What is the role of the dietitian? When to consult a dietitian and why? Which training to choose to become a dietitian? What is the difference between a dietitian and a nutritionist? Here are some tracks.
In 1967, the International Labor Organization proposed a definition of the profession of the dietitian: “Dieticians organize and monitor the preparation of diets for individuals or groups, monitor and evaluate the elements of food programs that relate to nutrition, help to identify the various factors related to diet and diet problems in the community. ”
Then, in 1980, the European Federation of the Associations of Dietitians (EFAD) defined the dietitian as the “person with a legally recognized qualification in nutrition and dietetics; and who applies the sciences of nutrition to the food and the education of groups, of the population of individual persons who are healthy or sick ”
According to the Petit Larousse illustrated 1982, dietetics is “a science whose purpose is the study of the food value of food and that of diseases caused by poor nutrition and the determination of rations suitable for various categories of consumers” .
The role of the dietitian is:
– both a preventive and curative role;
– at the same time a role of advice in nutrition and readjustment of it when it is defective.
I – The Role of the Dietitian
In general :
(1) – The Dietitian Has an Advisory Role in Actions Such As:
– the choice of a diet when one has a problem of weight (example: Dunkan, dissociated diet …);
– how to compose menus and balanced meals: for individuals or communities such as schools, for example;
– how to calculate your ideal weight (BMI: Body Mass Index), that is to say, not the weight that corresponds to a mental image but a weight that does not put our health at risk.
(2) – The Dietitian Also Has a Therapeutic Role For:
– the development of menus adapted to certain disorders such as excess of cholesterol, diabetes, disorders of the cardiovascular system, physical fatigue, nervous fatigue, memory problems, professional stress …;
– the development of an individual follow-up for specific cases: follow-up of a professional sportsman, menus adapted to clients in such or such situation (example: thalassotherapy).
II – Missions of a Dietician
The missions of the dietician vary according to the country, according to the law governing this mission. However, we offer for some countries:
*** In Quebec
The title dietitian is a reserved title equivalent to the terms nutritionist and dietitian. He represents nutrition professionals with a bachelor’s degree and is a member of the Professional Order of Dietitians of Quebec.
– In Quebec, a dietitian is considered as a professional in the nutrition sector who, through his knowledge of food, nutrition, and the human being in his physiological, psychological and socio-economic aspects. economic is able to inform and advise individuals and groups, sick or healthy, in terms of food from a perspective of health promotion.
In other words, the duties of a dietitian are multiple. The dietitian studies the needs of various clients and assesses the diet and nutritional status of its clients. Then he determines and ensures the nutritional treatment plan and monitors the effects of the preferred intervention strategy in the person. It also formulates objectives, in the short and long term, to ensure a healthy diet at acceptable costs for the targeted clienteles and determines the action programs to reach them. He can also develop menus for various communities of patients and well-being and marketing them. He plans and controls the quality of meals and coordinates the operation of collective feeding services. The dietitian plans, organizes and directs nutrition programs, alone or in collaboration with a multidisciplinary team, and develops food policies. It develops awareness programs for good nutrition and evaluates new food products, food production and distribution systems, and nutrition intervention programs. He can also plan and organize research programs.
As a result, the dietitian acts in a broad field of action: clinical nutrition, food service management, community nutrition, counseling, research, teaching, communications, public relations, journalism, advertising, marketing, and advocacy.
*** In Belgium
In Belgium, this profession is of the paramedical type. […] His missions are as follows:
– Make dietary assessments, ie:
* Determination of the qualitative and quantitative requirements in terms of nutrients and non-nutrients, generally for certain pathologies and individually, in some patients;
* Determination of food consumption, based on food surveys.
– Make dietary interventions, ie:
* Translation in terms of food of the dietary prescription established by the doctor, on the basis of nutritional data;
* Issuance of dietary and nutritional advice, after evaluation of the dietary and dietary habits of the patient as well as his know-how regarding the advice given;
* Preparation, execution, and evaluation of low-germ feeds;
* Preparation and sale of food for the particular diet.
These actions must be followed by a written technical report of the observations made, addressed to the prescribing physician.
In addition, dieticians may also be responsible for preparatory acts for diagnosis or for the application of treatment or the implementation of preventive medicine measures:
– Prevention and detection of disorders concerning nutritious products or foods, including the application of food hygiene rules.
– Information on dietetics and diet.
– Measure anthropometric parameters and collect data to assess body composition;
– Measurement and evaluation of individual energy expenditure by direct or indirect methods.
– Ensures the correct application of dietary requirements and special diets for groups of patients.
– Ensures nutritional assessment of impatient groups and food-drug interactions.
*** In France
This is a certified and recognized health professional. Its role is to preserve and/or improve health through nutrition. The dietitian will, therefore, act in two major areas in accordance with Article L4371-1 of the Public Health Code:
– Respect of French and European hygiene regulations (Hygiene Package, Health Control Plan, HACCP, Guide to Good Hygiene Practices, etc.) and nutrition (GEMRCN recommendations)
– Nutritional education (theory and practice) of individuals, which can be carried out with:
* Patients (or patients): diabetes, obesity, undernutrition, inflammatory bowel diseases, liver diseases, pancreatic diseases, renal diseases, food allergies/intolerances, adaptation according to drug treatment, etc.
* Healthy people: children, teenagers, adults, pregnant women, athletes, vegetarians/vegans, seniors, etc.
