The American Dietetic Association’s Monopoly Continues to Grow—But You Can Stop It Cold!

NutritionistNew bills have been introduced in a number of states that will give the ADA a monopoly over the practice of nutritional therapy—these are the people in charge of the wonderful hospital food. Please take action in your state to stop this power grab and ensure consumer choice!

The American Dietetic Association (ADA) has sponsored legislation in over 40 states. These bills 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 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.
In some states, individuals are even prohibited from using the words “nutritionist” and “nutritional care.” Such legislation impedes an individual’s right to access highly qualified nutritional therapists of their choice, and prohibits hundreds of qualified practitioners from providing nutritional therapy.
Nutritionists and dietitians differ in important ways. In general, nutritionists are health practitioners with comprehensive knowledge of how nutrition impacts the whole body focusing on medical nutrition therapy, metabolism and biochemistry, and work primarily in private practice settings conducting one-on-one nutrition counseling. Nutritionists practice an integrative approach to medicine and concentrate on prevention and treatment of chronic disease. Dietitians, in general, are experts in what passes for nutrition science today, much of it often woefully out of date, with training focusing on institutional diets and food service management—developing diets for hospital patients, school food service programs, and nursing homes. Dietitians can provide individualized counseling on diet and disease and there can be an overlap in the type of work each profession practices.
California
Read our bill analysis HERE

The California Legislature is currently considering a bill that would create a new Dieticians Bureau and create and an advisory committee made up of dietitians. Under this bill nutritionists are forced to become licensed as dietitians in order to practice, regardless of whether they already have a Masters degree or a PHd. This bill would effectively eliminate an entire profession and removes all competition in the field of nutrition services.

California residents please take action now!
New Jersey
NJ Assembly bill AB1987 and the senate version in the NJ Senate, S809, is the Dietitian/Nutritionist Licensing Act. This bill 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.
This is not the first time we’ve worked in New Jersey on this issue—we were able to kill two different bills last session.
New Jersey residents please take action now!
New York
A.5666 and its identical companion bill in the NY Senate, S.3556, provides for the licensure of dietitians and nutritionists. This proposed bill lumps dieticians and nutritionists together under one title, “Licensed Dietitian/Nutritionist” or “LDN” rather than providing separate licensing for each.
The bill creates a joint board, appointing four members of the ADA and three representing nutritional associations. It does not identify the required exam—but it directs the board to do so. We have run into this problem in other states, where the board, heavy with ADA reps, refuses any but the ADA exam. Note further that this is a title provision, meaning that they aren’t preventing the practice of nutrition (subject to these requirements), but they are limiting the title by which one may advertise! And their certification requirements are standard-issue ADA: a BA, 900 hours supervision, etc.
New York currently recognizes credentialing agencies beyond the ADA—in particular the Certification Board for Nutrition Specialists (CBNS), which is specifically designed for nutritionists. This would change once the ADA-majority board takes its first vote. Any new legislation must keep nutritionists separate from dieticians (who will immediately take control of the licensing process), and must ensure the same protections.
New York residents please take action now!

76 comments

  1. WAY too much power for the ADA, who is in bed with their corporate sponsors!

    1. Look, there are plenty of dietitians who are also naturopaths; it’s a great partnership so give me a break about corporate sponsorship. If someone wants to practice medicine, they can’t do so no matter how much education they have until they pass their boards; the same should hold true for those who wish to practice medical nutrition therapy. If you have the education then take it all the way. Meet the requirements; prove you’re not a quack and practice away!!

        1. I do not agree with the corporate sponsors of the ADA. RD’s must go through intense schooling and a very competitive internship process to gain their credentials which are then discredited by people calling themselves nutritionist. Per the comment above “Don’t tell me you have to have a license to talk about food!” thats what you think because all the “nutritionist’ trying to make money off of weightloss products. Dietitians play a crucial role in preventing chronic diseases as well as healing the chronically ill.

          1. DS RD says:
            “Dietitians play a crucial role in preventing chronic diseases as well as healing the chronically ill.”
            Yes, but only if they are willing to “buck” the system that has been put in place in this country by “Corporate” food and “Big Pharma.” When so much money is channeled into medical education by these sponsors, the real information about nutrition is suppressed or completely skewed in favor of a rationale that suggests diet isn’t as important as medicating the issues that result from poor eating habits.
            Why on earth, when food is the very fuel we use to power our bodies, and good eating habits stemming from REAL, UNBIASED, and TRUTHFUL nutrition information can prevent most diseases, do most medical students only receive a token overview of nutrition in this country? Yet the amount of education that they receive in medical school, and continuing education throughout their practices, regarding drug administration is so much more comprehensive? Because the information they are taught is bought and paid for by Corporate food and Big Pharma.
            I am stunned on a daily basis when I hear of so many with diabetes whose doctors, instead of severely cutting carbs, and in many cases thereby eliminating the issue of AC1 levels, instead continually adjust the diabetes meds in an effort to keep a patient on a “balanced” diet? What is balanced about a diet that a patient needs medications to stay on? I would think that after THAT many years of medical training, ANY Dr. should be able to tell a patient that there is really NO medical reason to even eat carbohydrates at all, and even with vegetables, a minimum carb load can be a better way to regulate blood sugar – yet none do.
            If Dieticians stand up and choose to find and use the nutritional information that is unbiased and truthful, which IS out there, and IS accessible, then they will be treating disease and chronic conditions. But that is an effort that goes above and beyond the selective, misleading, and wrong information most students are given in most “accredited” medical training institutions.
            My suggestion is always follow the money, and when you reach the source of the information that is presented by those with that money, seek the truth elsewhere!

        2. i served i n viet nam,my dad in wwII, we need more freedom not less.
          do yr part and stop these stupid regulations!! best jimmy mack

        3. That’s what the ADA wants. However, many RDs work in schools, prisons and hospitals and look at how people come out of these places — often sicker than when they went in. Some RDs on the other hand have taken it upon themselves to go back to ND or holistic nutrition programs and learn that good fat is
          (not canola, soybean and corn oil) but saturated fat is necessary and so are supplements and herbs. So the RD exam is essentially worthless unless one is going to work in institutions. Why inflict this pain on anyone else?

