As a licensed nutritionist, I get questions about CNS® certification vs. RD certification all the time. This post is here to help you clear up any confusion and figure out which path is right for you!
This post is part of a Nutritionist Behind the Scenes series that is hosted on Frugal Nutrition to help CNS® nutritionists navigate the industry after graduation. To see the full series, please visit The CNS® Path: Exam Study Tips, Internships, Licensing, Getting a Job.
CNS Nutritionists vs. RD Nutritionists: What's Different and What's the Same?
In Baltimore, Maryland, where I currently live, the training is different, but the scope and licensure of a CNS® is the same as an RD; however, this isn’t true in all states.
Let’s check out the differences in training, and what it really means to be a licensed or certified nutritionist.
What is a Nutritionist?
Believe it or not, this is not a simple answer.
The assumption is that a nutritionist is someone who is well trained in nutrition and has the authority to practice nutrition counseling and give nutrition advice.
However, in several states, ANYONE can call themselves a nutritionist. These states include:
- California, Oregon, New Hampshire, Vermont, Alaska, Washington, and many others.
This means your Crossfit gym owner can do a lot of research online and call themselves a nutritionist, just without the term “licensed” or “certified.”
Personal trainers and health coaches without biochemistry backgrounds, and Instagram influencers with no formal training can call themselves nutritionists and legally (but not ethically) give nutrition advice in several states.
The Laws in Your State:
- CNS® Licensure Map by the American Nutrition Association
- RD Licensure Map by The American Academy of Nutrition and Dietetics
It is super important to acknowledge that there are incredibly intelligent, well-meaning individuals without training who actually do a great job in nutrition counseling. But, they’re often lacking the training required to give them the full picture.
One of the biggest takeaways from an advanced nutrition degree is how much we DON’T know about nutrition, as well as how much we probably CAN’T know about nutrition. Anybody with legitimate training knows the limitations of our nutrition knowledge and nutrition science.
As we like to say, it’s impossible to do true double blind randomized control trials (the gold standard) with whole foods: You know if you’re eating an apple or not.
I've also see many of these well-meaning individuals encourage disordered eating and trigger eating disorders - NOT OKAY.
It’s really important to note that if it is powerful enough to heal, it is powerful enough to harm. Certified practitioners are well versed in this dichotomy and understand the benefits and limitations of things like supplements, therapeutic diets, and biases in research.
What is a Board Certified Nutritionist?
There are actually several boards that certify nutritionists.
- Certified Nutrition Specialist® (CNS® pathway)
- Commission on Dietetic Registration (RD pathway)
- Clinical Nutrition Certification Board (CCN Pathway)
According to the American Nutrition Association, these board certifications are defined as such:
"Certified Nutritional Specialist (CNS®): a Certified Nutrition Specialist is a highly qualified nutritional professional with an advanced degree (graduate or doctorate) from a fully accredited university in nutrition plus 1,000 hours of a supervised internship and must pass the rigorous exam administered by the Board for Certification of Nutrition Specialists...It is the most widely recognized nutrition certification by federal and state governments. It is the only non-dietetics credential and examination widely named in state nutrition licensure laws."
"Certified Clinical Nutritionist (CCN): a CCN is a highly qualified nutritional professional with a 4-year bachelor's degree and a 900-hour internship, a 56-hour post-graduate intensive study in clinical nutrition or a master's degree in human nutrition from the University of Bridgeport or Bastyr University and must pass the national board exam issued by the CNCB [7]. The CCN focuses on how foods are digested, absorbed, and assimilated, and ultimately how food affects the body biochemically..."
"Registered Dietitian (RD): an RD is a food and dietary professional, usually with a 4-year bachelor's degree and 900-1200 hours in a dietetic internship through an accredited program and passing a dietetics registration exam. Dietitians focus on calories (energy), quality of food in regard to freshness, sanitation and freedom from spoilage and contamination, meal planning, evaluation of standard measurements of foods, specific diets for certain conditions, and eating patterns based primarily on food groups, such as the food pyramid, and other guidelines based on daily food intake strictly outlined by health organizations [10]. Dietitians often work in health institutions as clinical dietitians, management dietitians, but can also work as community or consultant dietitians."
Here's a link to the PDF on the FTC's site with more information on these designations.
