Making Sense of All Those Confusing Degrees and Credentials
Every month we get letters from members asking how to become a nutritionist. Many of our members want to learn more about Dr Price’s dietary laws in an academic setting while also gaining the credentials needed to be licensed and work professionally. We wish there were a simple answer.
First, let’s look at the term “nutritionist.”
A nutritionist can be anything from a PhD-trained professional to the friendly multi-level marketer down the street who is all too eager to testify to the healing powers of his or her brand’s (and only that brand’s) vitamins, shakes and energy bars. Assistants in the supplement sections at Whole Foods and other marketplaces probably call themselves nutritionists. So might your Uncle Harry if he both eats and has read a few diet books. “Nutritionists” may have advanced degrees or no degrees. They can be licensed professionals, gifted educators, idiot proseltyzers or opinionated people.
The term “nutritionist” is so vague, it is meaningless. To improve their credibility, some professionals have banded together to form organizations in which members are required to attain certain levels of expertise or competence, as determined by completing coursework, passing examinations, obtaining continuing education credits and otherwise proving their mettle. Indeed, nutritionists today can earn all sorts of certifications, some of which are respected, some less so or not at all. (We’ll discuss some of these later in this article.) Those who earn the right—or just pay the right fees—may be the only ones allowed to put certain trademarked initials after their name, but there’s nothing to stop people from calling themselves “nutritionists.”
The only thing that’s certain is that “nutritionists” cannot call themselves “dietitians.” The terms are not interchangeable.
The term “dietitian” (sometimes spelled dietician) can be used only by someone who has completed coursework approved by the American Dietetic Association (ADA). Registered Dietitians have jumped through additional ADA hoops, including completion of an approved internship and passing of the ADA’s CDR (Commission on Dietetic Registration) examination. Thereafter, they must keep up continuing education requirements and remain paid up members in good standing.
RDs can be licensed in any state that has licensing requirements, which is close to fifty at this writing. Because the ADA has a hammerlock on licensing in many of these states, it’s a valuable credential to have. Registered Dietitians can open a private practice or work for doctors, hospitals, schools, nursing homes and other institutions. Most such employers will only consider RDs for these positions.
The initials RD after the name confers credibility with mainstream publishers, and being an RD will also increase the likelihood of being quoted as an expert in the mainstream media. Subscribers to the ProfNet service—a networking service that matches reporters and producers with “experts” in many different fields—notice that many of the inquiries request a response only from RDs or MDs.
TRAINED TO DISPENSE PROCESSED FOOD
Registered Dietitians generally get a bad rap in the alternative medical and nutrition communities. After all, they are the people who serve up white bread, jello and foods fried with trans fats in school and hospital cafeterias, who help doctors enforce lowfat, low-cholesterol diet plans and advise weight loss patients to drink calorie-free diet sodas. Indeed, the ADA thinks that plenty of processed, packaged and fast foods, are just fine in the context of a varied diet. As Mary Enig, PhD, MACN, is fond of saying, “Dietitians are trained to dispense processed food.”
Although there’s an excellent chance that processed food would be poor nutritionally, the ADA generally advises against vitamins, minerals or other supplements. It also sees no reason to go organic, grassfed or non-GMO. As for raw milk, the very idea is unsafe, unsanitary, outdated, illegal and otherwise beyond the pale.
Jonny Bowden, PhD, CNS, celebrity nutritionist and fitness trainer and author of The 150 Healthiest Foods on Earth and numerous other books, pulls no punches when he writes about the ADA on his website www.jonnybowden.com. “The American Dietetic Association at this point has no useful purpose on the planet except to protect its union members and shill for its flatliner positions, which are now running about two decades behind their sell-by date.”
But as with any other profession, there is the herd that kowtows to the party line, and the leaders who have imagination, intelligence, conviction and courage. As Bowden puts it, there are RDs who “are brilliant and forward thinking. . . . but they will be the first to tell you that their organization—the ADA—is beyond horrific when it comes to advancing the health of America.”
This new breed of dietitian somehow survives in the belly of the beast. They may complete the required coursework and internship biting their tongues the whole time, be alternately bored and irritated at ADA conferences and dismiss the outdated information in some if not all of the official Position Papers. They are often gravely disturbed by the fact that ADA’s sponsors include Kelloggs, Nestles, General Foods, PepsiCo and other mega corporations. Furthermore, some are troubled by the fact that industry scientists, such as soy industry lobbyist and spokesperson Mark Messina, PhD, are hired to speak at conferences as if they are impartial experts.
Even so, most of these RDs value their credential.
SUPPLEMENTING ADA DOGMA
Many RDs are frustrated by the ADA’s opposition to routine supplement use, and say they learned in school to keep their mouths shut about vitamins in order to get their degree. The ADA has been saying “just eat right” for years. But Americans are not eating right. For the average American, the problem is the Standard American Diet (SAD) with all its processed, packaged and fast foods. For health conscious people lowfat, plant-based and even high-soy diets are fashionable. Both lead to deficiencies and imbalances that benefit from correction through supplements. That may be true even among those who use a nutrient-dense traditional diet for healing, especially if they cannot obtain raw milk or the other recommended healing foods. The reality is in this world many people do need supplements.
Rather than wait for the lumbering ADA to get on board, increasing numbers of dietitians have taken the steps to educate themselves about proper supplement use. For some this means self study, for others trainings and seminars that cover the latest findings in scientific journals and state-of-the-art laboratory testing. Most of these people agree that one-size-fits all prescriptions can look good on paper but are often outright wrong or inadequate on a person-by-person basis.
According to the International and American Association of Clinical Nutritionists (IAACN) Clinical Nutrition Certification Board (CNCB), clinical nutritionists use “case history, anthropomorphic measurements, physical signs, laboratory tests, and nutrition/lifestyle analysis” in order to assess an individual patients’ needs for dietary and nutritional optimization. From this assessment, a prescription can be made and, if needed, a proper referral to a physician or other medical professional.
Both the IAACN and the American College of Nutrition (ACN) count RDs in their midst. At CCN conferences the RDs even make it a point to get together one night. Although the numbers are small compared to the total forty-four thousand RDs in the ADA, they are making their voices heard both within and without their organization.
“RDs are changing,” says Deborah Ford of Van Wert, Ohio, “A lot of us are now into functional and integrative medicine. I call myself RD/Clinical Nutritionist so I won’t be tagged as one of the outdated, old-style RDs. No white shoes and hair net here.”
Ford opened the Good Earth Health Food Store thirty-three years ago. Soon afterwards, her state passed a licensing law that made it illegal for anyone but an RD to dispense nutritional advice. “I had been reading journals. I knew my stuff, but every time someone came in I felt like I might soon be on the butcher block,” says Ford. Rather than just hope for the best or try to get around the law by calling herself an “educator,” Ford went back to school to take all the pre-med and nutrition courses necessary to became an RD. She then decided to “sink my teeth into the science” and went on to earn a Master’s Degree in Human Nutrition at the University of Bridgeport, and then topped that with the Certified Clinical Nutritionist (CCN) credential.
Ford has not chosen to leave the ADA behind; instead she has helped it move forward. “The ADA is moving slowly and I’ve had to learn to be patient, but as with any old organization, changes comes slowly,” she says. “As alternative medicine has become more and more evidence based, ADA has been forced to take it seriously. They can no longer sweep it under the carpet.” Indeed, Ford is active in an ADA practice group studying complementary medicine, herbs and genetics, and notes that attendees at some ADA conferences start the day with yoga sessions, “and they get credit for that!”
