Dietitian vs Nutritionist vs Health Coach

I was inspired to finally write this article when I stumbled across a headline last week. It was some bad press about a woman referred to as a nutritionist. This well-intentioned, entrepreneurial (white) woman basically claimed she invented healthy Chinese food, and was ripped a new one on social media and major news outlets.

My problem is this shit show being associated with the field of dietetics. This woman is NOT a nutritionist. Her ‘about’ page says she is a health coach, and even provides a link to the 6-month online program she completed. She also sells jewelry on her website. I e-mailed the New York Times about it (I’m normally not a tight-ass but I felt the need to defend RDN credentials). They informed me this woman was claiming to be a nutritionist until she got this media attention and has since removed the title from her website. They updated the article accordingly. Mini victory!

This post is about why my seemingly petty correction is really important to me (and hopefully you!). There can be big differences between the titles of dietitian vs nutritionist vs health coach.

What is a Dietitian?

Registered dietitians are health care professionals who are trained to provide advice and counselling about diet, food and nutrition. They use the best available evidence coupled with good judgment about the client’s or communities’ unique values and circumstances to determine guidance and recommendations. – Dietitians of Canada

All dietitians must legally have the following:

  • 4 year bachelor’s degree majoring in nutrition

  • 1 year internship

  • Passing grade on a national registration exam

  • Many opt to get a master’s degree as well (including yours truly). It will be mandatory in the states as of 2024

This is the same across all Canadian provinces and most states.

Dietitian (or registered dietitian, RD) is a protected title. This means it is illegal to call yourself a dietitian unless you are registered with the regulatory body. This protects the public by ensuring all RDs are competent and are updating their knowledge regularly.

If a dietitian is preaching something that is BS, they can be reported and have their license and title taken away.

What is a nutritionist?

This is a little trickier. In some states and provinces, the title is equivalent to ‘dietitian’. In Canada, ‘nutritionist’ is a protected title in Alberta, Quebec, and Nova Scotia.

Unfortunately, the requirements are inconsistent across North America. In other states and provinces, anyone can call themselves a nutritionist even if they’ve never gone to school. This includes Ontario! ‘Registered Nutritionist’ is protected in New York state where the incident above happened, so this woman should not be referred to as such. You can look up the rules in your own province or state to see if nutritionists are regulated.

What is a health coach?

As the name implies, the role of a ‘health coach’ is much broader than a dietitian or nutritionist. Their training usually involves behavior change strategies that apply to any number of health challenges. This can be diet but also exercise, smoking, stress management, etc. They are a supportive mentor for whatever health goals you are trying to reach. Some RDs also become health coaches.

Health coaches can have any level of education, including zero. It is not a protected title and it is not a government regulated profession. Of course, they have a passion for helping people, and the vast majority have at least some formal training. Some even have master’s degrees. The point is, their qualifications are not guaranteed, and you need to assess each individual coach yourself.

If you meet a health coach that you are excited to work with, ask about their qualifications:

What is their training?

  • Do they focus on fitness, nutrition, mental health, etc? Is their training relevant to the issues you want to tackle?

  • They may have a previous career or degree that complements their health coach training.

How long ago did they train?

  • If they took a 6 month diploma 10 years ago, ask how they keep up to date with current research & best practices. Research is always evolving.

Are they certified by the Health Coach Alliance (Canada) or the National Consortium for Credentialing Health & Wellness Coaches (U.S.)

  • It isn’t mandatory that they are, but it helps confirm they've met basic competency.

Do they sell products?

  • Assess their motives and priorities if they try to sell you something other than their services.

Do they make promises that sound too good to be true?

  • Health coaches are not held accountable for claims they make like registered dietitians or nutritionists. If they promise you’ll lose X amount of pounds or that they’ll change your life in 4 weeks proceed with caution.

Health coaches can be a great addition to your healthcare team. Unfortunately, as a new field its regulation has not caught up with the industry. It should not be the public's job to decide if a health practitioner is qualified or not. Whether you’re seeing a doctor or a health coach, professional health advice should always be reliable.

If a health coach preaches something that is BS, they may get bad press and Google reviews, but nobody can tell them to stop. If they are charismatic and people trust them, not much can be done to prevent them from spreading misinformation.

That is because the PRACTICE of nutrition counseling is not legally protected (with the exception of some states). Anyone can do it. That is why it's important to have standards for any title that implies someone is an expert. In the meantime, come armed with questions for anyone unregulated you're considering working with.

In the end we are all your cheerleaders. Dietitians, nutritionists and health coaches are all out there helping people improve their quality of life. The important thing is that you trust and feel comfortable with the individual. I wish you the best of luck in finding your support team, whatever credentials they may have!

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