There's also a relatively new board, founded in 2008, that now certifies holistic nutritionists. It is not as strictly regulated, but it does teach current practitioners how to become well versed in holistic nutrition.
- HNCB Holistic Nutrition Credentialing Board (Holistic Nutritionist Pathway)
What is a Certified Nutrition Specialist® (CNS® Nutritionist)?
Full disclosure: I’m biased here because this is my certification!
A Certified Nutrition Specialist® is a federally recognized board certification with state-by-state licensure that is not federally recognized. Approximately 5 states give CNS® nutritionists and RD nutritionists the same licensure (called an LDN in Maryland), while another 13 states support the CNS® certification without licensure.
As of this posting, a CNS® nutritionist must graduate with a Master’s of Science in Human Clinical Nutrition, complete a 1,000-hour internship and pass a board exam.
Certified Nutrition Specialists® are important players in the functional medicine world. Functional medicine is the “root cause approach” to wellness. Functional practitioners are trained to find the root cause of disease, and to practice preventative care.
For this reason, CNS nutritionists are generally not found in hospitals, although according to a 2014 ruling, they technically can order therapeutic diets in hospitals! It just isn't always the best use of a CNS's high level training in personalized nutrition. Most CNS nutritionists work in private clinical practice alongside other modalities, such as functional MDs, chiropractors, and acupuncturists. You will also find them working in community nutrition and public health in similar positions as RDs - working in corporate wellness, in school systems, and on college campuses.
In short: A CNS’s graduate training is focused on functional medicine and root cause approaches to optimal wellness. Although some of the science classes are similar, the integrative approach for a CNS is completely different from what is covered in an undergraduate nutrition degree for the RD pathway. (Some programs may be exceptions to this rule, but I haven't found them yet!)
And remember, just because someone is “certified” and “licensed” as a Certified Nutrition Specialist® or as a Registered Dietitian, this does not mean they are well versed in the latest research.
What is a Registered Dietitian or (RD Nutritionist)?
A registered dietitian is a board certification and state licensure that is federally recognized.
As of this posting, an RD nutritionist must graduate with a Bachelor's of Science in Nutrition or Dietetics, complete a 1,200-hour internship and pass a board exam.
States have recently added nutritionist to the title to highlight that all RDs are technically nutritionists, but not all nutritionists are RDs.
Registered Dietitians are important players in the conventional medicine world. They learn about federal nutrition guidelines, are trained to support and utilize the USDA's resources, and have a wide variety of positions, working in hospitals, for large corporations, in school systems, and on college campuses.
They are trained in parenteral nutrition, and are historically taught to support the low-fat, calorie-counting mentality of conventional medicine.
However, more recently it has become commonplace to see registered dietitians taking the unconventional path - getting trained in functional medicine or working in private clinical practice.
Just like in any field, there are complacent RDs and excellent, creative-thinking RDs. Registered Dietitians who have taken it upon themselves to get further functional training are perfectly suited to navigate the crossovers between conventional medicine and functional medicine - and all the ones I know do an excellent job!
In short: A registered dietitian's undergraduate training is very conventional. They must go out on their own to learn about functional medicine approaches to nutrition.
What about Online Certification Programs?
There are a number of online programs that certify health coaches, and create their own nutrition certifications such as IIN, CNC, NTP/NTC, but these are short certification programs, sometimes just 200-hour online classes.
The caliber of these online programs is just not the same as a two-year master's degree from an accredited university, a rigorous clinical internship, and a challenging board exam.
This is like comparing someone with EMT training to a Nurse. That's the difference between a 200-hour training program and a 2-year+ program with clinical practice and a challenging board exam. Some similar coursework. Completely different levels of training. Completely different requirements.
Again, many of these practitioners are excellent health coaches, but due to their lack of high level science courses and relatively lenient programs, they should not be lumped in with board-certified nutritionists.
How To Find a Board-Certified Functional Nutritionist?
- Use the CNS Practitioner Finder on theana.org
- Go to ifm.org and search using their Find a Practitioner tool
- Search the alumni page at Maryland University of Integrative Health
- Search other alumni pages of schools such as Bridgeport University and Bastyr University
CNS Nutritionist vs. RD Nutritionist
In this section:
- Education
- Experiential Training
- Board Exams
- Continuing Education Requirements
- Career Paths
- Primary Focus: Conventional vs. Functional Medicine
- Scope of Practice
- Insurance Reimbursement for Nutrition Counseling
- What's the Job Market for an RD vs. a CNS?