Education can be done in groups or individually. In the context of individual education, the dietitian relies, among other things, on a personalized evaluation using medical information, a food survey as well as lifestyle, tastes, and beliefs (in the broad sense). of the patient. This information allows him to establish a dietary diagnosis and objectives in partnership with the patient that will serve as a basis for monitoring.
III – Training and Place of Practice of the Dietician
Regarding training to become a dietitian, again, it varies according to the country and the provision of their law. For example :
– In Quebec, training in dietetics and nutrition is necessary … The duration of studies is usually 3.5 years and can go up to 5 years, in the case of studies in nutrition science in particular.
– In France, it is compulsory to have a Bac + 2 validated by a diploma to become a dietician, namely: either the STB (Senior Technician Brevet) in dietetics; – the TUD (Technician University Diploma) in Biological Engineering, dietary specialty.
The dietitian can exercise in many different structures. Here, his place of exercise varies according to the country and their law. Take the case of France and Quebec.
*** In France
– Public or private health facility: hospital, clinic, institute, follow-up care and rehabilitation facility (SRH), the establishment of elderly and dependent housing (EHPAD), etc.
– Collective catering: school canteens, company restaurants, university restaurants, central kitchens, etc.
– Home Health Provider: Enteral Nutrition
– Community: schools, retirement homes, maternal and child health services, etc.
– Food industry
– Individual or group Liberal Cabinet
– Club or sports center: within a federation or in a gym
– Health Network
– Education: training of students in dietetics, training of (future) health professionals (nurses, carers, etc.), training of (future) social professionals (social and family economics adviser)
– Humanitarian organization
– Laboratory and health industry
– Community pharmacy
The activities of the dietitian vary according to the structure but also within the structure according to the needs identified by the latter, the skills of the dietician and the number of working hours in the structure, the objectives set, etc.
*** In Quebec
The dietitian can work for a variety of employers:
– To their account
– Reception centers
– Fitness centers
– Hospital centers
– Long-term care hospitals
– Local Community Service Centers (CLSCs)
– Medical clinics
– Educational institutions
– Canadian Forces
– Federal or Provincial Government
– Food and Beverage Industry
– Pharmaceuticals and drugs industry
– Food stores
IV – The Role of the Dietitian and the Nutritionist: What Are the Differences?
You have decided to go on a diet to lose weight? Your child is suffering from obesity? You have decided to turn to a health professional and it is a wise decision. But which one to choose: a nutritionist doctor or a dietician?
We often confuse dietician and nutritionist. If their common point is to take care, each at their level, of your diet, they have not followed the same training and have a very different function. Overview of the two trades.
1 – The Nutritionist
“Normally, the term nutritionist should not be used alone, it must be attached to the exact job,” says the French Nutrition Society. It can be used by any person (doctor, dietician, engineer) with training in nutrition.
However, we often find this term alone, without any other qualifier. It must be understood as referring to a doctor, the correct expression being “nutritionist doctor”.
*** The Nutritionist Is a Doctor
“The nutritionist or nutritionist has undergone basic medical training (Bac +8) and additional specialized training in nutrition in the form of a University degree (DU) or inter-university diploma (IUD), or a diploma of complementary specialized studies (DESC) “, explains Dr. Valérie Espinasse, a micro-nutritionist in Paris.
The nutritionist anticipates, diagnoses and deals with disorders related to nutrition (diabetes, food allergy or intolerance, obesity, cholesterol, anorexia …).
With his status as a doctor, he has the ability to prescribe examinations, tests or drugs. He can perform his duties as a liberal profession, at home, in a medical team or in a hospital.
*** In Which Cases to Consult a Nutritionist?
A nutritionist is usually consulted when one is overweight, suffering from cardiovascular pathologies or metabolic diseases (diabetes, gout, thyroid disease or cholesterol).
*** In Summary: The Nutritionist
The term nutritionist justifies a competence in nutrition. A nutritionist doctor is, therefore, a doctor with a degree in nutrition. Its job is to prevent, detect and then take care of diseases related to nutrition (diabetes, obesity, cholesterol, food intolerance …). As a doctor, he can prescribe medications, tests or medical examinations.
2 – The Dietitian
*** The Dietician Is a Health Professional Expert in Nutrition
The dietitian or dietician nutritionist is a health professional in the field of nutrition. After the baccalaureate, he completed a diploma of the senior technician (DST or BST) specializing in dietetics or a university degree in technology (UDT or TUD) in biological engineering, dietary option, in two years.
The dietitian plays the role of trainer and educator in nutrition. He develops personalized food programs and ensures the nutritional balance of his patients. He can practice his profession in a liberal profession, in a hospital environment, in collaboration with doctors or in communities (school canteens, holiday centers …).
*** In Which Cases to Consult a Dietician?
Most often, a dietician is consulted when seeking a personalized diet. The diet can be for children, teenagers or adults.
Thanks to the dietitian, you learn how to make recipes adapted to your new diet while benefiting from regular monitoring. “A general practitioner or specialist can possibly send his patients with metabolic disorders or diet to a dietitian, for it establishes a suitable diet,” says Anne-Marie Costille, a dietician in Lyon.
*** In Summary: The Dietitian
A dietician is a paramedical health professional, a food technician. The latter puts into practice the sciences of nutrition and carries out balance sheets. He can set up diets, previously prescribed by a doctor.