What Is an Integrative Dietitian?

There are many of us nutrition professionals now aligning ourselves with Integrative Medicine. I consider myself in this group. Maybe you are asking yourself what exactly this is and most importantly, does it really matter?

First of all, let me distinguish between the types of "nutritionists" out there. Thankfully in Washington we do have laws around these terms so you can be sure you know who and what you are dealing with. I, for example, am legally a Registered Dietitian. To be an RD, one must complete a Bachelor's or Master's degree in nutrition. Then you must do a one year internship through a health or medical center before taking a national exam which then entitles you to the credential. It's no small feat. There are years of education and on-the-job experience required. You don't just wake up one day and become a Dietitian. While many of us work in private practice, our credentialing also allows us to work in hospitals, outpatient clinics, research centers, and federal nutrition programs.

A Certified Nutritionist (CN), as they are called in Washington, is someone who has a Master's degree in nutrition. They have not done an internship or taken a national exam, however it does not mean they are not qualified to act as private practice practitioners. In many cases they are even allowed to accept insurance. However, they are often not allowed to work in hospitals or the other medical areas that RDs are.

Generic "nutritionists" are those that claim to have some sort of nutrition knowledge or degree but do not have the requirements to be credentialed as the state requires. In fact, they are not even allowed to call themselves nutritionists in our state (but watch out in other states that are less regulated) and will often go by the title "Holistic Health Coach" or something similar. They are often still valid practitioners, however they are not typically well equipped for Medical Nutrition Therapy, especially in cases like diabetes, cardiovascular disease and gastrointestinal disorders. There is very specific knowledge required in these cases about diet guidelines and lab biomarkers that one must take into consideration which is taught in accredited degree programs and on the job training. Online programs or experiential learning may or may not provide that type of information, so just do your research when working with these people. Many are wonderful and can be extremely helpful, especially in the areas of weight loss and general preventative care. They are not allowed to accept insurance, however, so that factors into the decision for some.

The reason I went through all that mundane information is so that you have a better understanding of the types of nutrition professionals who might be representing themselves as Integrative Medicine Practitioners. To sum all that up, check credentials and ask about experience and specialty areas. If they say their specialty area is diabetes but they do not have an accredited nutrition degree, dig a little deeper to make sure they have the experience you are looking for.

Now that we've straightened that out, let's get to Integrative Medicine. Many types of practitioners practice Integrative Medicine, from RDs like myself to MDs to PTs to Holistic Health Coaches. But what does this mean? Why does it matter to you?

Integrative Medicine is basically the notion of holistic healthcare. It's a whole body approach that treats each person not in parts but as a whole. Everything is interconnected so an issue in one organ system is inextricably connected with all the others. The root cause must be found in order to treat the entire person. Medications and a single system approach merely mask the symptoms. It does not solve the health problem. High cholesterol, for example, is not simply too much dietary fat remedied by taking a statin. It may be due to excess sugar consumption, obesity, genetic polymorphisms, misinformation about proper diet, etc.

These types of solutions, however, take time. That is why with Integrative Medicine a key value is patient-centered care. This involves listening to the patient's health history and together embarking on a path towards solving the problem. It is not the traditional top-down approach where you present with a problem and the practitioner hands you an already decided upon solution all within fifteen minutes. Each person is unique and so every recommendation is unique. It is not uncommon for appointments with Integrative Medicine practitioners to last an hour or longer.

Contrary to popular belief, Integrative Medicine is also heavily science based. While we integrate traditional Western practices, we also look to proven methods in other modalities that may be termed "alternative" medicine. Examples include the use of botanicals, supplements, dietary treatments, stress management, and exercise programs. An assessment of the entire person and their unique health history (not just their presenting complaint) determines the exact mix of these approaches.

So how does this apply to the Dietitian? As you know, Dietitians are not exactly trained to diagnose or treat. Our job is to work with these other modalities to help provide the complete care and treatment that patients need, typically after a proper diagnosis has been made. Our role is the use of diet (which in many cases is the most important factor!) to help ameliorate a variety of health conditions. As Integrative Dietitians we employ the use of specialized diets, targeted foods, certain supplements, and occasionally lab work such as food sensitivity testing or requesting various nutrition-related lab values. Basically, we are not the RDs that are going to throw a patient education handout at you and tell you good luck. We take great care in providing personalized assessments, individualized diet recommendations based on the latest research, and round out our approach with lab work and supplements as needed.

If you are currently dealing with a health concern and are not happy with your progress, consider seeing one of us Integrative RDs for additional guidance. Often we catch overlooked dietary issues that can significantly impact your treatment success. We can also make appropriate referrals to other practitioners if needed. If you are working with an Integrative practitioner already, then consider seeing an Integrative RD to help round out your care. Like I said, we are trained to catch dietary problems that others often overlook. Also we spend a considerable amount of time doing diet education that other practitioners simply don't have time for or are not equipped to provide. We can help get you started on that diet you were told to implement or help you figure out what exactly the best diet protocol is for you.

Whatever state of health you may be in, finding a good Integrative Dietitian can be a valuable resource to keep you living the healthiest life possible.