Education
- CNS: Master’s of Science in Human Clinical Nutrition
- RD: Bachelor’s of Science in Nutrition (starting in 2024, a Master’s degree will be required)
Experiential Training
- CNS: 1,000 hours: 400 client-based, 200 education-based, 400 elective (can be client or education based, depending on intended focus)
- CNSs must have 50-90% of their internship hours in client-based clinical settings, with the remainder in education. CNSs rarely do clinical rotations in hospitals.
- The CNS internship is highly customizable.
- RDN: 900-1,200 hours
- RDNs are not required to have experiential practice in private clinics, but some choose to add this to their internship rotation and can have a few weeks of one-on-one client training before licensure.
- The RD internship is highly competitive and highly structured.
Board Exams
CNS: Certified Nutrition Specialist® Board Exam
- This test is offered twice per year and is updated yearly to reflect the latest science.
RD: Commission on Dietetic Registration Exam
Continuing Education Requirements:
Both CNSs and RDNs are required to get 75 hours of continuing education credits every 5 years. Additional state-based requirements may apply.
Career Paths: CNS Nutritionist vs. RD Nutritionist
When it comes to the standard career paths, RDNs are trained for acute care, such as hospital care, including parenteral (tube) nutrition, while CNSs are trained in chronic care and private clinical practice, working in doctor’s offices or in private wellness centers.
Both can be found working in public health and on college campuses, but CNSs do not have any experiential practice in tube feeding, and are unlikely to be found working in a hospital.
Focus: Conventional vs. Functional Medicine
The biggest difference between a CNS and an RDN is the content they’re exposed to during their education and internship training. An RDN is trained in conventional medicine. This means they are trained to follow the USDA’s guidelines and their training incorporates more general recommendations for the population at large rather than personalized nutrition.
CNSs are trained in functional medicine, which looks for the root cause of imbalance or disease and acknowledges that a person’s bio-individuality might not fit the mold of conventional medicine recommendations. This means a CNS doesn’t usually support USDA recommendations, does not usually recommend counting calories, and looks for more outside-the-box solutions.
You will often find an RDN who has stepped outside of conventional medicine to learn and practice integrative and functional medicine, but you are unlikely to find a CNS who practices conventional medicine.
There are TONS of amazing RDNs who practice personalized nutrition, but 95% of RD-pathway academic programs are conventional.
Scope of Practice
Scope varies by state, depending on the State Department of Health’s licensure.
For example, the state of Maryland has a Licensed Dietitian Nutritionist (LDN) designation, and both CNSs and RDNs can receive this license. Generally speaking, the scope of a CNS and an RDN is the same in all states that allow both to be licensed as an LDN. All states will recognize RDNs, but not all states will recognize CNSs.
There are some states that do not license, certify, or recognize CNS practitioners and only RDs are allowed to use the term "nutritionist." These states are shown here in red: theana.org/advocate
As of this posting, the following states have licensure pathways for both CNSs and RDs, essentially putting them on even footing.
- Maryland
- Delaware
- Illinois
- Florida
Insurance Reimbursement for Nutrition Counseling
Insurance can be used for both RDNs and CNSs depending on the state, but many choose not to accept it because there are a lot of limitations to what can be covered by insurance.
Nutritional counseling is not usually 100% covered for private practice professionals because it is often considered preventative, and our current healthcare climate doesn't prioritize preventative care.
What's the Job Market for an RD vs. a CNS?
This topic might become it's own post all together, but in short, the job market is quite different, and if you want to pursue one-on-one nutritional counseling, the job market is pretty lean for both CNSs and RDs.
Registered Dietitians tend to have access to more conventional full-time positions with paid vacation and health benefits. They work for hospitals, major food corporations, and for large corporate wellness companies.
RD Nutritionists have more job security than CNS Nutritionists, but it might not be the types of jobs you want.
Certified Nutrition Specialist® have limited access to these positions. Since many of these big name companies are national, they hire RDs since the RD certification is more widely known and accepted.