        4. It is not just having a license to talk about food, but controlling what you can say about it. The FDA has already declared that any health claims for food will make it a drug and then the FDA can control that industry. They have threatened the cherry growers for making health claims for cherries. More recently they have done the same for walnuts. Do you remember when schools taught about citrus fruits and Vit C and Scurvy? or Vit d and rickets. Technically the current FDA rules makes this illegal. The reality is that if you promote drinking processed milk and toxicified meat that supports agribiz industry you are safe. However, if you promote organic foods and unprocessed milk then you are illegal. And horrors that you say that some foods prevent arterial plaque build up then you are stepping on the toes of Big Pharma’s profits and you become illegal.
          These bills promote industries interests only and have nothing to do with health of the public which is the only justification for any laws.

      1. I couldn’t agree more thank you. I have my BS in nutrition and just completed my dietetic internship. I also have attended holistic schooling on the side at the Institute of Integrative Nutrition. I knew that I would not get the natural, holistic education from a Bachelors program, and I won’t even pretend to say that I agreed with everything that was taught to me in undergrad. But people, that is life. If you don’t have enough common sense to weigh what you learn and seek out the information that truly interests you elsewhere then why would I want to come to you for nutrition advice in the first place. The ADA is frustrating as hell sometimes, but where would we be without it? There are enough people out there with ZERO education spewing their latest diet trend. There has to be some sort of regulatory agency, especially to give credentials to those of us who have worked our asses off the reach that. I’ve done the holistic school thing and I know that I would not be half the dietitian I am now if I hadn’t also gotten my RD. Believe it or not there is alot of truth in evidenced based medicine and research. We need people who are able to shift through the BS and think critically. I will say I am disappointed and surprised that more dietitians are not naturally minded.

  2. Please check the sample letter regarding CA Assembly bill AB 575. I starts out in support of the bill, the opposite of ANH’s (and my) position.
    I rewrote it: others should do likewise.

  3. All American’s should stand up for their rights and STOP THIS BILL!!!!!!!!!! What is nutrition??? Depends on what you know. Schools serve hot dog’s on white buns and call this good
    food.. NOT!!!! Were is our right to choose what WE WANT!!!

    1. With every new regulation you lose more and more freedoms. You have to remember that voting does have consequences.

  4. GE foods are a risk, and so is the ‘Terminator seed’, which is about to be approved by the USDA. This seed will modify plants so that their seeds will be useless, and farmers will be forced to buy seeds every year from the seed companies. We need to write Congress and express opposition.

  5. They will probably craft recipes to create more cases of diabetes to keep customers coming and have a reason for having a job a cure will put them out of business think about it.

    1. “Even if the nutritionist holds a Masters or a PhD in nutrition, the nutritionist is still required to complete registration through ADA in order to keep practicing.” This is false. they can indeed become licensed in some states as a licensed nutritionist. It’s up to the different states. I am a registered dietitian and a licensed nutritionist. But you don’t necessarily have to be registered to be licensed. Masters and PhD’s in nutrition can also be registered. Licensure is there to keep just anyone from claiming to be a nutritionist. Some states require plumbers to be licensed, for instance. I don’t want a pastry chef telling me he is a plumber, so he can do the plumbing in my new house with no expertise in the field. While I understand and appreciate freedom of access to “experts”, I must say this article is lacking in balanced and accurate information.

      1. Hi Drowell, the quote above refers to legislation that the ADA has passed in some states and is trying to pass in others. In North Carolina, only RDs are permitted to practice nutrition because of legislation pushed successfully by the ADA there. CNS and CCN professionals are not permitted to practice. ADA is currently pushing similar legislation in other states.

  6. This are more special interest bills that should be stopped now. There are hundreds of trained nutritionists that are needed if we are going to build a healthy America. We need the new practices and research that these types of practitioners can bring about by counseling people in all areas of health and nutrition on how to stay healthy and well. Registered dietitians are trained to make trays of jello and count calories based on uneducated Physicians knowledge of diet. Please stop this kind of unhealthy information from becoming law. I urge you to vote NO on all of these bills.
    Thank you,
    Linda Fisher

    1. I’m a registered dietitian. I do not work in a hospital, do not create menus, and do not serve jello.
      What’s a nutritionist? Clearly you have no idea what registered dietitians do. Sure some are employed in quantity food production, but many are not. Many are counselors, some licensed social workers as well, many have advanced degrees in nutrition, many are authors and speakers, and all have a very thorough understanding of nutrition, biochemistry, human physiology, diet therapy in both health and disease, and also a deep understanding of human behavior. This is hardly what you describe as training “….based on uneducated physician’s knowledge of diet”. I was never trained by a physician, and you’re right, they get a miniscule amount of nutrition education during medical school – that’s why they should refer patients to an RD.
      So throw out your stereotype of dietitians hanging out in white coats in nursing homes or hospital kitchens, and start educating yourself. http://www.eatright.org/Public/content.aspx?id=6713
      Helping people make dietary and lifestyle changes is complex. It not only involves helping them choose the best foods, but more importantly supports behavior change. I know, because I’ve been doing it for 25 years. My whole practice is based on prevention, as well as education and one on one counseling.
      A final note- if not regulated by the ADA, who is going to regulate every self-proclaimed nutritionist (and I’m not talking about the ones with PhDs)?
      Would you allow someone who goes to medical school but is never supervised in a residency program or passes any exam or satisfies any criteria operate on you?
      Be careful what you wish for.

