When it comes to securing reliable dietary advice and information, it is important to seek support from an appropriately knowledgeable, evidence-backed source or professional. The world of nutrition can often be confusing and overwhelming, especially for those who don’t have the necessary scientific background to be able to see through the bogus marketing claims of food manufacturers and the endless pages of clickbait on the internet. When you need professional dietary advice or support, who do you turn to?
In this article, we will explore a number of different professional nutrition roles and describe their individual functions and limitations. Specifically, we’ll be focusing on dieticians, nutritionists, including sports nutritionists and nutrition coaches. It is important to recognise that each of these roles are very different, both in terms of the duties they perform and the qualifications that are needed to practice. Therefore, their titles cannot and should not be used interchangeably!
Dieticians are licensed healthcare professionals that provide care in the form of nutrition and dietary support. They typically work in clinical settings like hospitals, doctors’ surgeries and the community, providing dietary advice, support and generally promoting healthy eating. They will typically work with patients that have complex medical conditions, diseases and/or needs.
A dietician will typically assess their patient’s clinical and dietary needs, identify any nutritional deficiencies, and prescribe the most appropriate nutritional advice or treatment. Given that dieticians are licensed healthcare professionals, they are required to operate within very stringent guidelines published by the National Institute for Health and Care Excellence (NICE) to ensure that their approach is backed by the latest scientific evidence.
The British Dietetic Association (BDA), which is the professional body for dieticians, state that dieticians cannot offer advice where there would be personal or financial gain. Consequently, most dieticians are employed by the NHS and other private care providers, although some dieticians may work on a freelance basis as nutrition journalists or providing specialist expertise in a business’s marketing or product development department. Dieticians can also specialise in multiple disciplines, including:
• diabetes management
• obesity
• paediatric
• sports nutrition
• mental health
An important part of a dietician’s role is to advise, train and influence other health care staff as part of a wider clinical team. They also have the ability to prescribe some prescription-only medication, like insulin for example.
Dieticians are the only nutrition professionals to be regulated by law. The regulatory body responsible for the quality and ethical standards of all dieticians is the Health & Care Professions Council (HCPC). A dietician must be registered with the HCPC to legally practice in the UK and a public register of all licensed dieticians is available on the HPCP website.
As previously mentioned, a dietician must be registered with the HCPC to practice in the UK. In order to register with the HCPC, you must hold a BSc degree in Dietetics. Postgraduate courses are also available and these require a relevant honours degree on entry.
Nutritionists are also responsible for creating nutrition and diet plans for people to improve their health, wellbeing and even athletic performance. In fact, some nutritionists even specialise in animal nutrition. Unlike dieticians, nutritionists are not healthcare professionals and so they do not generally work with people that are ill or who have complex medical needs. Consequently, most nutritionists work in the private sector, or in a sport and/or exercise setting.
A nutritionist may specialise in any of the following five areas:
• Nutrition science
• Public health
• Food
• Sports and exercise performance
• Animal nutrition
Nutritionists provide information, advice and support to people about the impact of foods, nutrition and general eating habits and behaviours. Their duties can range from providing advice and information on how individuals can make positive dietary changes, to detailed and complex meal plans which address a number of nutritional deficiencies, insufficiencies and needs.
A nutritionist will perform a range of duties, including:
• Analysis of client’s dietary needs
• Providing ongoing education and advice to clients
• Counselling clients on how they can make positive dietary changes
• Providing ongoing support and encouragement to clients
• Creating specific meal plans for clients to follow
• Performing regular client reviews to ensure changes are effective
• Working alongside other nutrition, exercise or medical professionals to ensure clients receive a high-level of care
• Analysing the athletic needs of clients and ensuring that those athletic needs are fully met with an appropriate dietary plan/strategy
The above range of duties are examples of the sort of things nutritionists will frequently do. Specific duties will vary from one role to the next depending on where the nutritionist is working.
The Association for Nutrition (AfN) is a registered charity and is the main regulator of nutritionists. The AfN manages the UK Voluntary Register of Nutritionists (UKVRN). There is no legal requirement for nutritionists to be registered with the AfN in order to practice, which is why the Register is ‘voluntary’. Also, unlike dieticians, the title of ‘nutritionist’ is not legally protected and theoretically, anybody can call themselves a nutritionist. It is however considered best practice for nutritionists to complete the necessary nutrition qualifications (see below) and supervised work experienced before using this title. Most diligent employers/clients would expect their nutritionists to be on the UKVRN. Those nutritionists listed on the UKVRN have clearly demonstrated that they are committed to demonstrating the highest standards of quality and ethical practice.
Typically, nutritionists will hold a BSc degree in nutritional science or a postgraduate qualification accredited by the AfN. The AfN publishes a list of accredited degree programmes on their website which, upon completion, would allow graduates to submit an application to register for the UKVRN.