A CNS nutritionist is more likely to work as a contractor, an educator, or in private practice. Here are some of the roles my fellow CNS's have:
- One-on-One Self-Pay Nutrition Counseling (independent practice)
- tends to be more complicated cases such as chronic illness, gut health, hormones, infections, autoimmune diseases, etc., rather than 'weight loss'
- One-on-One Insurance-based Nutrition Counseling (working alongside psychiatrists, general practitioners, chiropractors, cardiologists)
- Community Nutrition Programs - for schools, for community centers, for the recently incarcerated
- Professors & Teaching Assistants
- Clinical educators for functional testing companies
- Technical researchers / writers for supplement companies
- Writers for online publications
I wrote a detailed post about my hunt for a job and my first year as a CNS® here: CNS® MASTER’S IN NUTRITION: WHAT HAPPENS NEXT?
Keep in mind that there are plenty of RD's who do this type of work as listed above, but they're not quite as common. And they're not typically as well trained in the more complicated cases unless they do additional functional training outside of school.
That was quite the topic - but I hope it provides some answers! Any additional questions? Shoot me an email or reach out on Instagram. You can also schedule a free 20-minute call on my calendar: Schedule with me here.
Looking for more on this topic?
This post links to all the sub topics I've covered about being a Certified Nutrition Specialist®: THE CNS® PATH: EXAM STUDY TIPS, INTERNSHIPS, LICENSING, GETTING A JOB
Disclaimers:
Information on this website and blog are not provided by or affiliated with the American Nutrition Association®, Board for Certification of Nutrition Specialists℠ or the Certified Nutrition Specialist® (CNS®) credential. For information on the organizations, please visit https://theana.org and https://theana.org/certify.
Information on this website and blog are not provided by or affiliated with the Academy of Nutrition and Dietetics or Commission on Dietetic Registration. For information on these organizations, please visit https://www.cdrnet.org/ and https://www.eatright.org/.
Helpful post! I don't agree with everything stated about RDs given that I've had my undergrad, internship, and masters, but I see that other individuals have already stated some shared issues with the post. Nutrition as a science and as a medicine is one of our mottos. I disagree that the care and education RD's receive is "conventional" given that my coursework took a big focus on preventative and integrative/functional medicine~ perhaps this is a more recent change in the last 10 years. Hospitals like The Cleveland Clinic have its own Functional Medicine Clinic with RDs and its a huge step in Medicine for focusing on preventative whole care. I've had the personal pleasure of working with multiple RDs who practice under the AND SOPP for Integrative and Functional Medicine at VA Hospitals, private practices, and clinics who are registered under the IFM. I think at the end of the day both RDs and CNS's should be working together to advocate for preventative healthcare and medicine while also educating those about the scaries of taking advice from someone without solid qualifications and education. Its not enough that individuals cannot seek nutrition counseling due to financial barriers or because of Drs not recognizing the importance of nutrition as medicine and understanding what nutrition professionals practice/do. I'd love to know more about the coursework that CNS's take and what the clinical practice looks like to have a more well rounded understanding of the care you provide!
Hey Cailtin,
Thank you so much for making this post.
As someone pursing their CNS, I hope you don't mind me stealing this analogy, lol!
"The frequent saying is that if someone sits on a tack and has pain, in the conventional world they might give you ibuprofen for the pain, and in the functional world they might remove the tack. I like to think that in the holistic / TCM space, they might ask why the tack was there, who put it there, what drove you to sit on it...etc."
I love this. And I feel that integrative health gives us that middle ground space between functional and holistic.
Absolutely! This is exactly what integrative health is - asking the questions and also knowing when to use symptom management! :) Thanks Taylor!
Hi Caitlin,
Thank you for your extensive and passionate research on a topic of deep interest for both CNS professionals and RD professionals. I sincerely hope that in this country and maybe even abroad someday, both credentials are viewed with respect and trust, especially given the amount of training required, in order to serve multiple populations with chronic illnesses. This is an extraordinary field for all mankind. I appreciate both pathways and have even tried to take continuing education courses from a few RD internet sites.
I didn't interpret your post as a negative interpretation of the RDN training, or setting up one group against the other. On the contrary, that approach would oppose everything for which we stand - partnership, integration and mutual cooperation to better mankind. So many job openings are exclusively for the RDN as they are highly respected and talented. And yet, many doctor's offices and companies are seeking functionally trained practitioners with licenses. The different pathways can be confusing at times and lead to long discussions. I believe each pathway can provide tremendous healing to those in need.
