in the body for metabolism then the autonomic nervous system and the rate of oxidation????? If your not assessing these systems, seeing which one is dominant and prescribing nutrition that will correct and balance, your not practicing nutrition. Your pharmaceutical feeding, chemical following is crap!!!!!!!! I would never even claim to be apart of a nutritional agency who’s corporate sponsors include Kellogg and Coke!!!!!

    3. I’m also not sure where Liz got her information from, but there are a LOT of exceptions to the license law in North Carolina. You do not NEED a license to practice nutrition in this state, but you do need a license to bill insurance companies. THEY require the Registration through CDR–Commission of Dietetic Registration. I have not seen a medical practice that bill insurance that will hire a nutritionist without the RD. You may open your own practice and bill you clients fee-for-service. As for the accredited institution that some people obtain these so-called degrees in nutrition, they would have known that they weren’t qualified for taking the RD exam from the school. As Sue says below, it is a very STRICT program from an accredited institution, including interning. I’ve know many PhD level nutritionists that are not qualified to practice Medical Nutrition Therapy because that is not the area that the PhD is for, but can qualify them for research, publication and teaching.
      Many of us have specialized after we gained our RD. I went for my MPH right after I finished my internship, sat for the exam, and received training for children with special heath care needs. Read the law before attempting to fight it. In many states it is only for insurance purposes and is not well enforced to those who do not have one, until they get sued by someone. A speech pathologist got sued for giving dietetic advise to a client that was not appropriate. Could a herbologist or other “nutritionists” get sued with the same issue? Do they have specific policies and procedures they HAVE to follow as well as a code of ethics? A license is only part of what we need to BE a nutritionist.

    4. It is sad that this is happening. I go help a woman who had a stroke and am appalled at the so called “food” that hey expect her to eat at the rehabilitation center where she is right now. It’s all dead, overcooked and lacking in nutrition! I have to bring her descent whole grain foods and protein powder with sea greens in it just to keep her from getting malnutrition! When I spoke to the dietician, she didn’t even understand what was wrong with the pasty white bread, and grease soaked meals! Of course that’s why the staff is over weight and sick looking!

  2. Patrick Henry famously said, “the price of liberty is eternal vigilance.” In every legislative session since 1999, Texas has had a dietetics practice act filed by the Texas Dietetic Association (except this session, due to fiscal restrictions). The reasons we have defeated them are as follows:
    1. Creating a strong coalition, following the principle of “united we stand, divided we fall.” Natural health advocacy/professional groups need to set aside their differences and focus on their commonalties.
    2. Set up a legislative watch committee. If your state online legislative web site has a word search function, you can have two or three people do regular word searches (daily during the session), to pick up on bills that are of interest.
    3. Pick a strong witness team, train them and use them repeatdely in hearings. A group of just ten people can do this, provided they take the time to rehearse and critique themselves. The more experienced they are, the better thye will defend your collective rights.
    It’s worked in Texas, it can work elsewhere.

  3. Can you please tell me how this affects nutrition therapists? I am a student at The Nutrition Therapy Institute in Denver (www.ntischool.com). NTI is a very reputable holiistic nutrition school, we receive over 500 classroom hours across the course of two very intensive years with coursework that includes biochemistry, anatomy and physiology and numerous nutrition courses. The difference between NTI and a typical university dietetics program is that we are not ADA-sanctioned, and do not learn or teach according to the ADA/USDA dietary guidelines.
    Thank you.

    1. Then you ARE NOT legally allowed to do NUTRITION COUNSELING, because you can harm the public!! You can give general nutrition ideas, but cannot COUNSEL.

      1. Sue Parks, you represent very well what is wrong in this country with the tyranny of our government. If your training is so wonderful (ADA), why don’t you get the same stellar results that the holistic/”alternative” practitioners get? We, the people, are sick and tired of your bully/monopolistic/tyrannical tactics that do NOT serve we, the people. I’ve seen what your curriculum offers and it is pathetic. You are part of the medical/pharmaceutical/industrial/military complex and you all need to GO.

        1. Stellar results…that’s funny! If the cirriculum is so pathetic and easy why can’t you do it? I agree with Sue! Trust someone with ACTUAL education who has spent many years practicing and training to be a dietitan and has to take and pass an exam to say they are qualified. Yes some nutritionists have spent many years training and practicing and are very qualified if not more so than some RD, but without having a credential or the term “nutritionist” protected like “RD” is how do you know who is legit?

  4. Hurray!
    I was offered a job and educational oppotunity to become a Dietican in my youth, but politics in the hospital stopped the process. I finally realized that I was up against a brick wall because Dietitians
    do not believe that soils are depleted and are not trained in molecular micronutrients and high dosages of vitamin C and antioxidants…..complex carbohydrates choices come before carbs from white rice, sugar, fat, salt and white flour. Hospitals have a budget and will not always buy foods whole grains and fresh frutis and vegetable. There is no compensation for hours of cooked foods in steam tables….loosing nutrients and refrigeration proscess.

  5. The ADA need to fix their home before going behind the backs of Americans, to push their single-minded thinking when it comes to what are dietary needs are or we choose to establish for ourselves, the American public.

    1. There is a difference in helping people eat healthier, vs prescribing WRONG FOODS AND DIETS to people. Giving general good nutrition advice is appropriate as long as you have the CORRECT knowledge and understand the biology, biochemistry, pharmacology etc. But just because what works for you is perhaps good, doesn’t make it right to prescribe or counsel others to do what you do, or what the media tells you to do.

  6. God these so called medical asscociations, are a money grabbing lot with No concience what so ever!

    1. I disagree. We are here to protect the public from wrong information and quacks.

  7. I have relied on advice from naturopathic sources for years. I am 74 years of age and take no medicines. I eat properly and exercise. I take care of myselt. I am very concerned that my resources will be taken away from me.

    1. You are exactly what the medical profession/drug companies do not want to see…a healthy, older, person who has no need of their high priced “fixes”. They would be all out of work if everyone got smart and started to take care of themselves through a holistic approach…God forbid!!!

      1. Actually this is not true. As registered dietitians, we are strong advocates of using natural foods instead of medication when at all possible! We do not support fixing the issues we are trained to deal with by prescribing pills and potions, which is exactly why we are licensed professionals, attesting to the fact that we have taken rigorous course work, applied this knowledge to real world experience in an internship of many hours (unpaid for most of us,) and then passed a comprehensive test to ensure we are able to “Do no harm”!

        1. DO NO HARM does not always equate to doing much good unfortunately.
          My mum was recently told it was OK to take frusemide and movacol at the same time and that she didn’t need to change her diet as it was “normal” at her age (72) to be a little (3 stone) overweight and on blood pressure meds and if she was going to change anything have bran flakes for breakfast instead of cornflakes as it has more fibre (and more sugar!) and not to drink in the evenings if it kept her up all night at the toilet.

  8. Please do not support any bill which lumps together licensed dietitians and nutritionists nor prohibits well trained nutritionists from practice.

    1. Then tell me the difference between a well trained and educated dietitian and a nutritionist (which nowadays can mean almost anything)! How can you trust what they recommend? Are you guaranteed that it won’t make you more sick or cause the cancer cell to grow more!

