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'{{Short description|Expert in nutrition and malnutrition}} {{Redirect-distinguish|Dietetics|Dianetics}} {{Infobox medical specialty | title = Dietitian | subdivisions = | image = | caption = | focus = [[Diet (nutrition)|Diet]], [[human nutrition]] | diseases = Malnutrition | tests = | specialist = Registered dietitian (RD) }} A '''dietitian''', [[Clinical nutrition|medical dietitian]], or '''dietician'''<ref>The spelling with "c" is listed first in UK dictionaries, for example [https://web.archive.org/web/20140407100421/http://www.oxforddictionaries.com/definition/english/dietician?q=dietitian Oxford], [http://www.ldoceonline.com/dictionary/dietician Longman], and [http://www.collinsdictionary.com/dictionary/english/dietitian Collins]. The American English versions of [https://web.archive.org/web/20140407100953/http://www.oxforddictionaries.com/definition/american_english/dietitian?q=dietician Oxford] and [http://www.collinsdictionary.com/dictionary/american/dietitian Collins] list the spelling with "t" first.</ref> is an expert in identifying and treating disease-related [[malnutrition]] and in conducting [[Medical Nutrition Therapy|medical nutrition therapy]], for example designing an enteral [[tube feeding]] regimen or mitigating the effects of cancer [[cachexia]]. Many dietitians work in hospitals and usually see specific patients where a nutritional assessment and intervention has been requested by a doctor or nurse, for example if a patient has lost their ability to swallow or requires artificial nutrition due to intestinal failure. Dietitians are regulated healthcare professionals licensed to assess, diagnose, and treat such problems. In the United Kingdom, dietitian is a 'protected title', meaning identifying yourself as a dietitian without appropriate education and registration is prohibited by law.<ref> {{cite news | last1 = Lee | first1 = Jason | title = Dietitians do more than tell you what to eat | url = https://www.chicagotribune.com/2013/01/18/dietitians-do-more-than-tell-you-what-to-eat/ | newspaper = Chicago Tribune | publication-date = 2013-01-18 | agency = Tribune Media Services | access-date = 2014-11-20 | quote = 'Registered dietitians offer a wide array of professional knowledge and experience in a variety of settings from clinical to community and public policy to media communications,' says Dee Sandquist, a registered dietitian and spokesperson for the Chicago-based Academy of Nutrition and Dietetics. }} </ref><ref>{{Cite web|title=Professions and protected titles {{!}}|url=https://www.hcpc-uk.org/about-us/who-we-regulate/the-professions/|access-date=2021-01-12|website=www.hcpc-uk.org|language=en-GB}}</ref><ref>{{Cite web|last=BDA|title=Critical Care Specialist Group|url=https://www.bda.uk.com/specialist-groups-and-branches/critical-care-specialist-group.html|access-date=2021-01-12|website=www.bda.uk.com}}</ref> A registered dietitian (RD) (UK/USA) or registered dietitian nutritionist (RDN) (USA)<ref>{{cite web|url=http://www.clinicalnutritioncenter.com/meet-our-medical-weight-loss-professionals/registered-dietitians-nutritionists/registered-dietitian-vs-nutritionist|title=Registered Dietitian vs. Nutritionist - Clinical Nutrition Center|website=www.clinicalnutritioncenter.com|date=3 November 2011 |access-date=21 March 2018}}</ref><ref>{{cite web |last1=Ilton |first1=Erica |title=Dietitian vs. Nutritionist |url=https://www.berkeleywellness.com/healthy-eating/diet-weight-loss/article/dietitian-vs-nutritionist |website=Berkeley Wellness |access-date=19 May 2020}}</ref><ref>{{cite web |title=Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN)* Certification |url=https://www.cdrnet.org/certifications/registered-dietitian-rd-certification |website=Commission on Dietetic Registration |access-date=19 May 2020 |archive-date=30 September 2022 |archive-url=https://web.archive.org/web/20220930071246/https://www.cdrnet.org/certifications/registered-dietitian-rd-certification |url-status=dead }}</ref> meets all of a set of special academic and professional requirements, including the completion of a bachelor's and/or master's degree in nutrition and dietetics (or equivalent). One or more internships (USA) or clinical placements (UK) must also be completed. These may be allocated and monitored by the university as part of the structured degree programme (UK) or may be applied for separately (USA). Roughly half of all RD(N)s hold [[Postgraduate education|graduate degrees]]<ref>{{cite web|title=Dietetics FAQs|url=https://nfsc.umd.edu/undergraduate/undergraduate-admissions/dietetics-faqs|website=University of Maryland College of Agriculture and Natural Resources|publisher=University of Maryland|access-date=20 April 2016|archive-date=13 April 2016|archive-url=https://web.archive.org/web/20160413102620/http://nfsc.umd.edu/undergraduate/undergraduate-admissions/dietetics-faqs|url-status=dead}}</ref> and many have certifications in specialized fields such as nutrition support, sports, paediatrics, renal, oncological, food-allergy, or gerontological nutrition. Although assessment priorities differ depending on the specialist area, a patient's medical and surgical history, biochemistry, diet history, eating and exercise habits usually form the basis of assessment. The RD(N) negotiates a treatment plan with the patient which may include prescriptions, and follow-up visits often focus on maintenance and monitoring progress. Most RDs work in the treatment and prevention of [[disease]] (administering medical nutrition therapy, as part of medical teams), often in hospitals, [[health maintenance organization|health-maintenance organization]]s, private practices, or other health-care facilities. In addition, many registered dietitians work in community and public-health settings, and/or in academia and research. A growing number of dietitians work in the [[food industry]], journalism, sports nutrition, corporate wellness programs, and other non-traditional dietetics settings.