Common Misconceptions about Dietitians

By: Alyce Reichenbacher

I love being a part of the dietetics profession and I cannot wait to one day have MS, RD at the end of my name. However, sometimes others make assumptions about my nutritional choices due to my association with dietetics. For example, I will be in line at a buffet and the person in front of me says “don’t judge me, I know it’s bad” as they reach for the chocolate chip cookie at the end of the table. Or I walk into a patient’s room and they refer to me as the “food police.” Or I order boneless buffalo wings with ranch instead of the house salad when I’m out to dinner with friends and get a look from them like wait you eat THAT, I thought you were in dietetics. I’ve started to feel like the average person perceives dietitians as judgemental fitness freaks that force you to eat kale and quinoa for each meal.

No fear, I am here to squash those misconceptions of Registered Dietitians (RDs) and bring some truth to the profession. Here is a list of five commonly faulty thoughts about dietitians.

1. Dietitians eat healthy 100% of the time and think you should too
1. Not everyone is perfect! We all deserve to treat ourselves once in a while and I am a firm believer that we need to feed our body and our soul. Depriving ourselves of things we love is not only torture, but it will most likely force us to binge later on. As dietitians, it is our job to help our clients and patients still eat the foods they love while keeping their body healthy. That advice goes for us, health professionals, as well. I most certainly do not eat healthy for every single meal. What is life without chocolate peanut butter ice cream or a barbeque chicken pizza every once in a while? The most important advice we can give you is to enjoy everything in moderation. When it comes time to have that special treat, appreciate it! Take pleasure in treating yourself to a favorite food on occasion.
2. We know everything when it comes to food
1. As much as I would like to say that statement is true... it is not. Especially as a Dietetic Intern, I feel like I have only scratched the surface on food and nutrition. It is such a vast subject and I have so much more to learn. That being said, eventually we all find our niche. It is common for RDs to specialize in a certain area which can cause them to not stay as up-to-date on information in other areas. For example, a RD who works in an eating disorder facility is not always up to speed on the most recent recommendations in sports nutrition. Because it is such a dense field, we may not be able to answer a specific question right off the bat if it is in an area we are not as familiar with. However, we often know where to find science-based answers or can direct you to someone who can!
3. Our field is “black and white”
1. Is red meat bad for me? Will intermittent fasting help me lose weight? Should I take a multivitamin? Sometimes I struggle when people ask me questions and the answer is often “it depends.” There are so many aspects of a person’s health that you have to consider when talking about nutrition. Every client has different dietary needs, goals, lifestyles, and food preferences. What works for one person most likely will not work for the next. In addition, each RD has their own beliefs and backgrounds. Luckily, we are trained on how to tailor unique advice for every individual using evidence-based research.
4. Dietitians are the same as Nutritionists
1. Registered Dietitian, Nutritionist, Registered Dietitian Nutritionist? It’s confusing to know which term is correct. If someone claims to be a Nutritionist, he/she could be a qualified professional but they could also be someone who took a class or two on health and wellness. There really is no accreditation for being a nutritionist and there is no regulation on who can call themselves nutritionists. Registered Dietitian, Registered Dietitian Nutritionist, RD, RDN, and Dietitian are all ways of saying the same thing. An RDN is someone who has completed a minimum of a bachelor’s degree in nutrition and dietetics, completed an ACEND-accredited supervised practice program (fancy way of saying internship) where we accomplished at least 1,200 hours of supervised practice, and passed a national examination often referred to as the RD exam or CDR. 
5. All we do is meal plan and get people to lose weight
1. That is the same as saying all photographers do is point and shoot; when really, there are countless things that need to happen. The photographer has to find the correct lighting, backgrounds, and position characters the way that best suits how the shot needs to be captured etc. In fact, most dietitians do not create meal plans for their clients. This is because meal plans can be a temporary and unrealistic way of fitting a person’s lifestyle long-term. Our goal is to make life changing and sustaining tweaks to your diet and/or lifestyle in a way that is healthy, maintainable, and individualized to you. Not to mention, RDs work in a vast array of settings. Weight loss is only one area in which they specialize in. Other careers in dietetics can include working in a cancer center helping patients maintain good nutrition to keep fighting, in a children’s hospital calculating tube feedings for kiddos who are too ill to eat, in a private practice setting delivering corporate wellness speeches to big companies, in a food service operation as a chef or menu designer, in a diabetes clinic teaching those newly diagnosed how to work their pumps and count carbohydrates, in a nursing home working to keep the geriatric population happy and healthy, in a OBGYN office providing women with prenatal nutrition, and the list goes on and on. We often wear many hats and our days consist of so much more than typing up meal plans and telling people calories in equals calories out.

