What Lane Do You Practice In?

Have you noticed that the field of nutrition is expanding… more players?  

Over the last decade, nutrition has become a competitive, saturated field of services with lots of lanes to practice in.

Do you ever wonder where all of these lanes come from? 

Social media certainly has played a role in facilitating a platform for anyone. Lots of folks are not just giving an opinion about nutrition, but also giving nutrition advice.

If you are a legit nutrition expert, how do you embolden your skills as a licensed practitioner to separate yourself from the pack —and give you the leeway of a few more practice lanes?

Yes, this is for you RDs and RNs too. Are you practicing up to your potential and are you able to change lanes if you want to?

Someone recently asked me what kind of nutritionist am I?  My first thought was to respond, “A good one”, but my humility kicked in and I asked them to clarify a bit more. They responded with, “Do you do low carb?”  I explained that low carb is really a microcosm of the field of nutrition. 

Finally, I explained that I am an RD who provides a system biology approach to nutrition care— addressing individual health needs, and yes, sometimes focusing on lowering carbohydrates. 

We talked a little bit more and they were quite curious to hear my response because they had no idea what an RD really does.  Even with the internet, their awareness of my scope of practice was a microcosm of what my scope of practice really is.

This is a big reason why I developed my online System Biology coursework for RDs and RNs. It’s also why I’ve been a member of DIFM (Dietitians In Integrated and Functional Medicine), for as long as I’ve been practicing.

Truth is, there are lots of people out there giving nutrition advice. In my opinion, some who are not RDs are qualified and some who are not.

What exactly constitutes nutrition advice? 

When I made the choice to become an RD years ago, there were not many lanes to practice in. If I wanted to practice within a standard of care, and be able to open up someone’s medical history, interpret labs, recommend supplements, if necessary, the only discipline that best matched this job description was to become a RD. 

I  had to take certain undergrad requirements, a national board exam, fulfill a year internship with a high level of proficiency and then later licensure in my state, my graduate degree and years of continuing education. (Now RDs, are required to have a MS degree in order to sit for their board exam.)

Today, if a consumer wants to receive nutrition advice, there are lots of services to choose from and the public often doesn’t know the difference. We’ve got health coaches, nutrition coaches, holistic coaches, clinical nutritionists, chiropractors, nurses, functional physicians and of course, the nutrition supplement reps. 

With all of these “services”, the requirements may stem from nothing but an interest in food to a PhD, licensed clinician who has passed a board exam and fulfilled a proficiency of clinical requirements.

All of these services have the ability to put a website online and go out there and provide nutrition advice.

Depending on the state you practice in, you may be able to provide Medical Nutrition Therapy (MNT).  MNT is an evidence-based medical approach to treating certain chronic conditions through a tailored nutrition plan, provided by an RD and is usually approved by insurance. But I have my issues with MNT—more on that later.

As an RN, I greatly respect the field of nursing but RNs have limited nutrition education in nursing school— however, they carry a wide umbrella in the medical system. Throughout your health care life, you will have more contacts with a nurse than you will with any other health care provider.

So, certainly it makes sense for RNs to be up to date with nutrition knowledge. An RN’s scope of practice allows them to give nutrition advice but they are not able to provide MNT except under the supervision of a physician or unless they are a diabetes educator.

But back to the consumer. What are people looking for when they seek nutrition advice? Seems safe to say they are seeking someone who understands the science of food and nutrients and their various components and can translate that into food recommendations, perhaps recipes, cooking knowledge, grocery shopping, etc. 

But food doesn’t enter the body and just stay in the mouth —it enters the body and then takes a journey, traveling through the GI tract ultimately having both positive and negative systemic effects, virtually affecting every cell in the body.

Food can also emit epigenetic effects within the body.  Well, now we have just entered the realm of someone’s health, which opens the door to their medical history, medications, etc., and hello, MNT. 

These layers of nutrition practice, essentially are our practice lanes. If you are a licensed practitioner such as an RD, you have several lanes to practice in and RDs can do all of this in their own private practice, not under the supervision of a physician.

A health coach or anyone else without this training really only has one practice lane and if they venture into any medical advice, they must be under the supervision of a physician.

Truth be told, isn’t MNT ultimately the goal of everyone who asks for nutrition advice?  Unless, the consumer is just seeking a few different recipes or wants to learn to cook, people seek nutrition advice to improve their health—medical nutrition therapy!  It all requires knowledge well beyond just what’s in food, knowledge of anatomy and physiology of the body.

You can see how separating out the layers of nutrition advice is nearly impossible. You can’t separate the mouth and the body from the purpose of food and its systemic effects. To do so, is the slipperiest of slippery slopes. It may be one thing to separate philosophies of nutrition practice,  but regardless of your philosophy or the limitless knowledge you may have about food and nutrients, if you are going to give out you must have an understanding of anatomy and physiology and how the systems work together, if you are giving nutrition advice.

As important as it is to stay within your scope of practice, it’s also important to maximize the scope you have earned. A strong foundation of systems biology and anatomy and physiology to match your nutrition knowledge also allows you to practice in more than one lane. Embolden and distinguish your nutrition skills with a systems biology framework and now you are practicing on the full nutrition highway.