Essentially, there are two levels of nutritionist membership with the AfN:
1. Registered Associate Nutritionist (ANutr) – associates will have graduated from a BSc (Hons) or MSc in a nutritional science within the last 3 years and can prove they have the necessary knowledge. However, they have not yet acquired the volume of work-based experience required and/or practical application of this knowledge required to become a Registered Nutritionist (RNutr).
2. Registered Nutritionist (RNutr) – registrants will have demonstrated they have sufficient knowledge and understanding of the science of nutrition at a minimum of honours degree level plus around 3 years’ experience (gained within the last 5 years) of evidence-based application of nutrition science in professional practice.
Membership with the AfN demonstrates that nutritionists are committed to the highest standard of professionalism and knowledge.
Sports and exercise nutritionists will typically provide specialist nutrition advice and support to promote athletic performance in sports. Working with clients across a broad range of levels (e.g. recreational, amateur, semi-professional or professional), they consult with athletes and teams alike to help them develop optimum diet and nutrition strategies to improve athletic performance.
These duties will include, but are not limited to:
• Consulting with a broad-range of athletes
• Analysing dietary habits and nutritional needs of athletes
• Identifying potential nutritional deficiencies and insufficiencies
• Developing nutrition strategies and meal plans to improve athletic performance
• Travelling with athletes and players to tournaments, liaising with chefs, kitchens and food suppliers
• Educating athletes and coaches about dietary changes needed around key training/events
• Recommending nutrition supplements and ergogenic aids to improve performance
Many sports nutritionists are also employed by food producers and manufacturers to provide advice and guidance on their products.
The route to becoming a sports nutritionist is slightly different to that of a general nutritionist because sports nutritionists need to have sufficient knowledge and understanding of a range of sport and exercise science subjects, especially exercise physiology and bioenergetics. Therefore, sports nutritionists will typically complete a specific BSc or MSc degree programme in Sport and Exercise Nutrition. There are a number of universities around the UK which offer these programmes and most good degree programmes will include a healthy balance of supervised work experience in a live occupational setting.
Once qualified, sports nutritionists will also want to register with the Sport and Exercise Nutrition register (SENr) to demonstrate that they have the requisite knowledge, skills and professionalism to practice.
Nutrition coaches, who may also be known as ‘nutrition advisors’, are usually exercise and nutrition professionals that work in a non-clinical and less formal setting, like gyms and health clubs, or on a mobile basis in the homes of their clients. They do not necessarily have academic qualifications (e.g. like a degree), and instead pursue a more vocational route to developing their nutrition qualifications.
Nutrition coaches will typically provide more general nutrition support, advice and guidance than nutritionists and dieticians, focusing more of their efforts on educating their clients so that they can make better decisions about healthy eating. Specifically, the duties of a nutrition coach may include:
• Consulting with clients about their general lifestyle and eating habits
• Performing physical measurements, like height, weight (BMI), body circumferences and body composition (% body fat)
• Motivational interviewing
• Supporting behaviour change, including identifying barriers and exploring strategies for success
• Providing general advice, guidance and education on how to make healthy food choices to support the clients’ goals and/or sport, exercise and fitness training needs
• Signposting to nutritionists/dieticians (as required) for more specialist nutrition interventions
The relationship between a nutrition coach and their client is more collaborative in nature and the coach will usually educate and guide their clients as they embark on their healthy eating journey, effectively empowering them to make better decisions about the foods they choose to eat. This approach is much less prescriptive and the goal really is to give the client the necessary knowledge and understanding to make informed decisions for themselves. In fact, most nutrition coaches would refrain from providing overly prescriptive advice or guidance about diet and nutrition because they understand that for their clients to succeed in the long-term, the decisions must be made by the client.
There is no formal regulatory body for nutrition coaches because there are no regulated qualifications with ‘nutrition coach’ in their title. As previously stated, most nutrition coaches are in fact also qualified exercise professionals and they perform a dual role of supporting their clients with their exercise and nutritional needs. Therefore, you would expect to find most nutrition coaches to be registered as an exercise professional with the Chartered Institute for the Management of Sport and Physical Activity (CIMSPA).
It is important to underline at this junction that although the specific roles and responsibilities of dieticians and nutritionists are more clearly defined and their regulation is somewhat more formal, nutrition coaches do still play an integral role in providing diet and nutrition support. In fact, in an exercise environment, it might be argued that exercise professionals providing nutrition support services are better placed to provide this type of support given the amount of time and contact they will have with their clients. A client is far more likely to reach out to their personal trainer for help than they are to make an appointment with a Registered Nutritionist or dietician.
There are no formal qualifications with the title of nutrition coach and so the pathway is less defined as it is with Registered Nutritionist s and dieticians. However, most credible nutrition coaches will hold one or more regulated nutrition qualifications and will have also undertaken an extensive range of continuing professional development (CPD) to ensure that their knowledge is sufficiently broad, varied and up to date. These qualifications and CPD programmes can include, but are not limited to:
Although these titles can be confusing, be sure to look for the proper accreditations and qualifications if you decide to work with a nutrition professional.
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