A dietitian is an expert in nutrition science, but how is this actually put into practice?
In the process of applying nutrition science, a dietitian must wear many hats. An effective dietitian is not only a scientist but also a teacher and a psychologist. They must research, plan, analyse, investigate, interpret, explain, motivate and counsel. Each of the areas dietitians work in have their own special set of required skills, be it clinical, community, public health, food industry, marketing and communications, food service, private practice.
Now I’m not a dietitian, but as a fourth year Nutrition & Dietetics student in the middle of an eight week hospital placement, I think I have a little bit of an idea about what nutrition and dietetics in practice is all about. I could go on for days about the numerous roles and skills required of dietitians and nutrition professionals in the many practice areas, however for the sake of brevity, I will focus on my own current experience in the hospital setting.
All of the science in the world is next to useless if it can’t be translated and communicated effectively.
The years of studying sciences like chemistry, biology, physiology and nutrition are the foundations for practice as a dietitian. This knowledge is vital to a nutrition professional in order to understand and solve nutrition problems, however it is rarely shared with other people. The job of a dietitian is to take this vast background knowledge and sum it up into manageable chunks of information appropriate for the individual. All of the science in the world is next to useless if it can’t be translated and communicated effectively. We now know that simply telling a person what to do does not work, it is much more complex than this. Explaining the mechanisms behind coeliac disease and that gluten must be avoided probably won’t help a newly diagnosed coeliac to remove gluten from their diet. Just as explaining energy balance and weight loss might not do a single thing to help someone lose weight. A nutrition professional uses their background in nutrition science to advise an little elderly woman to add a teaspoon of margarine to her bread or milk powder to her drink. To explain to a person with coeliac disease how to read food labels to determine whether or not they contain gluten. To counsel a person with diabetes in switching their plain rice to basmati. Or to motivate the change from salting foods to using herbs and spices.
In other words, the popular catchall ‘clinical reasoning’ is required. This refers to the professional judgement necessary in order to make informed decisions and evidence based management plans tailored to complex circumstances and any number of conditions, or combinations thereof, not just cases found in a textbook. There is an endless array of unique situations in which a dietitian must problem solve in order to tailor interventions to the specific set of circumstance of an individual. After all, a condition or nutrition problem does not exist in isolation but in the context of a human life.
In terms of clinical practice, nutrition professionals must simultaneously understand the enormous complexity and multifactorial nature of nutrition issues and break them down into simple steps and small changes. They must be able to see multiple possible solutions to a nutrition problem but guide a client to them rather than telling them. They must be a detective, finding out about what is really happening in a person’s life. They must be a motivator and counsellor, inspiring small yet significant and sustainable change. They must be credible, up to date and evidenced based, but must also understand the latest fads, myths and quack nutrition advice.
What does being a dietitian or nutrition professional mean to you?