      1. I am seriously offended when people continue to refer to me as a nutritionist, not because people without the RD are inferior as people, or don’t know anything, but because I earned my credentials and even though I don’t like paying for ADA membership, licenses, and other affiliation fees, I will do so to make sure that “nutritionists” are not out there telling people that HCG Diet is okay and that we shouldn’t eat any carbs or that everyone should be gluten and dairy free! I’m so sick of people spreading these nutrition rumors that are not only a bunch of crap, but are harmful! If you are worth of practice, you won’t need to hide from the education, training, testing, and licenses required of you to go ahead and become an ADA member. Not saying that it is a perfect relationship and perhaps there are some questionable sponsors, but would you let someone do surgery on you that doesn’t have the proper credentials? If so, you could end up like one of those botch jobs you see on tv of people who go out of the states to have the surgery done cheaper, where there are no standards and rules to ensure safety.

        1. 6-11 grains???? When the majority of the people in this country genetically have problems digesting grains? Seriously that was a previous recommendation of the USDA feed guide pyramid (as in feed lot). You don’t take a stance against pesticides, herbicides, fungicides, yet some common sense basic soil science class can tell you how important the TOTAL ecosystem is. I would never trust an organization with such brain washing that its practitioners can’t understand the most BASIC of sciences and instead think they are smarter then nature. Get a real education then join us in the fight against those who poison us with the ADA’s blessings!!!!!

      2. How can anyone trust what dietitians recommend!!! Are you guaranteeing that the packages process cereal you are recommending does not make someone more sick or cause the cancer cell to grow more?! NOT!!! In fact a lot of what dietitians recommend actually causes heart disease and cancer to flourish. I know. I own many of the ADA textbooks that dietitians studt from. Typical government propaganda that all everyone needs is a balanced diet and that Idea of a balanced diet is pretty poor. I realize the need for you to defend your years of education, but as one holistic physician put it, your years of study do you no good if most of what you learned is WRONG. I would never, repeat NEVER go to a dietitian for dietary advice! If I had I would probably be dead already. So I went back to school to study nutrition and herbal medicine, to save my own life. Since laws won’t let me practice, I won’t break the law, but I will also not promote dietitians either. Things need to change radically because Americans are on a collision course with more and more total disability and early death with few productive years, all due to sanctioned government dietary advice as taught to dietitians.

  9. Many thanks for your help here in California!!! Any bill that gives the sadly out-of-date and fast food funded ADA a monopoly is a giant step backward for consumers and the healthcare industry.

    1. You are totally wrong! There are toooo many quacks giving out inappropriate nutrition/herbal information or selling (for money) inappropriate supplements. This has got to stop, in order to protect the public from harm.

      1. Let me guess, if someone IS well trained, then they wont hurt the public? What about most doctors and most officers of the law? They took tests and got certified and yet “they” harm the public daily. But I guess thats ok because they have taken the required tests. Give me a break. Doctors prescribe drugs all the time and yet they know nothing about the patients they prescribe them to except, “How are you going to be paying me, cash,credit, or through your insurance?” But I think as long as non-ADA’s doesnt portray being licensed, then the public should have the choice over their own healthcare.

      2. Sue, I’m sorry to inform you, but individuals can buy supplements at any local drug store with absolutely no guidance at all. People buy and take supplements everyday without discussing safety or contraindications with anyone. In other words, your argument doesn’t really make sense. Another point is that food advice be it correct or incorrect, actually won’t kill anyone. The only time you run into an issue with dietetics is possibly an error in miscalculating TPN in a hospital setting, which dietitians are the only one’s licensed to do. I am in the middle of my internship currently to be licensed as an RD, but am appalled at your anger with this legislative situation. I think the more we have people out there practicing be it RD or nutritionist to get the word out about the importance of a whole foods based diet, the better off Americans may be in making healthier dietary changes. The current state of affairs with America’s diet habits is what is killing them!

  10. To my understanding, ADA is tyring to make it possible for people with higher level degrees to become RD’s as well without having to go back and take the “lower” courses. ADA is not trying to monopolize the health care sysytem, just trying to make it a gold standard. I agree that there are many nutritionists who are just as qualified as RD’s but you have to admit some are not. With no regulation on the name “nutritionist” how can we ensure a gold standard of practice? Anyone can call themselves a nutritionist even if they have had no schooling.

    1. Jennifer,
      Gold Standard? What do you mean…make “RD” a gold standard? FYI…Liz Lipski’s situation is a pretty good example that they have zero intention of letting higher level degreed non-dietitians join their ranks.
      The “some (nutritionists) are not” (as qualified as SOME RD’s) argument is seriously silly. Anyone can call themselves a Teacher too… we do not need the government to be deciding for us who we can trust and choose to aggregate and disseminate information.
      Regulating the term “Nutritionist” can never happen…really, do you trust our government to do this, do you trust our government to ensure that you’re getting the “Gold Standard” of diet and nutrition guidance, and do you really think that (as a whole) the ADA is able to meet that “Gold Standard” when they are in bed with the McDonalds, Coca Cola’s, and Big Pharma folks of the world?
      Seriously… these folks believe that ketchup is a vegetable.
      I do not discount that fact that there are many super awesome RD’s out there doing great things for the public good… HOWEVER, in the aggregate…”they” and their parent organization, the ADA, are partially culpable for the childhood obesity epidemic and multiple other pervasive health issues facing Americans. They happily tout CRAP foods to our kids in schools…and CRAP food for sick people trying to recover from illness in institutions. The contrasts between your “average” RD and “average” nutritionist are stark.
      Follow the money, observe the behavior.
      Martin

      1. I did not mean make RD’s the “gold standard” i just ment they are trying to find a way to give a “gold standard” of care by regulating who can and cant give out nutrition information. And no, anyone cannot call themselves a teacher. You have to have a degree and pass and exam. Exactly my point. How can you trust (some) “nutritionists ” who have had no schooling or anything to back up their information. Many nutritionists have just as much if not more schooling than some RD’s and kudos to them. They need to find a way to be able to credential them as well. Just so you know i really dont care about ADA, im not trying to protect them. Im just standing up for the fact there has to be some regulation on who can and cant give out information. And just a few days ago ADA did send out an email about getting people with higher degrees credentialed without having to go back to school. They are not ignorant….they know they are leaving some well qualified professionals out.
        And do i trust out government to regulate this? NO! I dont trust our government to do anything. I dont have a solution im just putting my opinion out there.

        1. And they have no idea what they are talking about. Now if you want to talk about *nutritionists with PhDs* setting the gold standard, maybe we can talk.

      2. I think you just defeated yourself in your flawed argument. Yes, anyone can call him or herself a teacher; however, to be a teacher in a sanctioned educational institution, there are standards and requirements of education and training before the individual is determined qualified to be a teacher in a school. The same is true of a nutritionist. Anyone can call him or herself one; however, to teach the body of knowledge you need to go through the steps to prove you are qualified.

        1. My comment was in regards to the person saying we don’t need standards and speaking against ADA. I too am not supporting the ADA organization, but the fact that we need to protect the people.

        2. That is not true. There are NO limitations on who can call themselves a nutritionist. Yes there are some nutritionist credentials, and im not at all saying they are not qualified, but the fact is any person who feels they know something about nutrition can call themselves a nutritionist.

    2. There are those in all fields that claim to be what they are not. I once had a cardiologist for a company required physical that was found to be a fake. The same is true of those who claim to be nutritionist without training. A quack is a quack but there seems little desire to eliminate them from our society.
      I believe there should be a recognized standard for nutritionist; however, it appears that if they want to work in the medical field they must agree to the recommendations of the USDA and others. My problem is that most physicians have not studied nutrition since the 1950s and the dieticians have little understanding of what the body contains or requires. If they did, they could not make the recommendations to avoid cholesterol containing foods and the nutrients found in them compared to the content of the foods they recommend.