DIETITIAN OF THE YEAR
Betty Wedman-St. Louis, PhD, RD, LD, was recognized by the ADA as “Young Dietitian of the Year” in 1974 and won the Allene Van Son Award from the American Association of Diabetes Educators in 1987. She worked at ADA headquarters for two years and is widely recognized in the RDA ranks as the author of a series of practical books for diabetics, including Fast and Simple Diabetes Menus, Diabetes Meals on the Run, Diabetic Desserts and the Quick and Easy Diabetes Menus Cookbook. She started on the establishment academic path, earning her BS in Foods and Nutrition from the University of Minnesota and MS in Foods and Nutrition from Northern Illinois University.
In mid-career, Wedman-St. Louis fell ill due to sick building syndrome and multiple chemical sensitivities. Rather than give in to a life of fatigue and debility, she determined to find out what was making her sick, why this was happening and how to reverse it. Her successful struggle to heal herself led to a firm commitment to understand the science behind her recovery and use it to help others. To this end, she earned a PhD in Nutrition and Environmental Health from Union Institute and University and has become a leading advocate for the growing numbers of people suffering from multiple chemical sensitivities. Her book Environmental Illness –The Growing Health Effects of Chemical Pollution is a comprehensive guide to healthy living through clean air, pure water and nutritious food. Today she teaches in the alternative medicine program at Everglades University in its Sarasota, Florida branch, works privately with clients and writes books. Of particular interest to WAPF members will be a book an how the small amounts of non-irradiated herbs and spices as used traditionally in cooking can promote health and healing.
QUACKS, QUACKPOTS AND QUACKBUSTERS
As these examples make clear, many RDs today remain open to new ideas, even ideas that the Mother House frowns upon. Most of these renegade RDs work quietly and don’t attract the attention of the ADA, but a few have been publicly vilified as quacks. The most prominent of these was the late Shari Lieberman, PhD, CNS, FACN.
Dr. Lieberman earned her PhD in Clinical Nutrition and Exercise Physiology from the Union Institute, Cincinnati, Ohio, and her MS degree in Nutrition, Food Science and Dietetics from New York University. She was a Certified Nutrition Specialist (CNS), a board member of the Certification Board for Nutrition Specialists and a Fellow of the American College of Nutrition (FACN). In addition, she was a member of the New York Academy of Science and the American Academy of Anti-Aging Medicine (A4M). She was also President of the American Association for Health Freedom and received the National Nutritional Foods Association 2003 Clinician of the Year Award. Dr. Lieberman was also instrumental in creating and implementing master’s programs in nutrition at the University of Bridgeport and New York Chiropractic College. These are two of the best regionally accredited programs available today for those who want to explore alternative non-ADA ideas in a rigorous long-distance learning programs.
In the early 1990s, however, Lieberman had not yet earned her PhD nor won her many other honors and still valued her RD credential. She lost it for a time when the ADA took issue with her promotion of megavitamin therapy.
As one of the coauthors of The Real Vitamin and Mineral Book (first published by Avery in 1990), Lieberman proposed the use of vitamin and mineral supplements not only to protect against disease but to reach the highest levels of mental and physical well-being. Lieberman recommended scientifically documented Optimum Daily Intakes (ODI), which were generally well above the government’s Recommended Daily Intake (RDI). In contrast, the ADA’s position— as stated on their website and in their press releases—was that 100 percent of the government standard was the most that anyone would require in a supplement, provided they needed a supplement at all, which would be unlikely.
In 1994, the American Dietetic Association struck, suspending Lieberman’s RD credential for three years because of her alleged failure to adhere to the ethical standards set by the ADA. At issue was Principle 7 of the 1985 ADA Code of Ethics, which states, “The dietetic practitioner practices dietetics based on scientific principles and current information.”
The man behind the attack was not an ADA official all but Stephen Barrett, MD, the infamous “quackbuster.” Barrett’s website, www.quackwatch.com, has been heavily touted by the AMA, FDA and FTC, AARP and numerous other organizations with ties to the medical and pharmaceutical cartels. Over the years, Barrett has savaged many practitioners of alternative, complementary, integrative and holistic medicine, especially chiropractors. He was also outspokenly critical of two-time Nobel prize winner Linus Pauling.
Barrett calls himself a retired psychiatrist. However, in a 2007 court proceeding in Allentown, Pennsylvania, under heated cross examination, attorney Carlos Negrete exposed the fact that Barrett had never actually practiced psychiatry and had not even passed his credentialing exam. The legal team for that case included James Turner, Esq, counsel for the Weston A. Price Foundation.
Back in 1994, Barrett testified against Lieberman at a hearing he instigated before the ADA. In testimony, he represented himself as knowledgeable about nutrition despite his lack of any formal academic training or publications in that field. Despite this, the ADA found Lieberman guilty as charged and stripped her of her RD credential. Lieberman then launched a forty million dollar defamation lawsuit against the ADA. In court proceedings, it became clear that Barrett had falsified the charges against her and had no expertise. Learned testimony from heavily credentialed experts in nutritional science, convinced the ADA to settle the case.
The ADA reinstated Lieberman’s RD credential and published a statement noting this fact in the ADA’s Journal and Courier. Other details including any damages paid to Lieberman for humiliation and loss of credibility are not a matter of public record. As per the terms of the settlement, Lieberman could never speak of, or advertise, her win. For this reason, the victory has not freed other dietitians as much as might have been hoped.
“Shari became a hero in the alternative and complementary field,” says Wedman-St. Louis, “but most dietitians never heard about it.” Nor has it completely stopped ADA from disciplining other free-thinking members. “It’s the same ADA,” says H. Ira Fritz, PhD, CNS, FACN, “but they are now a lot more careful and seek better legal counsel.” What everyone familiar with the case agrees on is that they were not smart to make an example of Shari Lieberman. She was just too smart, too feisty and too well connected to take it lying down.
THE RD ADVANTAGE
These stories make it clear that there are pros and cons to becoming— and being—an RD. Those who wish to make a difference in public hospitals or school cafeterias will have an extremely difficult time getting hired unless they take this route. Practitioners who want to receive referrals and listings with insurance plans need to consider this option as well. “In some corporate wellness plans, people are permitted to seek dietary advice, but usually only with an RD,” says Deborah Ford, MS, RD, CCN. “If prevention becomes an important part of health reform, we know RDs will be part of the program. Prevention has been a big focus in the new health care reform, with RD visits allowed up to four times per year.”
People who prefer to practice nutrition with a license should also weigh the RD option carefully as it is the ticket to licensing nearly everywhere. Although most nutritionists stay under the radar and never attract ADA whistleblowers, a few do, and not everyone is cut out to be a martyr. Although some states have loose requirements and lax enforcement, the trend today is towards licensing. The era of people talking about nutrition while calling themselves “educators” or “ministers” is coming to an end. The good news is that despite the ADA’s best efforts, there may be other options for licensing.
LETTERS AND THE LAW
The ADA still lobbies for laws that make it illegal for anyone but an RD to dispense dietary advice, but they are enjoying fewer and fewer successes. “There has been an organized process by the American Dietetic Association to make everyone believe that they are the only credible source for nutrition advice,” says Melvyn Grovit, DPM, MS, CNS, and President of the Certification Board for Nutrition Specialists of the American College of Nutrition (ACN). “Recently the ACN became affiliated with the American Association for Health Freedom (www.healthfreedom.net) to fight the choke hold that the ADA has on credible nutrition expertise.” The International and American Association of Clinical Nutritionists (IAACN) in Dallas, Texas, has also actively lobbied for licensing of Certified Clinical Nutritionists (CCNs) and won victories in a few states.