I wanted to add, the job openings for functionally trained, integrative practitioners doesn't exclude the RDN. This type of job description just doesn't eliminate a CNS altogether, unless "RD only" is stated.
Hi Kristin,
Thank you for attempting to clarify something that is very difficult to explain to the general population. As someone who went down the CNS/CCN pathway first then did it all over to become an RD, I think the best way to explain it is that CNS and CCNs do not have as broad of a scope of practice as RDs. RDs can practice functional medicine, it just isn’t a key part of their training for the RD exam. They are provided with the base education in biochemistry and then have the option to specialize through advanced certification. In addition to doing what a CNS and CCN does, they also are eligible to work as managers, directors, in public health, sports/performance nutrition, for WIC, in eating disorder clinics, rehabilitation facilities, skilled nursing, respiratory care, food manufacturing, public policy, correctional facilities, for government entities, and many others. It is a shame that the notion that RDs push the food pyramid (which doesn’t exist anymore) is still making the rounds. That is not at all what RDs are taught. Yes they learn about the guidelines for Americans, but they are exactly what they are. Guidelines. Basically a starting point. They then apply and individualized, food first approach. Meaning, the approach is holistic by teaching individuals how to obtain adequate nutrition from wholesome foods first and only relying on supplements as necessary. I hope that helps add a bit more clarity for your readers.
Hi Carrie - thanks for your comment and clarity. I love that you did both pathways - I've been trying to find someone who has done both pathways for years! This is great information and very useful. I appreciate you!
This is SO helpful, thank you so much! I've been looking for this type of clarity.
I do have one question. It seems like holistic nutrition and functional nutrition are similar but "functional" comes from the medical world and "holistic" comes from eastern practices. Is that right? I know holistic nutrition isn't as well regulated currently as a CNS program but I'm trying to figure out what the difference is. I initially got interested in going back to school through a holistic program and then found the CNS degree so I'm feeling confused about which path to take. Thanks very much!
Sammi
Hey Sammi! I would agree with your basic assessment, but I do not know any holistic practitioners, so I can't say with certainty.
"Functional" is essentially a version of medicine that looks for the root causes of conditions instead of treating individual disparate symptoms. It is, generally, considered more holistic in nature. It was introduced as a concept in the US in the 70's or 80's and Dr. Jeffrey Bland is credited with the coining of the term. Some versions of functional medicine certainly existed around the world before then (especially in Germany), and it is almost a bit of an offshoot of Naturopathic Medicine, which was founded in the early 1900's. I would consider functional medicine as a bit of an incorporative / integrative way of approaching health care and medicine. It is often deemed the opposite of "conventional medicine" which is hospital, acute care, and prescription-based disease care.
Nowadays, I think functional medicine can sometimes rely a bit too heavily on supplements and expensive testing, but the core tenets are the same. I am not an authority on this subject necessarily, but it is what I often see functional providers doing in practice.
Holistic medicine has kind of lost a bit of its original definition. I think it was originally describing TCM and Ayurveda, just as you mentioned. But here in the West, we sort of butchered it up a bit and muddied the definition. In practice, the way I see it, is that it certainly has a similar core tenet to functional medicine - addressing root cause imbalances - but it may incorporate more TCM understandings such as temperament, energy, emotions, community/spiritual connection, and other aspects that are more challenging to be measured by modern methods, but have been used for 5,000 years with great success.
The frequent saying is that if someone sits on a tack and has pain, in the conventional world they might give you ibuprofen for the pain, and in the functional world they might remove the tack. I like to think that in the holistic / TCM space, they might ask why the tack was there, who put it there, what drove you to sit on it...etc.
I hope that helps! Happy to chat with you a little more if you'd like! Just fill out my contact form and we'll set up a time.
As someone who is studying to be a dietitian in South Africa, I am shocked and honestly offended at the way you minimised our 4 years of training in chemistry, biochemistry, biology, nutrition, anatomy, physiology and psychology to merely “conventional American guidelines” (???) Holistic nutrition is one of our key focuses and dietitians are very commonly found in private practice. A very obviously biased post from someone who seems like they have something to prove.