      1. We actually do understand the concept of cholesterol quite well. We know that the human body synthesizes cholesterol, as well as the fact that some people genetically over produce it. We know there are various types of cholesterol, how they are synthesized from the dietary fat (mostly triglycerides) we ingest. We also know that it is more important to advise limiting the intake of saturated fats, since this has a greater impact on cholesterol levels than does dietary cholesterol. So, is there something we are missing, or were you perhaps confused that perhaps maybe it was the nutritionists, not the dietitians who were confused? I don’t claim that we are experts in all things medical. That is why there are doctors. And like you said, doctors do not receive more than a basic nutrition class most of the time, to which many admit paying little attention because of the demands of their strenuous education. Therefore dietitians are the experts in nutrition and doctors are the experts in their area of specialized practice. We should be working together, not against one another.

        1. Sorry, Jamie, but your claim to know about cholesterol rings very hollow. Your low-fat mantra is so seriously outdated that it is laughable. As Mr. Rongey said, “most physicians have not studied nutrition since the 1950s and the dieticians have little understanding of what the body contains or requires.” Your gold standard is to parrot the USDA, FDA, CDC, BigPharm and its parrots, the lamestream media. He is spot on and YOU are not.

        2. Triglycerides are also synthesized from fructose (a component of table sugar, and of course in high fructose corn syrup.! You are taught that since glucose is the end result of carbohydrate metabolism, it cannot cause hyperactivity and you make no mention of its role in high triglyceride levels. Fructose is metabolized the same as alcohol and we all know what alcoholism dies t triglyceride levels. Educate yourself. See this video by at you tube to see what you should be learning! All the relevant biochemistry and studies are given and cited.
          Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin. Series: UCSF Mini Medical School for the Public [7/2009] [Health and Medicine] [Show ID: 16717] He totally debunks the last 30 years of Nutrition information in America. (As still taught by the ADA!!)
          http://www.youtube.com/watch?v=dBnniua6-oM
          Linda

          1. Correction. No mention of fructose’s role in high tryglyerides. Glucose, however, has its own set of problems.

        3. Really Jamie? You just made your own mistake. Saturated fats are bad, huh? How about the fact that humans have been eating saturated fats for most of our development? Do you think a Wooly mammoth had saturated fats? Do you think a deer has saturated fats? Do you think an antelope has saturated fats? The problem is NOT saturated fats, its factory farming and the horrible nature in which we grow our future food. But you would know that if you took into account such inconveniences for modern nutrition such as natural selection, genetics, anthropology. YOU KNOW SCIENCE?!?!?!

    3. After what I saw on the hospital menu the last time my girl was in, don’t you dare talk to me about RDs being superior. Spaghetti-Os. SPAGHETTI-Os.

      1. A) People are not expected to live in hospitals, therefore, the hospital menu is not expected to be consumed over the long haul. B) Children in a hospital have a lot to worry about, providing them with spaghetti-os they are familiar with may be better than something super duper healthy in a time where our goal is often to get them to eat before they can leave, not to not-eat. C) I would not recommended spaghetti-os to a client trying to lose weight or for optimal health; however, it is a balanced meal in that they contain carbohydrates, protein, and fat with vegetables, grains, and sometimes meat and dairy. You have to look at things as situational and not say that because we offer a kid favorite at a hospital where they are likely injured or ill and not feeling their best, that we are horrible people. It is a lot better than the majority of food America is eating. You need to consider the whole picture and put things in perspective before you try to use one example to make you a non believer in credentialing and licensing professionals

        1. People in hospitals aren’t expected live……WHAT? So we feed them all, whatever seriousness of condition, crap pseudo-food? There IS no justification for feeding anyone this utter crap and yet you support this. Every time you comment you are furthering people’s opinions that you folks are largely anti-health and anti-knowledge. You are demonstrating that your “profession” is an utter waste of time.

        2. Spagettios is a balanced meal? That’s a hoot! I can’t stop rolling on the floor laughing. Lot’s of good stuff in there! Ha ha!

        3. Spaghetti-os is hardly a balanced healthy meal! White flour wheat Spaghetti, overcooked [most likely moldy] as tomatoes as tomato sauces are made from lots of tomato rejects for OTC sale, and bad red meat. Balanced in the sense that it contains carbs (refined), a vegetable, (You consider moldy tomato sauce a veggie), and bad red meat, probably filled with GMO soy and fed GMO corn feed.. You just made our case! Once again, I have many of the ADA textbooks you studied from. I think it is YOU that has to put things in perspective. What you are doing has not made the American public any healthier. You actually BELIEVE the government crap you were taught. Just because it is in a government-approved textbook does not make it true. In fact more often than not that textbook was written with a specific [not necessarily good] agenda in mind.

          1. Hi Linda and others.
            As a Registered Dietician, I do not advocate spaghetti Os or other processed junk foods. You should eat as much raw whole natural organic foods as possible, drink pure water, and avoid fast food and overly processed items.
            And in the meantime, quit categorizing people. Because one dietician says something, does not mean we all do.
            Our education is very much rigorous work, however, many dieticians simply keep people alive with food, and not necessarily ‘thriving’, therein lies the discrepancy.