Wedman-St. Louis PhD, RD, LD, speaks for many when she says, “I strongly believe that no one organization should have control over who is licensed.” It’s only right, after all, to allow highly educated and credentialed men and women to practice nutrition. Many of the leading figures in the field of nutrition are not dietitians. For example, Mary G. Enig, PhD, MACN and Vice President of the Weston A. Price Foundation, is licensed as a nutritionist in the state of Maryland. Marion Nestle, MPH, PhD, the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University and author of Food Politics and What to Eat, is licensed in the state of New York.
Licensing laws for nutritionists vary from state to state. RDs are shooins everywhere. As for just about everyone else, the rules are inconsistent, unpredictable and changeable. The time to investigate these laws is before going back to school and investing time and money in a degree, certification or other program. It’s also a good policy to call the appropriate regulatory agency to learn whether new laws are in the works. Good to also check out neighboring states in case you might open an office there. It’s a mistake to assume that you can practice as you please so long as nutritionists with few or no credentials are in business. Such people may either have been lucky enough not to attract attention or may have been grandfathered in.
Wedman-St. Louis, PhD, RD, LD, recommends the cautious approach. She advises her students at Everglades University to become an RD or an LD/LN if they wish to practice nutrition. The latter stands for Licensed Dietitian or Licensed Nutritionist. “RD has reciprocity among the different states. You can easily move around. LD or LN is not reciprocal from state to state, and licensing requirements vary greatly,” she explains. Some states, for example, accept a master’s degree or PhD from a regionally accredited college whereas a nationally accredited or non-accredited school will not pass muster. In some states, such as New York State, the respected CNS credential will suffice.
In some states non RDs who meet educational and/or credentialing criteria must sit for a state exam, typically the very same Bachelor’s level CDR exam required of RDs. This test can be challenging for test takers who have no plans to ever work in a hospital or manage a school cafeteria for they will need to be up to snuff on tube feeding, diabetic exchanges, food service management and other issues that will most likely be irrelevant to their practice. (See Sidebar below for sample test questions.) To learn your state’s requirements, go online to www.cdrnet.org/certifications/licensure/agencylist.htm. However, it is wise to not trust any one source and check into the most current regulations in your state.
Accreditation is the primary means by which colleges and universities assure quality to students and the public. Legitimate accrediting agencies are independent organizations approved by the U.S. Department of Education. Accredited status means minimum standards have been met in terms of faculty, curricula, student services, libraries and fiscal stability.
Regional accreditation is the gold standard. Well-known, well-established brick-and-mortar colleges such as Harvard, Vassar, Stanford, Rice, Oberlin, University of Michigan, and the University of New Mexico at Albuquerque are regionally accredited. So are most community colleges. Regional accreditation is conferred by one of six regional accrediting bodies according to location. These are the Middle States Association of Colleges and Schools; New England Association of Schools and Colleges; North Central Association of Colleges and Schools; Northwest Commission on Colleges and Universities; Southern Association of Colleges and Schools; the Western Association of Schools and Colleges; and Accrediting Commission for Community and Junior Colleges.
In recent years, national accreditation bodies have sprung up to meet the needs of newer schools, including long-distance learning institutions. The most respected of these is the Distance Education Training Council (DETC), which has been accrediting long-distance learning schools—formerly known as correspondence schools—since 1955. Both the Council for Higher Education Accreditation and the United States Department of Education recognize the DETC as a legitimate accrediting agency. DETC schools are often niche schools that offer specialized degrees or types of training. Although many graduates from DETC-accredited schools have used their degrees to advance in their careers, others have found to their dismay that the degrees carry little weight compared to those from regionally accredited schools.
One of the biggest problems reported with DETC accreditation concerns transfer of credits. Whereas credits from regionally accredited schools tend to transfer easily to other regionally accredited schools, credits from DETC-accredited schools may be viewed askance. Some schools accept DETC credits, some give partial credit and some will reject the transcript outright. According to DETC’s own study of the transfer situation, students attempting transfer of credits succeed about two-thirds of the time. The DETC blames the rejected credits in part on anti-competitive business practices in higher education.
In the field of nutrition, a big problem is the unwillingness of some state licensing boards to accept a DETC-accredited education as valid.
The DETC has high standards and a thorough review process. However, it’s buyer beware when it comes to some other national accrediting agencies. The worst of these are spurious, startup organizations founded only to give credibility to substandard programs and diploma mills. If a college says it’s accredited, get the details, follow through to confirm, and carefully consider whether this form of accreditation will meet your specific career needs.
Many well-known schools in the alternative health, nutrition or fitness fields are either not accredited, or not optimally accredited. These include vocational schools such as Clayton College of Natural Health*, Hawthorn University, Bauman College of Nutrition and Culinary Arts, the Optimal Performance Institute and others. Many people enjoy their coursework at these institutions, and use the knowledge, experience and degrees for career building. The cost can be substantially less than at accredited schools.
Compared to traditional schools with their AMA- ADA-approved curricula, non-accredited places are far more likely to be open-minded, forward thinking, willing to entertain opposite sides of an issue and respectful towards traditional diets. But those who compare required reading lists between regionally accredited and non-accredited institutions, will see why some non-accredited colleges don’t get much respect. For example, a pathophysiology course offered at Santa Fe Community College at the associate’s level required a dense and oversize 700-page textbook. A similarly named course at a “doctoral level” at non-accredited university required reading Ann Louise Gittleman’s 208-page popular book Guess What Came to Dinner: Parasites and Your Health. However students at the community college spent months memorizing facts without clear practical application whereas Gittleman’s readers were introduced to the role of parasites in allergies, chronic fatigue syndrome, bowel disorders and other ailments, to ways to parasite-proof food and water at home and while traveling, to methods of detection, to anti-parasitic treatments, and to herbal remedies. The ideal learning experience would be a course with a real textbook that would also allow students to explore the hard science behind Gittleman’s book.
Accreditation can be a complicated, time-consuming and troublesome process, both to initiate and maintain. It requires a major commitment of time and money that smaller institutions may not be able to make. Despite castigation by Stephen Barrett of QuackWatch and other pro ADA/AMA groups, most of the non-accredited schools that permit the study of supplements, herbs, homeopathy, aromatherapy, iridology, reflexology and other alternative subjects are legitimate learning institutions. When choosing a school, lack of accreditation is a signal to “look out” but not an automatic disqualifier. The question is whether a non-accredited education will serve in terms of immediate and long-term career goals.
Karen Lyke, MS, CCN, DANLA, has chosen to earn a non-accredited doctorate after earning a long list of formidable credentials. She earned her Master of Science in Human Nutrition at the University of Bridgeport, a program she chose because the program is “substantial” and also regionally accredited. “It’s important for holistic nutritionists to understand the science, to be able to communicate with people in all dimensions of the healing arts, she says. Lyke’s credentials also include CCN (Certified Clinical Nutritionist) and DANLA (Diplomate in Advanced Nutritional Laboratory Assessment) from the Clinical Nutrition Certification Board (CNCB). She completed the (IFM) Institute for Functional Medicine’s AFMCP (Applying Functional Medicine in Clinical Practice) foundation week in 2007, and regularly attends IFM, IAACN and National Autism Association symposia. Now living in northwest Ohio, Lyke has a small private practice and teaches at Hawthorn University. She is also now a candidate for Hawthorn University’s Doctorate in Holistic Nutrition Education—a study experience she describes as “unique because it’s not draining but exhilarating and enlivening.”
Non-accredited schools are not interchangeable with “diploma mills.” Diploma mills allow people to buy bachelor’s, master’s, doctorates and even law and medical degrees upon the payment of a fee. Transcripts and diplomas can be provided and may even look authentic. Some of these require a minor amount of work—perhaps a few months study or a short “dissertation.” Others require only the fee. If it sounds too good to be true, it probably is!