I hope these few points help to clear your mind about dietitians and can also allow you see how expansive this profession really is! We are non-judgemental, pro-quality of life individuals just trying to make the world a healthier place, one whole food at a time!

Off the Beaten Path

By Loni Pereszlenyi

The “Controversial” Story of How I Got Here

Caution: Extreme honesty ahead! (As if anyone who knows me expected anything less!)

        Everybody has a reason for choosing his or her life’s work. Think about the multitude of disciplines and the plethora of job titles that can be found under those disciplines. Now, if you are reading this, go ahead and think about why you chose your career. Chances are that for many of you, you realized you had a specific skill set or excelled in one area in one way or another. For those of us in the health professions, chances are we thought a little bit more with our hearts than with our heads. I know for myself in particular, the reason why I wanted to become a registered dietitian was something that is not only personal, but it can be considered controversial, as well - and this is because I am an eating disorder survivor. My mission in life is to help those with eating disorders/disordered eating get to a place of recovery and resiliency, because I was once lost in the depths of this debilitating disease and I’m not only surviving - I’m absolutely thriving. 

So, for those of you who don’t know, I am sure you’re curious as to why my pursuing a career as a registered dietitian would be a topic of controversy. Before I get to that, I’d like to tell you the story of how I got to this point, so that you can have all of the facts before taking a side on the topic.

I was 15 years old and at the end of my sophomore year of high school when I began to starve myself. Many things happened to me as a teenager. Possibly my favorite person ever to exist, my Bubby (for those of you who don’t know what a Bubby is, it’s grandmother in Yiddish - an old time Jewish language of sorts), passed away. I really didn’t know how to deal with that. It was the first loss of that magnitude I had ever experienced. At the same time, I was developing this body that I absolutely hated. I was getting curvier, and my body was changing at an incredible rate. Some people literally used to call me “boobs,” back in high school. It’s all people looked at when they looked at me. I didn’t even know how to dress myself. All of my friends had these tiny bodies, and all I wanted to do was hide away because I was so uncomfortable with myself. I was sad over my Bubby passing, I hated the way I looked, and the only way I knew how to control it was to punish myself for the changes all I was going through. It’s funny to look back on it now, because I was 120 pounds, and I looked good! However, by the start of my junior year, I weighed 90 pounds. I hadn’t had a period for months. My hair was falling out. I was gaunt and had no energy to get through my days at school. I would overhear people at school whispering about how skinny I’d become, and I thrived on it. At the lowest point of my eating disorder, my diet consisted of an apple and a salad to get me through my days. Nobody knew how to approach me about what I was going through. So, my mom took me to my doctor and a dietitian. I was told I’d wind up in the hospital with tubes and needles sticking out of my arms and that I’d die. That scared me enough into eating again. However, my body and metabolism had become so screwed up that I ended up gaining almost 50 pounds back. Even though I gained the “required” weight, my eating disorder was never addressed, leaving it unresolved. I never learned how starving myself affected me physiologically. I never learned how to eat mindfully. I never learned that I was using starvation as a way to not have to deal with any of the changes in my life. Since none of this was addressed, I did not have the proper mechanisms to process the life changes that would inevitably come my way in the future.

Fast forward five years - I was a junior in college majoring in liberal studies. What is liberal studies you ask? It means you have zero clue what you want to pursue as a career. It means that you have to apply to grad school to have more years (and more loans) to figure it all out. It means that you take whatever classes sound good to you. As it was, I was lost. But my friend the eating disorder was sitting on my shoulder like the devil. For almost three years, I dipped into another period of restriction - and this time, excessive exercise - to cope with this new life change. I couldn’t fathom how someone with a college degree just simply could not find her passion. So, I kept my focus on how I was winning this game of restricting food while exercising during all of my free time throughout the day. One day - and I remember this day vividly - I was too tired to work out. I punished myself. I didn’t eat anything but a protein bar that entire day. The next day, I remember turning to my mom and telling her that I was worried because my hair was falling out in clumps. I was anxious because I didn’t want to gain weight, but I knew I was entirely too underweight. I was tired. I was tired of being tired. I knew I had to get help, but I didn’t know if I had the ability or the strength to see it all through. Then came the moment that changed the course of my life; I’m not being dramatic, either - this one moment really changed my life!