      1. Ok I am about to reply to this. I have a fully accredited Diploma in Clinical Nutrition from a UK career college accredited by an agency empowered by the UK government to accredit UK National Vocational Qualifications. in the UK this Diploma would enable me to obtain indemnity insurance and call myself a nutritionist. i also have Diploma’s in Anatomy and Physiology, and Herbal Medicine, and am in the process of gaining some more nutritional qualifications.
        I went back to school because NO registered dietitian on this planet could or was qualified to help me with fthe autoimmune condition that I have. That is because dietitians are taught that dietary supplements are not necessary and most are harmful, and the herbs…well God forbid anyone take these horrible things that are no regulated by the US government. Oh yes, and did I forget to mention that most of the ADA nutrition books I own are very keen to tell you that Genetically modified foods are perfectly safe because they have been approved by the FDA. (Of course that is an outright lie because GM foods have just been rubber-stamped as substantially equivalent to conventional foods because Business lobbied for such “substantial equivalency).
        Did you learn about detoxification, and N-Acetyl Cysteine and how as a supplement it is the precursor to manufacturing glutathione in the body, and how glutathione is needed in phase 2 detoxification? I would venture not. You learned how packaged dead cereal is healthy for you and were inundated with propaganda about how “Fad” health food diets can wreck your health. Isn’t The ADA’s mantra “All Foods can Fit”.
        Well most of us who value our health know that all foods CAN’T fit and that sugar laden ice cream and GM soy and corn and foods sprayed with toxic pesticides really should not be a part of any healthy person’s diet. Many of such items should not even be called “food”. Dietitians learn how to plan a diet for someone with kidney disease. How about learning how to plan healthy whole food organic diets, with added supplements to help people not get kidney disease in the first place.
        And then there is the fact that the ADA has sponsors and partnerships that include Mars Bars and Coca cola. PLEASE!! I see what the dietitians feed my diabetic mother in the nursing home and you could not pay me to eat that garbage. White rice and bread, no fresh salads or vegetables, processed devitalized foodstuffs designed to keep people ill is what i call it.
        As one wholistic physician put it, 4-5 years of an accredited nutrition education means beans if almost everything you were taught in those 4-5 years was WRONG! And he added that dietitians, in league with US government agencies, are actually responsible for the horrific nutritional state of affairs and the obesity epidemic in this country.
        Contrary to your beliefs or what you have been taught, dietetics is NOT the science of NUTRITION. It is the science of dietetics. The ADA simply wants to maintain a monopoly by outlawing all the competitiion. i would be dead today if it were not for what I learned and continue to learn in Nutrition courses that are really about building health and the actual science of nutrition. As one commentator noted, not all dietitians are uneducated in REAL nutrition, but for the most part those that are educated in REAL nutrition taught themselves as they pushed to go beyond the limits of what they were taught in school. But this blog is about the ADA making it illegal for anyone else to practice as a nutritionist or call themselves such except Dietitians. And that is a forced monopoly that anyone who is interested in real health should be against.

      2. And MY reply to you is – No one is disputing the amount of “training” you received – what is in question is where you received it, and consequently, what you decide to do with it. If you are simply getting MORE of the SAME claptrap that the institutions in this country accredited by the AMA are insisting be taught, and consequently passing that drivel on to patients who need the unbiased truth about nutrition to help them heal, then you really don’t have much more to offer than those Dr.s that we mentioned get very little training at all. As with most things in life, it isn’t about quantity, it’s about quality, and if you only learn what’s taught by a very biased, slanted, and skewed accredited curriculum, you won’t know how to best treat the human body and it’s nutritional needs.
        There is such a lack of good nutritional sources out there, because most of the institutions teaching medicine and it’s supporting fields are so heavily influenced by Big Pharma and Corporate food – a dangerous duo that together know that it doesn’t matter if you are getting sick from their recommendations – they will make their money on you one way or another – if their food sickens you it doesn’t matter – you will then feed their wallets by needing their drugs to keep you alive.
        Americans are getting smarter, so if you think you can throw credentials and diplomas around and expect anyone to be impressed and put their trust in you, beware. It may work for a while, but you’d better have something more behind you than that, because if you continue to spew the current nutritional advice that the writers of the USDA food guide do, you are just adding to the problem and sickening more people.

  7. As someone who cannot tolerate many prescription drugs because the cause dizziness, nausea, etc., I depend on supplements to try and keep well so that I do not end up in a nursing home.
    Supplements are my lifeline. I probably would not survive too long without them, since I suffer post-gallbladder surgery problems. I now cannot digest fats or sugar. They cause immediate diarrhea. This problem controls my life. I cannot enjoy tours or luncheons. Thus, it is important that I use supplements.
    Please do not pass legislation that will in any way prevent my use of supplements or their manufacturers who are reputable companies and have been in business for years.

  8. We must keep the field of nutrition distinct from the field of diet. They have different disciplinary emphasis and requirements of study and different areas of concentration. These should not be commingled and confused. Linking them together would mean dilution of the strict requirements of the field of nutrition. We should maintain the strict requirements and standards of the study of nutrition. Mary Ann Detlefsen, PhD

  9. +PAX Please keep the ADA out of our intake of what we want for food. Look at the illness that we have in our country because the ADA do not know what they are saying. They are bureaucratic. We Americans have to start taking charge of what we eat. Do not follow like sheep take charge of your life. God bless you. Theresa Rothenbach +JMJ+

  10. At least the ADA stands up for the health benefits of a vegan lifestyle – I don’t see too many, if any nutritionists in this country who are promoting this fact !

  11. In Wisconsin the WDA almost passed this legislation in the last session of the legislature. Our Wisconsin Health Freedom Coalition packed the hearing rooms in both the Senate and the Assembly with opposition, but the Health committees of each branch passed it anyway. This should not be a partisan issue, but the committees voted on strict party lines with all Democrats voting for it and alll Republicans voting no.
    The election gave control to the Republicans and we are now ready to introduce a Consumers Health Choice Bill and will do it as soon as the budget crisis is taken care of. Wi Health Freedom Coalition has a website, http://www.WIHFC.com

  12. Please keep in mind that many readers of your newsletter might be RD’s such as myself. All RDs are not uneducated in REAL nutrition, just some of them. The difference is not between nutritionist and dietitian but in “traditional” and “alternative” regarding either name.

    1. Hi Millie, I hope we haven’t offended any readers like yourself. We did note that, “Dietitians can provide individualized counseling on diet and disease and there can be an overlap in the type of work each profession practices.” We only spoke in broad strokes about the general type of training each profession has. We feel that the training the ADA provides is woefully inadequate and oppose an ADA monopoly on nutrition, though we certainly applaud RDs who have sought better nutritional training. Similarly, we are opposed to the AMA and its attempt to gain a monopoly on medicine, though we have many MDs on our list – indeed, even on our Board of Directors. Our qualm is absolutely not with RDs or MDs, but with the ADA and the AMA who seem to want to water-down their respective fields with junk and harmful science, while shutting all others out of the field.