        4. Spaghetti-Os are a manmade, industrially made food product (I didn’t say food; I said food PRODUCT) and isn’t REAL food. Granted, getting kids to eat when they’re in the hospital is a noble goal; however, giving them something that is nutritionally devoid of living nutrients is not what they should be fed. I have soy and gluten intolerance and a casein allergy; trying to find ANYTHING in a hospital cafeteria that I can eat is almost laughable. There’s more to “good eating” than just eating plain fruit and veges.
          Our current health problems are because of seriously depleted soil nutrients and manmade industrial food crap. Everyone’s chronic illnesses would go away if they ate nutrient dense, REAL food. It took me three years after I
          changed my eating habits, but I got OFF 12 (twelve) pharmaceutical drugs (Yes, at the age of 40 years I was on 12 pharma drugs. And I am a small person, not obese). That is not what my doctor who let me go from the clinic wanted to hear. He wanted to keep on prescribing me drugs. Why? Because that makes me a continuous patient who needs to keep seeing him in order to get my pharma drugs renewed. And you know what else it does? By taking pharma drugs–which ALL have serious side effects–I was virtually guaranteed to be a repeat patient for life, because once you take a pharma drug, the side effects almost always guarantee that you’ll be put on another one, then another one, than another one… Is it any wonder that some Senior Citizens take 7 to 15 drugs a year?
          I have gone over to the alternative medicine camp and like my healthcare there very much, thank you. Eating REAL food has been an absolute savior for my family. I’m off all pharma drugs; my daughter’s sensory processing disorder is almost nonexistent (taking gluten and dairy out of her diet made a TON of difference), and all those strange aches and pains we’d been having have–gasp!–magically “disappeared.” We did all of this ON OUR OWN. Allopathic doctors, no matter who they are–registered dieticians (they had absolutely no ideas for how to help our daughter with her sensory issues (food related when she was a baby/toddler/younger) and couldn’t give us any recommendations on how to help her weight/lose weight. That’s okay; I helped her myself), medical doctors, pulmonary doctors (I saw an asthma doctor 2x; after I quit eating and drinking cow dairy products, I gave up my Advair and haven’t had any issues with Asthma since; it’s now a year and a half later and still no issues), dermatologists (my goodness, did I go through the drugs for acne! And you know what the issue was? Severe heavy metal toxicity and my body detoxing through my skin (because of food allergies and intolerances). Wow, shocking!), along with too many others to count–are either 1) not trained to see the root cause of a illness and take measures to correct it or 2) if they do know or suspect the root cause and help their patient, they risk having their medical license pulled.
          Now, I ask you, do you really want to be a part of the medical/pharma/military/big ag/big business conglomeration of tyrants who want to dictate what we can and cannot do with OUR OWN LIVES? Why is it not right for me to make my own decisions for me and my family when it comes to our health? If a person isn’t who he or she says she is–word of mouth and market dictates will get rid of said person. Use, rely on, and trust your inner gut. And get references, for God’s sake. If a practitioner isn’t good, word will get around! Stay around from the shady ones and go see the ones who everyone raves about. They’re raving because those people know what they’re doing, because they’ve helped people. People don’t rave about someone if they don’t get help from them. I have never–ever–had even one registered dietician help me, my daughter, or my husband when we’ve gone to them for help. However, every one of the nutritionists in the alternative healthcare field HAS helped us, and helped us enormously.
          You might say that ADA is not trying to control the field of nutrition, but we all know that once a precedent is set or a “rule” is made, it’s all too easy to march onward to complete control and dictatorship. After all, that’s really what the allopathic community wants is TOTAL CONTROL over anything and everything to do with anything that is considered “alternative medicine.” That way, they have the monopoly and us common folks have to abide by their rules, whether we want to or not. Whether we believe in what they tell us or preach. Whether what they tell us is good for us–or isn’t. I don’t believe in vaccines (Autism, anyone? How about some chronic, life-long health issues?). Once there’s a stranglehold on what they can tell us about food–hell, let’s take away all natural and organic supplements, all good organic and nutrient dense foods, foods full of vitamins and minerals and enzymes and amino acids and plant foods that are replete in those things our bodies need to live. Let’s decree that we can no longer have anything that even remotely is good for our bodies–let’s all eat manufactured, manmade food products! Then we can all be a nation of sick, sick people, so that there isn’t anyone left to go to work because we’re all lying around with chronic health problems that prevent us from working and contributing to society. And while we’re at it, let’s crash our economic system because we CANNOT continue to support a sick-care society. The only way–the only way–to save our economy from total collapse is to start supporting healthy eating and healthy bodies, and that starts with finding the ROOT CAUSES of all issues/problems in the body and FIXING them–not putting a Band-aid over them, like the allopathic community/doctors love to do.
          At some point, when do we cease to be a nation of sick people doing for ourselves, to the point where we can’t defend ourselves from outside invasion? Who’s going to go to work and do the jobs when Americans are all sitting at home, eating manmade commercially processed foods full of chemicals and preservatives and food colorings and dyes, eating meat that’s been injected with all types of antibodies and preservatives and growth-enhancing hormones that was packed tighter than a drum on a feedlot, or eating GMOs that are nutritionally deficient and interact with our bodies and our cellular membranes in ways we never even thought would ever happen? When do we turn into Frankenstein people ourselves? When do we start being concerned about us as a human species and less so about power and control and the Almighty dollar?
          Sorry. I’m finally HEALTHY, when I’ve been sickly for a very long time. I’m not interested or willing to give up my health freedoms so that down the road, even what I eat is controlled, regulated, and I have to abide by what is considered “normal” or good for me. Even the RDA levels on supplements and on what our bodies need daily from the foods we eat are dangerously too low. And contrary to what the dermatologists say, I believe the sun is good for me and it gives me Vitamin D.
          Every one of the alternative healthcare people I use for my health is very, very well schooled in their specific treatment area. My naturopathic doctor, besides all of his coursework for his ND, holds a PhD in microbiology. He understands and gets what’s happening at the “cellular level.” The nutritionist he has in his clinic has spent thousands and thousands of hours working on getting her degree and does continuing education, just like a RD does. You can have 5 different abbreviations after your name, but that doesn’t mean you’re good at what you do, nor does that mean you’ve learned–or been taught–what you need to know. My cousin is a MD. I asked her how much time she spend in medical school, being taught about food and nutrition. She said one day. Out of 6-8 years of higher education to be a medical doctor, they spent exactly one day learning about food and nutrition, the stuff that keeps our bodies in fine working condition.
          That, I think, says it all.
          Oh, and just in case you’re curious–the registered dietician was not interested in discussing or talking about our gluten and soy intolerances or our casein allergy. Apparently, to her, there is no such thing. Hmm. Okay, but our gastrointestional issues are basically gone. Oh, and getting testing done to even check for any issues with food? Um, yeah. If you’re a baby, they do it. If you’re an adult–it must all be in your head.
          My doctor of 10 years who kicked me out of the clinic told me to go and find someone who could help me. So I did. I knew I wasn’t crazy, and I knew there was a very viable and legitimate reason why I was so sick. Thank goodness, there is the alternative healthcare community. What a blessing.

        5. You proved what is wrong with dietitians. I would not feed Spaghetti-Os to a healthy child never mind a sick child in a hospital. It has NO fiber as it is made with white flour. The list of additvies is great too. This is why we have so many ADHD children. You proved that the ADA is backed by all the processed food companies, Cattlemen’s Association, Dairy Industry, Monsanto (the biggest chemical company who is trying to take over the food supply), etc. You probably believe GMOs and radiated foods are fine. That’s the purpose of this legislation. That way Monsanto can go on taking over the food supply step by step with the ADA backing them. The child is in the hospital because they are sick for some reason. They need to get fresh, healthy vegetables, whole grains, fresh fruit, and easily digestible protein not the garbage that is given them. The meat is full of hormones. That is pathetic to say eating garbage is better than not eating. I’ve had a people over the years tell me what they are served in the hospital and it is disgusting. Extremely salty, sugary, processed foods. And Jello! I don’t know which conglomerate makes Jello but get rid of it already. There is nothing healthy in it. All I can say is God help us if the ADA (aka government is where we get all our nutritional information). It is a wonder anyone has any strength to leave a hospital.

        6. I am studying nutrition, both on my own and in a classroom. I am very torn about my educational pursuits as I understand what antiquated and outdated knowledge is required for consumption on the RD route. This is a good example. Your information about cholesterol is outdated. Look at sugar as the bigger culprit.
          RD = brainwashed drone.
          Any agency that would advocate sugary, fake foods to cancer patients makes me want to question who is paying their wages.
          RDs advocate the path of least resistance instead of the truth. Why? It’s easier to get the patient to eat crap than to eat healthy. But isn’t the job of the RD to tell the truth? No, that is the job of the nutritionist, because the RDs have sold themselves to food company hell.

      2. Excellent comment, Dana. These medical/pharmaceutical/government shills just don’t get it. They are a big part of the problem.

      3. Yeah, you go to the hospital and get boullion broth, full of msg, coffee, lemon ice, jello, etc. for a liquid diet. Give me a break!
        Why not healthy fresh made vegetable or fruit juices instead?