The numbers of diploma mills diminished in the 1980s because of the “DipScam” (DiplomaScam) task force of the FBI. However some still exist, as is obvious to anyone who gets email: “GET YOUR DIPLOMA TODAY! If you are looking for a fast and effective way to get a diploma, this is the best way out for you. Provide us with degree you are interested in. Call us right now . . . ”
Many WAPF members have asked for an accredited long-distance learning program to study nutrition, preferably one that teaches Weston A. Price principles as the one true path. They may have a farm in a remote part of the country, be too busy raising children to attend school full time or be unable or unwilling to move. Some members who could attend a traditional college nearby have chosen not to do so because of the ADA- or AMA-driven curriculum.
Currently two distance-learning schools offer master’s degrees in nutrition and hold the gold standard of regional accreditation. These are the University of Bridgeport in Connecticut and New York Chiropractic College. Though Dr. Weston A. Price’s findings play a minor role at best in these programs, they place a value on whole foods, real foods and slow foods, and perceive the dangers of processed, packaged and fast foods. Both programs emphasize an integrative approach to health care with a focus on using diet and nutritional supplements to prevent, manage and reverse disease.
Since 1977, the Nutrition Institute at Bridgeport has offered courses in nutrition, clinical biochemistry, counseling, biostatistics and public health leading to an Master of Science degree in Human Nutrition. Substantial prerequisites in the sciences are required. In the weekend program, classes are held on the Bridgeport campus, one weekend per month for eighteen consecutive months. For the online degree program, students interact with professors and other students by email and through an online discussion board. They need show up on campus only once—for a final, comprehensive examination. Bridgeport’s Human Nutrition Institute also offers an annual Practice Management Workshop and internship opportunities.
Martha Pickard, MS, of Gabriels, New York, is Grazing Program Coordinator for the Adirondack North Country Association. After studying environmental sciences at Paul Smiths College and Natural Research Management at Cornell, she entered the Master’s Degree in Human Nutrition program at Bridgeport because it was the only program on the east coast that offered a holistic approach to nutrition, regional accreditation and an on-campus option. “I didn’t feel that I would do well with an on-line program,” she says. “I wanted to be in the classroom. I drove to Bridgeport one weekend a month for two and one-half years.”
Pickard feels Bridgeport gave her a strong foundation in biochemistry and nutritional sciences. “The curriculum was not completely in-line with WAPF philosophy, but Price was discussed in several classes, and I was able to write my thesis on raw milk and child asthma and allergies.” The biggest drawback was a lack of opportunity for hands-on clinical time.” Supervised clinical time is now a priority for her as it is required for both her CNS credential and New York State license. Her desire to build a practice in line with WAPF principles led her to choose an internship with Kaayla T. Daniel, PhD, CCN, author of this article.
New York Chiropractic College offers Masters Degree in Applied Clinical Nutrition, which is open to other candidates besides chiropractors. The program focuses on nutrition and its application to disease prevention and management. Graduates are trained to practice in a wide range of clinical, consulting and industry settings. While a background in health care is not required in order to be accepted into the program, clinical experience may be necessary in order to be licensed. Students need to come to campus one weekend per month throughout the two-year program.
One college—Huntington College of Health Science—has been nationally accredited by DETC. It claims to be the first and only distance learning nutrition college to earn this accreditation. Huntington offers an Associate of Science degree in Applied Nutrition, a Bachelor of Health Science degree in Nutrition, a Master of Science degree in Nutrition, and many individual undergraduate and graduate courses. Founded in 1985 as the American Academy of Nutrition, it changed its name to Huntington in 2005.
For years, the Union Institute and University in Cincinnati was a respected choice for a regionally accredited, long-distance learning school offering a PhD. Although Union still exists, learners can no longer concentrate in Nutritional Sciences, Environmental Health Sciences, Exercise Physiology or similar fields. H. Ira Fritz, PhD, CNS, FACN, now emeritus professor at both Union and Wright State University in Dayton, was the “first core” mentor there for a number of superstars in the nutrition field including Lieberman, Wedman-St. Louis and Kathleen DesMaisons, a leader in the field of nutrition for addictions and author of Potatoes not Prozac. His reputation was so formidable that Robert Crayhon, MS, CNS, director of Crayhon Research and organizer of the BoulderFest conferences, nicknamed Union “The Fritz Institute.” Kaayla Daniel, author of this article, received her PhD there under the guidance of Fritz. “He was well known at Union as a ‘tough first core.’ He required rigorous thinking and academic excellence. He was tolerant of alternative viewpoints but showed little tolerance for shoddy scholarship. Some Union learners sailed through easy programs, but not those of us who signed on with Ira.”
What to do right now? “There really isn’t a good choice,” according to Fritz. He is not a fan of nationally accredited or non-accredited institutions. They are just not rigorous enough or credible enough. “Taking the route of least resistance may get you somewhere,” he says carefully, then asks, “but is it really where you want to go? This obviously has to be answered on an individual basis, but as someone who looks at credentials, I don’t recommend it.”
Until a suitable, regionally accredited, long-distance PhD program becomes available, Fritz recommends completing a master’s degree or PhD program at a traditional, regionally accredited school. For many alternative-minded people, the most viable option might be “biting the bullet” at a state college and earning, say, a Masters in Public Health or Health Education. These programs are widely available at state colleges, take about two years, and they cost considerably less than private colleges. Upon completion, graduates can then move on to become expert in alternative areas through any number of high quality certifying and credentialing groups.
AN UNUSUAL ADA-APPROVED OPTION
Bastyr University in Seattle is a regionally accredited school with rigorous programs at the bachelor’s, master’s and doctoral level in naturopathy, traditional oriental medicine, nutrition and other subjects. Those who think the programs will be easy because they are “alternative” will find themselves in for a lot of hard work, some of which will take place before they even begin. Depending on their previous science background, students are required to take some serious chemistry, biology and anatomy and physiology courses as prerequisites.
As part of its goal “to be in the forefront of developing the model for 21st century medicine,” Bastyr recently introduced an ADA-approved dietetic program. Bastyr is the only school in the country with a whole-foods approach to nutrition that is approved by ADA for RD-track students. It offers a both a Bachelor and Master of Science Didactic Program in Dietetics as well as an approved dietetic internship. Although some students complain that the program is not sufficiently alternative, it can obviously go only so far and still be ADA approved. Bastyr does not offer online or long distance learning. Students will need to move to Seattle to enroll in this program.
The best route to practicing nutrition might be to not become a nutritionist at all. People leaning towards alternative medicine might be better off as a naturopath, oriental medical doctor, chiropractor or even MD. These licensed professionals can generally practice nutrition without fear, especially if it is within their “standard of practice,” a term that refers to both the profession’s definition of itself and pertinent licensing laws.
Naturopaths, for example, consider nutrition an integral part of their practice along with the many other modalities such as biofeedback, herbology or homeopathy. Although old-time naturopaths practiced freely without a license, sixteen states now require a license and more states will surely follow. Regionally accredited programs for obtaining an ND require science prerequisites typical of pre-med programs, take three to four years to complete and include some practicum. States that offer licensure may also require a post-graduate internship and a passing score on a professional board examination. Today three colleges offer regionally accredited naturopathy programs: Bastyr in Seattle, The National College of Natural Medicine in Portland and Southwest College of Naturopathic Medicine and Health Sciences in Phoenix. The National University of Health Sciences in Lombard, Illinois, is progressing towards regional accreditation.
Any Oriental Medical Doctor who is properly licensed can probably practice nutrition. OMDs focus on the restoration of health by promoting and regulating a harmonious balance of yin, yang and qi. Standard therapeutic methods include acupuncture-moxibustion, herbal medicine, nutrition, massage and other bodywork, and qigong.