  13. Wow – are you woefully out of date! There are a LOT of dietitians practicing functional medicine. One of the dietetic practice groups in the American Dietetic Association is call Dietitians in Functional Medicine. Some of them work at very high levels in Functional medicine, for example the dietitians working with Dr. Mark Hyman, one of the top functional medicine docs in the US. I think your article is sterotyping at its worst. I have seen some excellent RDs who knew their stuff (NOT in food service by the way) and some RDs who are out of touch. I have seen some nutritionists who were top notch, and some who were very dangerous and practicing out of their league giving erroneous recommendations. Please don’t reduce this important discussion to sterotyping. Do your homework and use this platform to elevate the discussion not trash it!

  14. I am a retired dietitian/ nutritionist … “dietitian” if I were in ~hospital/working with patients in hospitals and “nutritionist” if in public health or Preventive setting
    My primary work was in Intensive Care Units. I’ve never felt that the term Nutritionist in any way related to the work that I did.
    We worked very hard to get licensure passed to protect the patient from calous care administered by non-qualified people. This was in the 80’s when “Nutritionist” degrees were often given through the maiil and cases such as a dog in Massachusetts receiving one.
    But times are changing and not only is there a need for people to be called “Nutritionist” without going through the ordeal of meeting ADA criteria but perhaps Nutritionist need to form their own body.

  15. The American Dietetic Association’s Monopoly Continues to Grow—But You Can Stop It Cold! In some states, individuals are even prohibited from using the words “nutritionist” and “nutritional care.” Such legislation impedes an individual’s right to access highly qualified nutritional therapists of their choice, and prohibits hundreds of qualified practitioners from providing nutritional therapy.
    Right now, a number of new bills have been introduced in different states that would increase the ADA monopoly even further. These are urgent Action Alerts. If you are a resident in one of the states below, please contact your lawmakers immediately and ask them to oppose these bills!

  16. Lumping the dieticians with nutritionists is a counterproductive way to run this legislation. Once the the dieticians are lumped together with the nutritionists, the nutritionists will be required to conform to all the dictates and licensing procedures of the dieticians. Nutritionists are a separate entity with different goals and procedures from dieticians and should not be expected to change their goals and purposes to conform to ill conceived law

  17. A dienutritionist, when I was a kid nutrition was food nutrient value and diet ment food restriction. When will our legisltors obey their oath of office? Why should the government or it’s opressive lobbiests care to restrict my access to the safe local food, pet milk cows or my own diesel processing plant? Who the hell cares if I use hemp rope or cotton string or polyesther boat line with an extra dabbled line for safty? This is a war between the political class and the rest of us. They are trying to starve us like killing the buffallo to starve out the american indian.They are killing our seeds and rights and retirement accounts. It’s class warfare of a subtle sort.

  18. Poor choice of words.
    The ADA Monopoly Does NOT continue to grow
    They keep trying but have been unsuccessful and we will stop them EVERYTIME!
    Speak in terms of the affirmative.
    Thanks for getting the word out.

  19. Actually, we need to do something that does not relate to any specific bill. It is through the “passing” of “laws” that the powerful, wealthy elitist control, limit and deny us our rights and freedoms. We do not need 300,000,000,000,000 new laws every year!
    What we must do is stop electing LAWYERS to positions of power. You do not need to be a lawyer to be a good leader/legislator! Like the biochemist who create all the toxic worthless ineffective drugs, food additives, preservatives, GMO seeds, pesticides, etc. ad nauseam, we don’t need lawyers to pervert language, obfuscate facts, distort truths, imbed lies in a surfeit of legalese, etc. ad nauseam! Perhaps Shakespeare was correct when he said in Hamlet (I believe), “The first thing we must do is kill all the lawyers”, i.e. don’t give them power to harm by electing them to office.
    Now go out and subscribe to Jim Hightower’s “The Lowdown” and work to re-establish the Populist party that gave us so many good things in the late 1800s and early 1900s.

    1. How about we just limit the government by the Constitution? That’ll stop all of the over-reaching.

  20. As the ADA is heavily influenced by Very Large Corporate Interests, this is a very bad idea. The concept of FASCISM comes to mind.

  21. Are you joking me? Please not let this be real.
    The ADA knows nothing about real nutrition.

  22. Can a “nutritionist” who does not have the education to receive the credential “RD” and “LD” calculate TPN and tube feedings (nutrition support)? Are they qualified to teach an insulin dependent diabetic carb counting and recommend changes to their insulin regimen to their Endocrinologist? Can a “nutritionist” manage a patient on dialysis? Be careful with how you choose to discredit dietitians and what we have worked very hard for, not only to obtain our degrees, pass a national exam to become registered, but also stay current on evidence-based information by obtaining 75 continuing education hours every five years to maintain registration and 20 hours to maintain our license.

    1. You can see the requirements for another certifying body here: http://cbns.org/certification/cns-certification-requirements-and-instructions/ The CNS credential requires a master’s or doctorate in a nutrition field, at least 50 hours in supervised nutrition practice, passing of their certifying examination, and 75 hours of continuing education every 5 years to maintain their license. Nutritionists with a CNS credential are at least as qualified to practice nutrition as those with the RD and LD credential, but the ADA is engaged in a power play to eliminate competition from these professionals. Please note that we are not discrediting individual RDs and LDs – we are strictly concerned with the ADA’s attempts to bar all other qualified professionals from the field. Read here about the story of Liz Lipski, who holds a PhD in clinical nutrition and two board certifications, but was denied the RD credential by the ADA because she didn’t have a Bachelor’s in dietetics: http://nourishinghope.com/blog/2011/04/california-ab-575-protect-your-health-and-nutrition-freedoms/
      Their actions are like that of the AMA trying to drive chiropractors out of the practice of medicine. See: http://en.wikipedia.org/wiki/Wilk_v._American_Medical_Association for information on the AMA’s “lengthy, systematic, successful and unlawful boycott designed to restrict cooperation between MDs and chiropractors in order to eliminate the profession of chiropractic.” (The Judge’s words, not ours!) We believe that the ADA is engaged in a systematic effort to eliminate the profession of nutrition in order to reduce competition for dietitians. Efficacy and safety, not legal monopolies, should be the standard by which medical practice of nutritional therapy is accessible to patients.

      1. It is actually not 50 hours but 1000 hours of supervised clinical experience to be allowed to sit for the CNS certification exam.

