COVID-19 has impacted all of us. Despite the negatives, there have been some positive changes that have transformed the way we live, work, shop, exercise and seek medical care, including nutrition counseling services.

Nutrition counseling is defined as an ongoing process in which a person receives nutrition education and advice from a health professional, often a registered dietitian, to optimize dietary intakes. Nutrition is always a hot topic, and nutrition counseling is now widely available through a number of different platforms including in-person, telehealth, virtual visits and via social media.

Whether you have sought out a nutritionist or nutrition coach, have been referred to a dietitian or are interested in joining the field yourself, I want to take the time to sort out commonalities and dissimilarities within the various “nutritionist” titles out there. It can be confusing to know which is which. I will review what it takes to become a registered dietitian, certified health and wellness coach and non-licensed nutritionist.

Registered dietitian

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A registered dietitian (RD) is a food and nutrition expert who is able to provide scientific and evidence-based medical nutrition therapy, complete nutrition assessments, educate and counsel clients on clinical conditions, patients and family members, and offer a variety of additional nutrition-related job duties as outlined in the scope of practice and job description.

Registered dietitians need to meet the current academic requirements set forth by the Commission on Dietetic Registration, which includes the completion of a bachelor’s degree in dietetics and/or nutritional science-based degree through an accredited college or university.

Students pursuing a career in dietetics also complete a supervised practice experience or internship with at least 1,200 hours. Upon completion of an accredited bachelor’s degree and internship, successful completion of the registration examination is required. Starting Jan. 1, 2024, a graduate degree will also be required to be eligible for the registration examination. In addition, each state may require additional licensure or certification. Annual fees and 75 continuing education credits need to be completed over a five-year cycle. These are mandatory requirements in order to maintain an active status to practice legally. A registered dietitian is also a nutritionist and may hold the registered dietitian nutritionist RDN title. However, not all nutritionists are registered dietitians. A registered dietitian may work in a variety of settings, not limited to, health care, community and managerial positions. Registered dietitians with licensure in the state of Minnesota can bill insurance for the service.

Wellness coach

A national board certified health and wellness coach (NBC-HWC) is one who has a diverse education and professional background with the ability to work closely with clients to facilitate education and support in order to help achieve a client based health and wellness goals. These individuals need to follow a code of ethics and often work in corporate wellness, public and community health, and primary or private practice. To qualify for the national board certification exam, one must have an associate’s degree or higher, or 4,000 hours of any work experience, complete an approved coach training program with at least 75 contact training program hours, pass the health and wellness certifying exam and has documented 50 health and wellness coaching sessions.

Following certification, you need to complete a re-certification process, which includes 36 hours of continuing education every three years. Certified coaches can provide counseling to improve health through lifestyle and behavior choices and can support long-term goals. All national, board certified health and wellness coaches are considered health and wellness coaches but not all health and wellness coaches are national, board certified.

Non-licensed

For all the other non-licensed nutritionists or health coaches, any certifying body or state agency does not regulate these roles. Non-licensed nutritionists do not have any mandatory educational classes, requirements to fulfill or examinations to pass. One must have a thorough knowledge and understanding of nutrition and foods. Depending on the job, some employers require a minimum of an associate’s degree while others may require a master’s degree. Courses for a non-licensed nutritionist may be available through traditional colleges, universities or specialized trade schools. Non-licensed nutritionist or health coaches can work in a variety of settings, most often non-clinical, including fitness centers, holistic and alternative medicine clinics. They cannot bill insurance for the services provided.

Nutrition counseling is widely available, and the advice may differ depending on who you talk with. The biggest differences between a registered dietitian and nutritionist are the degree and education requirements, supervised practice experience hours and successful completion of the registration examination.

Registered dietitians by law can provide counseling and treat clinical conditions within the scope of practice and can bill insurance. Nutritionists can provide client counseling and education but cannot bill for service. In closing, be your own health advocate and seek reliable nutrition related information from a registered or certified professional who motivates you and supports your goals through sustainable counseling. When everything else is constantly changing, the desire to feel well, energized and balanced is constant and nutrition professionals are here to help.

Personally, as a registered dietitian, certified diabetes care and education specialist, licensed in the state of Minnesota and certified in the state of Wisconsin, I provide outpatient diabetes and nutrition education at St. Luke’s hospital and outreach clinics.

Tammy Licari
Tammy Licari

Tammy Licari, RD, CDCES, LD, CD, is a St. Luke’s Clinical Dietitian.