Dietitians and Nutritionists

• Nature of the Work

  Dietitians and nutritionists plan nutrition programs and supervise the preparation and serving of meals. They help prevent and treat illnesses by promoting healthy eating habits, scientifically evaluating clients' diets, and suggesting modifications such as less salt for those with high blood pressure or reduced fat and sugar intake for those who are overweight.

  Dietitians run food service systems for institutions such as hospitals and schools, promote sound eating habits through education, and conduct research. Major areas of practice are clinical, community, management, and consultant dietetics.

  Clinical dietitians provide nutritional services for patients in institutions such as hospitals and nursing homes. They assess patients' nutritional needs, develop and implement nutrition programs, and evaluate and report the results. They also confer with doctors and other health care professionals in order to coordinate medical and nutritional needs. Some clinical dietitians specialize in the management of overweight patients, care of the critically ill, or care of renal (kidney) and diabetic patients. In addition, clinical dietitians in nursing homes or small hospitals may also manage the food service department.

  Community dietitians counsel individuals and groups on nutritional practices designed to prevent disease and to promote good health. Working in such places as public health clinics, home health agencies, and health maintenance organizations, they evaluate individual needs, develop nutritional care plans, and instruct individuals and their families. Dietitians working in home health agencies may provide instruction on grocery shopping and food preparation to the elderly, or patients with AIDS, cancer, or diabetes.

  Popular interest in nutrition has led to opportunities in food manufacturing, advertising, and marketing, where dietitians analyze foods, prepare literature for distribution, or report on issues such as the nutritional content of recipes, dietary fiber, or vitamin supplements.

  Management dietitians oversee large-scale meal planning and preparation in such places as health care facilities, company cafeterias, prisons, and schools. They hire, train, and direct other dietitians and food service workers; budget for and purchase food, equipment, and supplies; enforce sanitary and safety regulations; and prepare records and reports.

  Consultant dietitians work under contract with health care facilities or in their own private practice. They perform nutrition screening for their clients, and offer advice on diet-related concerns such as weight loss or cholesterol reduction. Some work for wellness programs, sports teams, supermarkets, and other nutrition-related businesses. They may consult with food service managers, providing expertise in sanitation, safety procedures, budgeting, and planning.

• Working Conditions

  Most dietitians work a regular 40-hour week, although some work weekends. Many dietitians work part time.

  Dietitians and nutritionists spend much of their time in clean, well-lighted, and well-ventilated areas. However, some dietitians spend time in hot, steamy kitchens. Dietitians and nutritionists may be on their feet for most of the workday.

• Employment

  Dietitians and nutritionists held about 53,000 jobs in 1994. Over half were in hospitals and nursing homes.

  State and local governments provided about 1 job in 6—mostly in health departments and other public health related areas. Other jobs were in social service agencies, residential care facilities, diet workshops, physical fitness facilities, school systems, colleges and universities, and the Federal Government—mostly in the Department of Veterans Affairs. Others were employed by firms that provide food services on contract to such facilities as colleges and universities, airlines, and company cafeterias.

  Some dietitians were self-employed, working as consultants to facilities like hospitals and nursing homes and seeing individual clients.

• Training, Other Qualifications, and Advancement

  The basic educational requirement is a bachelor's degree with a major in dietetics, foods and nutrition, food service systems management, or a related area. Students take courses in foods, nutrition, institution management, chemistry, biology, microbiology, and physiology. Other suggested courses include business, mathematics, statistics, computer science, psychology, sociology, and economics.

  Of the 37 States that have laws governing dietetics, 24 require licensure, 12 require certification, and 1 requires registration. The Commission on Dietetic Registration of the American Dietetic Association (ADA) awards the Registered Dietitian credential to those who pass a certification exam after completing their academic education and supervised experience.

  As of 1995, there were 233 ADA-approved bachelor's degree programs. Supervised practice experience can be acquired in two ways. There are 51 ADA-accredited coordinated programs that combine academic and supervised practice experience in a 4-year program. The second option requires completion of 900 hours of supervised practice experience, either in one of the 157 ADA-accredited internships or in one of the 91 ADA-approved preprofessional practice programs. Internships and preprofessional practice programs may be full-time programs lasting 9 to 12 months or part time programs lasting 2 years. Students interested in research, advanced clinical positions, or public health should get a graduate degree.

  Recommended high school courses include biology, chemistry, mathematics, health, and home economics.

  Experienced dietitians may advance to assistant, associate, or director of a dietetic department or become self-employed. Some dietitians specialize in areas such as renal or pediatric dietetics. Others may leave the occupation to become sales representatives for equipment or food manufacturers.

• Job Outlook

  Employment of dietitians is expected to grow about as fast as the average for all occupations through the year 2005 due to increased emphasis on the prevention of disease by improved health habits. A growing and aging population will increase demand for meals and nutritional counseling in nursing homes, schools, prisons, community health programs, and home health care agencies. Public interest in nutrition and the emphasis on health education and prudent lifestyles will also spur demand. Besides employment growth, job openings will also result from the need to replace experienced workers who leave the occupation.

  Employment of dietitians in hospitals is expected to show little change because of anticipated slow growth in the number of inpatients, and as hospitals contract out food service operations. On the other hand, faster than average growth in employment is expected in nursing homes as the number of very old people rises sharply, in contract providers of food services, in residential care facilities, in offices and clinics of physicians, and in other social services.

  Employment growth for dietitians and nutritionists may be somewhat constrained by the substitutability of other workers such as nurses, health educators, food service managers, and dietetic technicians. Growth would also be faster except for limitations on insurance reimbursement for dietetic services.

• Earnings

  According to the American Dietetic Association, full-time registered dietitians with 5 years or less experience earned a median annual salary of $29,600 a year in 1993; those with 6-10 years of experience, $34,400; 11-15 years, $37,900; 16-20 years, $40,400; and 20 years or more, $41,600. Management and self-employed dietitians earned more than clinical and community dietitians. Salaries also vary by educational level, geographic region, and size of community.

  According to a University of Texas Medical Branch survey of hospitals and medical centers, the median annual salary of dietitians was $31,372 in October 1994. The average minimum salary was $26,138 and the average maximum was $38,987.

• Related Occupations

  Dietitians and nutritionists apply the principles of nutrition in a variety of situations. Workers with duties similar to those of management dietitians include home economists and food service managers. Nurses and health educators often provide services related to those of community dietitians.

• Sources of Additional Information

  For a list of academic programs, scholarships, and other information about dietetics, contact:
  The American Dietetic Association, 216 West Jackson Blvd., Chicago, IL 60606-6995.

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