I knew dietitians as professionals in working with food. I knew what I was doing by using food restriction as a coping mechanism for life’s changes. I remember finding a particular outpatient dietitian’s website online. I said to my mom - the only person I trusted at the time to know what I was going through - I think I need to call this person for help. Hands down it was the best decision I have ever made. This particular dietitian - we will call her “L” - never gave up on me. Each time we met, L guided me through each appointment in a way that allowed me to talk about what I felt contributed to the patterns I had held onto for years. I never once felt uncomfortable or ashamed in L’s presence, because each session felt like a natural conversation. I felt like for once I was talking to somebody that really understood me. And my eating disorders started to feel like an evil burden on my body.

Now I know what you’re thinking; eating disorder recovery seems so easy. Not so fast. Part of what made L so amazing is that whenever I left each session, I felt encouraged to take the goals we set and work on them. It took me some time to trust in our connection as practitioner and patient, but as I said before, L never gave up on me. If I came back to session and did not complete an assignment or achieve a goal, L held me accountable. In time, by trusting L, I learned to trust myself and the ability I had to make a full recovery. Throughout the recovery process, I reiterated to L that I wanted to take what I’ve learned and help others just like me. I realized that as our sessions became fewer and far between, I was recovering, but the need to help others in my position was not wavering. I realized that I wanted to become an eating disorders dietitian just like L. 

I waited until I felt like I was at a place in my recovery in which I would be able to fully immerse myself into my schoolwork and field experiences, and I made the decision to return to school to pursue a career as a registered dietitian. I worked incredibly hard and received my bachelor’s degree in nutrition and dietetics in 2016, and began my dietetic internship/masters degree at SLU in 2017, focusing on pediatric nutrition. Although it has been an arduous and long journey, I have never lost sight of my goal of becoming an eating disorders dietitian. If I can replicate in the future - even just one time - what L did for me and save even one life .. well, I’d say I’m going to be a damn good eating disorders dietitian.  

So let’s get back to the controversial topic of being an eating disorder survivor and becoming a registered dietitian. It’s very easy to assume that someone who has battled eating disorders will judge their patients. It’s very easy to assume that someone who has once battled eating disorders will relapse again and encourage his or her patients to continue on with their disordered behavior. It’s very easy to assume that counseling and educating eating disorder patients will result in the registered dietitian relapsing into prior behaviors. It’s simply very easy to assume that someone who has battled eating disorders will never fully experience recovery. 

These assumptions are not proven facts. While dietitians who are eating disorder survivors may be at an increased risk of relapsing, this does not mean that they cannot effectively counsel eating disorder patients. I personally know many former alcohol and drug abusers who have made careers out of counseling current alcohol and drug abusers. Therefore, I cannot change your opinion if you’ve already formed one about this topic, but let me be a vocal exception to all of those assumptions. I am an eating disorder survivor and thriver, and I am here to tell you that my MISSION in life is to help my future patients overcome their eating disorders/disordered eating and live, love, and value their lives. I’ve often abided by the poem “The Road Not Taken” by Robert Frost. “Two roads diverged in a wood, and I - I took the one less traveled by, and that has made all the difference.” My “roads” were not about one path vs. another path. I did not choose my eating disorders. However, I wanted to make something out of the path that I took, and hopefully I will make a difference in the paths of those that come after me.

Photo Credit:

https://www.amazon.in/Alter-Ego-Robert-Famous-Inspirational/dp/B01D5WK4FU

One of the 4%

A Male Perspective on Diversity in the Field of Dietetics

By Joseph Nilges

I started out as a culinary student, working my way from job to job on a yearly basis. After competing in a cooking competition and winning a bronze medal, I knew that I had reached new heights in my career, but I didn’t feel like this accomplishment was enough. I soon found the number for the Saint Louis University Nutrition & Dietetics office and transferred into their program the following semester. Now, after 4 consecutive years attending Saint Louis University, I have discovered how little diversity there is within the field of dietetics. 

Coming into dietetics with a culinary background I was always part of the majority, now I am of the smallest minority and adapting to the change was challenging.

One of the 4% reflects how little diversity there really is within the dietetics field. As of February 19, 2018 the Academy of Nutrition & Dietetics reported 3,690 (3.8%) male registered dietitians floating among 88,883 (90.6%) female registered dietitians (RD), leaving 5.6% unreported. Of the total 98,000 registered dietitians white ethnicity represented the majority at 77.8% with unreported coming in 2nd at 7%. Over the next few paragraphs we will discuss why there are not more males in dietetics, barriers that can be challenging for males within the field, and what the future might hold for bringing more males into the profession.

