Why a Clinical Nutritionist?

The best description of this difference between the two fields of thought was provided by the IAACN (International and American Association of Clinical Nutrition) in which they simplify it in this way, “diet” refers to the foods and beverages we consume while “nutrition” refers to the biochemical processes that are a result of the foods and beverages we choose to consume.  Dieticians are mostly found in the institutional realm (hospitals, schools) in which their major focus is based upon the calorie (energy) consumption of foods. Often these recommendations are determined by government set food pyramids and standards.  Dieticians will focus on meal planning, specific diets for certain conditions and often will monitor sanitation of foods.  

In comparison to the dietician (RD) the Clinical Nutritionist bases their approach on current evidence based science research regarding concepts of nutritional effectiveness.  Clinical Nutritionists will have a background in the complementary-alternative healthcare.  The Clinical Nutritionists approach to diet is determined by the best approach for the individual and the individual’s personal differences (biochemical, genetic, lifestyle, diet, metabolic, toxic load) and will not provide a standard approach to an individual when not one individual is identical to another.  This approach is determined by the unique biochemical differences of the individual and is supported by research that supports the approach most valid for these differences.  

Clinical Nutritionist’s focus on the nutritional value of the foods, not the calorie (energy) density of the foods like a Registered Dietician would.  Clinical Nutritionist’s will also understand the importance of finding the best quality foods that are devoid of modification and/or denaturation.  Furthermore, depending upon the client’s unique presentation the Clinical Nutritionist will want to consider whether or not foods are being consumed, absorbed and utilized by the body appropriately.  Various aspects that we consider as Clinical Nutritionists in regard to latest nutrition research is the process of digestion, immune function, neurotransmitter response, allergies (environmental, food), pathways involved in detoxification and the health of the gut in general.

One of the grandfathers of this concept was Dr. Roger Williams who wrote the book Biochemical Individuality.  Williams discovered this individual uniqueness of each person based upon their unique biochemical presentation in which some individuals may require more nutrients in one area, compared to another individual, based solely on their biochemical make-up.  When addressing these imbalances appropriately with nutritional interventions Williams noted that these individuals were able to reverse and/or prevent the progression of chronic disease.  Clinical Nutritionists understand these underlying mechanisms that could be creating the root cause of the individual’s health concerns.  What is good for one individual may be completely destructive to another due to these underlying mechanisms.  As Clinical Nutritionists it is essential to assess their varying differences amongst individuals, find the best dietary intervention while also recommending nutritional supplementation as needed to support any nutrient deficiencies.  

What constitutes an assessment?  Through our rigorous training we have been taught how to read laboratory values to understand some of the underlying issues that lead to the development of adverse symptoms in many clients.  In addition to understanding these types of tests (complete blood panel, metabolic panel, salivary cortisol, DUTCH test, Organic acid test, stool tests, toxin tests, hair mineral analysis, micronutrient tests, microbiome tests, food allergy tests, 23and me test results, etc.), Clinical Nutritionists also consider anthropometric tests (weight, height, waist-to-hip ratio, blood pressure, etc.), family health history, medication usage, dietary intake (analysis of macro and micro nutrient intake) and supplementation usage are also consider during the intake process.  We also tend to have rather rigorous questionnaires in which we can see the whole picture of the individual and determine a timeline as to what factors began the health decline process.  The questionnaire, although lengthy and many question the types of questions asked, it is truly a key component of our ability to put the puzzle pieces together to find the root cause(s) of symptoms.  

What Qualifies a Clinical Nutritionist?

Clinical Nutritionists most often hold a Master’s degree in the field of nutrition, have obtained hours within a supervised internship program, and have passed intense national certifying board exams to hold a certification in the field of clinical nutrition.  Clinical Nutritionists must at least hold a B.S. degree but many who obtain the M.S. degree have achieved higher level education in the field of nutrition while also furthering their education in the field of science with higher level biology, chemistry, physiology and biochemistry.  After this level of training the Clinical Nutritionists is then eligible to apply for an internship to obtain experience in the clinical approach to nutrition.  These hours are in a supervised setting and provide clinical experience and the review of many patient case presentations.  Upon completion of internship hours the Clinical Nutritionist is then eligible to sit for the national certifying boards for their certification either as a Certified Clinical Nutritionist and/or a Certified Nutrition Specialists in which these individuals are esteemed as highly knowledgeable in the field of nutrition.

Clinical Nutritionists must continue their education throughout their years of nutrition counseling.  These nutritionists will always be found at some of the best integrative medicine conferences where they obtain further understanding of the current research and learn from the most prominent individuals in the field of health.  Clinical Nutritionists who pursue their training in Functional Medicine can obtain their AMFCP certification from the Institute of Functional Medicine where they further fin tune their nutritional counseling skills by understanding this complex science.

Clinical Nutritionists offer a great source of support to those seeking to improve their overall health.  These individuals are highly capable and can offer insight to the effects of diet and lifestyle changes can have on one’s change in health.  

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References:

1) Friedrich, J.  Certified Clinical Nutritionists: Today's Complementary-Alternative Nutrition Professionals.  Channel 4 New York Website http://www.nbcnewyork.com/news/health/Certified_Clinical_Nutritionists__Today_s_Complementary-Alternative_Nutrition_Professionals.html.  July 18 2009.  Accessed on February 22 2017.

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