Can nutritionists give out diet plans?

Upon completion of the BTN Practical Academy, you become a BTN Certified Nutrition Coach and are able to practice as a nutritionist. Because of this, some of the biggest questions I get asked as manager of the BTN Academy is:-

What can a nutritionist do, can a nutritionist give out diet plans, and what’s the difference between a nutritionist and a dietitian?

It’s my hope that this blog will give me somewhere to forward those who ask these incredibly sensible questions, so that I can provide a far more in-depth and informative response than I would ever be able to via email or a facebook post. As such, this blog will be somewhat different to my usual (if you want the heavily referenced and practically useful stuff – check out my blog from last week because it’s a corker... after reading this, obviously!).

The first thing you need to know is that although they both have very similar titles, nutritionists and dietitians do different things. Additionally the route you need to take in order to achieve nutritionist and dietitian status is very different. As such it makes sense that the route you need to take will depend on what it is you ultimately want to do and who you’d like to work with.

Personal trainer with client

Personal trainer with client

The difference between a Dietitian and a Nutritionist

A dietitian is a highly qualified professional in the area of nutrition. They are able to work in clinical settings and are able to treat illness and disease such as diabetes, obesity and heart conditions, as well as working with people post-surgery, post-heart attack or during chemotherapy. They can also prescribe things to people, meaning they can tell them exactly what to do in order to solve a particular problem, much like a doctor will. A dietitian can, for example, tell someone with a renal disorder exactly what to eat; or indeed tell their doctor what to feed them.

In the UK you’ll usually find dietitians in the NHS, in schools, at sports teams or in clinical settings. They can also get involved with setting guidelines for public health, and will therefore often be found working at places like the Scientific Advisory Committee on Nutrition (SACN) or Public Health England (PHE). Finally, sports dietitians are generally affiliated with sports teams or clubs, and they will focus on improving athlete performance, recovery and overall health.

Dietitians have completed extensive training (including specific degrees and, typically, masters degrees or PhD’s) and must register and comply with the Health and Care Professions Council (HCPC). “Dietitian”, therefore, is a protected title and if you’d like to become one, the only path is to go to university. For many that isn’t feasible, though – and most people interested in nutrition aren’t actually interested in working in clinical settings or with government bodies, anyway. Most people want to get in on the ground and help everyday folks eat a little better – that’s where the next profession comes in.

Being a (good) nutritionist

Good nutritionists are individuals with a great understanding of the science of nutrition, who are able to provide evidence-based, non-prescriptive advice to non-clinical clients. These individuals typically – though not always – work in freelance positions as a coach or personal trainer, or for small organisations in the private sector, and they will generally focus their attention on things like fat loss, muscle growth, general health improvement, family eating and sports nutrition (depending on your course and what it covered).

As a side note, all of us at BTN are nutritionist, apart from Heather Osborn who is a Registered Dietitian (RD) and teaches on our academy on some of our specialist topics. We all work with and help clients; and have done for many years - some of us working in elite sport, some with specialist populations, and all with everyday folk. So again, you don’t need to be a dietitian to help people with food.

Essentially a nutritionist is there to help someone explore food and it’s relationship to their health and wellbeing by informing them of the current research and it’s implications for what they do day-to-day, though some nutritionists will also focus on the aforementioned body composition or sports performance niches (typically, these individuals will have undergone training as sports nutritionists, or done a course that contained sports nutrition, like the BTN Academy).

Nutritionists can help people understand the way that food affects their weight and general health, then assist them in coming up with a plan that is at the same time adherent to the general guidelines that apply to everyone, and bespoke to the individual’s needs.

The title “Nutritionist” is NOT protected, meaning that no qualifications are required to be one, but it’s definitely the case that training (including but often not university education) is a very good idea, and is often a prerequisite to get insured. Some nutritionists (especially those looking to work in familial health, or with schools or specific populations like pre and post natal women) may also register with voluntary registers, such as the one held by the AfN, the Voluntary Register of Nutritionists. This doesn’t qualify you to do anything different; but because it ensures (as much as is reasonably possible) that you know what you are doing, you adhere to the body’s strict guidelines and you stay up to date with CPD. Some organisations looking for a nutritionist may only accept applications from those registered on such a register.

Alternatives include the organisation BANT which tends to specialise in more fringe, alternative therapies (some of which are legitimate, some of which are not – see my blog on adrenal fatigue for more info on alternative health). For nutritionists wanting to work with the general public, some will ask for this but most will not, so it’s far from a requirement in general.