Where Are All The...

The gender discrepancy can be traced back to the 1920’s where therapeutic diet treatments were entrusted to senior hospital nurses who had developed certain skills. Nursing had risen to become a female profession until recently, so it is not surprising that males do not make a majority. There are many different reasons why we do not see more male dietitians in the field, one of them being that the educational pipeline that helps drive interest in the field of dietetics does not start early enough within the school system. The educational pipeline refers to the integrated system of institutions from primary school to university that seeks to attract students to colleges with a goal of attaining the skilled individuals in the workforce. 

The Academy of Nutrition & Dietetics noted that active, committed participation with academia is crucial for addressing the low percentage of diversity in dietetics. This participation is negatively influenced by parental and peer group perceptions of college attendance often based on financial measures, substandard academic preparation, lack of support among teachers and guidance counselors who have lower academic expectations, inadequate guidance through college planning and financial aid process, perceptions of dietetics being a “woman” field, lower salary received for amount of education involved, and difficulty among some groups of academic requirements to name a few.  

“People still see dietitians as hairnet-wearing women who act as food police. There are also things that prevent men from entering dietetics such as low pay for dietitians” – Rick Hall, MS, RD Arizona State University

Overcoming Difficulty

Men that are thinking about entering the field of dietetics I have some personal advice for you. First off, be prepared to have feeling of being different and finding personal identity. Second, be prepared to adapt to the profession through different means of communication with the female majority. Third, be prepared to stand out among the profession. 

1.              Be prepared to have feelings of being different and finding personal identity.

Being a male in dietetics can have its difficulties. I have personally felt the feeling of

being different and finding my place within the profession during my undergraduate and graduate degrees at Saint Louis University. I commonly have felt disconnection with my class mates and coworkers based on the fact that I am male and women interact differently with one another. Often I have found myself conforming to the norms of the dietetics profession, such as personally feeling more pressure from preceptors to perform at a specific level. 

2.          Be prepared to adapt to the current norms.

Often I have found myself feeling like I was alone and conforming myself to fit the norms of the female dominated dietetics profession. I found that a strong sense of self -identity, self-awareness, and open communication with peers were the best ways for myself to overcome this barrier. Surrounding myself with a strong support system of friends and family was also beneficial for me to confront my disconnect  with feeling of being an outsider.

3.        Be prepared to stand out among the profession and bring a voice.

Being able to stand out for males seems to be easier and can have advantages although performance standards seem to be heightened for male students. The opportunities for males within dietetics are continually growing, so employers want to assure that if they hire a male dietitian they will bring new ideas to the table, which could put more pressure on male dietitians. There is also a need for males to project their voice to help to bring more males into the dietetics profession. Bringing a voice and advocating for more males in the profession is an important part of being a minority in any profession to help increase diversity in the field. 

Passion seems to be one of the drivers of success for males in the dietetics. 

Future of male involvement in dietetics

The most important influence for diversity in dietetics is to involve more stakeholders into the equation including: parents, students, teachers, counselors, teaching programs, and advising boards and governmental officials alike that can influence policy change to introduce greater involvement of nutrition education and knowledge of dietetics. It is important that male dietitians project a voice to appeal for more men recruitment, but it is not only the responsibility of the minority groups to do so. Everyone along the institutional learning process must get involved and work together to change the future generation of practitioners. 

References:

Eat right ™. Commission on Dietetic Registration the credentia ling agency for the Academy of Nutrition and Dietetics. (2018, February 19). Retrieved February 26, 2018, from https://www.cdrnet.org/registry-statistics?id=2579&actionxm=ByDemographics

Flowers in the urinal: Is the lack of men in dietetics really an issue? (2015, October 15). Retrieved February 26, 2018, from https://www.dietitians.ca/Learn/Practice-Blog/October-2015/Flowers-in-the-urinal-Is-the-lack-of-men-in-diete.aspx

Lordly, D., Gheller, B., & Joy, P. (2017). Becoming and being a male dietitian in a female dominated dietetics profession. Retrieved February 24, 2018, from http://eds.b.ebscohost.com/abstract?site=eds&scope=site&jrnl=14863847&AN=124595822&h=r%2faMJj0l1muk%2faCdmmiA0kBioVQ8bSKyFJwV%2fywGf0Q8lwV43PckvpDVyLu6ZJDGeMxELgRkAjpYJCRSK9BNjA%3d%3d&crl=c&resultLocal=ErrCrlNoResults&resultNs=Ehost&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d14863847%26AN%3d124595822

Stein, K. (2018). The Educational Pipeline and Diversity in Dietetics. [online] jandonline.org. Available at: http://jandonline.org/article/S2212-2672(12)00481-9/fulltext [Accessed 26 Feb. 2018].