{{citation needed|date=November 2014}} ==The spellings "dietitian" and "dietician"== As explained by the [[American Heritage Dictionary|American Heritage]] and [[Merriam-Webster]]'s dictionaries, the cause of the confusion is that the spelling with "-tian" is an irregular alteration of the ending "-cian", which is otherwise exclusively used to refer to specialists and practitioners of other professions.<ref name="merriam-webster.com">{{cite web|url=http://www.merriam-webster.com/dictionary/dietitian|title=Definition of DIETITIAN|website=www.merriam-webster.com|access-date=21 March 2018}}</ref><ref>{{cite web|url=http://www.merriam-webster.com/dictionary/ician|title=Definition of -ICIAN|website=www.merriam-webster.com|access-date=21 March 2018}}</ref> These and other American dictionaries also list the spelling with "c" but list the spelling with "t" first because this spelling is more common in the United States. Nevertheless, the American publisher McGraw-Hill exclusively uses the spelling with "c" in the 2003 edition of the ''McGraw-Hill Dictionary of Scientific & Technical Terms'' and the 2002 edition of the McGraw-Hill ''Concise Dictionary of Modern Medicine''.<ref>{{cite web|url=http://encyclopedia2.thefreedictionary.com/dietician|title=dietician|access-date=21 March 2018|via=The Free Dictionary}}</ref><ref>{{cite web|url=http://medical-dictionary.thefreedictionary.com/dietician|title=dietician|access-date=21 March 2018|via=The Free Dictionary}}</ref> The spelling with "t" is the one preferred by the profession itself internationally,<ref name=":0">{{cite web|year=2010|title=The "c" in dietitians – a long history and fading future (maybe)|url=https://www.internationaldietetics.org/Newsletter/Vol17Issue2/Feature-Article/The-c-in-dietitians-a-long-history-and-fading-futu.aspx|publisher=International Confederation of Dietetic Associations}}</ref> but the spelling with "c" is used often enough in texts not written by members of the profession to be considered a valid variant by both American and British dictionaries. In fact, British dictionaries list the spelling with "c" first<ref>{{cite web|url=http://www.oxforddictionaries.com/definition/english/dietician?q=dietitian|archive-url=https://web.archive.org/web/20140407100421/http://www.oxforddictionaries.com/definition/english/dietician?q=dietitian|url-status=dead|archive-date=April 7, 2014|title=dietician - Definition of dietician in English by Oxford Dictionaries|website=Oxford Dictionaries - English|access-date=21 March 2018}}</ref><ref>{{cite web|url=http://www.ldoceonline.com/dictionary/dietician|title=dietician - meaning of dietician in Longman Dictionary of Contemporary English - LDOCE|website=www.ldoceonline.com|access-date=21 March 2018}}</ref><ref>{{cite web|url=http://www.collinsdictionary.com/dictionary/english/dietitian|title=Dietitian definition and meaning - Collins English Dictionary|website=www.collinsdictionary.com|access-date=21 March 2018}}</ref> and list the spelling with "t" as a variant. American dictionaries list the spelling with "t" first and the spelling with "c" as a variant.<ref name="merriam-webster.com"/><ref>{{cite web|url=http://www.yourdictionary.com/dietitian|title=Dietitian dictionary definition - dietitian defined|website=www.yourdictionary.com|access-date=21 March 2018}}</ref> As explained in a 2010 newsletter of the International Confederation of Dietetic Associations: {{blockquote|The spelling of the term "dietitian" has been debated for a long time by dietitians. In the early 1960s dietetic associations, under the auspices of the International Committee of Dietetic Associations (ICDA), worked together to standardize information about dietitians under the International Standard Classification of Occupations. When the International Labour Office confirmed the dietetic profession's classification in 1967, it also adopted the spelling "dietitian" at the request of the international dietetic community. This information can be found in the documentation held by ICDA and by the [[International Labour Office]] (ILO).<ref name=":0" />}} ILO has however also issued new documents using the spelling "dietician".<ref name=":0" /> ==World Health Organization classification== Dietitians supervise the preparation and [[foodservice|service of food]], develop modified [[diet (nutrition)|diet]]s, participate in [[research]], and educate individuals and groups on good nutritional habits.<ref name="WHO">World Health Organization. ''Classifying health workers''. Geneva, World Health Organization, 2010.</ref><ref name="BLS">[http://www.bls.gov/oco/ocos077.htm U.S. Bureau of Labor Statistics: ''Occupational Outlook Handbook, 2010–11 Edition''.] — ''Dietitians and Nutritionists.'' Accessed 11 March 2011.</ref> The goals of dietitians are to provide medical nutritional intervention, and to obtain, [[food safety|safely prepare]], serve and advise on flavorsome, attractive, and nutritious food for patients, groups and communities. Dietary modification to address medical issues involving dietary intake is a major part of '''dietetics''' (the study of nutrition as it relates to health). For example, working in consultation with [[physician]]s and other health care providers, a dietitian may provide specific artificial nutritional needs to patients unable to consume food normally. Professional dietitians may also provide specialist services such as in [[Diabetes mellitus|diabetes]], [[obesity]], [[oncology]], [[osteoporosis]], pediatrics, renal disease, and [[micronutrient]] research.<ref>[http://www.thematicnetworkdietetics.eu/everyone/3025 DIETS Thematic Network for Dietetics.] {{webarchive|url=https://web.archive.org/web/20110411065828/http://www.thematicnetworkdietetics.eu/everyone/3025 |date=2011-04-11 }} ''Improving the nutrition of Europe through a fully evidenced based profession of dietetics''. Accessed 11 March 2011.</ref><ref>Misner B. 2006. "Food Alone May Not Provide Sufficient Micronutrients for Preventing Deficiency." ''Int Soc Sports Nutr''; 3(1): 51–55.