California nutritionists’ ongoing fight to maintain legal legitimacy
What is the difference between a nutritionist and a dietitian? This may sound like an menial question to some, but ambivalence about this distinction sent holistic health professionals across California into a flurry of phone calls, letters, and public consternation regarding a piece of recently proposed legislation know as Assembly Bill 575.
Due to sizable disapproval over the written logistics of AB575, which was proposed by Assemblymember Mary Hayashi (D-Hayward), it was tabled on May 4 for revisions. However, the debate it sparked brings to light an ongoing controversy in the world of nutritional healthcare.
“There is a distinct profession of nutrition, and within that there are different practices,” says Edward Bauman, executive director of Bauman College for Holistic Nutrition and Culinary Arts, which has a school location in Santa Cruz. “Dietetics is not the only practice of nutrition. This bill has provided an opportunity to define the distinction between nutritionist and a dietitian and to look at overlaps. The similarity is that [both] are helping people get healthy by looking at their food. The difference is that [nutritionists] rely on natural foods, and they rely more on processed, enriched foods.”
Another difference between a registered dietitian (RD) and a certified nutritionist (NC) is the required training for each. To become a registered dietitian a person must have a bachelor’s degree as well as post-graduate training in an accredited program. They must then pass a licensing exam and keep their license current by completing continuing education classes for the entire time they are licensed.
The process to become a nutritionist involves less government regulation than a registered dietitian, but Bauman says it is more organized than many realize. For example, the National Association of Nutrition Professionals (NANP), a nonprofit business league, set out in 1985 to enhance the integrity of the holistic nutrition profession. It uses self-governance, educational standards, and a rigorous code of ethics to train nutritionists. It also requires an exam—the Board Exam in Holistic Nutrition.
As it was written, AB575 would have allowed only RD’s to perform medical nutrition therapy in the State of California, because it required licensure through the California Dietetic Association (CDA). Only registered dietitians can join the CDA, so nutritionists with just as much training as registered dietitians—if not more—would suddenly not be licensed to practice. This would put the burden on the state to enforce non-RD medical nutrition practice.
Terri Oberto is a Certified Clinical Nutritional Consultant and a member of the American Holistic Health Association and the NANP. She holds a bachelor’s degree in nutrition, and is currently working on her master’s degree in nutrition. Oberto also owns the local business Healthy Solutions. She says she would be financially and morally devastated if a bill like AB575 were to pass.
“I would lose over a million dollars in modality inventory,” says Oberto, whose facilities include a biofeedback machine, a vibration exercise machine similar to those used by astronauts in space, an exercise room, and much more.
Bauman says that what Oberto and others do is not the treatment of an illness, but rather in- depth education about individual health. “It’s about teaching people what the systems do and what you can do to help restore balance,” he says. “In most cases you’re not working directly under a doctor, and not directly treating an illness—you are treating an individual with health problems.”
If a bill like AB575 were to pass, highly trained nutritionists with degrees and certification would face misdemeanor charges and fines for doing their jobs. In the past, related bills have been proposed in California that would turn non-RDs into felons.
Some, like Santa Cruz resident Caroline Homlund, suspect ulterior motives at work behind this sort of legislation. Homlund has Lyme disease. She says her work with Oberto and other holistic health practices, saved her life when she was in the advanced stages of the illness.
“The [Federal Drug Administration] is initiating this law, and they are basically an extension of the pharmaceutical industry,” says Homlund. “[Bills like AB575] are trying to put anyone out of business that is competition to producing profit for the purveyors of the established health, ‘medical’ industry. It’s a global assault on real food.”
Bauman doesn’t quite agree, but he does feel that while, “Corporate takeover is not the intent of this bill, it is kind of the bigger pattern here.”
Bauman, Oberto and a large number of nutritionists’ online comments say it is important to keep multiple venues for nutritional health education open to the public. The California Labor Market Information Division reported that there were roughly 4,500 registered dietitians (RD) working in California in 2005.
“There are so many people who need health advice right now, and not enough good nutritionists or dietitians to connect with all those people,” says Bauman. “Nutritionists don’t prescribe—a nutritionist is not a pharmacy. We don’t treat symptoms, but we look at what it is in a lifestyle, environment, and attitude that’s out of whack. We then look at how to alleviate the issues from their origins.”
Bauman adds that certified nutritionists and registered dietitians do not negate one another, but rather can and should work together.
“We’re being viewed as the alternative, but I want to show up with dignity and respect and be in dialogue with dietitians—not with hate and slander,” says Bauman. “I want nutritionists to be able to collaborate with registered dietitians, not fight them.”