Images are credited to google images and personal photos. 

Let’s Get Clinical

By Alix Opfer 

Terrified is an understatement. This is how I felt when walking into my first clinical rotation. The word “clinical” was never something I related with. The thought of being in a hospital was not attractive to me and I had no intention of loving my clinical rotations while in my dietetic internship. I started at Missouri Baptist Hospital, my first day of clinical rotations with ten other interns and our graduate assistant. We guessed our way through the charting system and took turns going in pairs to visit patients. Our graduate assistant would ask “who wants to go next?”. I would hide behind my laptop or use the restroom at this time to avoid the experience. When I did have to see patients, I basically wrote a script of what I wanted to say so I wouldn’t forget from the nerves hitting me. I knew that I was going to have to get used to speaking with patients eventually, I just tried to defer that day as long as I could. These days were in late August of 2017.  

 

Fast forward to February of 2018, I have completed a number of weeks at various clinical rotations including gastrointestinal, cardiovascular, diabetes, pediatrics and oncology. As the weeks went by, I felt myself becoming more confident in talking with patients and providing educations. The fear went away pretty quickly as I was forced out of my comfort zone. Now 7 months later, I feel that I have little to no anxiety when entering patient’s rooms. I feel that I have made large steps in confidence in myself when working in a clinical setting. I still have TONS to work on, but I am happy to report that I would no longer hide behind my laptop or run to the restroom when asked to see patients J

I’m not writing this just to tell you that I’ve grown in this internship. I’m writing this for future dietetic interns who are fearful of the word “clinical” and believes they may have some anxiety as well when visiting patients for the first time. I can relate and I can also tell you that with practice and experience, it becomes much easier and you truly learn the value of the knowledge gained when working in a clinical setting. I’m still unsure that a clinical setting is particularly my forte, but I know that I have learned more than I ever thought possible in my clinical rotations. Clinical dietetics is truly the foundation that we need to be great dietitians. For those potential dietetic interns that have never worked in a clinical setting and are worried about this large aspect of the internship, I have a few tips for you that have helped me:

1. Think of an introduction: Practice how you want to introduce yourself to patients

2. Look at the chart carefully: a patient’s previous notes are what guide you, look carefully and thoroughly (labs, meds, old RD notes, etc.)

3. Learn your medications: I struggle with medications, a fellow intern made a large compilation of medications to help learn what each medication does. I wish I would have done this at the start of the internship

4. Comfy yet professional: wear comfortable clothing, especially shoes

5. Be confident in what you know

6. Handouts….and more handouts: use handouts to help emphasize your topic

7. Ask Questions: you will have tons of questions, don’t be scared to ask them

8. Enjoy! Even if a rotation is not your favorite, learn what you can 

I’m sure that the other interns have many other tips that they could add, but these are just a few things to keep in mind when starting into your clinical rotations. My main point is that for those that have never worked in a hospital, talked with patients in a clinical setting, or are just nervous in general; I can relate.

Home Delivery Meals, Yay or Nay?

By Danielle Moore

As a dietetic student and intern I get asked certain questions all the time, but the one I struggle with most is: “You must love to cook, right?”  The very short answer to that question is: “Absolutely not!”.  The long answer is: “Dear God, please, I will do anything to not have to cook tonight, including the risk of starvation.”.  When this question is asked of anyone within the dietetics community, it is readily assumed that the answer will be an emphatic: "Why yes, I love to cook.", so when my reply doesn’t fit their expectations, I’m met with a confused tilt of the head.  

Ladies and gentlemen, just because I am a "food professional" and have an in-depth knowledge of food and its inherent health benefits and consequences, does not mean that I want to cook a meal, whether it be for you, me or anyone!  This is my daily struggle, how do I find the time, energy and interest in cooking for myself?  I know that I need to eat healthy and to not fall into the fast food trap, even though I looooove the convenience and taste of it. When I got into this profession, I promised myself I wouldn't become one of those hypocrites that professed one thing to others, while following my own different path. What to Do? What to Do? So, after much internal angst, I decided to explore some of the home delivery meal service options, such as; Blue Apron, Home Chef, HelloFresh, Plated, Sun Basket, and Gobble, to see if that will help with my daily struggle.

