Conscious Choice: Navigating in “Nutritionland”

March 2000 | Health Conscious

Navigating in “Nutritionland”

by Rebecca Ephraim, RD, CCN

All the wonderful advancements in holistic health care have brought with them a kind of free-for-all in the world of nutrition or, as I will call it, Nutritionland. Case in point: browse the book section of any natural foods store and you’ll see oodles of nutrition authors with unfamiliar initials strung behind their names — CCN, CN, CNC, CNS, LNC, RD. And it’s no different when you look for a nutritionist to consult. These abbreviations are confusing and probably make little sense to the consumer who’s simply looking for good nutrition advice. Ultimately, the nutrition credential is of minor concern compared to the counselor’s clinical experience, advanced education, and success rate.

So let’s venture into Nutritionland and look at what you’ll need to know to choose a skilled nutritionist. The right ones can help you get your health back in order whether that means dropping pounds, overcoming a raging appetite and insatiable sugar cravings, boosting your immune system, or treating myriad other nutrition-related problems that may be making your life miserable. The wrong nutritionist may be undereducated and have little perspective on how to assess your problem. She can end up taking a lot of your money and, even worse, aggravating your health problems!

As a nutritionist myself (not in private practice), I’ve learned that nutrition credentials can be misleading. After all, anybody can be called a nutritionist. But, personally, I don’t want to pay just anybody to offer up advice on what I should be putting in my mouth to effect change in my body. For instance, in the back of most natural health magazines you’ll see ads for fast-track nutrition credentials. Out of curiosity, I sent for information on several. One would award a diploma as a "nutrition specialist" and through that same correspondence school I could opt for training in auto mechanics, plumbing, or dozens of other disparate specialties. Hey, I respect the skills of a good auto mechanic and a dependable plumber, but when it comes to my body I don’t want the same school that’s teaching oil changes and sewer cleanout also to be teaching nutrition (although I suppose in some ways sewer cleanout could be comparable!). A more appropriate education is a solid college-level grounding in the core health sciences followed, obviously, by nutrition courses.

In fact, technically speaking, the application of therapeutic nutrition (treating disease or disorders with nutrition) needs to be addressed at an individual biochemical level. This means finding an expert who knows how to apply effective dietary modification and nutritional supplementation — in other words, eating the right foods, avoiding the wrong ones, and taking the right dietary supplements. Your mission (if you so choose to accept it) is to find a nutritionist who practices at this level of sophistication.

Currently, in Nutritionland, it’s a very uneven playing field. I wish I could advise you simply to look for a particular credential, but I can’t. Take, for example, Registered Dietitians or RDs (of which I’m one). As a group, many dietitians frown on the use of supplements and base their dietary advice on the Food Pyramid. Unfortunately, eating less fat and eating more fruits and vegetables are not complete answers to solving the flaws of the standard American diet. Sure, at a simple bare-bones level using a general guide like the Food Pyramid does offer some nutritional benefits. But a growing body of scientific research has shown that a one-size-fits-all approach is simplistic and may be inadequate in addressing Americans’ chronic health problems.

There are a growing number of "progressive" RDs. Many have taken their cues from those nutritionists in the integrative nutrition field and joined their ranks. "Integrative" nutrition is best defined as an approach that incorporates the best of modern science with the best of common sense, back-to-basics living. For example, a good nutritionist would call on emerging research that shows the powerful role of nutrients (vitamins, minerals, etc.) over and above the amounts found in food, and use sophisticated techniques that can detect deficiencies. She would combine these with a selective whole-foods diet and encourage the use of other mind, body, and spirit paths.

These nutritionists, such as CCNs (Certified Clinical Nutritionists) or CNs (Certified Nutritionists) can often be found working for holistic physicians (chiropractors, MDs, naturopaths, etc.) who employ therapeutic nutrition approaches in their practices. However, who can do what and where varies widely as individual state laws determine who can be licensed to practice nutrition counseling.

My rule-of-thumb is that you shouldn’t pick a nutritionist based simply on the person’s credentials. Remember, a CCN who works primarily in retail or an RD whose specialty is food management may not have the intense one-on-one counseling experience that comes from working in a progressive clinical setting.

In his book, Nutrition Made Simple, nutritionist Robert Crayhon, M.S., has devised a scorecard to help you choose a nutritionist in private practice. He suggests that before you make an appointment, you should interview a prospective nutritionist over the phone, asking these questions:

What kind of degree do you have?

Registered dietitian ___ +5

Bachelor’s degree in nutrition ___ +5

Master’s degree in nutrition ___ +10

Ph.D. in nutrition ___ +15

Degree in naturopathic medicine ___ +15

What kind of diets do you design?

Everyone is put on a high-carbohydrate, low-fat diet ___ -10

Each person is given a diet to suit his/her own unique biochemistry ___+10

White flour products are permitted ___ -10

Margarine is recommended ___ -10

Can I have phone numbers of some of your happy clients to call?___ +10 if "yes"

Do you look for nutrient levels through hair and blood tests?___ +10 if "yes"

Do you think most people need supplements?___ +15 if "yes"

How many nutrients does the body require? (roughly 45)___ +10 if correct

Scoring:

20 or below: Nutrition from the Eisenhower era. Avoid.

20-45: You can do better.

Above 50: Make an appointment. This nutritionist will be able to help you.

Once you’ve chosen a nutritionist and begun the consultations, become an active partner in your treatment. Understand the basic reasons behind the diet adjustments and dietary supplements your nutritionist has recommended. Chances are, you’ll be more excited about making the changes if you understand the advice and buy into the reasoning. I’m confident your visit to Nutritionland will have a lasting, healthful impact.

Disclaimer: This column is for information only and no part of its contents should be construed as medical advice, diagnosis, recommendation or endorsement by Ms. Ephraim.

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