    2. No, a nutritionist who does not have the education to receive the credential “RD” and “LD” calculate TPN and tube feedings or in many cases qualified to teach an insulin diabetic carb counting and recommend changes to their insulin regimen to their endocrinologist. But nutritionists don’t do that, and won’t do that. So that is comparing apples and oranges. Having said that how many dietitians tell their diabetic patients it is ok to eat sugar-laden ice cream or white rice or white bread because a “carb” is a “carb” and all one has to do is carb count and adjust insulin accordingly? Too very many I’m afraid.
      As I mentioned above my mother is in a nursing home and her diabetes diet is regulated by the resident dietician and it is frankly appalling! I had a friend who was an insulin diabetic and he simply could not ever get his blood sugar’s under control and neither could his Endocrinologist. All I did was suggest some changes in the types of carbs he might choose to eat and other changes in the types of foods he might choose and still stay within his carb limit and also what food might be not so wise to eat (like sugar and desserts) and with the permission of his endocrinologist suggested some supplements and herbs. Well, after a short while his endocrinologist commented to him that he never saw a diabetic with such tightly controlled blood sugar levels.
      Of course he still has to take insulin but before no matter how much it was adjusted it was always all over the place. While i do not practice as a nutritionist and this was a personal friend and we were talking to each other as friends, this can show the some of the differences between nutritionists and many dietitians. I would never presume to believe that my education qualifies me to calculate TPN and tube feedings or qualifies me to teach an insulin diabetic carb counting and recommend changes to their insulin regimen to their Endocrinologist, maybe their are many things dietitians can learn from nutritionists with other qualifications, and visa versa.
      Again, this discussion is about Dietitians truly believing that they are the only qualified nutrition experts and therefore anyone with any other qualifications are “QUACKS”, unqualified, and therefore need to be outlawed for public protection. And frankly I do not think that is the real reason for all this systematic law making anyway. It is again, to outlaw the competition, period. When dietitians get on these boards, the first thing they usually do is up the license fees and then use those fees to go after everyone else with a vengeance. In one state this got so bad that even medical doctors who gave any kind of nutrition advice were subject to the licensing board witch-hunting and doctors had to hire dietitians in their offices to protect themselves. And Joe public was prevented from even talking about nutrition or healthy eating to a neighbor. Food is in the public domain, as should be freedom of speech. Who is kidding who? This is NOT about public protection. It is about the organization of the ADA wanting total monopoly on who and who cannot talk, or teach, or practice nutrition!

  23. The information in this article about Registered Dietitians is one-sided and terribly inaccurate. As someone who is a trained nutritionist, with a four-year degree in nutritional science, significant training in functional medicine, and a registered dietitian in the community and public health field, this article gives a very poor description of the role of Registered Dietitians. It is a horrible stereotype of RDs.This article states that, “Dietitians, in general, are experts in what passes for nutrition science today, much of it often woefully out of date, with training focusing on institutional diets and food service management—developing diets for hospital patients, school food service programs, and nursing homes.” THIS is inaccurate and out-dated information.
    Dietitians work in a wide-variety of settings – including hospital, food service, and nursing homes – BUT not limited to such facilities. Dietitians work in colleges and universities, grocery stores, private practice, public health, and management. I whole-heartedly agree with Susan B’s comment above. Please don’t be so close-minded as to think that dietitians are not effective nutrition educators in the private practice setting. There are a significant number of dietitians in the ADA practice group DIFM (Dietitians in Functional Medicine) that are highly trained in nutrition. There are also plenty of nutritionists with Master’s degrees and PhD’s in nutrition that are highly qualified individuals.
    Not all dietitians agree with ADA’s corporate sponsorship, in fact many don’t. ADA is certainly not the only association with controversial corporate sponsors — how about the American Academy of Family Physicians being sponsored by Coca Cola, UNICEF’s partnership with Cadbury candy, Chinese Nutrition Society and Nestle, Susan G. Komen for the cure partnering with KFC…. and the list goes on. Also, keep in mind that ADA’s corporate sponsors do carry some nutritionally sound products that many nutritionists/dietitians recommend – juices, oatmeal, nutritional bars, etc.
    Publishing inaccurate information like this is what makes dietitians fight more for legislation to eliminate under-qualified “nutritionists.” So watch your back…

    1. I completely agree! This article is straight propaganda.
      Anyone can call themselves a nutritionist- including people working at a gym with no credentials, or someone who attends an unaccredited school for nutrition or herbal medicine that pushes unregulated supplements.
      I don’t see anyone fighting against RN Associations.

      1. RN Associations have not attempted to legislate that RNs are the only people qualified to practice medicine. They acknowledge that many other types of licensed professionals can also do so.

      2. “or someone who attends an unaccredited school for nutrition or herbal medicine that pushes unregulated supplements.” Your biased schooling is showing all over the place! Herbs are unregulated and harmful, and supplements are pushed by people with no credentials. This is what you learn when getting an RD degree. Your textbooks are written by so called “experts” who know absolutely NOTHING about supplements or herbs and so what you are taught is that these things have absolutely no use. Ever heard of biochemical individuality? Probably not. Before you comment further, I suggest you read a book called “A Revolution in Health Through Nutritional Biochemistry” by John Neustadt ND and Steve Pieczenik MD, and get some understanding of the very reasons for the use of supplements in this age of over processed nutrient depleted foods (grown in over fertilized nutrient depleted soils, and the use of herbs that have been utilized by cultures all over the world for thousands of years and now have the science that backs up their traditionals uses. You know not of what you speak!!

  24. A shame that you have characterized both dietitians and nutritionists in such broad and sweeping(and inaccurate) strokes. It seems you also don’t seem not to be aware of the different roles of dietitians today including: culinary dietitians, dietitians in supermarkets and dietitians who work for spas,and professional sports teams – to name just a few. I know dietitians use the term nutritionist at times to describe their work, because we can. I’ve been a registered dietitian for almost 20 years and worked in the military and public health and now with a retail supermarket. I have great respect for many of my fellow dietitians who are educated and trained in top clinical settings to provide “… medical nutrition therapy……. and work primarily in private practice settings conducting one-on-one nutrition counseling.”- a description you attribute in your article to nutritionists. Many dietitians have sought out courses and expertise in alternative medicine. I have seen non-RDs with strong nutrition education that I have great respect for but I have also seen and heard clients and customers relate nutrition advice from people who call themselves “nutritionists” but have never seen a lab result and some who have never even completed a college degree with any sort of science background.
    Licensure laws are meant to protect the individual by limiting nutrition advice to people who have the background and training to do so. It also makes those individuals legally accountable.

