Who Can You Trust To Give Nutrition Advice?
Article by Rhiannon Lambert
What we put on our plates and how we use our bodies are the most powerful tools we have for maintaining good health. However, with a minefield of supposedly authoritative resources each providing their own take on a nutritional education, there is little wonder increasing numbers are seeking private nutritional advice, but who can you really trust?
Despite food playing a key role in our overall health, it's still not something your General Practitioner (GP) will typically discuss. One of the issues is that in medical school prospective doctors are mostly taught a model of care suitable for severe problems that is primarily pharmaceutical based. Meanwhile, the vast majority of chronic problems that GPs treat today include type 2 diabetes, obesity, gut problems, insomnia and headaches, all of which are largely driven by poor lifestyle choices. For many GPs, a frustration with the existing medical education encourages them to seek out individual study in nutrition.
Many of my fellow healthcare practitioners are excellent, hard working, qualified professionals. The trouble for anyone seeking nutritional advice is that there is no legal definition of a 'Nutritionist' and consequently, there is no specific exam or course you must pass to use this now fashionable title. There are a number of government-approved health practitioner registers but many of the estimated 100,000+ people practicing as Nutritionists in the U.K. are not present on any of them.
In Sainsbury’s January 2017 Eat Well, Move Well, Live Well report, their research found that nearly a quarter (21%) of young people refer to social media, YouTube stars and bloggers to find information on healthy eating. This is concerning as many vloggers, Instagrammers and other social media stars are not qualified nutritional experts and as such their advice is not monitored, so can be misleading or simply wrong. For instance, the study suggests 44% of young people think that cutting out a whole food group (e.g. Gluten - Should We All Go Gluten-Free?) can create a healthy lifestyle, increasing to 50% among social media users.
The problem is that when it comes to food, everyone thinks they are an expert! What’s worse is that literally anyone can set themselves up to offer nutritional advice, answerable to nobody, and trying to find the legitimate practitioners can be a confusing process. The wide variety of practitioners offering nutritional advice is overwhelming, and it doesn’t help that they use so many different terms to describe what they do. From Health Coaches and Diet Experts to Dietitians and Nutritionists, it can be very confusing to understand who's actually fully qualified.
Who is qualified to give personalised nutritional advice in the UK?
Registered Dietitian (RD)
Registered Dietitians (RD) typically have obtained at least a four-year university degree in nutrition and dietetics accredited by the British Dietetic Association. They manage and treat specific medical conditions using nutritional science and typically work in the NHS or medical research. Registered Dietitians are entitled to a legally protected title regulated by the Health Care Professions Council (HCPC).
Registered Nutritionist (ANutr & RNutr)
Registered Nutritionists typically have obtained at least a three-year university degree in nutrition along with postgraduate healthcare qualifications. They share scientific, evidence-based advice about the impacts of food and nutrition on the health of individuals. Registered Nutritionists are members of the government-approved Association for Nutrition (AFN). AFN membership has rigorous criteria requiring registrants to have obtained specific AFN accredited qualifications. Registered Associate Nutritionists (ANutr) are typically recent graduates and are required to have an additional 3 years supervised practice before applying for the RNutr title, something I am in the process of transferring to.
Nutritional Therapist
Nutritional Therapists typically have obtained a diploma or undergraduate degree in nutritional therapy accredited by either the British Association for Applied Nutrition and Nutritional Therapy (BANT), Complementary and Natural Healthcare Council (CNHC) or General Regulatory Council for Complimentary Therapies (GTCCT). Nutritional therapy is recognised as a form of complementary medicine, encompassing Naturopathy and other holistic alternative approaches. Their advice is based on a mixture of science and non-evidence-based practice.
The Association for Nutrition has been striving for professional regulation for qualified nutritionists for over 10 years, which would protect the title ‘Nutritionist’ so that it could only be used by those meeting the high standards required. It is thought that with significant AFN membership growth, it will be eventually possible to apply to the Privy Council for a Royal Charter. This could enable Registered Nutritionists to call themselves ‘Chartered Nutritionists,’ a legally protected title with international recognition. There is no doubting AFN’s unwavering stance on the importance of achieving statutory regulation for the nutrition profession but it is a lengthy process. Securing a legally protected title would immediately address any confusion in the media and protect the public by making sure people know where to turn to for reliable, evidence-based nutritional advice.
With an ever increasing number of self-proclaimed health gurus born online whose nutritional qualification is nothing more than a lifetime of eating, we must fight the culture of celebrities emerging as authorities on nutrition and health. Self-proclaimed health gurus are doing nothing wrong by encouraging healthy eating, yet some with their immeasurable social media influence, surely there is a responsibility to ground their promises in evidence. All sharing unique definitions of healthy, they appear to offer a similar trend of restriction. You’ll rarely find mention of a nutritional degree, which teaches the evidence-based biochemistry, immunology, pathophysiology and psychology required to dictate what someone should and shouldn’t be eating. Evidence-based means scientifically proven with studies suggesting whether something works or not, and whether it could do any harm. A deep lack of understanding from self-appointed health gurus has only served to encourage impressionable teenagers and young adults to adopt unsustainable and dangerous dietary regimes - Clean Eating & The Rise of Orthorexia.
Ultimately, anyone who uses a title other than Registered Dietitian (RD), Registered Nutritionist (ANutr, RNutr) or (evidence-based) Nutritional Therapist is not appropriately qualified to offer personalised nutritional advice. There are countless online nutrition courses boasting how you can call yourself a Nutritionist in as little as two weeks, yet none will qualify you to join any one of the recognised UK registers. One renowned New York-based course offers an online qualification ‘rooted in science’ to become a health coach. The institute quotes a student on its website who says that ‘with the ability to see clients before graduation, my education was paid for before it was completed’. The very fact that a school is boasting such a claim is concerning but even more so is the fact so many online graduates are pushing generalised advice to paying clients. The underlying sentiment of anyone studying basic nutrition isn’t a bad one, most of us would like to be healthier and learning about food should be encouraged. However, when an unqualified person believes they are knowledgeable enough to diagnose, treat and prescribe a dietary regime, it is quite frankly irresponsible.
When it comes to knowledge there are different kinds and different ways of acquiring them. On one side is theory and on the other is the practical application of theory. Both are important and both make you better at whatever you do. Theoretical knowledge teaches the why through the experience of others. Practical knowledge helps you acquire specific techniques that become the tools of your trade. Ultimately, there are some things you can only learn through doing and experiencing. Where theory is often taught, practical knowledge is learned through the reality of life. It is for this reason that taking advice from practitioners that work day-to-day with patients and clients are those who I believe should be trusted most. I also firmly believe that continuing professional development (CPD) is another significant consideration when interpreting just how informed advice is. CPD and periodically undertaking courses in related fields are important because it ensures you continue to be competent in your chosen profession. Learning is an on-going process and should continue throughout a career.
It is advisable to ask anyone who you are considering taking personalised nutritional advice from about their qualifications and satisfy yourself that they are appropriately qualified. Should you find yourself frustrated that unqualified people claim to be Nutritionists despite no credible qualifications, I implore you to help qualified nutrition professionals secure a legally protected title.
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