</ref><ref>[http://www.edu-lib.us/mcgill.ca/dietetics/ McGill University: ''School of Dietetics and Human Nutrition.''] {{webarchive|url=https://web.archive.org/web/20150923233806/http://www.edu-lib.us/mcgill.ca/dietetics/ |date=2015-09-23 }} Accessed 14 March 2011.</ref><ref name="NHS">[http://www.nhscareers.nhs.uk/details/Default.aspx?Id=285 National Health Service: ''Careers in detail – Dietitian''.] Accessed 1 April 2011.</ref> Different professional terms are used in different countries and employment settings, for example, clinical dietitian, community dietitian, dietetic educator, food-service dietitian, registered dietitian, public health dietitian, therapeutic dietitian, or research dietitian.<ref name="CANOCC">[http://stds.statcan.gc.ca/soc-cnp/2006/cs-rc-eng.asp?cretaria=D032&keyword=nutritionist&table=2&code_level= Statistics Canada: ''National Occupational Classification 2006''] {{Webarchive|url=https://web.archive.org/web/20110706181812/http://stds.statcan.gc.ca/soc-cnp/2006/cs-rc-eng.asp?cretaria=D032&keyword=nutritionist&table=2&code_level= |date=2011-07-06 }} — ''D032 Dietitians and Nutritionists''. Accessed 11 March 2011.</ref> In many countries, only people who have specified educational credentials and other [[healthcare provider requisites|professional requirements]] can call themselves "dietitians"—the title is legally protected. The term "[[nutritionist]]" is also widely used; however, the terms "dietitian" and "nutritionist" should not be considered interchangeable—the training, regulation and [[scope of practice]] of the two professional titles can be very different across individuals and jurisdictions. In many countries, the majority of dietitians are ''clinical'' or ''therapeutic'' dietitians, such as the case of the United States, the United Kingdom, and much of Africa. In other countries they are mostly foodservice dietitians, such as in Japan and many European countries.<ref name="BLS"/><ref name="EMHJ">Hwalla N, Koleilat M. 'Dietetic practice: the past, present and future.' ''Eastern Mediterranean Health Journal'', 2004, 10(6):716–730 http://www.emro.who.int/Publications/EMHJ/1006/index.htm</ref> ==Dietitians in practice== ===Clinical dietitians=== Clinical dietitians work in [[hospital]]s, outpatient clinics, [[nursing home|nursing care facilities]] and other health care facilities to provide nutrition therapy to [[patient]]s with a variety of health conditions, and provide dietary consultations to patients and their families. They confer with other health care professionals to review patients' [[medical record|medical charts]] and develop individual plans to meet nutritional requirements. Some clinical dietitians will also create or deliver outpatient or public education programs in health and nutrition.<ref name="BLS"/><ref name="NHS"/> Clinical dietitians may provide specialized services in areas of [[nourishment]] and [[diet (nutrition)|diet]]s, tube feedings (called [[Nasogastric intubation|enteral nutrition]]), and intravenous feedings (called parenteral nutrition) such as [[total parenteral nutrition]] (TPN) or [[peripheral parenteral nutrition]] (PPN). They work as a team with the [[physicians]], [[physician assistants]], [[physical therapist]]s, [[occupational therapists]], [[recreational therapist]]s, [[pharmacists]], [[speech therapist]]s, [[social workers]], [[nurses]], dietetic technicians, [[psychologists]] and other specialists to provide care to patients. Some clinical dietitians have dual responsibilities with patient nutrition therapy and in food service or research (described below). ===Community dietitians=== [[Community]] dietitians work with wellness programs, [[public health]] agencies, [[home care]] agencies, and health maintenance organizations. These dietitians apply and distribute knowledge about food and nutrition to individuals and groups of specific categories, life-styles and geographic areas in order to [[health promotion|promote health]]. They often focus on the needs of the elderly, children, or other individuals with special needs or limited access to healthy food. Some community dietitians conduct home visits for patients who are too physically ill to attend consultations in health facilities in order to provide care and instruction on grocery shopping and food preparation.<ref name="BLS"/><ref name="ALTA"/> ===Foodservice dietitians=== [[Foodservice]] dietitians or managers are responsible for large-scale food planning and service. They coordinate, assess and plan foodservice processes in [[health care]] facilities, school food-service programs, prisons, restaurants, and company [[cafeteria]]s.<ref name="ALTA">[http://alis.alberta.ca/occinfo/Content/RequestAction.asp?aspAction=GetHTMLProfile&format=html&occPro_ID=71002430 Alberta Employment and Immigration: "Alberta Occupational Profiles – Dietitian".] Accessed 1 April 2011.</ref> These dietitians may perform audits of their departments to ensure quality control and food safety standards, and launch new menus and various programs within their institution to meet health and nutritional requirements. They train and supervise other food service workers such as kitchen staff, delivery staff, and dietary assistants or aides. ===Gerontological dietitians=== Gerontological dietitians are specialists in nutrition and aging. They work in [[nursing homes]], community-based aged care agencies, government agencies in aging policy, and in higher education in the field of [[gerontology]] (the study of aging). ===Neonatal dietitians=== Neonatal dietitians provide individualized medical nutrition therapy for critically ill premature newborns. They are considered a part of the Neonatal Intensive Care Unit's medical team. The neonatal dietitian performs clinical assessment of patients, designs nutrition protocols and quality improvement initiatives with the medical team, develops enteral and parenteral regimens, helps establish and promote lactation/breastfeeding guidelines and often oversees the management of infection prevention in the handling, storage, and delivery of nutritional products. ===Pediatric dietitians=== Pediatric dietitians provide nutrition and health advice for infants, children, and adolescents. They focus on early nutritional needs, and often work closely with doctors, [[school health services]], clinics, hospitals and government agencies, in developing and implementing treatment plans for children with eating disorders, food allergies, or any condition where a child's diet factors into the equation, such as [[childhood obesity]].