Health coach Chip
Allman-Burgard, left, talks with client Myron Mix at Urban Orchard
grocery store in Andersonville. Allman-Burgard makes it clear to his
clients that he is not a registered dietitian, but, he says, “it’s often
precisely why they choose me.”
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After spending four miserable
days in the hospital with gallstones, Chicago resident Priscilla Dias
Hill resolved to improve her eating habits. Rather than working with a
licensed dietitian, however, she chose a holistic health coach.
Dias Hill's coach, Chip Allman-Burgard, came to her home and helped cook
meals. The two went grocery shopping together. And he taught her how to
choose whole, nutrient-rich foods over heavily processed substances.
But some say health coaches have
no business dishing out that sort of nutrition advice — especially when
medical issues may be involved — because they are not licensed by the
state of Illinois.
"When (a health coach) takes a client shopping, helps in meal
preparation, and then counsels on better meal choices, they are
performing the job of a registered dietitian," said Jackie King, a
registered dietitian and diabetes educator. Those who are not registered
dietitians, she added, "have no better credentials than a neighbor or
friend who would do the same thing, except they are profiting from it
financially."
Long ignored by medical doctors, the field of nutrition is now
recognized as an essential part of a healthy lifestyle. As interest
grows, registered dietitians have been fighting to protect their turf
against an influx of competition from not only health coaches but also
pharmacists, acupuncturists, herbalists, chiropractors, personal
trainers and bloggers.
The Academy of Nutrition and Dietetics, a trade group that represents
registered dietitians, has been working to ensure that only licensed
professionals can legally offer detailed nutrition counseling, both by
seeking licensure laws in states that do not have them and by opposing
efforts to relax rules elsewhere. To help its state affiliates submit
licensure bills, the association developed a Model Practice Act to be
used as a blueprint and offered training on effective lobbying
strategies.
A 2011 report from the group stressed that licensure was critical
because it protected the public from "incompetent, unqualified and
unskilled practitioners" and encourages its members to report "incidents
of harm." It also noted that dietitians face "a significant competitive
threat" as other practitioners expand their services to cover nutrition
counseling."
Opponents of restrictive licensure laws accuse the dietetics association
of trying to monopolize the field by excluding competition and
restricting choice at a time when nutrition professionals are needed
more than ever.
"Nutrition isn't an occupation like nursing; it's a tool kit used by
doctors, life coaches, dietitians, acupuncturists," said Zina Murray, of
Chicago, who used a holistic nutrition expert to restore her health and
traveled to Springfield to help lobby legislators for broader licensing
laws.
Until recently in Illinois, only registered dietitians could qualify as a
"licensed dietitian nutritionist," but in December the law was amended
to include certified nutrition specialists and several other groups who
undergo extensive training.
The new law, which the Illinois Dietetics Association initially opposed
but now says is "pleased" has passed, also offers slightly more
protection to those who give general nutrition advice, including
acupuncturists and employees of health food stores. Health coaches and
other unlicensed practitioners may describe themselves as a
"nutritionist" or "nutrition coach," provide broad information and
encourage healthy eating choices.
What remains unchanged is that unlicensed individuals may not legally
call themselves a "nutrition counselor" or another protected title or
advise clients on an individualized basis — such as by developing
customized diet regimens.
A license is also required to practice medical nutrition therapy, which
involves working with people who are ill or have conditions such as
diabetes or high cholesterol.
Though some certifications require more science-based nutrition training
than others, there isn't a single group that can claim to have the
edge, said Dr. David Miller, a pediatrician and licensed acupuncturist
who uses herbs and nutrition counseling in his practice.
"The science of nutrition hasn't been established yet and is, in fact, still a very active area of research," Miller said.
At the same time, Miller said, several overarching nutrition principles
seem to be holding up: eating fewer processed foods and emphasizing the
Mediterranean-style diet, which includes healthy fats, fruits and
vegetables.