    4. I agree with you. Isn’t there a gold standard for other professionals? MD, RN, DC etc. ADA is trying to make it fair for people who are WELL EDUCATED from credentialed schools, not just online general classes. ADA is NOT trying to control the field of nutrition, just trying to make is responsible, legitimate and respected. People who are not trained appropriately should NOT be giving out BAD advice to the public. ADA is just trying to prevent the public from being harmed.

      1. The public is harmed much more by the ADA and USDA food pyramid. Of course there are quacks out there trying to sell supplements that are the cure all but this is the minority in the holistic health fields. Most people who practice holistic health truly love helping people and have done far less harm than conventional medicine. I’m tired of hearing about the dangerous herbs when over 100,000 people each year die from prescription medicine in this country. When a person is “harmed” from taking a herb, it is usually because of a prescription drug that they are taking with it. So the FDA then bans the herb instead of the prescription drug with it’s dangerous side affects. Prescription drugs, on average go through 6 to 8 weeks of testing before approved by the FDA. Anyone taking a new drug within the first 3 years of being on the market is risking their health and maybe their life. Herbs, on the other hand, have been around thousands of years, and are relatively safe. But big Pharma, the AMA, and the FDA do not make money with herbs so lets ban them. Here’s the joke of the decade. Everyone is deficient in vitamin D because we have been told to lather on chemical sunscreen for decades. Now big Pharma has come up with prescription vitamin D. They are making money off prescription vitamin D. Suggesting that people take this vitamin in extemely high doses if they are deficient. The prescription vitamin D is synthetic. Not only is this dangerous as many people are having side affects taking high doses, it is expensive. The best vitamin D is over the counter in natural form. So who is doing harm? Why don’t doctors tell patients to get out in the sun for 15 minutes a day and take the natural form vitamin D? Can’t make money that way. Enough said.

  11. What is more important than one’s health via nutrition, the best, otherwise lowered immune systems
    take us downhill attracting poor health much more costly!

  12. Wow..really? You all sound like a bunch of “conspiracy theorists”. The ADA is not in bed with the food manufacturers and Big Pharma. The main issue is what Jennifer mentioned above: if you want to be a teacher, you have to follow the steps to become credentialed as a teacher. If you want to work in Medical Nutrition Therapy then you follow the steps to become a Registered Dietitian. A person with a PhD would only have to go through one year of Internship and take a test (obviously very easy for someone intelligent enough to get a PhD) to practice Medical Nutrition Therapy. Many Registered Dietitians go on to get an MS or a PhD. It all depends on which area of nutrition interests you. The goal of having a Registration process is to ensure for the public that there is a minimum level of education, knowledge and ethics that is attained and maintained. The ADA embraces evidence-based practice, and we dietitians provide care and education that is customized to the needs of the individual patient. We are not slaves to any one particular system or plan (rendering your comments about the USDA void) and it should be comforting to people that we honor a Code of Ethics, and that if an RD is found to be in violation of that code, that person can lose credentials. A person with a PhD cannot be barred from practice, his PhD cannot be taken away if he or she is irresponsible with the health of another. Likewise there is no consequence for a person who reads a book and then calls him/herslf a Nutritionist if something were to go wrong with a patient. What recourse would the public have? The practitioner could be sued, but not barred from doing the same thing to the next customer. Just because you have your own personal ethics does not mean that the Nutritionist next to you shares the same ethics. I am happy to know that when I work with other RDs that we share the same committment and that my coworker will be qualified to follow my patients. As a consumer, surely you can look at other professions and see the same logic? What if you did not need to be an RN to work as a nurse in the ICU? Should a CNA be able to say, well I have a PhD in biology so I should be able to work in the ICU? Would you want to be that person’s patient?? Everyone thinks that because they eat they are qualified to dispense nutrition advice. Well, I turn on lights all the time – does that make me a qualified electrician? Would you want to live in a house that I wired? I live in a house – should I be able to act as a licensed contractor? Wouldn’t want to live in that house! I drive and know the laws of the road – shouldn’t I be able to paint my car black and white, buy some lights and arrest all those who are speeding? Maybe if I were a Court Reporter and felt I knew every bit as much as any of those lawyers, I should just hang out my shingle and BE a lawyer. Who needs the Bar? If I am at least as smart as a lawyer, why bother to go to all that extra school? Or what if I have a PhD in Criminology…that should be good enough, right? Strangely, it doesn’t work that way.

    1. Well said, CA RD! The other problem with ‘nutritionist,’ naturopathy or other similar self-described professional idiom is that the products often recommended (herbs, etc.) are NOT REGULATED. According to the US Pharmacopeia, “The identity, quality, purity, strength, and consistency is of critical importance to the health of patients, who rely on good–quality medicines for saving lives, restoring health, and treating and preventing diseases”. This international team of chemistry PhDs went on to say, “Healthcare providers—including pharmacists, doctors and nurses, dieticians, and veterinarians—are the backbone of a well–functioning healthcare system. They are also valued partners for USP. Since 1820, USP has worked with healthcare providers representing various specialties as it strives to improve the health of people around the world through public standards and related programs that help ensure the quality, safety, and benefit of medicines and foods.” I do not sympathize with the PhD in my own state. If she were resisting because of ONE course needed, then why would she not just take it? Then, she would need to sit for the exam. No doubt, she is smart, but I wonder how she would score on the exam and fare in an internship? I went back to school in my mid 40s to become an RD. Although I met most of the required curriculum from my previous BS degree, I still ended up with a second BS degree after taking the core competencies –some of which were repeats from degree number one. It was hard as heck at that age, but I am glad I took every single class. Now I KNOW why RDs are the experts. There is so much more beyond the chemistry that qualifies an RD to obtain that status. With all its shortcomings, as all organizations have, the ADA is not a monopoly. I could not possibly keep up with all the association does on behalf of registered professionals. They perform a valuable service that covers many, many issues. If we all agree the internet in general is a hit and miss venture for creditable information on any particular subject, then the same can be said for non-credentialed practitioners. I am sure there are good ones and not-so-good ones. Credentialing laws exist to ensure standards of practice. If the standard changes via valid science, then ALL RDs adopt the new standards. Anything other than evidenced based continuity becomes disjointed and miss-matched. Read http://www.quackwatch.com/02ConsumerProtection/licensing.html about the proliferation of bogus degrees and titles. You will not find that with RDs. Furthermore, check http://www.chea.org/ about the accreditation process. Standards of education are not unique to RDs. It’s about accountability and consumer protection. It is also the law!

      1. You put your foot in your mouth bad-mouthing naturopathic physicians. They go to school for 8 years (4 in college and 4 in naturopathic college) and the colleges are Fully regionally accredited by the USDE appropriate agencies. The US Pharmacopeia is just blowing its own horn. As for Quackwatch’s Stephen Barrett, he is being sued once again, and in the end he always loses. He owes thousands to those who have successfully sued him. The courts no longer consider him a credible witness. When I see Quackwatch, or Mr. Barrett make any statement, I know to beware! Google Tim Bolen’s site and get an eyeful about Mr. Barrett.
        By the way Chea lists The American College of Healthcare sciences as DETC accredited, Huntington College of Health Sciences is also DETC accredited. These well-trained holistic nutritionists should be allowed to practice. I got my government accredited training in the UK, and am still taking more courses. I know my limits and when to refer out. I also know when dietitians have given family and friends horrific advice.