    1. Please reread the article. We note that, “Dietitians can provide individualized counseling on diet and disease and there can be an overlap in the type of work each profession practices.”
      Again, our qualm is not with dietitians themselves, but with the ADA’s attempt to squeeze all other nutritionists out of practice.

  25. Really? Are you all so misguided and unaware of what a registered dietitian is? How about we cease to require that nurses and medical doctors be licensed? I took a course in anatomy…I know where your liver is and I have a sharp knife…that should be enough for me to call myself surgeon?
    ADA is not CDR, the organization responsible for dietetic registration. The RD designation ensures that an individual has completed rigorous course work as well as 1000 hour internship.Please get your facts straight before posting irresponsible articles.
    These bills are not “power grabs” they are to protect the public from QUACKS!

  26. If your qualms are with ADA, please do not then make statements on what RD’s do without knowing the facts. PLENTY of RD’s, including myself, always keep up on the latest nutrition trends in addition to knowing the complicated scientific background behind it. CDR and the ADA is trying to protect the public from unqualified practitioners that are promoting fad diets and don’t understand the scientific background behind nutrition. I do not think 50 hours of supervised practice experience is enough to qualify to practice nutrition, considering the field of nutrition is endless. Just like any other healthcare field (medical, dental, nursing) there is a credentialing body and standard process on how to receive appropriate training, why should the field of nutrition be any different? Why should someone with 50 hours of training have the same opportunities as someone with 900 hours? I don’t think ADA is trying to exclude practitioners but merely assure the ones that are practicing are all receiving the same training so we don’t confuse the public any more than they already are! And dietitians do NOT serve jello please know your facts before you speak!

    1. Melissa, if you are referring to the CNS credential, if you follow the link, the 50 hours requirement is for MDs. Those without MDs are required to have 1,000 hours.

  27. I agree with the statement above the article misses the point that “licensure” is to protect the public not the practitioner. In CT we recognize both RDs and Nutritionists as long as they meet a minimum level of education, supervised practice and pass an exam either the CDR/ADA or the CBNS.
    The grossly inaccurate description of RDs is nothing but counterproductive and discussion of “corporate” sponsorship is really hypocritical, since I can’t think of an organization that doesn’t accept sponsorship. The suggestion that ADA is trying to create a monopoly is even more ridiculous. The concern is as it always has been providing accurate, scientific based information about nutrition and health for the safety of the public. Let’s compare apples to apples- 2 professionals with similar levels of education should be equally qualified. The target should be those less qualified, but still giving out inaccurate, possibly harmful advice. Face it there are always a few “bad” apples in any profession but that’s the exception not the rule.

    1. You are fortunate to live in CT. In many states the ADA has sought to pass legislation that does not recognize the CBNS or CNCB exams, recognizing ONLY the CDR exam as a valid qualification for practice. It is that kind of monopolistic legislation that we are fighitng again.

  28. When you talk about advanced degrees, not all are the same. I believe, RDs can only be obtained from regionally acredted schools; CNSs are from regionally or nationally acredited schools; CCNs allow regional, national, State and DETC Accredited University; and HNCB certified professionals are allowed to attend schools with no accreditation. Regional is the hardest, and what most standard Universities are, followed by national accreditaiton. Where do you draw the line?

  29. First of all, I have to say I am shocked by the lack of knowledge in this article. I see a lot of opinions, but not knowledge. Does this writer even know the difference between an RD and a nutritionist? The definition used for nutritionist by this writer is what I would pass for an RD. I am personally glad to see this happen as almost anyone can call themselves a ‘nutritionist’. Yes, that’s right, that means the idiot who may have no degree (and very little science background) is at the ‘health store’ telling you what cleanse, supplements, or dietary advice to take. This policy is just ensuring that all in the nutrition field have a full background in science (and potentially hands-on experience as well such as in the DI). After that, even an RD doesn’t have to be a member of the ADA and as long as they are practicing evidence-based nutrition (you’ve heard of the scientific method I hope?), they can practice. Yes, you should be licensed to talk about food! It’s not just food- after 4+ years of nutrition and pre-med classes, I can assure you, it’s not just food (ever heard of nutrition-medication interactions just to start with?). And it’s unfortunate that hospitals appear to have poor choices (but unfortunately, that is often not at the hands of the RD and tends to include red tape and things like being customer driven makes it hard to offer nutritional sound meals if customer surveys are down which then impact how much money is given towards dietary departments, etc. etc. etc.). If you had to see it from that angle, you might understand and the same goes for any institution. It’s also unfortunate to see that the writer believes RDs aren’t about prevention and natural methods. We are talking about food here, right? Healthy nutrition last I checked is key in preventing diseases and RDs often have the ability to take classes on herbs and supplements to better assist their clients (herbs, botanicals, and supplements are also listed with reference to how they performed in various studies in many MNT books for nutrition that I have). Ugh, it’s frustrating to see such a narrow-minded article backed by only what appears to be opinion. If you want to see both sides, complete a degree in dietetics, complete the internship, pass the national exam, and then see how it’s just food and how no one should be licensed and how unimportant it is that just anyone should be able to give you advise.

    1. I totally disagree. The methods being used and attempted are not the best course of action to solve the problem. Sure, there are quacks out there, and I’m all for creating a system that requires more stringent standards for calling yourself a nutritionist. But requiring that everyone be an RD or go through an AND accredited internship to practice any nutrition counseling? Ludicrous. I have my degree in Dietetics, but there were not internships in my state at that time, and moving wasn’t an option at that point in time for me either. I actually plan to complete mine at some point, but in the meantime, having my degree completely counted as basically worthless is ridiculous. I also have friends with PhD’s and Master’s Degrees in Nutrition, and this legislation limits them and me from the full scope of nutrition counseling practices. You can’t tell me those with PhD’s and MS’s aren’t qualified, or that it’s fair and practical to require them to go to MORE school (DI), or that my nutrition degree counts for absolutely nothing until I obtain my RD. I also agree with Cheryl Hull from a comment above that an AND accredited program in college doesn’t cover nearly enough of the natural and alternative areas of nutrition. The scope of the legislation by the AND is monopolistic, plain and simple. They’re acting like it’s the only solution. I think there should be more stringent requirements for calling yourself a “nutritionist”, absolutely, but not in such a highly exclusive manner.

