Dietitians vs Nutritionists: The New RDN Credential

There is already significant public confusion over the difference between a Dietitian and a Nutritionist, but now the Academy of Nutrition and Dietetics is throwing another term into the mix. Effective immediately, Registered Dietitians (RD) are able to identify themselves as Registered Dietitian Nutritionists (RDN). This new title is optional, and there is no difference between the practice, experience or skill set of an RD vs an RDN. According to the Academy, the change is meant to remind the public that “All Dietitians are Nutritionists, but not all Nutritionists are Dietitians”. But lets back up first…

What is the difference between a Dietitian and a Nutritionist?

I have covered this before, but here’s a quick recap. Registered Dietitians (RDs) are experts in the field of nutrition that have met the requirements in order to hold the legal title of “RD”.  Although some RDs may consider themselves nutritionists, do not assume that all nutritionists are RDs. In many states, almost anyone can call themselves a “nutritionist”, regardless of education or experience. Requirements to become an RD include:

  • a Bachelors degree in nutrition, dietetics, or a related field
  • Completion of 1200 supervised practice hours through an accredited program
  • Passing the registration exam given by the Commission on Dietetic Registration
  • RDs must then keep up with continuing education requirements in order to maintain their certification.

How does the RDN fit into this puzzle?

Personally, I think that “Nutritionist” is a much better description of nutrition practice, but because it is so unregulated, I prefer to be called a Dietitian. I worked hard to become a Dietitian, not just a Nutritionist, and I’m glad that my title reflects that. I don’t have strong opinions one way or another on the new title, but by making it optional, I believe that the Academy is creating divisions where such divisions don’t exist.

What about Licensure?

Licensure is an entirely different can of worms. Licensure is state regulated, so by becoming licensed, Dietitians are identified as state regulated nutrition professionals. Licensed Dietitians are identified by having “LD” or “LDN” following the RD (or RDN) in their title (example: Jane Doe, RD, LDN). There is no difference in meaning between LD and LDN. Some states (such as Texas) use LD, while other states (such as Massachusetts) use LDN. Many employers request that Dietitians become licensed, because licensed Dietitians qualify as providers by insurance companies, are recognized by JCAHO, meet the criteria for Medical Nutrition Therapy, and are the only professionals that can provide nutrition counseling.

So what’s all of the controversy about? Even though many states have licensure in place, recent persecution of a nonlicensed blogger providing nutrition counseling has sparked the debate that licensure is just a tool for the Academy to limit competition for RDs. On the other hand, the Academy sees licensure as protecting public health and setting a minimum standard for education and experience. As a recent article so eloquently put it, “just as there are licensed physicians and dentists, whose license ensures they’ve met a rigorous set of standards, so should there be licensed dietitians”.

For those that would like to learn more:

– Kelly

School Lunch

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Tomato soup, chicken with brown rice, fresh garden salad, an apple and low-fat milk from Burlington, VT schools. YUM! (here)

School lunch gets a bad rap, and it wasn’t always undeserved. But if you have visions of chicken nuggets and pizza, you must not have stepped foot in a cafeteria lately. School lunch ain’t what it used to be. Under the new school nutrition standards, there must be a greater amount of fruits and vegetables (and a greater variety), 50% of grains must be whole grain rich by July 2012 (and 100% by July 2014), milk must be either 1% (low fat) or skim (nonfat), and only nonfat milk can be flavored. Additionally, there are now standards for sodium and calorie levels (there used to be no maximum for either), and there must be 0g trans fats per serving (no previous restriction). Despite some concern over the new school guidelines, I applaud these changes, as they are absolutely a step in the right direction.

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Beautiful meal from Portland, Oregon. (here)

Room for improvement: The new school nutrition standards are no doubt a victory for childhood nutrition, but there are still some problems to be worked out. These are the biggest challenges facing school lunch today. And yes, sadly enough, pizza sauce does count towards the vegetable requirement…

  • School lunches are definitely getting healthier. So why can your child still eat chicken fingers and french fries for lunch everyday? Two words: Competitive foods. Foods from vending machines, snack bars, and fast food chains are not a part of the National School Lunch Program, and therefore are not subject to the school nutrition standards. If we really want to create a healthy environment for our children, we need to set stricter standards for competitive foods as well. (here)
  • Unfortunately, the increased amount of fruits and vegetables on lunch trays is often correlated with the increased amount of fruits and vegetables in trash cans and compost bins. Acceptability of healthy foods is a complex issue, and it takes time to adjust. My suggestions? Get more kids to eat lunch after recess, instead of before, so that they are not rushing through lunch to go out and play, and they come in hungrier and ready to eat. Additionally, interactive nutrition programs that teach children the importance of a healthy diet, as well as where their food comes from, will be beneficial when trying to get children to embrace healthy foods. And don’t forget that acceptability starts at home! Model positive eating behaviors for your children, and encourage them to try new foods frequently. (here)

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Navajo tacos on a whole wheat bread with from scratch chili, and topped with all the fixings, at Centennial Middle School in Utah. Looks delicious! (here)

Innovative Ideas: The new school nutrition standards present their share of challenges for schools trying to implement them. Here are some clever ways to combat challenges and make every student healthier. 

  • Hector P. Garcia Middle School has fought back against competitive foods by offering healthier choices at after school concession stands. (here)
  • Elkins Middle School is improving breakfast participation by serving breakfast later, grab & go style. (here)
  • Lafayette Parish School System is trying out healthy lunch vending machine kiosks to help combat the logistical issues of serving healthy meals. (here)
  • Hall High School students taste test new cafeteria food in order to increase student education of the school food service system, as well as make sure that student needs are being met in dining halls. (here)
  • Pajaro Valley Elementary School utilizes recess fruit carts with nutrition education as part of their farm to school program. This approach is popular with students, and doesn’t infringe on precious classroom time. (here)
  • This study demonstrates that catchy names for healthy foods increase children’s selection and consumption. What a simple way to help nudge children in the right direction! (here)
  • Chefs in schools are improving student’s knowledge of healthy foods and food preparation, as well increasing student interest in healthy eating. (here, here and here)

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Beautiful veggie hummus wrap from Ashland Public Schools in Massachusetts.  (here)

Can’t get enough?

  • All of the images above are from the Center for Science in the Public Interest’s Pinterest page. Check it out to see images of successful healthy lunches from around the country, as well as get the facts on school lunch.
  • Want better school lunches in your area? Click here for all of the resources you need.

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Scene from the trenches: My 6 weeks managing an elementary school cafeteria in 2012, just as the school nutrition guidelines were getting finalized.

– Kelly