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What is a "registered dietician" compared to a "nutritionist"?

Introduction To Nutrition

Susan Silberstein & Marilyn Joyce (Health and Nutrition Educator & Heath Counselor) gives expert video advice on: How was the food pyramid changed in 2005?; What information can be found on a "food label"? and more...

What is a "registered dietician" compared to a "nutritionist"?

There is a lot of controversy about what a nutritionist is, but let me just start by saying a nutritionist is anyone who puts a sign up outside their door and says, “I'm a nutritionist”; that is the overall definition. However, a true nutritionist, for example a registered dietician, has to have at least four years of university and then a year of an internship. Many of us have more than that, but that's the baseline to become a dietician. A “clinical nutritionist” has to go through two years of schooling and then becomes certified. That's a “certified clinical nutritionist.” So, there are different levels. For example, in Japan, this was interesting to me, they only have to have two years of university in order to become a dietician. So, it's different globally. However, in North America you have to have a baseline of four years plus an internship to be a registered dietician. A registered dietician goes through massive training to become a nutritionist; you can go between the two words “registered dietician” and ”nutritionist”, but if you're a nutritionist who doesn't have the RD status, you can only call yourself a nutritionist. There are many self-proclaimed nutritionists out there. You can go to someone with that kind of education (and many of them have spent years studying) but do they have the clinical basis? Do they understand how nutrition works on a cellular level? That's something you have to ask. I always tell people, “Ask a lot of questions. Find out how much education the person has. Find out what they know about the clinical aspects of nutrition and how it works with the metabolic systems.”

Well, the recommended daily allowance; that's a great question, because the recommended daily allowance is not something that I encourage my clients to really focus on. It's a minimum amount that you need, that a healthy person needs, in order to stay healthy. The challenge is that it's not enough for a person who's on the borderline. So, I always encourage people to aim for more then what they see as the recommended daily allowance as a minimum requirement. It was originally developed because people were not clear on what they required in order to maintain health, so in studying what the baseline was for general health, it was determined (I believe it was through science as well) that it was this particular level of, for example, vitamin c to prevent scurvy, and this level of vitamin b1 to prevent a deficiency that would lead to pellagra. These were things that they looked at and determined it as a base level. That's how this was originally set up; so that there was a level that we would be sure that if you met you would not get those particular deficiency illnesses. However, if you were already sick, you would not then be able to get well from that amount; you needed to have a better foundation in your diet in order to regain your health.

What constitutes "one serving" of food?

Most people think a serving is, for example, if they buy a package or, we'll go with spaghetti sauce. They get the can of spaghetti sauce and they think a serving is, you know, whatever they put on their pasta. In the meantime though, the servng may be double. Their serving may actually be double what the serving is on the can. So oftentimes people are getting two and three times the amount of whatever it is, pasta or spaghetti sauce or whatever the particular item is because they are not realizing that if they look at the package and it says serving size, it means how many servings are in that container not that half of that can necessarily is a serving but that there might be four servings in that can so you have to make sure you are only getting a quarter in that can. So it is really understanding what a serving is and only taking that amount. Unless you can afford to have more calories and more fat and whatever there is in that particular item that they are eating.

What is the "food pyramid"?

The food guide pyramid was originally developed by the food industry. It was not developed necessarily with health in mind. The food pyramid was more a vehicle for selling the food items; the dairy products, the meat products, and the canned processed products, because it was really not set up in a way that was conducive to good health. When you look at the very foundation of the food pyramid, the very base of it was carbohydrates. It was carbohydrates in any form that was baked and so it could be simple carbohydrates or complex carbohydrates. There was no differentiation. It was all grouped into the same bundle. As they moved up in the food pyramid, it was focused on dairy and meat instead of really focusing fully on what we know now to be really healthy foods; fruits, vegetables, and legumes. Actually they even basically overlooked things like beans, peas, lentils, split peas, and nuts, all of which healthy cultures in the world eat. So, the food pyramid was not founded on really nutritious foods. The food pyramid was founded on what the industry was really trying to sell. That was the basis of the food pyramid and it moved up from, you know, the carbohydrates at the bottom right up to the top where it was incorporating oils and things like that. However, it didn't differentiate even between which oils were healthy and which ones were not. So, again, there was no differentiation between healthy versus unhealthy in the food pyramid.

How was the food pyramid changed in 2005?

Now, the change that's occurring in the pyramid is still, unfortunately, ruled by the industry, but it is looking at the challenges we have to day with obesity in our children and obesity in our adult population. So we are looking now at the fact that 'ok, we have to include lifestyle.' At least they have incorporated something like fitness ideas into this pyramid and you know a little bit of differentiation between whole foods versus juice foods and they are looking at getting back to the basics a little more in the food department. There still isn't enough differentiation between unhealthy and healthy fats, or unhealthy and healthy sugars. It's still allowing, I feel, too much sugar in the program. Kids today are eating three quarters of a pound of sugar a week, or the equivalent to that a week! We need to teach children not to eat such high sugar products.

What information can be found on a "food label"?

The main thing to think about with a food label, and what I say when I'm teaching my clients how to read a food label, is that it's not that they have to read everything on that label. They have to focus in on a few things. One is the serving size because if you get a bottle of some sort of juice and it says, “50 calories per serving,” but there are four servings in that bottle, then you have to figure out that you're getting four times that if you drink the whole bottle. So that's one thing; understanding what a serving size is in that package or container. Number two is really looking at the list of ingredients. How many ingredients are in that particular food? If there's more than four or five, it's probably not a whole-food-based kind of product; it's probably a very synthetic kind of product with a lot of added things to preserve it, to keep it on a shelf for a long time. That would not be a good idea. You also look at what the first ingredient is. If it says “wheat flour,” you know you've got a white-flour product there. If it says “whole-wheat flour,” then you've got something that's got whole wheat as the foundation. Then, you look at what the next ingredient is, and the next ingredient. As long as you can read all of the ingredients and know what they are, that's a good start point. Then, it starts with the healthiest product. If it starts with sugar, don't pick it up and buy it. That's something that you don't need in your diet. However, if it's got a whole-grain base, that's probably a good alternative. The next thing to look at is how much sugar and how much sodium there is in the product, and what kind of fat it is in the product. Is it trans-fatty acids? How much of the trans fats are inherent in it? How much fat overall is there? I usually aim with my clients to teach them to have no more than 3 grams of fat per serving. That way they get a good serving size of fats but not too much, and especially, as I said a minute ago, you don't want to have trans-fatty acids.

What are "calories"?

Calories are energy measurements in food, and the number of calories you have will determine your health and your weight. You need calories for every metabolic function in the body. You need calories for energy to do any kind of atheletic sports, activities, etc. Anything in your life that's an activity, you need calories for. The challenge for most people today is that they're eating so much more than they require. For example, 3500 calories make a pound of fat, or a pound of weight. If you're getting too many calories in the food you are eating, you're going to gain weight. It's automatic that if you need to lose weight, you need to cut calories. I know there's a lot of fad diets around that don't talk about calories, but the fact is when it comes down to the nitty gritty of the whole thing, it's the number of calories you take in and the number of calories you burn - through metabolic activity, or what the body is doing and working on, or through activities that you do in your life. We often see people who go on a diet, and they don't really lose much weight because they're only cutting down their calories and not actually increasing their activity. The two things together will increase your ability to lose weight faster. The other point is that lean muscle tissue is very active tissue and it will actually burn calories faster.