For chiropractors, nutrition is not necessarily a part of their “standard of practice.” That might seem surprising given the frequency with which chiropractors practice nutrition as an adjunct to spinal adjustments, but the legality may depend on their degrees, credentials and state laws. Some might be able to practice applied kinesiology or muscle testing with no problems provided that they don’t also sell supplements.
It’s a rare MD who takes even one nutrition course while in medical school, but some go on to study the subject extensively and obtain genuine credentials in the field. Either way, the MD can dispense nutritional advice at will. “They can do what they want. They are Gods,” says Wedman-St. Louis.
ALPHABET SOUP: CONFUSING CERTIFICATIONS
Hundreds of nutrition certification and accrediting programs and associations exist, running the gamut from well-known and respected to not worth a diddle. It’s fine to be able to hang a handsome framed certificate in your office certifying that you are a Nutrition Specialist, Health Counselor, Integrative Health Pro, Certified Metabolic Typer Trainer or whatever, but what does it really mean? Will it help you get licensed, work with reputable laboratories, network with esteemed colleagues and attract clients? Will it serve as a fond reminder of an inspiring learning experience? Or will it just hang heavily on your wall as an expensively obtained piece of art?
Two very respected credentials are the Certified Nutrition Specialist (CNS) and the Certified Clinical Nutritionist (CCN). Both are backed by established organizations and can lead to licensing in some states. Both organizations count chiropractors, pharmacists, MDs, NDs, DCs and other health practitioners as well as qualified nutritionists in their ranks.
CERTIFIED NUTRITION SPECIALIST (CNS)
The Certification Board for Nutrition Specialists (CBNS) is the certifying arm of the American College of Nutrition (ACN). It allows nutritionists and other health professionals with master’s and doctoral level degrees from regionally accredited institutions to earn the Certified Nutrition Specialist (CNS) credential. Candidates must pass a rigorous written examination covering the broad science of nutrition, including clinical and research applications. CNSs must then maintain their certification by earning extensive continuing nutrition education credits, generally through attendance at educational programs in nutrition, such as the annual scientific—clinical meetings of the American College of Nutrition. The ACN was formed fifty years ago to foster high quality nutrition education, provide a forum for information sharing and discussion, lobby for mandatory nutrition courses in medical schools, and advocate for nutrition-minded doctors and other health professionals. It publishes the peer reviewed American Journal of Clinical Nutrition.
The ACN honors nutritionists who are leaders in their field. Fellows of the American College of Nutrition are permitted to use the initials FACN. They hold doctoral degrees, expertise as practitioners or educators and a publication track record. Dr. Fritz is a FACN. So was Dr. Lieberman. Dr. Mary Enig has been honored as Master of the American College of Nutrition (MACN), a prestigious category for those who have made outstanding contributions over an extended period of time to the field of nutrition.
CERTIFIED CLINICAL NUTRITIONIST (CCN)
The Clinical Nutrition Certification Board (CNCB) is the certifying arm of the International and American Association of Clinical Nutritionists (IAACN). Certified Clinical Nutritionists (CCN) must meet numerous requirements, including completion of core science and nutrition credits at regionally accredited colleges, clinical experience or an approved internship, attendance at the Post Graduate Seminars in Clinical Nutrition Program put on by the CNCB and the passing of a rigorous examination. To keep the credential, CCNs must meet continuing education requirements, particularly attendance at annual conferences and be recertified every five years. Although the focus of the IAACN is on nutrition, very few nutritionists are included among its speakers, almost all of whom are male MDs, DCs and RPhs.
The IAACN is a professional association of clinical nutritionists founded in 1983. Its services include advocacy at both state and national levels. Initially a Florida State organization, its founders soon realized the need for national and international professional standards, and for regulation and protection beyond the state level. Today IAACN closely monitors legislation that impacts the field of nutrition and coordinates needed legislative action. It also publishes the peer reviewed Journal of Applied Nutrition.
INSTITUTE OF FUNCTIONAL MEDICINE
The Institute of Functional Medicine (IFM) was founded in 1991 by Jeffrey Bland, PhD and his wife Susan Bland, MA. The Institute trains physicians and other nutrition-oriented practitioners to identify and correct clinical imbalances underlying disease in order to help the body to then heal itself. IFM offers a symposium and courses eligible for credit. A six-day on site course, Applying Functional Medicine in Clinical Practice (AFMCP), which can cost over thirty-five hundred dollars, plus travel and hotel expenses, is the first requirement towards becoming an IMF certified practitioner. Six two-day onsite Advance Practice Modules costing up to seventeen hundred dollars each plus travel and expenses, follow. The topics are Restoring Gastrointestinal Equilibrium; Understanding Biotransformation and Recognizing Toxicity; Menopause, Andropause and Mood Disorders; Diabetes, Insulin Resistance and Vascular Dysfunction; Fatigue and Oxidative Stress; and Pain, Inflammation and Immune Dysfunction. Follow-up webinars with case studies follow each module. Candidates then must review, pass a challenging exam and present case studies to earn this credential.
The Institute for Functional Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Becoming a Certified Practitioner (CP) with the IFM is clearly a rigorous credential for anyone, and has attracted numerous CNSs, CCNs and other highly qualified candidates. Membership is easy, becoming credentialed with IFM is time-consuming, difficult and extremely expensive. Not surprisingly, most who go all the way are physicians. Members, however, include many nutritionists who say they feel welcome, not only at conferences but all year through teleconferences and other educational opportunities.
Indeed, expense is a major roadblock for many health practitioners interested in earning and maintaining credentials such as CNS, CCN and IFM’s Certified Practitioner. What’s more, not everyone wants to focus their nutrition practice upon laboratory assessments and supplement protocols. Pharmaceutical to nutraceutical, after all, represents continuation of a medical model. Some nutritionists actually want to focus on food!
Attendees at these professional conferences hear warnings against trans fats, sugar, artificial sweeteners and gluten, as well as against the overall category of processed, packaged and fast foods, but food always plays second fiddle to pills and products. Whatever food recommendations participants receive may be lowfat and plant-based. From a Weston A. Price Foundation point of view, such recommendations will almost certainly lead over the long term to deficiencies and imbalances that would require either supplements or dietary adjustment to correct. Yet WAPF principles are rarely mentioned at these conferences or in trainings. A lecture on depression, for example, would likely address diverse causes ranging from diet and drugs to stress, examine laboratory and other assessment options, and review the research on St. John’s wort, SAMe, Vitamin D, folic acid, DHA and EPA, etc, but never mention cod liver oil.
The National Association of Nutrition Professionals (NANP), founded in 1985, is non-profit business league that is open to nutritionists, MDs, naturopaths, nurses, chiropractors and other health care practitioners, as well as independent consultants, marketing representatives, educators, authors, teachers, retail buyers, store owners, managers, chefs and others in the field of nutrition. Through its annual conference, trade publication Nutrition Professionals Quarterly, email updates and other means, NANP helps keep members apprised of state and national legislation, job opportunities, continuing education opportunities, upcoming events and news about holistic nutrition and whole foods.
Liz Lipski, PhD, CCN, and a special advisor to the NANP, is the Educational Director and the Director of Hawthorn University’s Doctorate of Science in Holistic Nutrition Program. She supports NANP’s acceptance of nutritionists with a wide variety of credentials, including degrees from non-accredited vocational schools such as Hawthorn, Clayton College of Natural Health, Bouman College of Nutrition and Culinary Arts, and others. Lipski received her PhD in clinical nutrition with a specialization in integrative medicine from the regionally accredited Union Institute. She has also served on the faculty and advisory board of IFM and spoken twice at IAACN conferences.
