Clinical nutrition (dietetics)

What is it?

According to the Academy of Nutrition and Dietetics: registered dietitian nutritionists (RDNs) are "food and nutrition experts" who hold at least a graduate degree from an accredited dietetics programme, have completed a supervised practice training requirement, passed a national exam, and continue professional development throughout their careers. Their work includes patient nutrition education and providing medical nutrition therapy within health care teams. According to the NHS, dietitians "translate the science of nutrition into everyday information about food" and advise people on their food choices.

According to NIDDK: medical nutrition therapy (MNT) is "nutrition counselling provided by a registered dietitian to help you reach your medical or health goals". ASPEN describes itself as a multi-professional community of dietitians, nurses, nurse practitioners, pharmacists, doctors, physician assistants and researchers, and aspires for every patient to receive "safe and effective nutrition care". The Academy describes its website as offering information on nutrition and health, from meal planning and preparation to choices that help prevent or manage health conditions.

Titles: according to the Academy (a US body) the titles "registered dietitian nutritionist" and "nutrition and dietetics technician, registered (NDTR)" are legally protected, whereas "nutritionist" has no uniform meaning and anyone can use it. A registered dietetic technician completes a two-year associate degree in an accredited programme with practical training and a national exam. According to the NHS, dietitians and nutritionists have different roles and training and are regulated by different bodies, and the usual route to becoming a dietitian is an approved degree in dietetics, usually at bachelor's level. Titles and licensing systems differ between countries.

Conditions it covers

According to the NHS a dietitian may work, for example, with people who have digestive problems, want to lose weight, need to gain weight after an illness, have HIV, have an eating disorder, want to improve sporting performance, or have an allergy, and works in hospitals or the community with individuals and communities. The Academy states that dietitians support varied goals "from improving everyday eating habits to managing health conditions and life changes".

Chronic kidney disease: according to NIDDK a care provider may recommend working with a registered dietitian, if possible, to make an eating plan that suits your needs, and the amount of protein and its sources is decided with them or with the care provider. Diabetes: according to NIDDK a registered dietitian can provide medical nutrition therapy that includes guidance on making and following a meal plan, and you may want a diabetes educator or dietitian on your team. Obesity: according to the NHS you may get support from a dietitian to follow a very low calorie diet, and someone who needs substantial support may be referred to a specialist weight management service.

Malnutrition and nutrition support: according to MedlinePlus, malnutrition is a condition that occurs when the body does not get enough nutrients; its causes include a poor diet, starvation due to lack of food, eating disorders, problems digesting or absorbing food, and some medical conditions that prevent eating. Nutrition support is treatment for people who cannot get enough nutrition by eating or drinking, such as those who cannot swallow, have appetite problems, severe malnutrition, or do not absorb nutrients through the digestive tract. Related pages: nutrition and sports medicine (AMSSM mentions nutrition and supplements as part of its work).

Common tests and procedures

According to MedlinePlus, testing for malnutrition depends on the specific disorder, and most care providers carry out a nutritional assessment and blood tests. Treatment usually consists of replacing the missing nutrients, treating symptoms as needed, and treating any underlying medical condition.

According to MedlinePlus, nutrition support is given through a needle or catheter in a vein, or through a feeding tube that reaches the stomach. ASPEN offers resources on all aspects of nutrition support in clinical practice, research and education. The care team decides the type and duration of support according to the condition, and this page does not cover detailed nutritional assessment tools.

When to see one

According to MedlinePlus you can ask your care provider about a diet that suits you, and they may refer you to a dietitian for specialised recommendations. NIDDK advises asking your care team or insurer whether coverage includes medical nutrition therapy; referral and coverage requirements differ between countries and bodies.

Referral to the specialist is usually decided by the primary care provider according to the condition (MedlinePlus). According to MedlinePlus, discuss the risk of malnutrition with your care provider, as treatment is necessary if there is a change in the ability of your body, or your child's, to perform its functions.

Common questions