<ref>[http://www.pediatricdietitian.net/pediatric-dietician/ PediatricDietician.net] {{webarchive|url=https://web.archive.org/web/20101107051750/http://www.pediatricdietitian.net/pediatric-dietician/ |date=2010-11-07 }}. Accessed 14 March 2011.</ref> ===Research dietitians=== [[Research]] dietitians may focus on [[social sciences]] or [[health services research]], for example, investigate the impact of [[health policy|health policies]] or [[behavior change (public health)|behaviour change]], or evaluate program effectiveness.<ref name="ALTA"/> They may survey food-service systems management in order to guide quality improvement. Some research dietitians study the biochemical aspects of nutrient interaction within the body.<ref>de Jong N et al. 'Functional Biochemical and Nutrient Indices in Frail Elderly People Are Partly Affected by Dietary Supplements but Not by Exercise.' ''Journal of Nutrition'' 1999;129:2028–2036.</ref> In universities, they also may have teaching responsibilities. Some clinical dietitians' roles involve research in addition to their patients care [[workload]]. ===Business dietitians=== [[Business]] dietitians serve as resource people in food and nutrition through business, marketing and communications.<ref>[http://dbconline.org/ ''Dietitians in Business and Communications (DBC)''] – dietetic practice group of the Academy of Nutrition and Dietetics. Accessed 13 July 2012.</ref> Dietitians' expertise in nutrition is often solicited in the [[Mass media|media]]—for example for expert guest opinions on television and radio news or cooking shows, columns for a newspaper or magazine, or resources for restaurants on recipe development and critique. Business dietitians may author books or corporate newsletters on nutrition and wellness. They also work as [[sales representatives]] for food manufacturing companies that provide [[nutritional supplements]] and tube feeding supplies. ===Consultant dietitians=== [[Consultant]] dietitians are those who are in [[Medical practice|private practice]] or practice on a contractual basis with health care facilities or corporations, such as used in Australia, Canada and the United States.<ref name="BLS"/><ref name="CANOCC"/> Consultant dietitians [[contract]] independently to provide nutrition or health related consultation and educational programs to individuals and health care facilities as well as sports teams, fitness clubs, and other health related businesses and corporations. ==Required qualifications and professional associations== In most countries, competent performance as a dietitian requires formal training at a higher educational institution in '''dietetics''' involving food and nutritional science, nutrition education and medical nutrition therapy.<ref name="WHO"/> Their education in [[health science]] involves scientific based knowledge in [[anatomy]], [[chemistry]], [[biochemistry]], [[biology]], and [[physiology]]. While the specific [[healthcare provider requisites|academic and professional requirements]] to becoming a fully qualified dietitian differ across countries and jurisdictions, as these are adapted to the needs of the individual countries and the opportunities available,<ref name="EMHJ"/> common academic routes include: *A [[bachelor degree]] in dietetics which requires four years of special studies such as anatomy, physiology, pathophysiology, biochemistry/metabolism, biology, microbiology, organic chemistry, nutritional sciences, food science, medical nutrition therapy; ''or'' *A Bachelor of Science degree and a [[postgraduate]] [[diploma]] or [[master's degree]] in dietetics. In addition, clinical/medical dietitians are required to undergo an [[intern]]ship in a hospital to learn counseling skills with patients and aspects of [[psychology]]. The internship process differs across countries and jurisdictions. Associations for dietetics professionals exist in many countries on every continent.<ref name="EMHJ"/> ===Australia=== Accredited Practising Dietitians (APDs) in [[Australia]] gain their qualifications through university courses accredited by Dietitians Australia (DA).<ref>[https://dietitiansaustralia.org.au/becoming-a-dietitian-in-australia/accreditation-of-dietetics-education-programs/ Accreditation of Dietetics Programs in Australia]</ref> In order for patients to receive a rebate from the national [[Medicare (Australia)|Medicare]] system or private health insurance, APD status is required. APDs are dietitians engaged in the Continuing Professional Development program offered by the DA and commit to upholding the DA Code of Professional Conduct and Code of Ethics. Dietitians who are not members of DA may participate in the DA's Continuing Professional Development Program and in this way can still hold APD status. However,<ref>https://www.legislation.gov.au/ {{nonspecific|date=April 2021}}</ref> health care providers must, as of 2009, either have statutory registration or be members of their national professional association to obtain a provider number. This means all private health funds will require private practitioners applying for provider numbers to be Dietitians Australia members (not just "eligible" for membership). ===Canada=== In [[Canada]], 'dietitian' is a protected professional title. Additionally, 'registered dietitian' and 'professional dietitian' are protected in some provinces. Each province has an independent professional college (for example, The College of Dietitians of Ontario<ref>[http://www.cdo.on.ca/en/ The College of Dietitians of Ontario] {{webarchive|url=https://web.archive.org/web/20110312011819/http://www.cdo.on.ca/en/ |date=2011-03-12}} Accessed 1 April 2011.