“The public has demanded holistically oriented nutrition professionals who have a recognized standard of care and scope of practice,” says Lipski. “Yet many professional organizations exclude many qualified nutrition professionals, nutrition educators and chefs. NANP has come to fill this gap. It differs from others by focusing first on whole foods and lifestyle, and second on use of nutritional supplements, herbs and lab testing. As a coalition, we can effect more change for sustainable agriculture and organics, while having fun and continuing to learn.”
In 2008 Lipski sat for NANP’s certification exam, which she describes as “a comprehensive and fair test, not a slam dunk. I felt proud to have passed.” Her goal is for the NANP credential to become respected and sought after worldwide. She also hopes it will become the title of choice among holistic practitioners. The NANP website explains why:
“Currently, holistically-trained nutrition professionals obtain their title from the school from which they received their nutrition education, including Certified Nutritionist (CN), Certified Nutrition Consultant (CNC), Certified Nutrition Educator (CNE), and Certified Nutritional Therapist (CNT). Not only has the myriad of nutritional titles fragmented the profession, but it has also discredited us by creating confusion among consumers and other health professionals. The credentialing board being created by the NANP aims to create one title/designation that is based on educational standards, a registration process, and passage of a national board exam, thereby aligning the credentialing of holistically trained nutrition professionals with the manner in which other types of health professionals are credentialed.”
“As the NANP builds a strong presence, it will encompass RDs, CCNs, CNSs and many others, and will become extremely influential,” says Karen Lyke, MS, CCN, DANLA. “A strong corps of holistic nutritionists will provide the twenty-first century’s standard for real healing, health based on science and rigorous understanding of the natural forces from which all life stems.”
CERTIFIED NUTRITIONIST (CN)
The Certified Nutritionist (CN) credential is a registered trademark of the American Health Sciences University, a distance learning school founded in 1980 and based in Oak Harbor, Washington. AHSU was nationally accredited by DETC, but one was shut down and is now reopened. Its MS program in nutrition is no longer available, but students can still enter a CN certification program. This involves taking six courses, passing an examination and completing what is called an “externship,” an internship of one hundred fifty hours. The required “textbook” for each course is a single popular book, for examples, the useful-but-limited book Breaking the Vicious Cycle by Elaine Gottschall for the course “Intestinal Health through Diet,” and the inaccurate book Fats that Heal Fats that Kill by Udo Erasmus for the course “The Importance of Fats and Oils in the Diet.”
Despite these limitations, many holistic nutritionists have gotten their start with a CN credential from AHSU.
Jen Allbritton, CN, earned a BS in Kinesiology (the study of human movement) with an emphasis on nutrition, at the College of William and Mary in Williamsburg, Virginia. She later decided to earn her Certified Nutritionist credential from American Health Sciences University, a school that was then accredited through DETC.
Allbritton began her career as a nutrition coordinator for a popular health food chain in Colorado. She oversaw nutrition education, presented lectures to the community and wrote article for the company’s monthly publication and the Denver Daily News. Once she became familiar with the Weston A. Price Foundation, she began to incorporate its principles into her work. “For the most part, the company I worked for followed the lowfat mantra. I was able to direct educational pieces towards traditional foods and highlight the benefits of saturated fats and fat-soluble vitamins.” In 2005, after Allbritton and her husband adopted their second child, she left her job and volunteered to write the column “Growing Wise Kids” for Wise Traditions. “Having been a member of WAPF for years, I noticed the need for more information about incorporating traditional foods into family life. It has been a fun column to write, as it reflects where I am in life. Feeding my family nourishing traditional foods is a passion.”
CERTIFIED NUTRITIONAL COUNSELOR (CNC)
The Certified Nutritional Counselor (CNC) is trademarked credential issued by the American Association of Nutritional Consultants (AANC). Those who earn this credential take a series of eleven open-book tests. To quality, candidates must have one year of previous education and/or experience in nutrition or another health-related field, pay a fee and successfully complete the certification exams. Test questions come from just eleven books. For “Children’s Health” it’s Kid Smart by Cheryl Townsley; for “Medical Chemistry,” it’s Guide to Body Chemistry and Nutrition by Bernard Jensen and for “Diet and Nutrition,” it’s the book Diet and Nutrition: A Holistic Approach by vegetarian Rudolph Ballentine.
The CNC credential has been labeled “bogus” by Quackwatch. Rather than call CNCs quacks, which would need to be determined on a case by case basis, it would be more accurate to alert consumers to the fact that CNCs may have marginal qualifications. Many well-known authors and practitioners display the CNC credential. These include Phyllis A. Balch CNC, co-author of the bestselling Prescription for Nutritional Healing, a reference guide that matches herbs and supplements to specific ailments and is frequently on display in the supplement sections of health food stores.
Another CNC is Jordan Rubin, NMD, PhD, CNC, author of the bestselling The Maker’s Diet and other books, and an honorary board member of the Weston A. Price Foundation. In that Rubin’s NMD (Natural Medical Doctor) and PhD also come from non-accredited colleges, he has often been attacked as having dubious credentials and limited credibility. As a popular writer, however, he has been a force for good, bringing news about Weston A. Price principles to thousands of people who wouldn’t have otherwise heard about them. His Garden of Life supplement line offers some of the better products available in health food stores.
There are literally thousands of credentials that can be earned or bought, far more than we can possibly investigate. Three that may be of interest to Weston A. Price Foundation members are the Certified Healing Foods Specialist (CHFS), the Nutritional Therapist Training (NTT) program of the Nutritional Therapy Association and the Health Counselor (HC) program of the Institute of Integrative Nutrition.
WAPF member Paul Yeager, author of Immune: How I Beat AIDS in My Kitchen, completed the CHFS program and declared it “awesome. . . There was a great reading list focusing on Weston A. Price, Francis Pottenger, Elson Haas and Ann Wigmore and we got together for four days of teaching, discussion and hands-on demonstrations. We also had three conference calls prior to the meeting.” Yeager is a gifted violinist who is deeply committed to holistic healing but currently working in website design and management. He regards himself as a “health educator,” does not interface with clients and feels no need to enter any accredited degree program.
The NTT program is sponsored by the Nutritional Therapy Association, a membership group that has sponsored conferences featuring speakers such as Sally Fallon Morell, Natasha Campbell-McBride, Ann Louise Gittleman and others. The NTT credential can be completed either onsite over an eight-month period or online over a nine-month period. The program focuses on the work of Drs Price and Pottenger in a curriculum that also includes basic chemistry, anatomy and physiology, food science and nutrition. There is a reading list of fifteen required books, thirty-seven recommended books and six other “good resources.” In addition, they have compiled a list of sixteen cookbooks, some of which are not cookbooks at all but vegan raw food guides. The book list includes works that have been given thumbs up, thumbs down and mixed reviews in Wise Traditions.
The Institute of Integrative Nutrition program in New York City serves a buffet of nutritional ideologies. “We are the only nutrition school integrating all the different dietary theories— combining the knowledge of traditional philosophies with modern concepts like the USDA pyramid, the glycemic index, The Zone, the South Beach Diet and raw foods. We teach more than one hundred different dietary theories and address the fundamental concepts, issues and ethics of eating in a modern world.” One week students might hear Sally Fallon Morell, another week it could be vegans Neal Barnard MD, Founder of the Physicians Committee for Responsible Medicine, or Michael Jacobsen, Executive Director of the Center for Science in the Public Interest. Best selling authors Barry Sears, PhD, Arthur Agatston, MD, Andrew Weil, MD, and Deepak Chopra, MD, have been at the IIN podium. Over a six-month period, students at IIN will study nutrition, counseling, business, eating habits, lifestyle choices and other topics that will lead to certification as a Health Counselor (HC).