  30. Look up the term “evidence based practice.” This is a big part of what distinguishes a nutritionist from an RD. How many nutritionists have been educated on how to properly critique a peer reviewed journal article, or the results a double blind clinical trial? or statistical analysis of results?
    I like the parallel between RD’s and doctor’s, whoever said it. I’ll ask it again, because noone has answered it yet: Would you let a doctor operate on you if he has not passed his board exams? If he has not interned, become a resident, and then finally an attending with 4 or 5 years of surgical experience under his belt? Would you say he was equally qualified to operate on your mother If he was fresh out of med school with no practicum experience?
    The difference between an RD and a nutritionist is not only education, but experience with
    RESEARCH BASED practice. And to go even further, the skills to interperate research, sift through the high quality vs poorer quality research, and the ability to put that research into a practical, usable context.
    Do you know the difference between validity and generalizability from a research stand point? If you don’t, than you aren’t even in the position to judge research, let alone use critical thinking skills to decide how to apply it to every day practice.
    Someone said “you need a licence to talk about food?” If you had any idea the physical harm that can be done to someone based soley on what they are ingesting, than you would realize how foolish that question sounds. THAT’S why RD’s practice based strictly from an evidence based stand point, and why we have to know how to JUDGE the evidence in front of us! Nutrition is a science AND a health profession. We realize that someone could die based on poor or sloppy Medical Nutrition Therapy, and therefore our practicum needs to be rigorous, and well defined. If you can’t handle the education and tough curriculum required to do what we do, than just get out of the game.

    1. I am an RD and while I agree with what some of my fellow RDs have said, I also agree with the frustration and the outrage professed by “Nutritionists.” I recognize that much of my education was not thorough enough with respect to functional medicine, ie. herbal supplements, vitamin supplements. I actually overheard a preceptor during my clinical rotation 6 years that herbs or spices don’t really mean anything to one’s health. I was shocked. I don’t agree with most of what the ADA says and I certainly disagree with the corporate sponsorship. I do believe that it’s important for all individuals that are working with the public providing nutritional advice whether they be RDs or Nutritionists should have the same level of educationalbackground. I also disagree with the ADA mantra “All Foods can Fit,” because I don’t believe it’s true. I also agree after having educating myself that the Food Guide Pyramid is probably one of the worst things to be done to or for the health of the general American Public. I think it’s more difficult for RDs that buck the traditional “nutritional” system that continues to be taught in a dietetic degree program. It would be great if there could be a mutual respect for the differences that RDs and well-educated nutritionists bring to the table. I know that I’ve learned more from Non-RD nutritionist in terms of herbal medicine, vegan diets, and raw foods than I would have ever been able to learn from a traditionally educated RD.

      1. I have spent many hours a week for ten years or more on the internet researching health subjects of all kinds. I have been taking vitamins and supplements of all kinds for over 45 years. My health is excellent at 80, and still improving the many of age related systems as I add more research aided vitamins and supplements. This research is made tedious by having to filter through the disinformation, miss-infromation, bias ‘experts’ and the outright lies posted on the internet and by the ‘media’. The worst are the ‘official’ or semi-official medical, nutritional groups, societies, associations, government, medical institutions, the AMA, FDA, CDC, etc., etc, Much of the information has so many counter dictions its ludicrous. To add power (control) to the ADA is to add limits to our unbiased need to be informed. The ADA, like the AMA, will restrict the members to the party line, just like the AMA and FDA is by the pharmaceutical corporations.

  31. When I signed the petition, I stated that:
    A) It is unconstitutional for the government to swallow up professions and the free choice to practice the ones we so choose
    B) I am absolutely un-impressed with Registered Dieticians and their “knowledge”, it’s pitiful actually, even embarrassing what I have read in magazines by RD’s.
    Feel free to use these talking points if you agree with them, as well as your own.
    Thanks!

  32. Cheryl….what foods do you believe do not fit into a human being’s life? I am just curious! You are an RD, and so I value your opinion 100% more than any non-registered person I talk to. Maybe that is ignorant, but I know the rigorous program I went through, so it’s hard. How can you exclude any food? Should someone not eat a piece of birthday cake? Or have a donut on a Sunday morning? And what is your scientific evidence to support this philosophy? Believe me, I share your frustrations with the sponsorship & ADA, but at the same time, NO health professional should be giving out advice that is not based on sound science. So, if you don’t like ADA science, what science do you base your beliefs on, and are you sure it is quality?

    1. There is in fact significant research that correlates sugar and high fructose corn syrup (independent of total calories) with chronic disease (the metabolic syndrome included). Even in a balanced diet, there is no scientific argument that supports the theory that HFCS and sugar do not promote inflammation that increases risk of chronic disease (even among normal weight individuals). For starters, please check out the following articles (note that they explore the relationship between fructose and health based on the fact that fructose intake has skyrocketing in the last few decades and that the major culprit for this increase is high fructose corn syrup where the uptake of fructose is magnified by the presence of glucose):
      1: Rutledge AC, Adeli K. Fructose and the metabolic syndrome: pathophysiology and
      molecular mechanisms. Nutr Rev. 2007 Jun;65(6 Pt 2):S13-23.
      2: Dekker MJ, Su Q, Baker C, Rutledge AC, Adeli K. Fructose: a highly lipogenic
      nutrient implicated in insulin resistance, hepatic steatosis, and the metabolic
      syndrome. Am J Physiol Endocrinol Metab. 2010 Nov;299(5):E685-94.
      3: Rayssiguier Y, Gueux E, Nowacki W, Rock E, Mazur A. High fructose consumption
      combined with low dietary magnesium intake may increase the incidence of the
      metabolic syndrome by inducing inflammation. Magnes Res. 2006 Dec;19(4):237-43.
      It is very important that we support the creation of laws that allow nutritionists to practice, who come from training backgrounds unbiased by the food industry messages.