</ref>) which is responsible for protecting the public and regulating the profession. The colleges are entirely funded from licensing fees collected from dietitians. Each college must have both public and professional members, and is empowered to investigate and censure (when malpractice/negligence is found) members of the profession who breach either their [[scope of practice]] or harm/endanger the health of a patient/client, and receive a complaint against them from a member of the public or another health care professional. To practice as a registered dietitian within a province, a dietitian must register with the college and obtain a license. The activities of the college are governed by legislation passed by the provincial government. It is the presence of this regulatory body which distinguishes registered dietitians from [[nutritionist]]s in Canada, the regulations for which vary by province (Exceptions: Alberta where "registered nutritionist" is a protected title that can only be used by dietitians. Similarly in Nova Scotia and Québec "nutritionist" is protected and can only be used by dietitians)<ref>[http://www.dietitians.ca/Downloads/Public/Dietitians-SmartChoice-Col.aspx Dietitians of Canada: Dietitians promote health through food and nutrition] {{webarchive|url=https://web.archive.org/web/20150628083610/http://www.dietitians.ca/Downloads/Public/Dietitians-SmartChoice-Col.aspx |date=2015-06-28}} Accessed 3 August 2015</ref> The colleges also set the minimum entry requirements for admission into practice as a registered dietitian. [[Healthcare provider requisites|Requirements to entry into practice]] as a dietitian include a four-year undergraduate degree from an accredited university (which includes courses in science, foods, nutrition, management, communication and psychology/sociology, among others), a 10–12 month supervised practice period (called an [[internship]]), and successfully passing a board exam in nutrition and dietetics.<ref>[http://www.dietitians.ca/Become-a-Dietitian/Education.aspx Dietitians of Canada: Become a Dietitian: Education] Accessed 3 August 2015</ref> The national professional association in Canada is [[Dietitians of Canada]]. ===Malaysia=== ====History of Dietitians in Malaysia==== Hospital dietetic services began in Malaysia in 1953 under the Ministry of Health. In 1965 dietetics services began in university hospitals and in private hospitals in 1982. In 1988, University Kebangsaan Malaysia started the first dietetics program to train dietitians. There are currently eight universities in Malaysia offering programs in dietetics at at least a bachelor's level. In 2005 the Ministry of Health recognized Dietitians under clinical and health services as an allied healthcare professional.<ref name="MDA3">{{cite web |title=Dietitians Who is a dietitian? - Malaysian Dietitians' Association |url=https://www.dietitians.org.my/dietitians/who-is-a-dietitian |website=www.dietitians.org.my |access-date=16 September 2023}}</ref> ====Regulation of Dietitians and Nutritionists in Malaysia==== Dietitians and nutritionists are regulated under the Allied Health Professional Act in [[Malaysia]].<ref name="MDA1">{{cite web |title=Allied Health Professional Act 774 |url=https://www.dietitians.org.my/pages/default/155647 |website=MDA Malaysia Dietitians Association |publisher=Parliament of Malaysia |access-date=16 September 2023}}</ref> Using the term "registered" is regulated and falsely presenting oneself as a registered dietitian/nutritionist in Malaysia is illegal. Practicing certificates are valid for two years. Practitioners must register with the Malaysian Allied Health Professionals Council. ====Pathways to Becoming a Dietitian in Malaysia==== There are three pathways to becoming a Registered Dietitian in Malaysia:<ref name="MDA2">{{cite web |title=Dietitians How to become a dietitian? - Malaysian Dietitians' Association |url=https://www.dietitians.org.my/dietitians/how-to-become-a-dietitian |website=www.dietitians.org.my |access-date=16 September 2023}}</ref> # Obtain a 4-year integrated undergraduate degree in Dietetics (with proof of having done Dietetics Internship Training) as the following: Bachelor of Science (Hons) in Dietetics or Bachelor of Science (Hons) in Nutrition & Dietetics # Obtain integrated postgraduate degree or master's degree in Dietetics with proof of having done Dietetics Internship Training # Postgraduate Diploma with proof of having done Dietetics Internship Training ===South Africa=== In South Africa, dietitians must be registered with the Health Professions Council of South Africa.<ref>[http://www.hpcsa.co.za/board_dietetics.php Health Professions Council of South Africa: "Dietetics and Nutrition Professional Board".] {{webarchive|url=https://web.archive.org/web/20110323083941/http://www.hpcsa.co.za/board_dietetics.php |date=2011-03-23}} Accessed 1 April 2011.</ref> The council regulates the following professional titles: dietitians, supplementary dietitians, and student dietitians, as well as nutritionists, supplementary nutritionists, and student nutritionists. Requirements for eligibility for registration include a recognised bachelor's degree in dietetics or nutrition from an accredited educational institution. The undergraduate training should include the three practice areas of therapeutic nutrition, community nutrition, and food service management. Against the backdrop of the [[HIV/AIDS in South Africa|HIV/AIDS epidemic in South Africa]], there remains high demand for greater numbers of practicing dietitians, along with other health care staff, in order to expand public sector health care services.