            Most home delivery services offer free or heavily discounted trial sessions to potential new, recurring customers.  Though I was initially tempted to try each one over a period of time due to my meager finances, I narrowed it down to three because of time constraints. During the course of my explorations, I discovered that there are some advantages and disadvantages to these home delivery meal service options. I have listed the Pros and Cons for the services, as I see them and given my verdict and the end; however, it is up to each individual to determine if these services are something that they may desire.

PROS:

·         Perfectly Portioned Portions:  When you order, you have the option of ordering portions for 2 to 6 people.

·         Easy Recyclable Packaging:  Pretty self-explanatory, no hydrocarbons here. 

·         Nutrition Labels for Each Recipe:  Each recipe comes with a recipe card and a nutrition label, which makes it easy and convenient for those individuals looking to monitor their diets.            

·         Vegetarian Options:  As a true omnivore I enjoy my meat dishes as well as my vegetarian dishes so I was pleasantly surprised with the amount and variety of vegetarian and vegan options available.

·         Vegetables:  A great variety of vegetables and ways to prepare them. 

·         Recipes:  These services provide many new recipes that people can add to their own personal cookbook. 

·         Variety:  These systems make it easy to try different foods and recipes that you may not otherwise have had the time, inclination or have thought to try.

CONS:

·         Directions:  At times the directions may be a little vague for unseasoned cooks.  Having taught enough cooking lessons; as well as having worked with inexperienced cooks, some instructions may not be so obvious to those less experienced.  As an example, “Drizzle a small amount”, was a common instruction, and I can see where a small amount to one person, could be a whole lot to someone else.  This simple term could have the adverse effect of altering the final nutrition labels that accompanies the recipe.

·         Limited Recipe Options:  Recipe options for any given week may be limited and if a person doesn’t have the experience or imagination to alter the given recipe, they may well be stuck with what was sent. 

·         Excessive Salt:  Many of the recipes call for added salt due to the comment: “salt and pepper to taste”.  I omitted the salt from most of the recipes and felt they were better off without the excess sodium.  Additionally, adding salt to an existing recipe could again skew the nutritional labels.

·         Delivery:  The kits are delivered and left outside ones’ house or apartment; depending on the weather, this could mean that the kits are left out in the elements for hours before being taken inside and put in the fridge. Additionally, the threat of theft is always a possibility.

·         Lack of Single Serving Options: There were not many options for just one person, most of the home delivery systems were for 2 or more people.

·         Waste:   There is a tendency to create an excessive amount of waste through poor packaging of the food.

The Verdict

The home delivery meal systems are a fantastic way for a busy person to make a home cooked meal in a reasonable amount of time.  With much of the prep work done, these recipes are basically ready, you just need to put all the ingredients together.  It takes the guess work out of cooking and saves you the ever-dreaded trip to the grocery store.  Living alone, I got the two-person meal kits and was able to take the second serving as lunch the next day, saving me much needed time in the morning. That is not to say that the systems are without fault.  Once the reduced priced trials are over, these systems can get pricey, with prices ranging from $65 to well over $100 a week.  You are definitely paying for the convenience. Overall, for the working adult who has little time for menu planning, grocery shopping, and daily cooking these home delivery systems are great, and with a little searching, finding one that fits your budget isn’t too hard. 

Expectations within the Profession

By Kate Miller

As a dietetic intern, you constantly make first impressions.  Among meeting new preceptors and their colleagues every two weeks, you must also make connections with volunteer coordinators, community members, patients, research associates and more.  Additionally, a dietetic internship experience can vary greatly depending on how much your preceptors appreciate your company or assume your ability.  The American Psychological Association states that a “snap judgment” takes only 50 milliseconds, which is less than the blink of an eye, and a 2010 Harvard study revealed that 55% of someone’s first impression is based on their visual appearance.  To add, the psychological concept of serial position effect, specifically primacy effect shows that people remember a person by their first impression of them more so than what comes after that.  Meaning, first impressions and pre-judgments for a dietetic intern matter, a lot.

It is no secret that within the dietetics profession, there is a profound lack of diversity.  As of February 2018, The Commission on Dietetic Registration lists 99,949 Registered Dietitian Nutritionists (RDN) in the United States.  Within that population of professionals, 89% are females (or more since 7.2% didn’t report), 76.3% are white, the average age is 40.4 and 45.2% received bachelor’s degrees in Health or Human Sciences.  This data implies that when preparing for a new rotation one can usually assume that their preceptor will be a middle-aged white woman.  Additionally, and potentially more detrimentally, this preceptor can usually assume that their next intern is a white female who the same education background and experiences as her.