Insurance for nutritionists tends to cost around £100 per year for public liability, and most insurance companies that cover self employed folks will cover you so long as you pay attention to the following paragraph:

Being qualified in some manner is not needed, but what IS required is an understanding of what you’re actually doing. Note above that I noted “Good Nutritionists…” and that was deliberate. Being a nutritionist 20 years ago made you a rare breed, but now anyone with a large Instagram following who has ever baked with protein powder is a nutritionist (or nutrition coach, or any other title that the individual feels properly describes what they do).

This has left the door open for a great deal of hucksters, con artists and well meaning folks that try really hard but don’t actually know what they’re doing. Cynics would say that the former is the most common form of bad nutritionist, but in my eyes it’s probably the latter – remember Hanlon’s Razor: “Never attribute to malice that which is adequately explained by stupidity".

Nutritionists, therefore, will typically fall into three categories:

  1. Hucksters who will sell anything to make bank. These guys aren’t really the focus of this article, and I hope they stand on an upturned electrical plug.
  2. People who want to be great nutritionists, but due to the complexity of the role and their lack of overall ability they struggle, give impractical or ineffective advice, and usually end up moving on to do something else
  3. Good nutritionists who have completed some kind of course designed to teach them what’s what.

The purpose of the BTN Academy is to turn category 2 people into category 3, or to help category 3 stay on point with their practice by offering CPD. It doesn’t offer a nationally recognised qualification but you don’t need one – it offers you the skills and support you need to move into the successful category, and allows you to become insured to practice

It’s a simple fact of free market economics that businesses that can provide a service their target market want, at a price they are willing to pay, and that fulfils expectations, will succeed. Those businesses that fail to do any of these three will fail. If you’re an ineffective nutritionist then you can practice, you can be insured, but you will likely become another statistic in studies about startup businesses that don’t make a profit (the average career length of a personal trainer is 18 months, just to add some context). Nutritionists are a real luxury for those that can afford them and so while it’s easy to start calling yourself a nutritionist, if you aren’t getting results for your clients they won’t stick around.

What we do here at BTN is provide you with the tools needed to succeed when working with clients to improve their nutrition. For that you need an in depth understanding of nutritional science as it applies to the demographics with which you may work, an appreciation for the practical application of that, and a good amount of knowledge around behaviour change, communication and client psychology. Nutritionists aren’t the food police, they are the people who are best placed (due to increased exposure time with clients) to help someone alter their food habits, but to do that you need to have everything that you need at your disposal.

So what is better, being a dietitian or being a nutritionist?

Well, that’s largely a matter of perspective, of overall aims, and of who you ask – as well as by what metric you are judging.

If you want to work with clinical people, folks with diseases or severe gastric issues or eating disorders, people pre and post surgery or people who need to lose weight in order to see next Christmas, then being a dietitian is for you. This is also the career path to take if you want to get involved with widespread public health initiatives and government guidelines.

The eatwell plate

The eatwell plate

Being a dietitian, unfortunately, also comes with it’s downsides. Aside from the obvious 3-5 years at university (depending on whether you do an MSc or not) you need to consider the large amount of red tape. Official guidelines change extremely slowly, and therefore it’s very likely that a dietitian may find him or herself offering outdated advice. You only need to look at the current public health focus on breakfast being vital, or 0.8g protein per kilo being optimal for everyone to see that advice isn’t always current, or look at how long it was before ‘healthy fats’ was added to the Eatwell Guide. Individual dietitians are not compelled to adhere to these guidelines but it is encouraged, and is the norm. Moreover, those who want to help governments alter their approaches will find that it can take a decade longer than you would expect to see a shift – this can be frustrating.

As a nutritionist you are not held to such strict rules (though registered nutritionists can be in many ways) and so you are free to alter your approach as nutritional science comes forward. This DOES mean you need an extremely good understanding of biology and physiology so that you can use proper critical thinking when assessing new information, and it certainly helps to have a few well-read textbooks on your shelf, but having the ability to increase your protein recommendation to more than the UK Government guidelines’ standard level when the research consistently supports doing so is highly freeing. This also means you can make an impact quicker, while still operating within your remit.

On the downside, nutritionists really need to make sure they understand their scope of practice. We are not able to prescribe anything, meaning that we need to discuss the facts and offer suggestions, but the final decision is up to the client.

This is the difference between writing “supplements: X, Y, Z” at the bottom of a nutritional plan, and saying to a client “because you really don’t like oily fish, it might be worth looking at a fish oil supplement. EPA and DHA do this and that, and here’s some literature to read on it. If you’d like a recommendation of a particular kind to go for, let me know”.

