If you have a question about nutrition, the most convenient source of information may be your physician, a local dietitian or home economist, or a local college or university nutrition department.
If your doctor is interested in nutrition, he or she may be a good place to start. The principles of nutrition are those of human biochemistry and physiology, courses required in every medical school. Although many medical schools do not teach a separate required course in nutrition, this does not mean that the subject is ignored. Many medical educators prefer that nutrition be included in other courses at the point where it is most relevant. In addition, most medical schools offer an elective course in nutrition.
Medical training, of course, does not end on graduation day. The medical profession advocates lifelong education, and physicians can further their knowledge of nutrition by reading medical journals, discussing cases with colleagues, and attending courses. If your doctor is unable or unwilling to provide what you need, you can be referred to someone who will—usually a registered dietitian.
Many accredited universities offer nutrition courses based on scientific principles and taught by qualified instructors. A bachelor's degree in nutrition requires four years of full-time study that qualify a graduate for entry level positions in dietetics or food service, often in a hospital. A master's degree, which can widen career opportunities, requires two more years of full-time study beyond the undergraduate level. People who wish to become nutrition researchers usually pursue a doctorate (Ph.D.) in biochemistry, which requires at least two years of additional study plus a thesis based on original laboratory research. Those wishing to concentrate on teaching or educational research usually seek a Ph.D. or Ed.D. degree in nutrition education.
In addition to an academic degree, most legitimate nutritionists seek professional certification. Active membership in the American Society for Nutritional Sciences (ASNS)—formerly called the American Institute of Nutrition—is open to those who have published meritorious research on some aspect of nutrition and are presently working in the field. The clinical arm of ASNS is the American Society for Clinical Nutrition (ASCN), which has similar requirements but specifies clinical research. Nutritionists at the doctoral level may also seek certification by the American Board of Nutrition as specialists in clinical nutrition (M.D.'s only) or human nutritional sciences (M.D.'s and Ph.D.'s). Board certification requires passage of comprehensive examination. Most board-certified nutritionists are affiliated with medical schools and hospitals, where they conduct clinical research and offer consultation to primary-care physicians.
Registered dietitians (R.D.s) are specially trained to translate nutrition research into healthful, tasty diets. The R.D. credential is available to individuals who obtain a bachelor's degree in nutrition accredited by the American Dietetic Association (ADA), complete an ADA-approved dietetic internship, and pass a comprehensive written test covering all aspects of nutrition and food-service management. To maintain their credential, they must also participate regularly in ADA-approved continuing-education programs. Although completion of a masters degree or Ph.D is highly desirable for nutrition professionals, it is not required to become a registered dietitian.
Most active R.D.s work in hospitals. Typically, they counsel patients and conduct classes for pregnant women, heart and kidney patients, diabetics, and other persons with special dietary needs. Dietitians are also employed by community agencies such as geriatric, day- care, and drug/alcohol abuse centers. Some dietitians do research. Others engage in private practice where they counsel physician-referred clients. The ADA also has a certification process for advanced-level practitioners and for specialists in renal (kidney), pediatric, and metabolic nutrition.
The Certification Board for Nutritional Specialists was founded by the American College of Nutrition in 1993. It offers a Certified Nutrition Specialist (CNS) credential to professionals with an accredited master's or doctoral degree who have clinical experience and pass an examination. Its requirements are substantial but less than those of the American Board of Nutrition and it does not screen its members as carefully.
Most conditions for which detailed nutrition advice is needed require medical diagnosis first. These include high blood cholesterol, diabetes, severe food allergy or sensitivity, high blood pressure, certain digestive problems, osteoporosis, severe kidney disease, cancer, and obesity. Consultation with an expert can also be worthwhile for pregnant and lactating women, competitive athletes, and individuals who feel confused about nutrition.
A Certified Clinical Nutritionist (CCN) credential is offered by the Clinical Nutrition Certification Board (CNCB), an organization founded in 1991 to provide credentialing to nutrition professionals who might not be eligible to become registered dietitians or to be certified by the American Board of Nutrition. Although some members are qualified and practice appropriately, both CNCB and its sponsoring organization (the International and American Associations of Clinical Nutrition) include promoters of highly dubious practices among their leaders.
American Health Science University offers a Certified Nutritionist (CN) credential to students who complete its six-course "distance learning program" and take an examination. Although accredited, it is closely aligned with the health-food industry and should not be regarded as trustworthy. Its president, James R. Johnston, does not appear to have a accredited doctoral degree.
The American Association of Nutritional Consultants issues a Certified Nutritional Consultant (CNC) credential to persons who take an open-book test. The CNC credential should be regarded as bogus.
The Society of Certified Nutritionists (SCN), established in 1985, includes Certified Clinical Nutritionists (CCN), Certified Nutritionists (CN), and Certified Nutrition Consultants (CNC) among its members. SCN membership should be regarded as a sign of poor judgment.
Because the titles "nutritionist" and "nutrition consultant" are unregulated in most states, they have been adopted by many individuals who lack recognized credentials and are unqualified. In addition, a small percentage of licensed practitioners are engaged in unscientific nutrition practices. The best way to avoid bad nutrition advice is to identify and avoid those who give it. I recommend steering clear of: