The world of nutrition is full of advice, from social media influencers to hospital professionals. When it comes to spelling the word for a nutrition expert, confusion often arises. Is it "dietitian" with a T or "dietician" with a C? While both spellings exist, one is generally preferred in the professional field.
A Brief History of the Term
Through the years, nutrition professionals have had a variety of names. In the 1870s, graduates of cooking schools were often called "dietists." In 1899, at the Lake Placid Conference on Home Economics, the term "dietitian" was created. During this period, "dietist" and "dietician" were also used. In 1917, the American Dietetics Association (ADA), now known as the Academy of Nutrition and Dietetics (AND), was created. In 1967, the International Labour Office, confirmed the dietetic’s profession classification in the International Standard Classification of Occupations.
Dietitian vs. Dietician: Usage and Preference
"Dietitian" is a variant spelling of "dietician," the older word. A dietitian is employed to tell others about their diet or how they eat and make suggestions to help improve their health and nutrition. In short, they are experts in the study of dietetics. While "dietician" was the original title of those who specialized in dietary needs in cooking schools, the title changed through the years to meet a wider explanation of dietary needs, and with it came a change in spelling.
The spelling variation "dietitian" is used about three times as much as "dietician" and is considered the more appropriate modern spelling.
Origins of the Spellings
The title of "dietician" originated in 1845 after the inception of professional cooking schools. The graduates were called dietists or dieticians due to their diet or food preparation expertise. The name was quickly adapted by physicians who specialized in dietetics or the application of the science of nutrition to control health and disease. By 1899, the title "dietitian" was used to refer to any professional, physician or otherwise, who specialized in nutritional knowledge and diet therapy needs as a medical necessity. The first dietitians were hospital workers who provided meals to their patients while meeting the nutritional needs required for hospital and home recovery. The term was formalized in 1917 with the inception of the American Dietetic Association (ADA) and currently continues to recognize "dietitian" as the correct spelling variant.
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Why the Confusion?
As explained by the 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. For example, physician, optician, technician, clinician, etc, all end in this suffix.
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. The spelling with "t" is the one preferred by the profession itself internationally, 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 and list the spelling with "t" as a variant.
The Dietitian's Perspective
If you ask a group of dietitians their biggest pet peeves, the spelling of dietitian is bound to come up. The topic is so popular, it has even become meme-worthy! There was a meme by Alysa Bajenaru RD, circulating in the dietitian community of Ryan Gosling letting everyone know, "Hey Girl, I would never spell dietitian with a ‘C’." Several memes have followed since.
If you want to rile up or poke fun at an RD, spell dietitian with a C! Most dietitians are quick to correct the mistake, especially when it comes to publications and job postings.
The Importance of Correct Spelling
The American language is full of words with more than one spelling, causing confusion (and occasionally irritation) when a less acceptable spelling is used. Dietician and dietitian are the perfect examples of spelling variations that create some annoyance in the professional nutrition field of study, so using the most acceptable spelling is essential.
Read also: RD Credential Information
What Does a Dietitian Do?
Dietitians are nutrition experts. Dietitians translate the science of nutrition into using that practice in everyday life. It is taking the science onto our plates, if you will, to make healthy eating attainable and sustainable. A dietitian is a degree qualified health professional who:
- Treats medical conditions through Medical Nutrition Therapy (MNT)
- Helps to promote nutritional well-being
- Prevents nutrition-related problems
- Provides practical and safe advice, based on current scientific evidence
Dietitians can work in a range of different specialties, including clinical, community, and foodservice management. They are the expert in providing dietary advice and promoting healthy eating habits.
Clinical Dietitians
Clinical dietitians provide medical nutrition therapy in settings such as hospitals, nursing homes, and long-term care facilities. Their role includes developing and directing nutritional care to promote health and manage disease. 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. Clinical dietitians may provide specialized services in areas of nourishment and diets, tube feedings (called 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 therapists, occupational therapists, recreational therapists, pharmacists, speech therapists, social workers, nurses, dietetic technicians, psychologists and other specialists to provide care to patients.
Community Dietitians
Community dietitians educate the public about food and nutrition topics. They can work for non-profit organizations or public health clinics such as Women, Infants, and Children (WIC). 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 promote health. They often focus on the needs of the elderly, children, or other individuals with special needs or limited access to healthy food.
Foodservice Management Dietitians
Foodservice management dietitians plan meal programs in foodservice settings such as hospitals, cafeterias, and food companies. 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 cafeterias. 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.
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Other Specializations
- Gerontological dietitians are specialists in nutrition and aging.
- 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.
- Pediatric dietitians provide nutrition and health advice for infants, children, and adolescents.
- Research dietitians may focus on social sciences or health services research, for example, investigate the impact of health policies or behaviour change, or evaluate program effectiveness. 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. In universities, they also may have teaching responsibilities.
- Administrative or management dietitians oversee and direct all aspects of clinical dietetics service, food policy and/or large-scale meal service operations in hospitals, government agencies, company cafeterias, prisons, and schools. They recruit, train and supervise employees of dietetics departments including dietitians and other personnel.
- Business dietitians serve as resource people in food and nutrition through business, marketing and communications. Dietitians' expertise in nutrition is often solicited in the 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. In addition, clinical/medical dietitians are required to undergo an internship in a hospital to learn counseling skills with patients and aspects of psychology.
Qualifications for Becoming a Registered Dietitian
Registered dietitians (RDs) are nutrition professionals who complete extensive coursework, an internship and pass an exam all in order to get their credentials.
A registered dietitian is to obtain a bachelor’s degree in nutrition or dietetics. Students take a variety of science and food courses, such as chemistry, physiology, food science, and foodservice management. In addition, to completing volunteer hours in nutrition. Complete a dietetic internship of at least 1,200 hours. This includes an extensive supervised program of practice working in clinical, food service, and community health care corporations. Pass the Registration Examination for Dietitians and fulfill the licensing/certification requirements of the state in which they plan to work. Licensing will either have RD, RDN, or RD/RDN stated which refers to Registered Dietitian or Registered Dietitian Nutritionist. Fulfill continuing education requirements that renew every five years.
Dietitian vs. Nutritionist
The terms “nutritionist” and “dietitian” are often used interchangeably, but they are not the same. They are certainly related since both professionals work in the field of nutrition, but these titles have distinct qualities. The biggest difference between dietitians and nutritionists is the legal rights they each have. Only nutritionists who become registered with the Commission on Dietetic Registration (CDR) may legally declare themselves as dietitians. They must complete all of the necessary work outlined above in order to do this.
On the other hand, the term “nutritionist” is much less protected under the law. Since the term “dietitian” is regulated and ensures that individuals with that title have completed extensive coursework and an internship, they are the ones who are allowed to provide medical nutrition therapy, whereas nutritionists legally cannot. On the other hand, some dietitians choose to go by nutritionists or registered dietitian nutritionists to be recognized by the public.
The Importance of Regulation
In many countries, only people who have specified educational credentials and other professional requirements can call themselves "dietitians"-the title is legally protected.
Examples of Regulation
- Australia: Accredited Practising Dietitians (APDs) in Australia gain their qualifications through university courses accredited by Dietitians Australia (DA). In order for patients to receive a rebate from the national Medicare system or private health insurance, APD status is required. 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, health care providers must, as of 2009, either have statutory registration or be members of their national professional association to obtain a provider number.
- 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) 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 nutritionists 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. The colleges also set the minimum entry requirements for admission into practice as a registered dietitian.
- 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. Dietitians and nutritionists are regulated under the Allied Health Professional Act in Malaysia. 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.
- South Africa: In South Africa, dietitians must be registered with the Health Professions Council of South Africa. 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. In addition to 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.
Seeing a Dietitian
It’s safe to say that meeting with one of these professionals would be a good idea if you would like to make adjustments to your diet. Dietitians can make recommendations for healthy substitutes, provide tips for portion control, and offer advice for how to make specific improvements to your diet in order to manage chronic health conditions. For example, a dietitian can work with those who have diabetes to count carbs and control blood sugar levels. They can also help individuals with other chronic diseases such as hypertension and COPD. Additionally, dietitians can help those with vitamin and mineral deficiencies. They are very knowledgeable about which specific foods are rich in these compounds. It’s also a good idea to consult with a dietitian as you get older in order to ensure that you are aging healthfully.