<ref>van Rensburg DHCJ et al. "Human resource development and antiretroviral treatment in Free State province, South Africa". ''Human Resources for Health'', 2008; 6:15 http://www.human-resources-health.com/content/6/1/15</ref> Academic programs, professional associations, and credentialing requirements do not exist for dietitians in most other African countries, where the number of professionals in dietetics is very low.<ref name="EMHJ"/> ===United Kingdom=== In the United Kingdom, dietitians must be registered with the [[Health and Care Professions Council]] (HCPC, formerly the Health Professions Council, HPC) in order to be able to work for the [[National Health Service]].<ref name="NHS"/> The education requirements include obtaining either a BSc in dietetics or a postgraduate qualification approved by the HCPC. ===United States=== In the United States, nutrition professionals include the '''dietitian''' or '''registered dietitian''' (RD), as well as "dietetic technician" or "dietetic technician, registered" (DTR) (see below). These terms are legally protected, regulated by the [[Academy of Nutrition and Dietetics]] which registers and confers professional credentials. The academy also recognizes and certifies certain specialty areas, such as in gerontological nutrition.<ref name="Academy of Nutrition and Dietetics">{{cite web|last=Academy of Nutrition and Dietetics|title=Eatright.org|url=http://www.eatright.org}}</ref> Dietitians are registered with the Commission on Dietetic Registration (the certifying agency of the academy) and are only able to use the label "Registered Dietitian" when they have met specific educational and professional prerequisites and passed a national registration examination. Besides academic education, dietitians must complete at least 1200 hours of practical, supervised experience through an accredited program before they can sit for the registration examination. In a coordinated program, students acquire internship hours concurrently with their coursework. In a didactic program, these hours are obtained through a dietetic [[internship]] that is completed after obtaining a degree.<ref>[http://www.eatright.org/BecomeanRDorDTR/content.aspx?id=8142 Become an RD or DTR.] {{Webarchive|url=https://web.archive.org/web/20120709095600/http://www.eatright.org/BecomeanRDorDTR/content.aspx?id=8142 |date=2012-07-09 }} Accessed 12 July 2012.</ref> In both programs the student is required to complete several areas of competency including rotations in clinical, community, long-term care nutrition as well as food service, [[public health]] and a variety of other worksites. Once the degree is earned, the internship completed, and registration examination passed, the individual can use the nationally recognized legal title, "registered dietitian", and is able to work in a variety of professional settings. To maintain the RD credential, professionals must participate in and earn continuing education units (often 75 hours every five years). In addition, many states require specific [[licensing|licensure]] to work in most settings. For instance, the California Business and Professions Code Section 2585-2586.8,<ref name="California">[http://law.justia.com/codes/california/2009/bpc/2585-2586.8.html Justia.com US Law: ''California Business and Professions Code Section 2585-2586.8''] — ''Chapter 5.65. Dietitians''. Accessed 11 March 2011.</ref> states that: {{blockquote|Any person representing himself or herself as a registered dietitian shall meet one of the following qualifications: #Been granted, prior to January 1, 1981, the right to use the term "registered dietitian" by a public or private agency or institution recognized by the [[California Department of Health Services|State Department of Health Services]] as qualified to grant the title, provided that person continues to meet all requirements and qualifications periodically prescribed by the agency or institution for the maintenance of that title. #Possess all of the following qualifications: ::(A) Be 18 years of age or older. ::(B) Satisfactory completion of appropriate academic requirements for the field of dietetics and related disciplines and receipt of a baccalaureate or higher degree from a college or university accredited by the [[Western Association of Schools and Colleges]] or other regional accreditation agency. ::(C) Satisfactory completion of a program of supervised practice for a minimum of 1200 hours that is designed to prepare entry level practitioners through instruction and assignments in a clinical setting. Supervisors of the program shall meet minimum qualifications established by public or private agencies or institutions recognized by the State Department of Health Services to establish those qualifications. ::(D) Satisfactory completion of an examination administered by a public or private agency or institution recognized by the State Department of Health Services as qualified to administer the examinations. ::(E) Satisfactory completion of continuing education requirements established by a public or private agency or institution recognized by the State Department of Health Services to establish the requirements.}} In addition: {{blockquote|It is a misdemeanor for any person not meeting the criteria... in connection with his or her name or place of business, the words "dietetic technician, registered", "dietitian", "dietician", "registered dietitian", "registered dietician", or the letters "RD", "DTR", or any other words, letters, abbreviations, or insignia indicating or implying that the person is a dietitian, or dietetic technician, registered or registered dietitian, or to represent, in any way, orally, in writing, in print or by sign, directly or by implication, that he or she is a dietitian or a dietetic technician, registered or a registered dietitian.