Dietitians and Nutritionists
The trend in health care today is to involve the patient in the responsibility and accountability for his own health care status. A healthy and nutritious diet is an important aspect of a healthy lifestyle. Dietitians and nutritionists are trained in food selection and preparation, nutrition, and how to adjust for specific needs due to allergies and diseases.
ssential
Dietitians have been members of the health care team for over 100 years, but in recent decades, more interest in healthy eating has brought them to the foreground. Dietitians are experts in nutrition, and they understand the correlation of disease to nutritional deficiencies.
Duties, Activities, and Scope of Practice
Dietitians plan and select meals based on the needs of the patients. They also supervise the preparation and serving of meals. They suggest modifications as appropriate to promote wellness and prevent disease. There are four main specialties and several subspecialties. The primary specialties are clinical, community, management, and consulting.
Clinical Dietitians
Clinical dietitians work in hospitals and nursing homes. They evaluate patients' needs and formulate and supervise plans for improved nutrition for the patients. They confer with the members of the health care team to determine the needs of the patient, with the patient to determine habits and likes/dislikes, and with the family to educate them regarding the maintenance of proper diet and nutrition upon discharge.
Community Dietitians
This group of professionals is more commonly known as
Management Dietitians
In this specialty, dietitians work for long-term care facilities, senior residences, restaurants, hotels, schools, and prisons to supervise large-scale food preparation and meal planning to meet the general needs of the population they serve. They help to plan and implement budgets, meet and maintain sanitary food and safety standards, and train food-preparation workers.
Consultant Dietitians
These professionals work in private practice to consult with individuals and institutions. They provide nutrition screenings, and they design plans for patients with issues such as weight control or disease control. Consultants may work for health care facilities, individuals, sports teams, or wellness programs.
Education and Training
Nutritionists and dietitians must obtain at least a bachelor's degree in dietetics, food service management, foods and nutrition, or other areas approved and accredited by the American Dietetic Association.
The areas of study include biology, biochemistry, microbiology, organic and inorganic chemistry, anatomy and physiology, diet therapy, nutrition, food service management, and food preparation in quantity. The program includes both classroom and laboratory studies and practical experience.
Licensure/Certification
Forty-six states have laws governing dietitians and nutritionists. Thirty of these states require a license, and fifteen require certification. Although only one state requires registration (the minimum professional status), most dietitians are registered. At one time registration was the only professional distinction, and most states still honor this. To become registered, candidates must meet the requirements set by the Commission on Dietetic Registration for classroom and clinical experience, and pass an examination. This can be accomplished in one of two ways. The first involves the completion of an accredited bachelor's degree in dietetics and an internship or ADA-approved prepractice program of 900 hours of supervised practice. The other route is to enroll in an ADA-approved coordinated program that combines academic studies with practical experience. When this program is completed, the student earns either a bachelor's or master's degree and has also completed the necessary hours of practical experience. When either of these programs is completed, the dietitian sits for a written exam given by the Commission on Dietetic Registration. This exam is given in October and April and is a half-day test of knowledge of normal nutrition, clinical nutrition, community nutrition, food service systems and management, and food science.
To maintain registration the dietitian must accumulate seventy-five hours of approved continuing education every five years.
Work Settings and Salaries
In 2004, dietitians and nutritionists held about 50,000 jobs, according to the U.S. Department of Labor. More than half of the dietitians worked in hospitals, nursing homes, outpatient settings, and doctors' offices. Others worked in a variety of settings such as private practice or for agencies that provide food service to schools, corporations, airlines, colleges and universities, prisons, home health care, and care facilities for seniors.
The median income reported by the U.S. Department of Labor for 2004 was $43,630. According to the ADA, dietitian salaries in 2005 ranged from approximately $45,000 to $60,000.
Career Potential and Additional Information
Increasing emphasis on improved dietary habits, promotion of wellness, and prevention of diseases will help to ensure that the outlook for employment for dietitians and nutritionists will continue to grow about as fast as the average for all occupations through 2014. There will be some areas where the needs for dietitians will most likely decline, such as in nursing homes and state agencies, because of the use of contract food services.
Growth will be increased if reimbursement issues are resolved and Medicare recognizes the need for these professional services.
For more information about careers in dietetics and nutrition, contact the American Dietetic Association. Their Web site is