We’re also not able to diagnose anything, or work with someone who has serious health issues. What we ARE able to do is refer someone to a medical professional (for example a gastroenterologist to check out digestive problems, a psychologist to work on someone’s binge eating, or simply a GP for some blood tests to rule out suspected deficiencies) and then work with the client on carrying out that professional’s recommendations.

Essentially, being a Dietitian allows you to work with those who are in clinical or medical settings, being a Nutritionist allows you to work with members of the general public wanting to improve their health, weight and performance.

Being a Dietitian requires university degrees and HCPC membership, being a Nutritionist requires nothing. Being a good Nutritionist, however, takes a lot of study. That’s why the BTN Academy is 12 months long and as extensive and challenging as it is – our students often report that they weren’t expecting the sheer amount of quality information that they are given, and they consistently tell us that our course is one of the best things they have ever done. Our mission isn’t to just give people a little education, we aim to make you a great nutritionist, and we have to say that our Academy alumni are a testament to that fact.

So - can a nutritionist write meal plans?

One area that people have debated for years, especially after a REPS statement put out to personal trainers some time ago is, “can nutrition coaches give out meal plans”. The answer, as it almost always – is yes and no. The primary difference between the two positions lies in the definition you give for a meal plan, so let’s start by defining the kind of meal plan a nutritionist absolutely cannot give out.

Meal plan version 1: The coach writes out a day (or if you’re lucky a few days) worth of food in a menu format. This may either take the shape of “Meal 1 – Oats and a protein shake, Meal 2, Fish and rice….etc” or the coach may have done some homework and will give you the quantities of food to include and sometimes even the macros. The client then blindly follows (or not), eats the food (or doesn’t), and does or does not lose weight depending on the effectiveness of that plan and their adherence. Nutritionists can’t do this because this is classed as prescriptive nutrition.

To be able to prescribe you need to be registered with an official body (HCPC) that keeps really close tabs on your performance. This is for a number of reasons but it primarily boils down to the fact that as soon as you tell someone what to eat you are simultaneously determining what they do not eat, and this leaves people open to nutritional deficiencies or simple nutritional imbalances if you don’t know what you’re doing. You may know exactly what you’re doing – but if you spend enough time on YouTube you’ll be able to service a boiler; doesn’t make it legal without proper registration.

Another issue here isn’t a legal one but a practical one. This prescriptive practice limits clients’ adherence ability and also provides them with almost zero autonomy. After the process is over they are likely to return to old habits because they haven’t learned new ones – unless you call following a plan that is provided to you a habit.

Meal plan version 2: This is the method we fully describe on the BTN Academy. Very briefly it involves including the client in the process of designing their weekly menu, it involves a degree of flexibility and preference, and it involves a full explanation of why everything is as it is. What you are doing is giving a client a starting point – a Launchpad from which to begin their journey to a position of greater autonomy. If someone really isn’t able to manage their nutrition at all then giving them more general guidelines can often leave them unable to start – so this approach (while not being right for everyone) is a perfect approach for true beginners. This is not a prescriptive plan, it’s assistance in planning – and it’s an incredibly powerful educational tool which can be profoundly effective both long and short term.

There is nothing wrong with giving someone a meal plan, it simply comes down to how you do it, why you are doing it, the language you are using with a client when implementing it and the means by which you design it. In our eyes the real blowback against meal plans stems from years and years of unqualified coaches using approach 1 (or potentially a little bit of industry elitism). If you’re using method 2, however, the picture is entirely different.

So how can I become a good nutritionist?

Get the right training. The Body Type Nutrition Academy not only teaches you nutrition, we teach you how to work ethically, effectively and in an educational manner that will empower your clients, rather than just tell them what to do to get leaner.

If you want to coach everyday people to be more awesome, lose weight, get healthy, improve their body compositon, improve their sports performance, have a better relationship with food, and thrive with their health then be a nutritionist. The only caveat is: be a good one, get the right education, get the right insurance, and practice ethically.

Sure, legally you don’t HAVE to do this, but whether this industry has effective regulation (yet) or not, people should still be getting the right training to do their job, period.

If you feel like being a Nutritionist is something you would want to do (or you simply want to learn a ton about nutrition), why not check out our online nutrition course the BTN Academy? In my opinion, it’s one of the best investments you’ll make, and one of the most rewarding careers you can have.

Thanks for reading.