Hi there Anonymous! I appreciate your concerns but I do think it is important to note that this post is for dietitians and nutrition professionals following the US guidelines. It looks like in South Africa you have to register with the Health Professions Council of South Africa - which is quite different from the AND. There are significantly different requirements all over the globe. For example, I know that there aren't a lot of programs for dietetics in Germany, but that their education is nothing like the conventional medicine approach in the US and they have a lot of holistic approaches to health...the US has some of the worst healthcare in the world so I'm not surprised to hear that you have such great training in South Africa! I have taken many undergraduate nutrition courses for dietitians and I am very well versed in what the US guidelines are. I have seen over the last 5+ years that things are changing quite a bit though, which is great! Good luck in your training - I know that degree programs of all kinds can be quite rigorous. I certainly did not mean to offend you and do have plans to update this post with the most recent changes - including the requirement in the US for dietitians to have master's degrees starting in 2024. Thanks for your comment!
Hello Sammi, I know this is an old post but have you looked into the NANP and what they have to offer for Holistic Certification? Here is there link nanp (dot) org
Dietetic intern here. RD/RDNs now require a MS. I don’t know where you got your information about RDs from but how your info is presented makes it seem like a CNS is superior to RD. Keep in mind, there's a reason the saying of all dietitians are nutritionists but not all nutritionists are dietitians. According to the CNS website I qualify for the exam as soon as I finish my internship but it's somewhat redundant. However you wouldn't qualify for the RD exam after finishing yours.
You make us seem uneducated (or less educated) and rigid in our views. We have required continued education where we are updated about current research and potential changes in current practices. My degree was in nutrition AND dietetics and I have a MS in Nutrition.
I went to a University that separated the 2 programs; nutrition with science and nutrition &dietetics. We had very specific courses because they have to meet ASCEND's standards with 2 separate applications (1 for the upper level and 1 for the internship). The nutrition with science degree have some of the classes overlap but a solid year of classes we take that nutrition degrees don't (that can meet the CNS standards).
We view food as medicine in acute and chronic conditions and we apply it as such. We do look at the root causes of nutrition problems and our interventions focus on treating them to reduce signs and symptoms. We don't just use information provided by the USDA. Some information yes, like food safety.
We make recommendations based on a patient/clients clinical condition, nutritional status (including malnutrition and nutrient deficiencies), their culture, and accessibility, behavior, and preferences to make sustainable changes that can be utilized in combination with medicine and exercise to treat chronic conditions. Some settings are more individualized than others (hospital<outpatient<private practice).
Calories are only mentioned by RDs when calculating nutrition support orders. Not one of the RDs I've shadowed in my program have focused on calories including bariatrics when counseling patients. The emphasis is proper meal pattern, meal composition and portions. We focus on nutrient dense foods rather than saying good foods/bad foods. We are trained in motivational interviewing and using other behavioral models for effective counseling.
Plus all RDs are in hospitals and many are actually in professions you mentioned in the list. It just so happens that the only nutritionists you find in most hospitals are RDs. We are involved in primary and tertiary prevention. Insurance does cover some of our services as well in the hospital, outpatient and some private practices.
The advice I've seen some 'nutritionists' give is inaccurate and dangerous. Multiple patients come in not eating or avoiding entire food groups because of things they've heard on the internet from other healthcare professionals giving advice because anyone can claim to be a nutritionist. According to the CNS website 11 states still say it's illegal for anyone besides RDs to perform individual nutrition counseling. (By phrasing it this way means that RDs are qualified to give this counseling which means we were taught how to do so.)
Your view of RDs literally discredits our title to give credibility to yours. Advocate for your credentials but not in a way that disrespects another. Cause this article wasn't a way to obtain respect from RDs.
Hi Anonymous, congratulations on becoming a dietetic intern! I know that is very competitive. I appreciate your view as someone new to the field.
I know that the field has changed over the last few years - dietitians like Kathie Swift (founder of IFNA), & Lily Nichols have done an amazing job of advancing the training of Dietitians.
As of the original posting of this, a master's degree was not required to become an RD - you're one of the first graduating classes to need it! It is important to note that you can get a master's in any field (such as business, public health)...so it doesn't necessarily advance the RD's understanding of nutrition. If we were to get super specific here.
I do think it is important to draw a dotted line between a CNS vs an RD from a functional vs. conventional perspective. I think RD's are getting a lot more integrative & functional training now, which is what has historically been the specialty of CNS's. And, it is a personal & professional belief of mine that the integrative & functional approach is superior to the conventional approach.