So, this begs the question, what happens when you don’t fit this construct?  How do you make good first impressions, and have the best possible learning experience, when you aren’t what you’re “assumed” to be?

Research conducted at Cambridge University in England has shown that even the lowest levels of unmet expectations (such as an unexpected looking dietetic intern) are highly correlated to drops in neural dopamine levels and subtle increases in threat responses.  Dopamine is the neurotransmitter of desire, reward, curiosity and interest.  Meaning, that in order to best sustain a preceptor’s interest and curiosity in you, you must meet their expectations of what you’re “assumed” to be within that 50 millisecond first impression window.

My experience of the dietetic internship has been greatly impacted by the subliminal pressure for me to attempt to try and fit into the constructs that have been laid out before me.  Personally, that means that I must make a conscious effort to dress more feminine and cover all my tattoos while at internship.  Additionally, it means that I must always be aware of the way that I present to my preceptors, trying to be quieter, softer, less confident and generally less “me.”  It means making a choice everyday about whether its best for me to correct a preceptor who assumes I am straight, or assumes I share the same political viewpoints as her.  It means knowing I am going to stick out like a sore thumb when I enter a room with my classmates, and knowing that I won’t be able to relate to them on more topics than I can count in both hands.  Finally, and most importantly it means knowing that I am going to have different viewpoints on intervention plans than my preceptors and classmates, and knowing that I am going to have to fight for those opinions to be heard.

In order for our profession to grow and in order for RDN’s to give the best care that they can to every patient, every time, diversity and implicit biases need to be addressed more seriously.  Undergraduate and Internship programs need to make significant improvements on their recruitment process and they need to target more than one type of student.  The Academy needs to offer CEU incentive credits for diversity and bias training and financial aid so that all qualified students can actually attend one of these expensive internship programs.  Additionally, all potential preceptors should attend teaching trainings and be screened more thoroughly.  Finally, we need to create a conversation and a space for the RDN’s, interns and dietetics undergraduate students who don’t fit the construct of what they’re expected to be.

So, without further ado: my name is Kate Miller, I am your raging liberal tattooed lesbian dietetic intern, I have a loud laugh, a big smile and I’ll probably skateboard to clinic, but I’ll be there on time and I’ll be happy to make those copies for you.

The Career Option for Dietitians (almost) Nobody Talks About: Online Business

By Megan Matthews

It’s no secret there are countless career opportunities in the field of nutrition and dietetics. In fact, it is one of the things I have loved about this career path from the beginning. The words of my undergraduate academic advisor always resonated with me: “the opportunities in dietetics are only limited by your imagination”. Throughout our education and the dietetic internship, we are exposed to numerous job opportunities and gain hands-on experience in many positions. For example, this year we have interacted with dietitians who work in eating disorders, private practice, schools, hospitals, clinics, and wellness centers to name a few. But there is one career option we talk about less often: online business. This a relatively new path for Registered Dietitians, but one that should not be overlooked nonetheless. Sure, it’s a bit abstract and not a “traditional” path to follow. But it’s intriguing.

Like many others, I have followed food bloggers on Instagram and other forms of social media for quite some time. However, I noticed most of the accounts I came across were run by foodies, wellness coaches, and nutritionists. Until recently, I found only a small social media presence of individuals who had those beloved credentials behind their name: RDN.

I’ve always found the idea of starting an online business fascinating, but thought “that’s great for them, but that could never be me”. However, recently I started learning more about the online business field, simply out of curiosity. I’ve watched webinars about food photography and how to create a successful 6-figure online business. I’ve listened to podcasts about why and how people decided to become an online entrepreneur. I’ve started following Registered Dietitians who have made a name for themselves through their online business. In gathering this information, one thing has been clear: people are making a real living as online business owners, entrepreneurs, and influencers. Not only are they making a living, they LOVE what they do. This path is a feasible career option for nutrition professionals. Here are 5 reasons why online business should not be overlooked by dietitians:

     1. Others are doing it, we need Registered Dietitians to do it too!

We are all aware that there is a plethora of health information on the internet. Even if individuals doeverywhere. In blogs, commercials, magazines, ads, posts, etc. Unfortunately—as we know—this includes plenty of misinformation. An article published in the International Journal of Eating Disorders in 2014 identified dysfunctional eating attitudes and behaviors among “healthy” living bloggers. Many of the bloggers claiming to promote healthy lifestyles had an eating disorder themselves, were currently dieting, experienced difficulty with menstruation or fertility, or wrote negative messages about food. While this study had a limited sample of only 21 bloggers, it brings light to an important issue: the fact that anyone can publish anything online. It is important that as the food and nutrition experts, Registered Dietitians have a voice in this pool of accessible online information. This is a great opportunity to make our evidence-based practice accessible to a wider audience.