        1. Amen!! There are many drugs that are regulated and killing people so regulation by the FDA is a big joke. Big Pharma and Monsanto line the pockets of the FDA and the ADA. These are not conspiracy theories. Do your own research. And comparing a nutritionists to an operating room nurse is ridiculous. Nutritionist, naturopaths, herbologists, homeopths, and other natural practitioners give our advice on helping improve someone’s health without drugs by using food and supplements if necessary. I would rather take my chances on a supplement than a drug. I have used homeopathy, which the medical community believes does nothing, with great success. And before you tell me it’s the placebo effect, I used it successfully on my dogs. Homeopathy is used throughout Europe. Legislation is trying to get rid of that profession also. Even if homeopathy doesn’t work on someone, it doesn’t harm them. It can be used with conventional medicine. What about acupunture? Another profession the medical community would like to make illegal. I have used it along with herbs with great success on one of my dogs who had bladder stones. It took 1 1/2 years but the stones are gone. A previous Vet wanted to perform surgery for $2,200. It costs me about half that but it worked without surgery. A “holistic” veternarian who is a licensed Vet but took classes in Canada for the holistic education. I would NEVER go to an RD for nutritional advice. So if all this legislation passes, then I guess this country will make holistic health care a secret community because it is not going away.

  13. Registered dietitian (RD) is identical with registered nutritionist (RN). Both, RD and RN have a graduate degree and pass and exam. They apply evidence-based dietetics practice in different branche of medicine, public health e.t.c. using a team approach.
    Medical doctors/phisicians (MD) with medical specialization can have a subspecialization on field of food, nutrition and medical dietetics, and in addition and PhD in medical dietetics. This type of MD., subspecialist of food, nutrition and medical dietetics, and also with PhD degree is ideal dietiticians or nutritionist naimed “the expert”.
    This type of expert are rare in worldwide. From that reason, the profession of sietetics or nutrition must to apply a team approach.

  14. I have seen many cases of harm to patients as a result of unlicensed nutritionists’ advice/counsel to their clients, so these protections are not unwarranted. Examples include patients prescribed avoidance diets based on IgG testing with significant unhealthful weight loss and protein depletion, patients with untreated mental illness prescribed supplements and extreme diets, leaving them suffering without the proper treatment, and patients prescribed diets that eliminate entire food groups, only to be sold expensive supplements that they cannot really afford. I agree with Califnornia RD.

  15. Regulating individuals who perform medical nutrition assessments and who provide nutrition advice and interventions is no different than regulating other professionals. The public needs practitioners who are trained under the most rigorous academic programs followed by an intensive internship in acute and long-term care facilities, working directly with physicians, nurses, pharmacists, and other regulated health care professionals. This basic preparation is essential for the application of nutrition therapy. There are no other academic programs that come close to providing the type of comprehensive education and training programs that the ADA oversees.

    1. Great work, RD posters! You know, would you want to go see a doctor who had never been to medical school? It’s imperative that nutritionists get the proper credentials (RD or even DTR) to handle serious cases in nutrition. I think it was a great point you brought up, Laura, that there no other training programs that come close to the ADA’s. So true.. In addition, people complain about the sponsorships that ADA receives from large corporations – and even I found myself quite irritated by that – but then why don’t other major corporations that provide healthful foods sponsor the ADA? Why don’t more people donate money to the ADA and not just sit around waiting for the soda, beef and dairy companies to do it? This group needs money like anyone else for what it has to do (keep reading ill get to more about that)..But I’ll tell you what – for the most part I have been very impressed with the ADA’s quality of professionalism and education to its RD’s and even (gasp) its openmindedness and ability to grow. For example, some folks I know were turned off by the ADA’s seeming support of the dairy and meat industries – However, they didn’t even know (i had to tell these folks) that the ADA recently came out with a new position paper on vegetarianism, stating publicy that people of ALL AGES can benefit from a well planned vegetarian diet, and that the vegetarian diet can even treat and prevent many diseases. If they were so biased, this position paper would not even have come out in fear of ticking off their meat providing sponsors. Like I said, I’ve been pretty impressed with the ADA’s ability to be a reliable nutrition authority for the public and for dietitians. And nutrition is such a new, deep and complex field in which they’re doing pretty well keeping up with. In addition, RD’s are not just ADA puppets sitting around doing what the ADA tells them to. I’ve seen RD’s offer input and influence the way the ADA will go; i’ve seen it be a 2-way street.

      1. Cathy,
        Why doesn’t the ADA stand on ethical grounds and refuse the funding by the corporate entities? It is a complete conflict of interest to accept these monies. The products created by these groups are so processed that the nutritional components are destroyed in the process and then trace portions are re-introduced so that they can say “With X,Y and Z added!”. Processed food products have NO place in dietary protocols.

  16. Wow, the ADA certainly has their advocate/spokesperson here in this string, don’t they :-

    1. Yes, and it’s nauseating to hear the utter lies but that’s the way our government has become……one lie after another.

  17. I have been in the fitness industry for over 20 years and I have waited for something like this to come along. There are way too many quacks out there selling misinformation to ill-informed people. The fitness industry has jumped on this nutritionist band wagon. Most of the people who call them selves fitness experts are sticking their hands into the pockets of these ignorant people and stealing their money. It is about time we have some serious regulations on the supplementation industry before too many people get hurt. The only people who really have a problem with this kind of legislation are those who have the most to lose. If one is a true professional they will help the government make this industry a better one for all involved, not just so they can pad their own pockets.
    Dwayne Wimmer

  18. I am an RD by credentials and have been in the field of holistic, functional and integrative nutrition for 20 years. I have also worked in the academic world and understand necessity of standardized education. However, in my opinion there are exceptions on a one-by-one basis, depending upon the individuals background and education. I compare this to a medical professional who is coming from another country and wanting/expecting to perform the same medical practice but when arriving to the United States he/she has to make up certain coursework to reach the education standards in this country. It may be clinical practice or it may be coursework or it may be both. I myself tried to practice in New York and was denied due to my college not having exactly what the NY dietetic board was asking for and I graduated from NY! and I was a licensed dietitian at the time! I agree with the standardization of basic education and training in clinical nutrition because isn’t it “treating a person” when you give specific advise of foods, supplements, etc. You need to know how to read blood tests, etc. to keep your patient safe and do no harm. This is just one example of many. HOWEVER, this is a complicated subject and there are many qualified individuals out there like Liz who are practicing safely and have the knowledge to do so. The one area I feel strongly about is to reform our dietetic internships and update them so that someone who does not want to be in organizational dietetics should be able to acquire a more aggressive approach to nutrition to include approaches in holistic, functional and integrative nutrition so that the individuals who either want or have to get their clinical experience in an internship can attain a standard education as a nutritionist. Again, I think this is a complicated topic and does vary from state to state and should be dissected carefully and respectfully. Because this is a new regulation coming through our country and there has been individuals here that already are practicing effectively and safely there should be exceptions in my opinion.