As I mentioned in a previous comment, I have spoken with many CNS's and RD's in the creation of this post. Some of this comes directly from what RD's have reported to me! However, I acknowledge that some of the generalizations feel exclusive and I will plan to update this when I get the chance. I'd be happy to have you review some of my changes for inaccuracies or triggering phrasing when it is ready to publish.
At the end of the day, we are on the same side here - so I would like this post to reflect that and will absolutely be making changes. 👍
Just to add a bit of clarification to the MS requirement for RDs, the reason why people can get a degree in any field, provided they at least have one degree from an ACEND accredited dietetics program, is due to the broad scope of practice for RDs. Those who want to continue in clinical care, do go on to get a masters in nutrition and some go on for a degree in functional medicine. But, those who want to use their credential in a different capacity will seek out a complementary degree. For example, those who want to practice in eating disorders, they often go on for a degree in psychology and will complete the advanced training credential for eating disorders. Or, people who want to start their own business will often go on for an MBA. Some want to work in research so they go on for a PhD in the sciences. Some want to work in public health so they get an MPH or DrPH. And so on…So the broad range of degrees is actually a positive aspect.I hope this helps!
This is a very interesting (and clearly biased) view of registered dietitians.
Using terms like "conventionally trained" rather than "credentialed in evidence-based care" is an old tool.
Dietitians are trained in human nutrition, nutrition counseling and education, food science, behavioral science, medical nutrition therapy, public health, and other areas of nutrition practice. Some become dietitians for sports teams, some hang out a shingle and provide individual care. Many work in hospitals providing medical nutrition therapy (which is not simply tube feeding and parenteral nutrition).
Certainly, others can become nutrition experts (having pursued advanced degrees in human nutrition/nutrition science) but let's not try to subtly (or not so subtly) suggest that the RDN credential is somehow "old school."
Ah. My comment is awaiting moderation. Let's see if it posts!
Hi Deb! Thanks for your comment. I appreciate your perspective and feedback, and acknowledge that there are a lot of discrepancies in opinions and emotions on this topic. I had this reviewed by two RDs before posting, and the concept of RD training being more conventional vs. functional was the primary thing that they brought up as the difference between an RD and a CNS. The term conventional here isn't meant to imply "old school" but rather the differences delineating Conventional Medicine training and Functional Medicine training. As one of my RD friends puts it, there is no 'functional' training in RD programs, it follows conventional medicine training. (Both are evidence-based, both are important.) If anything, functional medicine incorporates more 'old school' tools such as herbal "medicine" which has been around for longer than anything in the conventional world.
I greatly appreciate your comment that a hospital dietitian does more than parenteral nutrition - I certainly didn't mean to imply that was their only role, as they are essential, live-saving members of a hospital care team and are often not treated or compensated as such. I would be happy to link out to a resource here that describes the role of a hospital dietitian in more detail.
I understand where some of this is coming from, saying RDs are taught "conventional" medical treatment that very evidenced based. However, I completely disagree that RDs don't provide personalised nutrition and only follow USDA's guidelines. We are taught, heavily, in training that nutrition is never black and white and should be individualized. If we told people exactly how they should eat, they wouldnt stick with what works for them. We use techniques to guide them towards healthful eating, trying to get to the root cause of their symptoms - NOT just treating the problem as a bandaid. Maybe we dont use herbal treatments, but again, that would be like telling them to take something to fix problems instead of getting to the root cause.
Hi Kristin - thanks for your message. I really appreciate what you're saying! I'm going to go over this post in a little more detail to correct anything that could be misleading. I agree with your assessment and have a lot of respect for RDs in my field. And a lot of RDs DO in fact use herbal treatments and practice in much the same way as I do (I've learned from some of them!). There is certainly a spectrum from conventional - integrative - functional and RDs can fall anywhere along that spectrum. I was trying to highlight that CNS's do not really fall on the conventional end, but I want to make sure this is clear and not written in a way that disrespects or misrepresents RDs. Thank you!
Caitlin thank you so much for your informative post. Could you please elaborate what those 5 states are where CNS can also become an LDN?Thank you so much in advance
Hi sunstar! This is changing regularly, and there may even be more states than 5 now! I would check theana.org/advocate for the latest and most up-to-date information!