  33. A serious misunderstanding among RDs that is fostered by the academic training sanctioned by the ADA is that there training is superior to that of other nutrition disciplines. This leads to a tedious string of misinformed comments on articles like this by RDs saying that the monopolistic legislation put forth by the ADA is legitimate and necessary. What if the training for both RDs and Clinical Nutritionists were both valid but simply different specializations in the same field? The ADA bills create a monopoly for one with the exclusion of the other that will only hurt the public in the long run. If you are fed up with the infighting, educate yourself of the legislative activity of the ADA, fight these monopolistic bills, and work towards inclusive legislation that succeeds in identifying quality trained practitioners without resorting to seeking criminalization join the conversation at http://www.facebook.com/unitedinhealth!!!

      1. I agree, Anna! I actually have my degree in Dietetics and Nutrition & Food Science (double major), but have never participated in an internship necessary to obtain my RD. As much as I plan to obtain my RD at some point, and stay home with my small children now, I hate the thought that my degree means absolutely nothing in the eyes of the AND (Academy of Nutrition & Dietetics – formerly the ADA). I wholeheartedly believe that there are too many people out there claiming to be nutrition professionals, and actually have very few credentials, but if they simply, as you suggested, were valid but simply separate training. The actions of the ADA seem highly exclusive. More regulation on being able to use the term “nutritionist” – I’m all for it – but limiting it to those with JUST RD’s is ridiculous. Many of my nutrition professors, and now friends from college who have gone on to complete advanced degrees, are some of the most brilliant “nutritionists” I know, but they don’t have their RD’s. I think it’s a slap in the face to the intelligence and validity of these highly educated people to claim they can’t do the same job of someone with a Bachelor’s Degree, plus a one year internship and subsequent exam.

        1. Actually Melanie, my nutrition professors all had RDs because they were awarded to anyone with an advanced degree prior to the 90’s. By the time I obtained my BS and MS degrees in dietetics, the laws had changed. So, anyone over a certain age that has a RD may not have participated in an internship or taken the exam! I’m all for providing certification to practice but the AND is simply too monopolistic at this point. I chose not to go that route and am very happy with my career. The AND is sponsored by top food companies whose motives are profits not nutrition (Coca Cola – really AND?). In addition, the US diet has not improved under AND. No one even knows who the AND is – they certainly are not good at getting their message across. The only interest I have in the AND at this point is their certification only because they have a monopoly. I don’t feel they have a market on knowledge, advice, or research. I have nothing against my RD colleagues, and I suspect they feel the same way that I do. By the way, I was eligible for an internship (got one but turned it down) and decided years later to pursue it. I was turned down – because I had not taken calculus and a few other courses. I guess the 10 years between the time I was eligible and the time I wanted to apply, the knowledge I needed had advanced significantly – not. I guess the fact that I’m a nutrition professor wasn’t good enough. I became a certified nutrition specialist instead. They are slowly winning the fight against the AND.

  34. To all the nutritionists and RD’s posting here:
    I find this kind of quibbling very disheartening. The fact remains, that people should be free to practice the profession of their own choosing, by constitutional law. Period.
    I disagree with the “science” the RD’s here are so proudly talking about. University, hospital, nursing home diets are embarrassing examples of such “science” which you all brag about. give me a break!
    The person who posted that herbs are unregulated and ineffective knows nothing of what they are talking about. Science a-plenty exists and studies are logged on to the government medical database, http://www.pubmed.gov To assert that supplements and herbs are “unregulated” and “ineffective” and “Unproven” is to assert ignorance, on a public level. Embarrassing “Science’ and “education”, right there…..

  35. Dietitians are highly overrated. During the last year of my mother’s life, she was hospitalized numerous times. Every time I would talk with the dietitian and tell her that my mother was prone to become potassium toxic. But when I would go to visit her at mealtime, she would have baked potatoes, bananas, tomatoes, etc., on her plate. Sure enough, she would get very, very sick and they would find she was toxic on potassium and would have to start treatment for that. It just seemed like it would have been in her best interests for them to listen and develop her diet accordingly rather than treating her after the fact. I have never really understood the purpose of dietitians.

    1. That’s only one dietitian you are talking about. You have to realize that dietitians don’t have much say power when it comes to diet therapy because dietitians can suggest things but due to their lack of licensure, the dietitians cannot cause anything to change unless the doctor orders it. Dietitians at my hospital here in Southern California have been really helpful and do help a lot with diet changes. And yes, they are strict on their patients. BUT CERTAIN patients who are less likely to eat may have a liberalized diet because yes they may have cardiac problems or other problems but it is better to give them foods they like than to give them foods they don’t like and eventually become malnourished. Also, your family member that was highly susceptible for potassium toxicity may have been on some sort of medication to prevent the uptake of potassium, therefore, foods that are potassium rich may not have an affect on her. Therefore, they allowed these types of foods. Try asking about medications and other things before saying a dietitian is overrated. Everybody feels like they can blame a dietitian but really it’s a health care team. Ask questions before pointing the finger.

    2. The real difference between an RD (Registered Dietitian) and a nutritionist is that the first must hold to national practice standards, practice evidence based healthcare and meets minimum educational and training standards. “Nutritionists” have absolutely no criterion to assures standards of practice or care. Essentially, my cousin Tony could decide today that he is a “nutritionist” and dole out any misinformation he chooses. I am sorry to break up the party, but there simply must be a method to differentiate between quackery and good care. Granted some “nutritionists” may be qualified and effective but there is nothing to differentiate them from the clowns. Medecine and wekkness has come a long way from the days of snake oil salesmen, witch doctors and barbershop surgeons – “I have whatever that ails ya”. Please lets not yearn for those days of horrible infant mortality rates
      and 50 year old life expectancies.

  36. Consumers are protected by plenty of laws. It is not that I am unable to become a registered dietitian, I choose not to. I don’t agree with the curriculum or bedfellows. As long as those of us in lifestyle management are not practicing medicine or lying about our credentialing, there is no need for further debate. If the RD curriculum has been the gold standard for the last 40 years, how are they doing? Can’t registered dietitians call themselves just that, pointing to their particular brand of counseling? I strongly disagree with adding the word “nutrition” to their title then passing laws monopolizing it. This is a giant step backward in health freedom.

Comments are closed.