There would be no Sustain + Nourish without my career in dietetics…so let’s learn more about the profession!
The History of Dietetics
March is National Nutrition Month where registered dietitians (RDs) and the field of nutrition are celebrated (as they should be!). It also just so happens that Women’s History Month is in March, too. These celebratory times align perfectly as the majority of dietitians in America are women.
Interestingly, the history of the field of dietetics dates back to ancient times, with references to the profession made in the writings of Homer, Plato, and Hippocrates in ancient Greece. Though, the field didn’t gain modern recognition until the 19th and 20th centuries.
The title dietitian was first used in America in 1899 to describe “a person working in a hospital who provided nutritious meals to patients.” The Academy of Nutrition and Dietetics was then formed in 1917 by a group of visionary women. Also known as the AND, the Academy is a U.S. non-profit professional organization representing RDs. This group was established to better meet the national nutrition and public health challenges presented by World War I.
Today, over 100 years later, the profession is more popular and diverse than ever with over 110,000 RDs working in the U.S today.
What Education is Required to Become an RD?
Becoming a dietitian is no small feat…especially when you consider the amount of education that’s required.
First, we must complete at least a bachelor’s of science (BS) degree in dietetics at an accredited U.S. university or college that has incorporated specific coursework and supervised practice approved by AND. However, starting this year, all RD candidates will be required to hold a master’s of science (MS) degree as well.
The required coursework is super comprehensive and spans biology, chemistry, human physiology, epidemiology, metabolism, business, and food science, in addition to practical skills like counseling and nutrition assessment. In fact, the coursework is so rigorous that I would’ve had to add another semester to my undergraduate career if I wanted to study abroad during the school year.
From there, a (typically unpaid) dietetic internship is required that the student must apply for, be accepted into (they’re super competitive), and pay to complete. These last anywhere from six months to a year and students spend this time shadowing RDs in the clinical, community, or foodservice settings.
The clinical experience is very similar to that of a medical doctor (MD) residency where students rotate through each medical specialty. We shadow dietitians in each medical unit to get a full understanding of the assessment and treatment process. For foodservice, we spend time in commercial kitchens to fully grasp how operations are run. Then, we complete the experience with community rotations through settings like food banks and Women, Infants, and Children (WIC) clinics. Some internships may also include other subspecialties like public health nutrition or nutrition-based research.
After all this, dietitian candidates must pass a national credentialing exam where the first time pass rate is just over 65 percent. Many states also require licensure to practice, which doesn’t necessitate an additional exam but is an extra annual fee.
Side note: You’ll commonly see the professional credential registered dietitian nutritionist (RDN) used as well. Though kind of confusing, RDN and RD are the same credential and require the same education. We can choose which we’d like to use upon accreditation.
To maintain accreditation, RDs and RDNS must take at least 75 hours of continuing education every five years to stay up-to-date with this constantly emerging field. Ethics training is required during each continuing education period.
The Difference Between a Dietitian and Nutritionist
As you can see, a lot of work and training that goes into becoming an RD —which sets the credential apart from other nutrition or wellness ‘experts.’ Just like anyone who loves science can call themself a scientist, anyone who loves nutrition can call themselves a nutritionist, as it’s an unregulated term.
There are plenty of holistic nutritionist and health coach certification programs, like ACE and the Institute of Integrative Nutrition (IIN). But these programs are not even close to the level rigor that’s required to become an RD. In fact, a lot of these programs can be completed in under six months. However, only those who went through the above training and have passed the national exam can be considered a registered dietitian.
What Do Dietitians Do?
So, with all this education, what kinds of roles can dietitians hold? Well, they truly run the gambit.
At the heart of the profession, RDs work with individuals to help inspire diet and lifestyle changes to help prevent chronic illnesses like diabetes, heart disease, stroke, cancer, obesity, and more. Physicians commonly refer their patients to dietitians for nutrition advice and guidance as we are the clinically-recognized experts on nutrition.
While the job pool was once confined to inpatient hospital and outpatient clinic positions, RDs now work in a variety of sectors and roles. These might include universities, private practices, medical schools, food companies, professional athletic teams, communication companies, and more. Dietitians can also work in the digital space through social media and content creation.
Many RDs hold a variety of roles throughout their career, myself included. I’ve worked in hospital, clinic, private practice, education, and content creation roles. Today, I work as an educator, clinician in a private practice, and freelance writer — though, I spend the majority of my time writing (gratefully!).
The Future of the Profession
So, as our career evolves, where might the future take us?
My hope for the field is that we double down on non-biased and evidence-based research, transparency and disclosure, and sustainability.
While I am biased, I believe that a nutritious diet is a sustainable diet (read more about what this means in my sustainable nutrition post). Because what’s the point of experiencing optimal health if 10 percent of the global population is experiencing hunger and planetary food security is diminishing by the day due to global temperature rise and unsustainable agricultural practices?
While integrating sustainability principles into practice settings like hospitals not realistic at the moment, I do hope that the field can move as a whole towards nutrition recommendations that increase the health of both our clients and our planet.