      2. Money, honey.

I think most of us would agree that people typically don’t enter the field of nutrition and dietetics for the money. In my experience, the dietitians and nutrition students I’ve interacted with genuinely want to make a difference in the lives of others. Again, this is something I love about our field. But after five years of schooling, I’m ready for (and in need of) some real income. At first, one of my biggest skepticisms of online business was whether or not someone could actually make a living from it. Based on what I’ve heard from people who are currently running online businesses, the answer is YES, YOU CAN. In fact, I’ve listened to a food photographer share her story of how she makes over $100,000 annually through online food photography. A dietitian who recently shared her success in online business generated over $200,000 of revenue in 2017. According to the Academy of Nutrition and Dietetics, the median salary of a Registered Dietitian was $63,700 in 2015. This indicates that there is potential for major profit in online business compared to some of the more traditional careers of Registered Dietitians. 

     3. It’s versatile.

Remember, “the options are only limited by your imagination”. This moto applies to online business as well. You don’t have to be a food blogger that develops recipes—although that sounds pretty fun to me. There are a variety of services you could offer online. Much of the nutrition and dietetics field is about educating others. I’ve heard quite a few people say “with the way technology is these days, anything that can be taught in person can be taught online”. I’m sure some would disagree with this, and I do not want to minimize in-person interactions in any way. But as I mentioned before, offering online education and services provides an avenue to reach a broader audience. Services offered online by a Registered Dietitian could include anything from meal-planning, cooking classes, and nutrition education to online counseling, or even gardening help.

     4. Schedule flexibility.

I’m certainly not an expert on entrepreneur lingo, but I think it goes something like this: work from home, be your own boss, set your own hours. Sounds good to me! If you’re someone who doesn’t love the traditional 9-5 work day schedule, starting your own online business can provide the flexibility you are looking for. This is by far one of the most common perks I have heard online entrepreneurs discuss. Shannon Monson, a dietitian who started the company Nutrition Simply, has shared how she is able to decide when and where she works while still financially supporting her family. She was able to take a vacation, personal leave, and spend time with her children over the summer in 2017 and still had her most profitable year to date.

     5. Have fun & channel creativity.

For many online entrepreneurs and influencers, their business has become a creative outlet (or their creative outlet has eventually grown into their full-time job). McKel Hill, an RDN and Founder of Nutrition Stripped, is very open about how her creative outlet naturally evolved into her successful online business. As the food and nutrition experts, dietitians have valuable knowledge to share with others.  Starting an online business is a way to relay that information to the public in creative and innovative ways. It is easy for the elements of fun and creativity to be overlooked when talking about careers. However, I believe these are important components of job satisfaction. At the Food and Nutrition Conference and Expo (FNCE) this past fall, two RDs expressed the importance of creativity and having fun. Dawn Jackson Blatner, the dietitian for the Chicago Cubs, said, “you would be more successful if you added more fun”. She outlined how chasing her passions has led to several successful job positions. Similarly, Rebecca Lewis, the head Dietitian at HelloFresh stated, “the last ingredient [for success in your future career] is creativity. You don’t want your career to get stale, you don’t want your passion to dry up”.

Of course, there will also be challenges to starting an online business, as there is with any new career endeavor. If you are interested in learning more about the journey of a dietitian who has successfully created her own online company, check out McKel Hill’s “5 Years of Business Advice” at https://nutritionstripped.com/5years-business-advice/

Media Sources:

http://www.keepcalmandposters.com/poster/5527013_keep_calm_and_ask_a_dietitian

http://businessbharat.com/online-business-kaise-start-kre-no-investment-in-hindi/

http://www.alliantstaffing.com/agency-nursing-highest-pay-most-flexibility

Other Sources:

Rodgers, D. (2015). Compensation and benefits survey 2015. Journal of the Academy of Nutrition and Dietetics, 166(3), 370-383.

Boepple, L. & Thompson, J. K. (2014). A content analysis of healthy living blogs: Evidence of content thematically consistent with dysfunctional eating attitudes and behaviors. International Journal of Eating Disorders, 47(4), 362-367.

Wolf, A., Blatner, D. J., Manring, D., & Lewis, R. (2017, October 23) Hot career paths in nutrition: expert panel. Presentation at the Food and Nutrion Conference and Expo, Chicago, IL.