A few years back, WAPF member Daniel Corrigan of Huntington Woods, Michigan, began taking biology and chemistry classes with plans to enter an RD program. He soon came to the realization that an ADA-approved degree did not make sense for him. His moment of truth came with the discussion of the egg in a biology class. “The instructor spent thirty minutes explaining the extraordinary properties of the yolk, then just two minutes on the white. He then told us how each morning he throws out the yolk and eats only the white! Almost everyone in the class agreed that this was a good policy! This told me the extent to which media propaganda would always outweigh the facts.” Corrigan decided to meet his longterm goal of making a difference for families with autism by using his computer skills. He is now building websites, including his own corriganics.com, designed to help parents prepare proper foods and heal the guts of their children. His interest stems from a godson diagnosed with autism, whose condition was completely reversed through WAPF-style dietary intervention.
Many people call WAPF president Sally Fallon Morell a nutritionist but she dismisses that claim straightaway. “I have no credentials whatsoever, “she laughs. “I cannot practice anywhere.” Fallon Morell, who has an Master of Arts degree in English from UCLA, solved the problem brilliantly when she teamed up with Mary G. Enig, PhD, FACN, as coauthor of her book Nourishing Traditions, as well as dozens of articles on fats, oils and other topics written for the Wise Traditions and other journals. She originally hired Enig as an expert reader. “Mary bluntly said I’d come to the right conclusions but didn’t have the science! She then pulled out charts and studies and patiently explained the chemistry of fats and oils. She spent so much time educating me that I couldn’t afford to keep paying her. My solution was to make her a
coauthor.” The partnership benefited both enormously. Fallon Morell became a highly credible though controversial author. Dr. Enig saw her pioneering work reach a wider public.
Fallon Morell thinks some prospective nutritionists would be better suited in careers as personal chefs, cooking consultants or even lifestyle coaches. Such professions are completely unregulated. “Help people declutter their cupboards of junk food and restock with nutrient-dense foods,” she says. “Teach them to cook proper meals. Or cook the meals for them. There are strict laws about opening catering businesses or restaurants, but no laws against working in other people’s kitchens, no matter what the level of sanitation. There are plenty of well-to-do families that desperately need this kind of help and are prepared to pay well.”
Clearly, there are many true paths to becoming a nutritionist. H. Ira Fritz, PhD, CNS, FACN, is a big believer in regionally accredited degrees and solid credentials, “The best and brightest don’t need school, but they do need credentials.” That said, he knows that education is ultimately less important than what’s made of it. It’s those triple-threat people with “integrity, intelligence and imagination” who will move the profession forward.
How to choose? “Follow your heart,” says Liz Lipski, PhD, CCN, “but use your head to choose a program that will help you follow that dream.”
REGISTERED DIETITIAN MEMBERS OF WAPF
The Weston A. Price Foundation has a surprising number of members who are registered dietitians. In addition, the ADA now allows continuing education units (CEUs) for dietitians at our Wise Traditions conferences.
Adirondack WAPF member Ruth Pino is a chef who owned her own catering business before she returned to school to become an RD. “I was tired of catering to the rich. I wanted to do something more meaningful,” she said. Pino completed her bachelor’s degree at Plattsburgh State University in upper New York State and researched her internship options very carefully, ultimately choosing an independent study program through Sodexo Foods. She spent the majority of her time working on a wellness policy for the Saranac Lake school system in Saranac Lake, New York, which led, in turn, to her current part-time job as the Acting Food Service Director. She also teaches at Paul Smith’s College.
Pino has made great strides in improving the quality of school lunches just by providing training to her food service staff. “Staff is the most expensive part of the food service budget,” she says. “So improving food quality while staying within budget really boils down to having a well-trained staff that knows how to prepare whole foods.” Pino has replaced chicken nuggets and patties with whole chicken breast, french fries with mashed potatoes and canned vegetables with frozen. If Pino’s current position turns into a full-time position, her next goal is to prepare all of the salad dressings and soups from scratch. One of the challenges she faces is introducing new food to children. “We did a baked fish one day that failed miserably. The students did not recognize it and did not eat it. For most of them the only fish they have ever seen was deep fried.”
Another frustration is the National School Lunch program requirement that saturated fat comprise no more than 10 percent and total fat no more than 30 percent of the menu. Keeping whole milk on the menu makes it very difficult to stay within the requirement, but getting rid of it makes it hard to keep the calorie count high enough. “Without whole milk it is difficult to get enough calories into the meals for the kids. That leads many food service professionals to add cookies and other inferior foods to make up the calories without exceeding the fat requirements”
Pam Schoenfeld, formerly a WAPF chapter leader in New Jersey, also chose to become an RD despite the ADA’s demonization of fats, cholesterol and organic and its support of processed, packaged and fast foods, She completed a BS in Nutrition Research at the University of Maryland, extra required courses at the College of Saint Elizabeth in New Jersey, and a rigorous internship with the University of Medicine and Dentistry of New Jersey. She passed the CDR (Commission on Dietetic Registration) examination this summer. She is currently enrolled in a Masters in Nutrition program at the College of St. Elizabeth, working part time for a doctor as a research assistant and exploring future career options.
Schoenfeld remains challenged by the schooling but still recommends an RD program. “To get through, you often have to spout back what you know not to be true, but if you can survive it, the time will come when you can make changes from within. It’s frustrating that so many people drawn into this field are narrow-minded thinkers who refuse to consider any position outside the ADA’s position papers. Even so, it’s clear that most dietitians mean well. I prefer not to see them as the enemy but as misguided people whom I have the power to influence.”
Schoenfeld’s goal is to make a difference in the medical system. “We all know it isn’t serving people well right now, but that’s where the majority of people get their care. My style is to help a lot of people make small changes. If I succeed in this, it will have a multiplying effect and feel very worthwhile for me. Most people won’t accept radical ideas and WAPF principles are radical for the average person. But I can point them in the right direction.”
Schoenfeld cites two examples of the influence she has had to date. One involved having “some influence” on vegan parents whose child had been on an extremely lowfat diet and had been diagnosed with “failure to thrive.” She was also instrumental in ordering a vitamin D test for a woman whose rib cage had unexpectedly broken during a lung transplant. The woman’s vitamin D levels were not even detectable. She’d been on steroids for years and she almost never went outside, but no one had thought to check.”
Kim Rodriguez, MD, RD, LD is a WAPF chapter leader in Aiken, South Carolina. In March, a local newspaper published an article about her work, “Registered dietician teaches the diet of Dr. Weston Price,” and in May, she participated in a meeting of forty-three registered dietitians (mostly under thirty years old) as one of four speakers. The first speaker was from Ross Pharmaceuticals and gave a presentation on Ensure. The second discussed a new appetite stimulant called Megace XP. The third discussed menus for nursing homes and how to meet the ADA guidelines for vitamin A via betacarotene in vegetables. Then Kim gave a presentation on Dr. Weston Price and traditional diets; she discussed her history as an RD and the reasons she valued the principles of the Weston A. Price Foundation.
Afterwards, many came forward to say, “thank you for finally speaking up.” Says Rodriguez: “It was almost as though every dietitian in the room knew—but was afraid to talk about it. There is lots of light in the American Dietetic Association’s tunnel!” She has since given her presentation to one other groups of young RDs, again well received. “None of them feels good about recommending Ensure and hope one day the RD’s role will not be what it is today.” Martha Pickard, MS
QUESTIONS TYPICAL OF THE ADA’S CDR EXAM
1. Which of the following is typically not associated with failure to thrive in children?
a. Lack of fiber in the diet
b. Vegetarian diet
c. Chronic illness
d. Food restriction stemming from parents’ excessive concern about atherosclerosis
2. A patient is receiving a nocturnal tube feeding from 7 p.m. to 7 a.m. The formula has a concentration of 1.5 kcal per ml and provides .795 ml of water per liter. What is the rate required to provide 1200 kcals and how much free water is provided during the nocturnal feeding?
a. 67 ml/hr and 636 ml free water
b. 75 ml/hr and 795 ml free water
c. 50 ml/hr and 650 ml free water
d. 75 ml/hr and 805 ml free water
3. A patient’s labs show the following: low albumin, Transferin WNL and high sodium. What do you suspect?
a. protein stores are low
d. nothing wrong with these labs
4. Details on how a federal law will be implemented, and any penalties that may be imposed if the law is violated are published in:
a. Congressional Journal
b. Federal Reserve
c. Congressional Report
d. Code of Federal Regulations.
