Hello Laura! Diane Sanfilippo of Balanced Bites sent me in your direction because she feels you could give me some good guidance… Here is my dilemma: I have such a passion for nutrition! So much so that my husband has urged me for a long time to go back to college to become a Registered Dietitian. But I am hesitant because everything I will “learn” in school goes completely against what I believe & know to be true about nutrition! I have no idea how to accomplish this without having to go backwards through conventional nutrition education. I want so much to help people get healthy through REAL nutrition! Is it in my best interest to go for RD, or would a different degree suit me better? Can you please tell me about how you did it? I would greatly appreciate any and all of your insight!! 

-Jessie S

If I had a nickel for every time someone asked me this question, well… I’d have a lot of nickels.

Many people who rediscover their own healthy by returning to an ancestral diet become passionate about sharing that knowledge with others. It’s a completely understandable reaction to having your life changed by nutrition: you want to help change others’ lives.

However, a huge stumbling block to many people is trying to decide how to become a professional nutritionist. There are dozens of different options for educational programming, some more intensive than others, and all have their pros and cons.

One major con is that the traditional dietetics program teaches nutritional information that has been sanctioned by the Academy of Nutrition and Dietetics, promoting diets that are low in saturated fat and animal products, and high in grains and low fat dairy. And as an RD, you may be putting yourself at risk by recommending foods like whole eggs, butter, and red meat, despite the complete lack of evidence that these foods are harmful.

These issues were brought up recently in a Balanced Bites podcast: Diane explained that “it’s more dangerous, perhaps, legally to have the RD and teach things that are… against what you were taught. Not dangerous, but that you might lose that license.” That’s definitely something that many people are concerned about when considering what type of program to attend.

I mean, who wants to spend 3 years getting a degree just to have it possibly taken from them for making evidence-based nutrition recommendations?

The good news is that if you’re willing to put in the time and energy it takes to build a private practice or to find a job that allows you to promote your nutrition philosophy, you won’t be under as much scrutiny as someone working for a hospital or public health department which is more likely to adhere to governmental guidelines. And as long as you can back up your recommendations with evidence or at least provide a disclaimer (and know your scope of practice!), you should be protected against persecution by local dietetics boards.

Getting through a conventional nutrition program can be a challenge, but it’s not impossible. And while the allure of an “alternative” nutrition program is strong, there are definitely benefits to taking the traditional dietetics route. Here are three reasons you should consider becoming a Registered Dietitian, even if you’re completely opposed to conventional dietary recommendations.

1. You’ll be able to legally help people in your state.

This is probably the number one thing to consider when deciding what type of nutrition program you want to pursue.

Some states have very strict laws about nutrition counseling; I live in North Carolina, which is infamous for its enforcement of these licensure laws. To be fair, I do think it’s reasonable for a state to require a certain level of education before nutrition advice is dispensed, and it’s unfortunate that many of the nutrition degrees that are available online don’t teach at a level that prepares you for clinical nutrition capabilities.

It’s important to realize that many of these licensure laws don’t prevent you from giving “general nutrition advice” but do prevent you from (legally) performing one-on-one nutrition counseling. As one RD/lawyer puts it, “You are no longer just providing information… You are assessing and counseling, both of which require a license.”

To be honest, I’m on her side when it comes to this matter. Hear me out: imagine you live in a state that does not have licensure laws, and you want to see a nutritionist. If you go see someone who has a certificate that they printed from an uncredentialed online program, how do you know they have any in-depth knowledge about nutrition? What if they give you unscientific or inappropriate advice?

I’m not saying RDs have a monopoly on nutrition knowledge, but if there are no rules about who can charge money for nutrition counseling services, how will you be protected against nutritional nonsense spouted by a “nutritionist” that barely has an education?

I can hear the arguments you’re making already: “but Laura, there are hundreds of dietitians giving crappy advice all the time!” Or, “I saw a dietitian one time and she gave me the worst advice ever!” Yes, this is an issue. It’s an issue for any health profession… there are crappy doctors, crappy dietitians, crappy personal trainers, crappy dentists… having a degree doesn’t guarantee common sense and deep understanding of human health.

But I will say that as a dietitian, we’ve gone through years of classes covering nutritional biochemistry, anatomy and physiology, clinical dietetics, and more. Having an understanding of human physiology and disease processes is important when making nutritional recommendations, and many uncredentialed programs don’t provide that education. (Some do, some don’t.)

Whether or not you agree with the licensure laws, they do exist and you need to be aware of them. Getting your RD degree helps ensure that no matter which state you live in, now or in the future, you’ll be able to legally dispense personalized nutrition advice to  individuals.

I will say I’ve seen plenty of non-RD “nutritionists” who are advertising themselves as health coaches, and the fact is that many of them don’t know how to handle more complicated medical cases with targeted diet and supplement protocols. RDs who identify themselves as “real food RDs” are usually quite knowledgable and can provide a more valuable service to patients who need someone who understands their health conditions and knows potential evidence-based treatment strategies. It’s just a fact that many of the non-degree nutrition programs out there don’t teach their students how to be clinicians… so don’t expect to become clinically competent by enrolling in those programs.