  19. For the registered dietitian community to claim that they are not influenced by their corporate sponsors is naive at best. First of all, take a look at who their sponsors are:
    http://www.eatright.org/corporatesponsors/
    Among them are some of the largest processed food companies on the planet, including Coca Cola, Pepsi, Mars Candy (!!!), Kellogg’s, General Mills, plus processed food giants Aramark and Unilever.
    Do you honestly believe that these companies are offering financial support out of the goodness of their hearts?
    Further, to claim that this corporate largesse does NOT affect the ADA’s recommendations flies in the face of the very scientific principles the ADA claims to uphold. In the April 5, 2009 issue of JAMA, a panel of 8 distinguished researchers found that incentives as small as a pen offered to health care professionals affect their treatment decision making. How much more are the ADA”s poliicies affected by the corporate giants, whose interests the ADA supports?
    But you don’t have to take my word for it. Here are the words of the late Nobel Laureate, Miltion Friedman, on the assertion that regulation “protects the public”:
    “In the arguments that seek to persuade legislatures to enact such licensure provisions, the justification is always said to be the necessity of protecting the public interest. However, the pressure on the legislature to license an occupation rarely comes from the members of the public who have been mulcted or in other ways abused by members of the occupation. On the contrary, the pressure invariably comes from members of the occupation itself. Of course, they are more aware than others of how much they exploit the customer and so perhaps they can lay claim to expert knowledge. Similarly, the arrangements made for licensure almost invariably involve control by members of the occupation which is to be licensed.”
    Bottom line: despite their protestations to the contrary, the American Dietetic Association and its state affiliates are an economically motivated special interest group, seeking to create a nationwide monopoly to protect the interests of their corporate sponsors. Thinking RDs need to wake up to the fact that they are being duped. The ADA should be stopped at any cost. We intend to see that they are in Texas.
    Peter McCarthy
    Chair, Texas Health Freedom Coalition

  20. Both myself and my partner are both trained as RD’s. Having now being an medical student, I can honestly say the education as an RD is surely lacking in some areas. I guess this is only my opinion, but even as I look at the required coursework I had to do to be become an RD, its severely lacking. The knowledge of biochemistry is severely limited. The knowledge of human physiology is lacking the essentials. Knowledge of pathology is weak and numbed down. Physical diagnosis is essentially ignored. Pharmacology never happened- although in Medical Nutrition Therapy diuretics are perhaps discussed. I can really go on.
    Now, do I expect someone who really just has a pre-med track undergraduate degree with extra coursework in food science, management and a few nutrition courses to be an EXPERT in nutrition advice? Of course not, in fact, the coursework doesn’t even qualify as pre-med as its lacking upper level biochemistry, biology, physics, and chemistry — I had to end up taking extra coursework after my bachelors to get into med school. The coursework does help you regurgitate out the USDA’s food guide pyramid (ever changing and heavily influenced by lobbies, and which doesn’t even agree with most scientific nutrition recommendations), but certainly doesn’t teach you to problem solve or think. In fact, no advanced coursework in research and statistics is required – but that is okay because the ADA spoonfeeds disseminated nutrition literature in its custom “evidence library” – “hey, I don’t even need to look through the literature myself– good thing I trust everything in here so much that I pay for membership!” Unfortunately just another gimmick that attempts to replace quality independent research of a competent clinician by reading actual papers themselves.
    Eventually an unpaid, ADA approved 900 hour (has it changed yet) matched internship and a very basic nutrition test are what make you the nutrition expert in the eyes of the ADA. The financial reality of paying thousands (or ten thousands) of dollars that DO NOT QUALIFY FOR STUDENT LOANS unless you are lucky enough to be matched with an internship that is run as “college credit” it frustrating as well– students need to start paying back undergraduate loans while working full time (most internships are unpaid) and paying thousands for their internship. In some cases, the internship yields minimal experience in the clinical setting, many focus on food service or community nutrition programming – which is the only chance a future RD has to learn the rope before actually beginning to practice.
    Now certainly, with ANY profession, someone who just finished their program will have much to learn— and my previous statements do not take much of that into account. But in my opinion, it seems perfectly rational that a medical doctor who has had additional training or certification is MORE THAN WELL QUALIFIED to dispense nutritional advice.
    In fact, as I learn more details about pharmacology and physiology, I would argue that RD’s may not be, in many advanced circumstances, able to dispense the most adequate nutritional advice. I guess ignorance is bliss, but when I would try my hand at writing diet orders and look at labs during my internship, I really was just following very basic “cookie cutter” understandings of labs and their disease and patients 6+ medications in order to make my recommendations. With what I know now, its laughable. I never knew many of my patients conditions existed. I didn’t know why labs would go up or down when so many metabolic pathways were influenced by medication. Sure I had a “drug nutrient interaction handbook,” but does that replace true knowledge of disease and medications? Many patients have so many things going on- how can anyone BUT a trained clinician give true advice?
    In that regard, the doctors at the facilities I trained at had to review and accept our diet orders, because its so easy for someone with almost no clinical experience or training in pathology to miss contraindications, or perhaps something “odd” that is therapeutically desired or expected. I just finished my 2nd year in med school, and think its sad that we can call an RD the expert when juxtaposed against an MD who has a PHD in nutrition and years of experience. Rational however, yes. I expect nothing less from an organization like the ADA to defend itself and its members like any organization, even if its at the expense of other PERFECTLY QUALIFIED professionals.
    I understand that we want to make sure people are “safe” by regulating nutritional advice… But to take it away from other medical professionals? Especially from the ADA, who have eaten up and continue to beg for my money to undermine other quality professionals who have more advanced clinical expertise and in some cases, better understanding of nutrition itself.

    1. I agree with some of your assertions, but the fact is the majority of medical schools do NOT require ANY mandatory training in complementary care, and most require minimal training in nutriton, with information similar to that offered to RDs. So if most of the doctors don’t have this knowledge, going to them for nutritional advice is a lot like going to the hardware store to buy oranges. The MDs who DO offer this kind of information to their patients are largely self taught. This is one more piece of evidence highlighting the dominance of Big Pharma and Big Food in our health care education system.

  21. I work on boith sides of the fence! On professional dietetic discussion groups I see where RD’s get patients they do not know how to treat BUT to a holistic trained eye, the approach is obvious. I also see where a particular nutritionist seems to have given odd adivce but a particular dietitian with a special expertise in an area had just the answer.
    What health professional can truthfully say they know how to treat every single person who walks through the door- successfully?
    Not every single dietitian knows what every other one knows. not every naturopathic nutritionist knows what every other one knows. That is why we all recognise ” second opinions” are important. Eaxg person knows when they have the right answer to our particukar problem. No one else can tell us they have the right answer for our body. it is something each of us somehow knows for ourselves.

  22. This regulation attempt, as do many comments by RD’s, seems just like the story of a group of people who stroll into a city and begin shouting:
    “Look over there! Some people might come up over that hill and if they do, they might be dangerous to you. We are experts in identifying dangerous people and we can save you.”
    Now, if the people get afraid and deliver themselves into the hands of the self-proclaimed experts, what might happen?
    This is a good variation on the Karpman Drama Triangle. Do we have a well intentioned group who are truly rescuing some possible victims before any bad people can do them harm? Or do we have a group of people who can set up defences around the city in such a way that no matter who walks over the hill, good or bad, is carefully lined up as a target? Who would the real victim be in such a case?

  23. Like an RD would know how to prescribe a diet to my bodybuilding clients and models who need to shave off ALL fat off their bodies. Or what my endurance athletes should eat while training for a 10K. The ADA is not just ruining MY profession as a specialize Sports Nutritionist, they are takinng away qualified experts that the public would need. Why on earth would anyone go to a doctor’s office to speak with an RD for a diet that will fuel a sports activity when they barely know what to do with a diabetic?