<ref name="California"/>}} As recent studies have shown the importance of diet in both [[preventive medicine|disease prevention]] and management, many US states have moved towards covering medical nutrition therapy under the [[Medicaid]]/[[Medicare (United States)|Medicare]] social insurance programs, making dietetics a much more lucrative profession due to insurance reimbursement. In the United States the governing body of dietetics practice is the Academy of Nutrition and Dietetics (formerly the ADA). This group is made up of approximately 72,000 members nationwide.<ref>{{cite web|url=http://www.jblearning.com/catalog/9781284026085/ |title=The Profession of Dietetics: A Team Approach |access-date=2015-02-23 |url-status=dead |archive-url=https://web.archive.org/web/20150224010614/http://www.jblearning.com/catalog/9781284026085/ |archive-date=2015-02-24}}</ref> ===International Confederation of Dietetic Associations (ICDA)=== The International Confederation of Dietetic Associations (ICDA) is a membership organization of over 40 national associations of dietitians and nutritionists. Dietetics associations are professional societies whose members have education qualifications in food, nutrition and dietetics recognized by a national authority.<ref>[https://www.internationaldietetics.org International Confederation of Dietetic Associations] Accessed 1 May 2011.</ref> The ICDA supports national dietetics associations and their members, beyond national and regional boundaries, by providing: * An integrated communications system * An enhanced image for the profession * Increased awareness of standards of education, training and practice in dietetics. ==Other nutrition personnel== These titles are general designations of nutrition personnel. Specific titles may vary across countries, jurisdictions and employment settings. In particular the title [[nutritionist]] is, in some countries, unregulated so anyone may claim to be a nutritionist. ===Dietetic technicians=== '''Dietetic technicians''' are involved in planning, implementing and monitoring nutritional programs and services in facilities such as [[hospital]]s, nursing homes and schools. They assist in education and assessment of clients' dietary needs, and may specialize in nutritional care or foodservice management. Dietetic technicians usually work with, and under the supervision of, a registered dietitian.<ref>U.S. Bureau of Labor Statistics. [http://www.bls.gov/oes/current/oes292051.htm Occupational Employment Statistics: Dietetic Technicians.] Occupational Employment and Wages, May 2010. Accessed 2 August 2011.</ref><ref>Mississippi Hospital Association. [http://www.mshealthcareers.com/careers/dietetictech.htm Health Careers Center: Dietetic Technician.] Accessed 2 August 2011.</ref><ref name="Ontario">College of Dietitians of Ontario. [http://www.cdo.on.ca/en/becomeRD/default.asp#dietetic Dietetic Technicians.] {{Webarchive|url=https://web.archive.org/web/20110729075027/http://www.cdo.on.ca/en/becomeRD/default.asp#dietetic |date=2011-07-29 }} Accessed 2 August 2011.</ref> The training requirements and professional regulation of dietetic technicians vary across countries, but usually include some formal (postsecondary) training in dietetics and nutrition care. In jurisdictions where the profession is regulated, such as in the United States, the title "'''Dietetic Technician, Registered'''" (DTR) may be used. ====Canada==== In Canada, there are national standards for academic training and qualifications for dietetic technicians, according to CSNM (the Canadian Society for Nutrition Management).<ref name="Ontario"/> In Ontario, [[Conestoga College]] offers a diploma program with a clinical focus for dietetic technicians.<ref>Conestoga College. In British Columbia, Langara College of Vancouver offers a diploma program for dietetic technicians with a focus on foodservice management. Also the Canadian Healthcare Association, based out of Ottawa, offers a certificate in foodservice management for diet technicians. [http://www.conestogac.on.ca/fulltime/program.jsp?SchoolID=3&ProgramCode=1155&v=1001&p=o Program Details: Dietetic Technician.] {{webarchive|url=https://web.archive.org/web/20110927071826/http://www.conestogac.on.ca/fulltime/program.jsp?SchoolID=3&ProgramCode=1155&v=1001&p=o |date=2011-09-27 }} Accessed 2 August 2011.</ref> ====United States==== In the United States, the [[Academy of Nutrition and Dietetics]] confers the "Dietetic Technician, Registered" (DTR) credentials. Qualified DTRs possess a specialized associate degree from [[community college]] programs which are accredited by the academy's Accreditation Council for Education in Nutrition and Dietetics Education (ACEND). They must complete a dietetic internship with a minimum of 450 supervised practice hours in the areas of foodservice theory and management, community dietetics, and clinical dietetics. They must also pass a national registration examination administered by the Commission on Dietetic Registration (CDR) of the academy. The DTR is an academy-credentialed nutrition practitioner who works independently in many nutrition settings; however, when performing clinical dietetics, they must work under the supervision of a Registered Dietitian. Some states have legislation specifying the [[scope of practice]] for the DTR in medical nutrition therapy settings. Effective June 1, 2009, a new pathway to becoming a Registered Dietetic Technician became available from the Commission on Dietetic Registration. Students may take the DTR examination without attending an internship after completion of a Baccalaureate degree granted by a US regionally accredited college/university, or foreign equivalent, and completion of an ACEND Didactic Program in dietetics or Coordinated Program in dietetics. Applicants must take and pass the CDR Dietetic Technician Registration Exam to qualify for the DTR credential.<ref>[http://www.cdrnet.org/programdirector/NewPathwayIII.cfm Commission on Dietetic Registration (CDR)] {{webarchive|url=https://web.archive.org/web/20120827015359/http://www.cdrnet.org/programdirector/NewPathwayIII.cfm |date=2012-08-27}}, the credentialing agency for the Academy of Nutrition and Dietetics.