5. Which contains the most Vitamin A:
a. 1 cup steamed carrots,
b. 1 slice white bread
c. 1 poached egg
d. 1 slice lemon meringue pie
6. You have a renal patient on hemodialysis treatment who needs to restrict potassium. Which food do you recommend:
a. 1/2 cup lowfat cottage cheese
b. Baked potato with skin
c. 1 cup 2% milk
d. 1 medium banana
7. The potatoes you are frying show an unusual increase in browning. What does this tell you about the potatoes:
a. They are old
b. They are contaminated
c. They were stored at a refrigerated temperature
d. They were not meant to be fried
8. For which of the following would be low fiber diet not be recommended:
a. nausea c. diverticulosis
b. IBS d. diverticulitis
9. What is Body Mass Index (BMI) for a woman 175 pounds and 5’ 2”
a. 23.9 c. 39.5
b. 32.3 d. 50.6
10. How many units must you sell to reach your break even point (BEP) if your selling price (SP) = $7, the variable costs (VC) equal $4.50 and the fixed costs (FC) = $2000?
a. 800 c. 13000
b. 1000 d. 1800
11. Cook chill, cook freeze and sous vide are three methods of preparation used in ________:
a. Ready prepared food service
b. Conventional food service
c. Commissary food service
d. Assembly serve food service
12. If your patient is on a low-residue diet, what can she consume:
a. turkey c. milk
b. wheat bran d. potatoes
13. In order for a product to be called “cholesterol free,” what is the maximum amount of cholesterol this product can have per serving?
a. 0 mg c. 5 mg
b. 2 mg d. 10 mg
14. What are the minutes/meal yesterday if you had 6.3 FTEs who served 190 meals?
a. 15.9 c. 12.6
b. 17.8 d. 23.4
15. How much ground beef will you need to purchase if you need 68 portions of 4 oz each with 25% shrinkage?
a. 20 lb c. 28 lb
b. 23 lb d. 68 lb
16. According to HAACCP, roast beef should be cooked at
a. 145 c. 165
b. 155 d. 185
ANSWERS: 1. b 2. a 3. c 4. c 5. a 6. a 7. c 8. c 9. b 10. a 11. a 12. a 13. b 14. a 15. b 16. a
QUESTIONS TYPICAL OF A CCN EXAM
Most RDs would probably flunk this exam, but in all fairness CCNs wouldn’t do well on theirs without a lot of studying on questions related to tube feeding, renal diets and cafeteria management. Check one or more:
1. One of the disposing causes to intestinal mucosal atrophy is said to be excess neurotensin production. The effects of neurotensin include
a. Diarrhea with digestive enzyme deficits
b. Increased anterior pituitary hormone release
c. Decreased glucagon release
d. Decreased cell proliferation
e. Hypergamic globulinemia
2. Common symptoms of the hypoadrenocortical state include
b. Mental depression
c. Flat glucose tolerance curve
d. Postural hypotension
3. Aspartame disease can be mistakenly diagnosed as
b. Parkinson’s disease
c. Hodgkin’s disease
d. Alzheimer’s disease
4. Non steroidal anti-inflammatory drugs (NSAIDS) may cause which of the following:
a. Increase folic acid
b. Increase gut immunity or impermeability
c. Decrease leukotrienes
d. Increase phase 2 liver detoxification substances
e. Decrease N-acetyl glucosamine
5. Wheat/gluten-derived hexapeptides have an entertoxic effect on the intestinal wall. Which diagnostic test is most likely to discover if this may be a problem for your patient?
a. Comprehensive stool digestive analysis
b. Essential amino acid quantification
c. Functional nutrient status
d. Delayed hypersensitivity immunology
e. Viral antibody titers and cultures
6. The Neuroendocrine Theory of Aging proposes that the most accepted means to retard aging are:
a. Caloric restriction
b. Early detection of disease
c. Administration of antioxidants
d. Lowfat (<20) diet
e. Physical exercise
7. The Paleolithic or Stone Age diet was usually high in:
a. Calcium and protein
b. Calcium but not protein
c. Protein but not calcium
d. Neither calcium nor protein
8. Phytoestrogens are found in:
a. Soy and alfalfa
b. Licorice and cayenne
c. Corn and soy
d. Oranges and apples
9. Synthetic progesterone:
a. Reduces cases of uterine cancer
b. Increases cases of birth defects
c. May cause depression
d. Causes fluid retention
e. Decreases T3 uptake
10. The cytochrome P450 enzymes of the adrenal gland can be protected by:
c. Ascorbic acid
d. Vitamin E
11. Zinc deficiency is often responsible for which of the following disease conditions:
a. Depressed cellular immunity
b. Intracutaneous delayed hypersensitivity reactions
c. Increased susceptibility to fungal infections
d. Increased susceptibility to viral infections
e. Chornic diarrhea of unexplained etiology
12. Which of these parsleys has a mobilizing effect on mercury, but carries side effects:
a. Fresh Chinese parsley (cilantro)
b. Petroselinum crispum
c. Fresh parsley
d. Dried cilantro
e. Parsley leaf
ANSWERS: 1. b and d 2. a, b, c, d and e 3. a and d 4. b 5. d 6. a, c and e 7. a 8. a 9. b, c, d and e 10. a, b and c 11. a, b, c, d and e 12. c
ANNOUNCING! WAPF-ORIENTED COURSES FROM HAWTHORN UNIVERSITY!
Dr. Weston A. Price’s last words were “You teach, you teach, you teach.” In response to requests from hundreds of our members, the Weston A. Price Foundation will launch a series of five courses at Hawthorn University this fall. These courses will be:
Introduction to the Principles of Healthy Traditional Diets Traditional Nutrition for Fertility, Pregnancy and Early Childhood Myths and Truths about Vegetarian Diets Fats, Oils, Cholesterol and Fat-Soluble Vitamins Dirty Little Secrets of the Food Processing Industry
Completion of the set of five courses will lead to a certificate from the Weston A. Price Foundation. The introductory course will also be able to be included as an elective in the master’s degree or doctoral programs at Hawthorn.
We chose Hawthorn University because it offers distance learning programs that are open-minded and non ideological, with a strong respect for traditional diets, for whole, organic and grassfed foods and for sustainable agriculture. Hawthorn graduates often join the National Association of Nutrition Professionals (NANP) and pursue careers in holistic health or related fields.
Course materials, including books, audio lectures on CDs, journal articles, websites, teleclass meetings, and hands-on and community-based assignments, will be all approved by the Weston A. Price Foundation, as will all course instructors. We think these courses will be a terrific opportunity for members who would like to study the principles of traditional diets along with the scientific research that backs them up in a guided and focused independent learning context. However, we urge prospective students to carefully consider how this program would fit in with their life plans and career goals. Hawthorn is not accredited, and its programs are not guaranteed to lead to state licensing Accordingly, it may not be the best choice for everyone. We ultimately hope to also offer these or similar courses at regionally accredited institutions.
*Clayton College of Natural Health closed in 2010.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Fall 2009.