  24. yes some nutritionists are highly educated. many are not. in fact, some websites allow to go online and pay for a fake degree that claims you are a nutritionist and you can input your dog, cat, or hamster’s name so they too can become a nutritionist. why would nutritionists want to work in an environment where that kind of shenanigan is acceptable? at least a dog, cat, or hamster can’t complete a rigorous 1200-hour minimum (other options poster, this has been increased but it sounds like you are so distant from being a dietitian you couldn’t take 2 seconds to research and figure that out before criticizing internships and the process – never mind that many are indeed heavily clinical to the point of meeting only the bare minimums for food service).
    furthermore, dietitians are one of the lowest paid health professionals, if not the lowest. believe me; i don’t think people become dietitians for the money! moreover, because they don’t push untested/potentially unsafe/possibly useless supplements – as part of the code of ethics – they wouldn’t achieve the financial gain a nutritionist could. hmm. no wonder nutritionist are so threatened.
    aside from what you feel reading my post, whether you agree, disagree, or feel neutral, i will say the one thing that no one yet has said or posted:
    *** TO BE A REGISTERED DIETITIAN, YOU DO NOT HAVE TO BE A MEMBER OF THE ADA. ***
    yes, read that again, all of the people out there who somehow think that RD = ADA when a RD has the free will and choice whether or not to belong to that organization in the first place. dietitians are credentialed through the commission of dietetic registration, which admittedly does have affiliation with the ADA, but if you do not have to be an ADA member to be an RD and practice, then shouldn’t that tell you that not every RD is an ADA “slave” or “drone” like various people have posted?
    for me, personally, i’d rather be a RD, ADA member or not, then a nutritionist any day of the week. at least all of my fellow professional colleagues would be people – and not hamsters that got their nutritionist certificate online with a credit card.

    1. Although anyone can call themselves a nutritionist, not anyone can call themselves a CCN or CNC. These titles are awarded by the CBNS and ACN, just as the RD is awarded by the CDR, and require extensive training and passing a comprehensive and rigorous exam. The argument that dogs and cats can call themselves nutritionists as an excuse for limiting the practice of nutrition to RDs only falls flat because these anti-competitive bills not only bar untrained and unverified folks from practicing, but highly skilled professionals holding professional credentials (CCN and CNS).

  25. The American Dietetic Association Should be Sued!!!!!!!!!
    Do I need to say anything more besides the following facts:
    American Dietetic Association’s stance on Aspartame: “ADA concludes ASPARATAME is SAFE and has issued a position statement approving non-nutritive sweeteners including aspartame. ADA is the professional organization that establishes standards of quality for practice for nearly 70,000 dietetic professionals, most of whom are registered dietitians.”
    American Dietetic Association stance on GMO foods: “It is the position of the American Dietetic Association that agricultural and food biotechnology techniques can enhance the quality, safety, nutritional value, and variety of food available for human consumption and increase the efficiency of food production, food processing, food distribution, and environmental and waste management. The ADA encourages the government, food manufacturers, food commodity groups, and qualified food and nutrition professionals to work together to inform consumers about this new technology and encourage availability of these products in the marketplace.”
    By the way I am a Registered Dietitian who would NEVER tell anyone to eat the above foods because I have gone through the research. Aspartame and GMO foods should be considered dangerous.
    The ADA should issue warnings in regard to the health risks of Asparatame and the lack of long term research on GMO foods. Clearly the ADA is governed my big corporate business.

  26. Medical doctors need organic chemistry. Nurse practitioners, PAs, etc… need organic chemistry. RDs also need organic chemistry, because bioCHEMISTRY is largely organic chemistry. To understand human metabolism and disease, it is imperative to have an understanding of organic chemistry. As a Ph.D. student in Biomedical Science at a top 20 medical university in the United States, I firmly state that comparing “applied” biochemistry to organic chemistry is misleading and inaccurate; organic chemistry trains the student to think in a specific way that is critical for problem-solving and relating health with disease at the macro- level. You cannot become a doctor or a nurse without certain courses; and it is exactly the same for becoming an RD.
    I work with top physicians and scientists in the world. They expect rigor, competency, and hard work – and nothing less – and would never hire a non-credentialed healthcare professional. Nor will I when I am a professor and independent investigator at an accredited university.
    Who do you think brought apples to McDonald’s? An RD. Who do you think increased the amount of whole grains in large-brand cereals? RDs. McDonald’s, Coke, Pepsi, etc… are going to continue to exist. It is completely unrealistic to expect them to disappear anytime soon. I do not always 100% agree in all of ADA’s partners (the corn syrup REALLY bothered me!), but I do agree that partnering with them ensures more control over these large corporations in the long-run, compared to turning are backs from them. Corporations are helping us by funding them, and in turn, we are helping by mandating that they have healthier options. Would I love to see all unhealthy fast-food disappear, of course! But is this realistic? Not at all. And we must be pragmatic in our practice.
    I value holistic medicine and agree that it should be incorporated into mainstream medicine. I lived in Switzerland for several years and their medical practice is holistic-based; however, to practice holistic nutrition and medicine; they must go to Medical school or become a Registered Dietitian (yes, Switzerland has RDs, too). Medical nutrition therapy can save lives – and it can conversely take away lives. It is crucial to receive standardized and accredited education.
    How do you propose, then, we create a system where we can ensure that all those practicing nutrition have been through an accredited education program and have received standardized training that is required for providing, at minimal, standard of care services to patients? How do we bridge the education provided through holistic nutrition schools with those of accredited universities? Perhaps it is time to stop bashing the ADA – and start proposing realistic solutions. Many RDs value holistic practices and would be interested in more training in it. There is ample opportunity, and need, to bridge both of our schools of thoughts; but it must start first with tolerance, acceptance, and respect.

    1. Well Said…I am not a member of ADA and have been a practicing registered dietitian in CA for years. RD’s don’t have to be members and like you, I do not go along with everything ADA does or stands for, but do see how they benefit in moving our profession toward a place closer to the standing of medical doctors and nurses. Specific classes, degrees, application and granting of licensure “should” be necessary to practice. (oh yea insurance reimbursement is quite a plus). I am a telephonic dietitian and speak to patients located all over the country. This unique job requires that I be licensed in all states that require it, so I know a lot about nutritionist and dietitian licensing and how much the criteria can differ from state to state. I have filled out applications that were pages long, background checks, transcipts, fingerprinting and evaluated for sound mind to obtain certain licenses. Why should RD’s be more subject to this kind of scruteny than a “natural” nutritionist that hangs out a shingle or someone that has a degree, but no professional credentials. Licensure elevates our profession, but it also comes with increased moral responsibility . I realize there are people with nutrition degrees, Masters, Phd’s that are qualified to do what I do and most are upstanding moral individuals. I also agree that these groups should have a chance to be licensed and not necessarily have to be RD’s or held to ADA’s exact criteria. Many of licenses I hold allow for just that. The dietetic and nutrition science degrees prepare us well and internships can be invaluable at shaping professionals that can think critically and advance our ever changing field. What is wrong with anyone wanting to practice in the field of nutrition getting a degree and proving basic entry level knowledge. Then you can practice in whatever area of expertise you choose. By the way, Rd’s have knowledge of “natural and/or holistic nutrition.” we are not puppets of ADA or Big food corporations….The more specialized nutritionist s and dietitians become the better we will be able to serve the public. I am welcoming all the credible research and information now available to us regarding “natural/holistic” nutrition with open arms.

  27. This is so ridiculous. These laws are to provide a way for dietitians and nutritionist to be paid by insurance companies for their services. Fighting the passage of the laws is hurting everyone.

Comments are closed.