I would like to start a conversation after seeing a post asking for others to sign on to the recent bill proposal to deregulate the licensure for nutrition counseling and I am completely open to non-threatening discussion regarding this topic. I hope that consumers, supporters, and opposers take time to really think this through.
I started by reviewing the action alert. And not surprised that the language includes that dietitians are monopolizing the market. The proposed letter that will be sent to legislators includes factual information that a person wishing to provide diet and nutrition advice have a state issued license. (AKA You do NOT have to be a dietitian to be licensed AND dietitians are not the ONLY professions who may provide nutrition info. So I guess the monopoly piece is a bit thrown out).
Next I reviewed the proposed house bill HB 1193. I am curious, if you signed to support this bill did you review it in it's entirety first? Do you know what you’re signing if you sign to support the deregulation of nutrition services? Also, have you read the ENTIRE 127 page bill that this is in? I have. Do you understand every line and agree with every proposed revision to the multiple licensed professionals out there? I don’t. It would take me some gobs of time and research to ensure I supported all those changes. But what i did think about is how many specialties out there have to be licensed and/or prove their education... barbers, house inspectors, architects, etc. The list seriously goes on. So why is nutrition different? Why can we have a professional who completed 4-6 years of school focused in nutrition & dietetics who also completed an accredited internship, and pass a national board exam be the same as the wide variance that comes with a health coach certification? (read on before answering). I personally would not want an unlicensed house inspector inspecting my to be bought home or an unlicensed chiropractor working on my myself or my family. So why is nutrition different?
Here is the thing I have met numerous health coaches in my time that are absolutely amazing (and refer to a dietitian when it is outside of their comfort level), but I have also seen many that have actually caused harm to the public with their advice. There is not enough regulation and definitive scope of practice for health coaches. So many "health coaches" have a certificate from a program that worked for them, which is amazing. But...just because it worked for them, doesn't mean it is to work for everyone.
The proposed letter to senators discusses the disparity of not enough dietitians. My answer to this is let's really look at inclusion. Who else could really be included to provide nutrition information. I LOVE natural health and functional nutrition so let’s please not make this about that and act as if ALL dietitians fit into the box that some are making them out to be. I love functional doctors, properly trained naturopaths, etc. So the top of my list to include is properly trained and educated naturopath doctors. I would also love to see more standardized training for other health care professionals and encouragement towards more providers seeking functional medicine training which highly incorporates nutrition into their care. I am not scared to say I would love more well educated qualified authorities in nutrition. Because here is the thing. Nutrition impacts EVERYONE! But what does scare me is the allowance of about anyone to provide nutrition advice for health intervention.
Just to go a bit further with this and clarify a little something....anyone can say... “hey I heard this food is good for you” or “I saw this article that says beet juice may help lower blood pressure”. And goodness knows we are surrounded by these statements at all times as consumers. But unless you are licensed you may not say... follow my prescriptive nutrition advice and your health will be altered. That is considered taking on liability to which a non-licensed person does not have. The requirement of the license basically ensures that those providing this information have met a standardized level of education to ensure safety to the public.
I will admit that my initial undergrad may have been a bit narrow but it laid the foundation for me and because of the requirement of continuing education I have grown leaps and bounds in the 20 years I have been a practitioner. And I can say one thing... nutrition is NOT as simple as some make it out be. Some may say... just eat this xyz food and all your problems will be solved. With that mentality the mere mental state of that person is not taken into account. How will they feel if they feel restricted? I can tell you... they will likely obsess about that food and likely indulge in either that food or another unhealthy behavior that further damages their health. There is a finesse to helping someone with their food choices. It’s called counseling, it's an art, and really only learned through the internship and years of practice. This art needs to be balanced out with the science of nutrition, the ability to understand the medical needs of the person in front of you. I am curious what a health coach might recommend for a senior (because that’s who is being targeted in the proposed Senator letter) who has stage 4 chronic kidney disease with a creatinine level of 2.2 and is on Coumadin? Or the 84 year old male who fell and was down for several days and therefore has rhabdomylosis and is also found with multiple stage 3 pressure wounds? Is this level of medical history obtained? Or who really is the target audience for services by health coaches?
I ask again, why is nutrition different than any other profession? Probably because food is connected to our emotions and therefore we feel connected to it. But here is the thing, if we truly strive to hold up the power of nutrition within our bodies we cannot put down the profession that has dedicated its career to supporting the vitality of nutrition as a core piece of health care. I have personally learned that a natural health practitioner I previously worked with received concerns that a dietitian was involved in the practice and that people that are in the natural health arena steer clear from dietitians in general. This literally broke my heart because it is so polarizing and unneeded. We need to come together, build each other up, and have a clear scope of practice. I understand some may have had a poor experience with a dietitian, but it does NOT mean we are all exactly the same. We all have our own strengths and have taken different paths for our continuing education. But we all do have the basis of knowing what could be harmful to a consumer either mentally or physically when it comes to food.