Bryna Gavin, MS, CNS
So your doctor gives you a diabetes diagnosis and says you need to change the way you’re eating. Or maybe you’re ready to start trying to have a baby and you want to make sure you’re as healthy as possible before conception. Maybe you’ve been struggling to lose that last 10-15 pounds, or are finally seeking help for the eating disorder that’s been plaguing you for years. Maybe you’ve just found out you have Celiac disease and everything you think you know about what to eat just got really confusing and you need some freaking guidance.
You want to see someone who can offer you personalized nutrition counseling, someone who can help you to uncover the cause of some unexplained symptoms. Ideally, someone who can make personalized meal plans and offer you some support and partnership while you navigate the road to healing.
Okay. you know you need help… but who are you supposed to seek out? A nutritionist? A dietician? Someone else? And what’s the difference anyway?
(Okay if at this point you realize that you didn’t signup to read a whole blog and you just want to get the bullet-point version, just scroll to the bottom. I got you.)
Listen, navigating the research that exists out there around food can be a scary and confusing thing (not to mention frustrating). What you know to be good for your body is seemingly always changing, and being told that you need to change what you eat or how you live can be anywhere from intimidating to downright terrifying.
Now what you’re about to read is by NO means the most comprehensive breakdown in the world, but it is the condensed version, to help you understand the difference (and similarities) of these titles.
“Dietitian” and “Nutritionist” are often confusing titles for lay people to navigate. In many ways, their training can be very similar, and both are regulated health care professionals. But there are a few important ways that they are different. (One of the most prominent being that earning a CNS certification requires a Master's Degree in the field of nutrition and 1,000 hours of supervised clinical internship where as an RD requires a bachelor’s degree). But before I go on tooting my own horn it should also be noted that RD’s make up a much larger percentage of the field, and they dominate in legislation and the professional world due to being around longer than the CNS. And that goes to show how well-known and trusted the RD credential is.
So why all the confusion between the two names?
Well, first of all, let me say this: universally, the term “dietitian” is pretty protected. Legally, you can’t declare yourself as a dietitian, or more precisely, registered dietitian (RD) until you become registered with Commission on Dietetic Registration (CDR).
Unfortunately for my colleagues and myself, the term “nutritionist” doesn’t have quite the same protections in most states. The laws on credentialing, and even using the term “nutritionist” varies state-to-state, meaning that in some states (like California where my private practice is based), literally anyone can call themselves a “nutritionist” with no legal recourse. Some states (depending on their categorization as red, yellow, orange, or green) require you to be board certified before you can practice nutrition, and some do not.
Worse yet, it’s becoming increasingly accessible (and incredibly uncool if you ask me) for someone to take a 2-week online certification course from a made-up organization and call themselves something like a “nutrition consultant”, “nutrition health coach” or that they have received their “nutrition coaching certification” from XYZ school. My concerns with these "certifications" is that oftentimes there are NO governing boards that review, standardize, or even qualify the material taught as being accurate. It’s the equivalent to paying your neighbor to tell you about their cat’s bowel movements and them dubbing you a “certified feline feces specialist”. It’s simply, not a real thing. And it matters that we empower ourselves to ask the right questions before we give people our money and listen to their advice about what to do with our bodies.
(Let me take a moment and sidebar here and say that although there is no one governing board that regulates Health Coaches, I know some brilliant practitioners who started as health coaches or use their health coaching background to work with individuals in states that would otherwise not let them practice as nutritionists and they are doing great work in the world. There are some very reputable organizations like the Institute of Functional Medicine (IFM) who offer health coaching certifications that have the sound, clinically-based teachings. Furthermore, I know some brilliant holistic practitioners who do not have extensive formal training in medicine who I personally believe to be more effective healers than some doctors I’ve met in my day… so you understand what I’m getting at, right?)
My point here isn’t that one credential is better than the other (as long as the credential is legit.) I just want to help guide people to ask the right questions so the person you pay to see is both capable, and going to be the right fit for your needs.
Now, back to business. Using the term Certified Nutrition Specialist (CNS), however, is legally protected. If you are seeing a nutritionist, you should be seeing a CNS, or a practitioner who studied nutrition science or a comparable track at an accredited university who has completed a supervised clinical internship and who is licensed or board certified. Now I know I’m biased, but I don’t believe you should be able to call yourself a nutritionist without completing ALL of the above.
If you’re not sure if the person you’d like to work with has a legit certification, a simple litmus test could be asking them for their National Provider Identifier (also known as “NPI”) number. An NPI number is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
Both RD’s and CNS’s can (and should) have an NPI number. Appropriately trained and credentialed health practitioners should all have one.
If someone markets themselves to you as a “nutritionist” but doesn’t have an NPI, and didn’t attend an accredited educational institution, I would empower you to dig a little deeper. Ask questions and make sure they are open to answering them.
Is it because they are finishing up an internship? Cool.
Is it because the “certification” they bought online was a 10-day crash course in celery juice cleanses and now they call themselves “Chad Johnson, CJCS - Celery Juice Cleanse Specialist”. Well… maybe there’s room for a few more questions before you decide to work with Chad.
All in all, what matters most is that the individual you are trusting with your health and your money:
A) knows what they are talking about (this is where proper education comes in).
B) Is someone that YOU want to work with.
So empower yourself to ask questions about how they practice, how they can help you reach your goals, and maybe even why they chose their educational path in the first place. This can help you to feel empowered and informed when you choose the nutritional professional you want to work with.
And if you’re still a little fuzzy on the difference, take a peek at this handy little summary below:
Distinguishing Between Dietitian vs Nutritionist
(The short and sweet version.)
REGISTERED DIETITIAN (RD)
This credential is governed by: Academy of Nutrition and Dietetics
To become a RD, dietitians must:
complete a baccalaureate degree from an ACEND-approved program; complete an ACEND-approved supervised clinical program
successfully pass the CDR registration examination
complete continuing professional education credits needed to maintain registration.
CERTIFIED NUTRITION SPECIALIST (CNS)
(the most common non-RD nutrition credential)
This credential is governed by: The Board for Certification of Nutrition Specialists (CBNS)
To become a CNS, nutritionists must:
complete a master’s or doctoral degree in a field-related discipline
complete 1,000 hours of supervised practical experience
successfully pass the BCNS certification examination
complete continuing professional education needed to maintain certification.
The above information comes from the this page called nutritioned.org that breaks down the state requirements for the nutrition and dietitian fields.