</ref> As for Registered Dietitians, in many cases the title "Dietetic Technician" is regulated by individual states. For instance, according to the California Business and Professions Code Section 2585-2586.8:<ref name="California"/>{{blockquote| Any person representing himself or herself as a dietetic technician, registered shall possess all of the following qualifications: # Be 18 years of age or older. # Satisfactory completion of appropriate academic requirements and receipt of an [[associate's degree]] or higher from a college or university accredited by the [[Western Association of Schools and Colleges]] or other regional accreditation agency. # Satisfactory completion of the dietetic technician program requirements by an accredited public or private agency or institution recognized by the State Department of Health Services including not less than 450 hours of supervised practice. # Satisfactory completion of an examination administered by a public or private agency or institution recognized by the State Department of Health Services to administer the examination. # Satisfactory completion of continuing education requirements established by a public or private agency or institution recognized by the State Department of Health Services to establish the requirements.}} ===Dietary assistants=== '''Dietary assistants''', also known as "nutrition assistants" or "dietary aides", assist dietitians and other nutrition professionals to maintain nutritional care for patients and groups with special dietary needs. They assist in preparing food in hospitals, childcare centres, and aged care facilities.<ref>Government of South Australia. [http://www.tafesa.edu.au/xml/profile/profile_330.aspx TAFE South Australia: Nutrition Assistant (Dietary Aide).] Accessed 2 August 2011.</ref> Dietary aides in some countries might also carry out a simple initial [[health screening]] for newly admitted patients in medical facilities, and inform the dietitian if any screened patients requires a dietitian's [[expertise]] for further assessments or [[Health intervention|intervention]]s. ===Dietary clerks=== ''Dietary clerks'', also sometimes known as "medical diet clerks" or "dietary workers", prepare dietary information for use by kitchen personnel in preparation of foods for hospital patients following standards established by a dietitian. They examine diet orders, prepare meal trays, maintain the storage area for food supplies, and ensure practice of sanitary procedures. They may operate computers to enter and retrieve data on patients' caloric requirements and intake, or to track financial information. Dietary workers are typically trained on the job.<ref>CBsalary. [http://www.cbsalary.com/national-salary-chart.aspx?specialty=Medical+Diet+Clerk&cty=&sid=&kw=Medical&jn=jn023&edu=&tid=68881&cbRecursionCnt=1&cbsid=c623f84074814332a4fd84537eb4c245-326911720-RQ-4&ns_siteid=ns_us_g_rate_of_pay_for_a_die_ Medical Diet Clerk Salary.] Accessed 2 August 2011.</ref> ===Dietary managers=== {{See also|Dietary management}} '''Dietary managers''' supervise the production and distribution of meals, as well as the budgeting and purchasing of food and the hiring, training and scheduling of support staff in various types of workplaces offering larger scale [[foodservice]]s, such as hospitals, nursing homes, school and college cafeterias, restaurants, correction facilities and [[catering]] services.<ref>Florida Health Careers. [http://www.flahec.org/hlthcareers/DIETMGR.HTM Dietetics and Nutrition: Dietary manager.] Accessed 2 August 2011.</ref><ref>Ontario Society of Nutrition Management. [http://www.osnm.org/content/dietary-manager-extended-application-deadline Dietary Manager.]{{dead link|date=September 2017 |bot=InternetArchiveBot |fix-attempted=yes }} Accessed 2 August 2011.</ref> They assure their department is compliant with [[food safety]] regulations, and that the food served meets dietary requirements established by a dietitian. Training requirements vary across jurisdictions and employment settings. Dietary management is not usually subject to professional regulation, although voluntary certification is preferred by many employers. * In Canada, dietary managers with recognized training in areas such as diet therapy, menu planning, food safety and food production may become members of the Canadian Society of Nutrition Management (CSNM).<ref>[http://www.csnm.ca/content/about-csnm Canadian Society of Nutrition Management.] {{Webarchive|url=https://web.archive.org/web/20111014034201/http://www.csnm.ca/content/about-csnm |date=2011-10-14 }} Accessed 2 August 2011.</ref> * In the United States, "Certified Dietary Managers" are certified by the credentialing agency known as the Association of Nutrition & Foodservice Professionals (ANFP). This agency also certifies a professional known as a "Certified Food Protection Professional". The ANFP certifies specific programs to meet its educational requirements, including courses in culinary management, clinical nutrition, and food safety. In addition, there are supervised practice requirements and a certification exam that must be passed. ===Dietary hosts=== '''Dietary hosts/hostesses''', also known as "food service aides", assist in patient tray services in hospitals and other health care settings, usually under the supervision of the dietary manager. They distribute menus, and prepare, deliver and bring back meal trays.<ref>Advocate Health Care. [http://jobs.advocatehealth.com/libertyville/dietary-and-food-services-jobs Food service worker registry.] {{webarchive|url=https://web.archive.org/web/20120313115825/http://jobs.advocatehealth.com/libertyville/dietary-and-food-services-jobs |date=2012-03-13 }} Accessed 2 August 2011.</ref> Usually no specific training is required for workers in this category. ==See also== {{Portal|Medical}} * [[Healthy diet]] * [[Nutritionist]] * [[Nutrition]] * [[Food science]] * [[Health care provider]]s * [[Allied health professions]] ==References== {{Reflist}} {{Diets}} {{Allied health professions}} {{Authority control}} [[Category:Dietitians| ]]'