In the early 2010s, physical therapists like Gray Cook (founder of FMS), Bob and Brad (Youtube’s dynamic PT duo) and Kelly Starrett (author of Becoming a Supple Leopard) started bringing physical therapy out of clinics and into gyms and homes. They created certifications, books and videos to educate fitness and healthcare professionals, and help would-be patients without the need to ever procure a script. Like anyone who tries to stir the pot, they were at first met with some backlash.
Traditionalists saw their actions as a liability - should we be enabling trainers to teach methodologies that extend beyond their scope? Should the average athlete or gym-goer be trusted to take matters into their own hands when it comes to more advanced techniques and exercises? Without proper guidance and trained supervision, this could be cause for concern.
Others saw their actions as a step forward in helping coaches to better guide their athletes, or empowering anyone with a youtube channel to be more proactive about their health. The more we know, the better we can do - and with increasing access to content (because internet), why not take the opportunity to educate?
Unsurprisingly, over the past 10+ years since those PTs took matters into their own hands, countless health professionals have created invaluable resources to help individuals prioritize wellness on their own terms.
Where are you going with this? I thought I was reading about nutrition stuff?
Well, while all of this was happening in the world of physical therapy, similar advancements in education were being seen with nutrition. We began to realize and embrace the notion that health can rarely be addressed in isolation: fitness, nutrition, sleep - they are all inextricably linked.
Precision Nutrition was founded in 2005 by exercise physiologist and nutritional biochemist Dr. John Berardi, who felt that what the majority of individuals seeking nutritional guidance needed was behavior-based counseling to reinforce lasting change. Around the same time, countless other certifying bodies for fitness professionals (ACE, NASM, etc.) began offering nutrition certifications. Like most fitness professionals, I have put in the time to learn everything I can about both nutrition and movement assessment, so that I can guide those I work with to the best of my ability - but in the end, I am not a subject expert in those areas. So, in the same way that I will refer to FX PT for any members with injuries, I refer to dietitians for members with nutrition needs that go beyond my scope of ability to help. Here are some times when you may benefit from seeing a dietitian:
The General Guidelines Aren’t Working, Or You Don’t Know How to Apply Them
You’ve tried everything you know to be reliable, foundational nutrition advice. (I mean really, truly, genuinely given it a chance). You’re eating well-balanced meals made of whole foods several times a day, including a variety of lean proteins, fruits, veggies, healthy fats and other complex carbs. You’re sleeping 7+ hours a day, exercising several times a week, taking plenty of time to chew food (sans distractions) during meals, you’re tuning into and respecting your hunger and fullness cues, and drinking half your bodyweight in oz of water (give or take).
You’ve kept a journal to make sure that what you think is happening, is actually happening. You’ve participated in my Fuel Your Fitness program to help you understand what all of the above means, and how it looks in your daily life (shameless plug). STILL, something is wrong - your energy levels are off, you’re constantly hungry, your digestion is funky, or you’re inexplicably gaining or losing weight. Or maybe the above guidelines feel utterly unrealistic (e.g. a variety of fresh foods are not accessible for whatever reason - money, proximity, availability, history or current battle with an eating disorder, etc. - and you’re unsure how to best take care of your body in a way that matches your resources). Sounds like it’s time to see a dietitian, because the general rules may be missing something for *you*.
You Have A Special Health Consideration
Pregnancy, PCOS, diabetes, a food allergy, sensitivity or intolerance, high blood pressure, cancer and chronic illness - these are just a few of the health conditions that benefit from specific nutritional guidance.
Dietitians undergo extensive education, clinical rotations, registration exams and continuing education to maintain their licensure to practice Medical Nutrition Therapy. Dietitians may also choose to obtain specialist certifications in everything from renal to pediatric to oncological nutrition. Elite athletes often work with board certified sports dietitians who understand the intricacies of their energy expenditure, and how to properly fuel and support performance-based needs.
Assess Bloodwork, Recommend Supplements and Write Meal Plans
Dietitians are trained to assess blood work and - taking into consideration your current dietary practices, lifestyle and medications - recommend supplements, dietary changes, or meal plans with a full understanding of the information at hand. They can prescribe diet plans with a working knowledge of the various impacts that diet will have on you, and reasons why it may help.
Please note that it is inappropriate (and often illegal, depending on the state) for any non-RD/CNS/etc. trainer or coach to prescribe a meal plan or diet (keto, intermittent fasting, paleo, calories or macros down to the gram, whatever).
They (this includes me!) don’t know enough about your health history, or have sufficient background, to understand the implications of a diet prescription. What they (and I) CAN do is discuss general guidelines (like these), and assist you with applying appropriate changes and small goals to help you adhere to these guidelines in ways most applicable to YOUR day-to-day life.
The ability to address your individual nutrition considerations from a foundation of well-rounded, expert knowledge and extensive education is critical to dietitians’ role as health care professionals. If any of these sound like they may apply to you, consider working with an RDN or CNS!
Check out these dietitians for reference:
https://thesassydietitian.com/
https://alexabedingfield.com/clinical-nutrition-counseling/
https://www.realfoodwithdana.com/
https://www.eleatnutrition.com/services