"The greatest problem is that the public doesn't have access to enough
professionals who can help them understand the basics of healthy
eating," said Miller, the director of East-West Integrated Medicine in
Chicago.
Critics of the Academy of Nutrition and Dietetics' tactics say the
group's partnerships with food industry giants — including Coca-Cola,
PepsiCo, Con Agra, the National Cattlemen's Beef Association, Mars and
the National Dairy Council — hurt the credibility of registered
dietitians.
"There are registered dietitians who advocate for chocolate milk, turkey
bacon and Splenda With Antioxidants," said Andy Bellatti, a Las
Vegas-based registered dietitian. "I find the RD credential much more
under attack by RDs who shill for PepsiCo and the Corn Refiners
Association than by a well-informed, capable non-RD nutrition
professional."
Less than 9 percent of the organization's annual operating budget comes
from outside groups, said Joan Salge Blake, a spokeswoman for the
Academy of Nutrition and Dietetics. "The academy is very sensitive to
even the perception of conflict of interest that may occur," she said,
adding that the organization maintains transparency and issues only
credible, science-based nutrition information to consumers.
And though licensure favors registered dietitians, the group says laws
are "not an attempt to control any market" and don't affect those who
simply describe the nutritional value of products. Regulation would,
however, provide "recourse for victims of unqualified and unscrupulous
individuals dispensing improper advice," the group says.
Health coach Allman-Burgard said he trained through the New York-based
Institute for Integrative Nutrition, which offers a yearlong online
course. He said he works in conjunction with a medical doctor at his
company, Naturally Fortified, and makes it clear to his clients that he
is not a registered dietitian.
In fact, he says, "it's often precisely why they choose me."
That was the case for Dias Hill, 32, who was faced with gallbladder
surgery. Instead, she hoped Allman-Burgard could help her change her
lifestyle "without resorting to unhealthy dieting or medication." The
two began working together in May. Today she credits him with helping
steer her down the right path and instilling habits that she enjoys,
such as her green morning smoothie made with vegetables, fruit, chia or
flaxseed, and raw nuts.
"A dedicated health coach offers you something critical: coaching," she
said. "It was amazing to work with someone committed to my well-being."
Among the many registered dietitians who work in health care settings is
Eric Sharer, who counsels patients at the Block Center for Integrative
Cancer Treatment in Skokie on what foods to eat, how much, and whether
certain supplements might be dangerous in conjunction with treatment.
Sharer said he believes there's a place for alternative nutritionists, as long as they are well-trained and licensed.
"I've had patients see a practitioner for nutrition counseling and end
up on a very unbalanced, potentially health hazardous diet," said
Sharer, who also conducts cooking classes for patients going through
chemotherapy and radiation treatment. "I've also had many patients
buying products they find on the Internet, which often have little
health benefits or could be potentially dangerous."
Ineffective or misleading nutrition advice doesn't have to be
life-threatening to have an impact, say licensure proponents. In some
cases it can cause people to lose faith that lifestyle changes will
work.
Chicago-based registered dietitian Monica Joyce recently saw a
24-year-old-client who had been taken off dairy and gluten by another
practitioner. But the woman wasn't lactose or gluten intolerant, Joyce
said.
"She was confused about what to eat and frustrated by the limitations of
the diet. She missed some of her favorite foods yet she hadn't lost any
weight on it and was miserable," Joyce said. "The information that
people receive from non-RDs is usually fragmented and diluted and
sometimes downright wacky."
Bellatti advises that "rather than going by whatever title someone has,
go by what they say. "In the same way that an RD who thinks nothing of
recommending highly processed 'diet foods' should raise a red flag, so
should a nutrition therapist who tells you that you need to subsist on a
liquid diet for a week to get rid of toxins."
According to a trulyhorrifying report released last week by public health lawyer Michele Simon, the information you’re getting from your RD may have made its way to you via Coca-Cola. Seriously.
5. Double Your Ds