 2. You’ll get thousands of hours of education and patient experience before graduating.

This is related to reason #1, but it goes a bit beyond as well. Even nutritional programs that provide credentialing like the NTP or CNC programs don’t typically require internships, and even those that offer internships as a bonus only last a few days to a few weeks. Bauman College has an internship component to their nutrition consultant program, but it apparently only lasts 175 hours. Better than nothing, obviously, but still pretty short.

Compare that to the 1200 hours of internship experience we dietitians had to achieve to get our degrees.

I’m not knocking these alternative programs, so don’t misunderstand my point here. Some of the most knowledgable and successful nutritionists I know have an NTP or NC degree. Ultimately, your knowledge isn’t going to come from the classroom only, and you’ll need to be a student for life to ensure that you’re providing the best information possible. No nutrition program will guarantee you a sufficient breadth of knowledge to be highly successful.

The most successful nutritionists don’t rest on their laurels. Despite all the work I already did for my program and the 2+ years I’ve worked with Chris Kresser, I still feel like I need to learn more. I’m now enrolled in an Integrative and Functional Medical Nutrition Therapy training program, since I want to continue to increase the depth of my knowledge when it comes to holistic nutrition counseling.

I never saw my educational program as the “end-all-be-all” for my nutrition education. Far from it, in fact.

I’ll readily acknowledge that my MPH-RD degree wasn’t enough of an education to do what I want to do with nutrition. Sometimes I get a little bummed about it since I worked really hard in the program, but then I realize there’s really no single educational program that provides the depth of knowledge I want to ultimately have. And there’s no way I could do what I’m doing now without the education and experience I got through the intense coursework and internship hours that my RD degree required.

Combining that with my constant self-education and research, plus attendance of highly informative conferences like the Ancestral Health Symposium and Wise Traditions, is really what allowed me to synthesize all the knowledge I obtained over the past 3+ years of education, both formal and informal.

Getting patient experience is one of the most important parts of your nutrition education, as all the nutrition knowledge in the world doesn’t mean a darn thing if you don’t know how to apply that knowledge to individuals. And getting clinical experience helps solidify the understanding that every person is different and one diet that might work great for one person doesn’t always work well for another person.

That, and you also learn a great deal about how to work with a huge range of clients, from the highly motivated to the completely disinterested. I strongly believe that the internship component of my education was crucial for my development as a nutritionist, and has made a big impact on my successful work with patients.

Whatever educational program you pursue, make sure it has some sort of internship component. You’ll miss out on a lot of hands-on learning if your program is completely online and doesn’t provide you any practical experience.

3. You’ll help change the face of conventional dietetics.

This might sound silly but I do think this is a factor that should be part of your consideration. Maybe not for your sake, but rather for the sake of the future of nutrition in this country.

Many people have a serious distrust of dietitians, and I feel that this is unfortunate. There are many, many real food RDs that promote a whole foods, ancestral diet, and it’s unfair to assume that their knowledge isn’t complete based on the letters that follow their name. I’m part of a Paleo RD practice group on Facebook that has 174 members (as of April 2014)! Clearly the numbers of ancestral health-minded RDs are growing, and it’s no longer safe to assume that an RD won’t help you make the most out of your Paleo diet, assuming that’s your goal.

I often promote dietetics programs to those who are debating it because there’s strength in numbers. The more of us that become RDs and use our voice to share our knowledge, the more we’ll push the profession in a positive direction. I already think there is a decent level of outspokenness amongst dietitians who realize that the conventional industry-sponsored dietary advice promoted by our professional organization is leading our country down a dark path of unhealthful eating.

There’s even an organization called the Dietitians for Professional Integrity who are advocating for greater financial transparency and ethical sponsorships within the Academy of Nutrition and Dietetics. These dietitians “do not think Coca-Cola, PepsiCo, Kellogg’s, and other Big Food giants should sponsor the country’s largest nutrition organization,” and “believe the American public deserves nutrition information that is not tainted by food industry interests.” This group has over 8,000 members on Facebook.

Ultimately, the more of us that become RDs and promote a whole-foods approach to nutrition, the more vindicated we will be in our nutritional philosophies. There’s a bit of fear amongst real food RDs that we’ll be persecuted for promoting an ancestral approach to nutrition, but I honestly believe that the more of us that stand together in our nutritional beliefs, the better protected we’ll be against retaliation from other ill-informed medical professionals. And the more of us that are getting amazing results by putting our clients on a whole foods ancestral diet, the more clinical evidence we’ll be able to provide for the effectiveness of our recommendations despite the lack of support by our governing bodies.

The dietetics profession is moving in the right direction… albeit slowly. The more outspoken RDs promoting a real foods approach to nutrition, the faster our nutritional philosophy will be legitimized in the public eye, which will allow more people in our community to be exposed to this potentially life-saving information.

So yes, Jessie, I do think you should consider getting your dietetics degree! It will be hard, you’ll want to tear your hair out several times a week, and you should prepare your husband for an onslaught of “guess what I was ‘taught’ today” conversations (I had them with my mom on a regular basis!), but ultimately I believe it will be worth it in the end.

Come join the dark side! 🙂