“A dietitian came into work to talk to the personal trainers,” he told me. Even over the phone, his voice had a certain strained-quality about it. I pictured a group of fit trainers, eager for solid nutrition advice to pass on to their clients, gathered around a young, white lady (my imagination went with the odds on that one).
“Yeah… She told us all about how she had an eating disorder…”
My hand clenched around the phone. I knew where this was going already. “That she diagnosed herself?”
“Yip.” The strained quality in his voice was more pronounced than ever. “Said that she had healed herself from it by going low-carb. Keto.”
“Yeah… She even said that she didn’t learn any of this when she studied nutrition at university.”
“Red flag.” I was shaking my head by this point.
“Uh huh. Basically said that we should be getting all of our clients to go low-carb.”
“So she had issues with food when she was younger, and instead of getting help to deal with her relationship with food and the causes behind it, she decided to study nutrition and ultimately follow a restrictive diet. And now she blanket recommends that same diet to all her clients because if it ‘worked’ for her, it will work for them, too.” I’m certain he could feel the air quotes by my tone alone.
“So effing typical.”
There are many wonderful nutritionists and dietitians who work hard every day to help their clients. But the thing is, there are a lot of shit ones, too. When you only know a little bit about something, I think it’s far more dangerous than knowing nothing. People who know nothing about a topic don’t give others advice about it, and they certainly don’t proclaim to be experts in that topic. But people who know a little bit often think they know a lot. They don’t know enough to recognize that they don’t know shit. Know what I mean?
If you’re thinking about seeing a nutritionist or dietitian I don’t want to put you off, I just want to help you choose a good one, and avoid the dodgy ones. Let’s go.
First off, what’s the difference between a dietitian and a nutritionist?
In New Zealand, a dietitian has a bachelors and masters degree in nutrition. Or, if they’re older, they might have a two-year post grad diploma instead of a masters. They need to be registered with the Dietitians Board and hold an annual practicing certificate. They need to log points every year, detailing their professional development. And they are bound to abide by a code of ethics. No one can use the title of ‘Dietitian’ unless they do all that. They often work in quite specialized fields.
Nutritionists are a bit different. The title isn’t protected in the same way ‘Dietitian’ is. So there are PhD-level nutritionists, and there’s that chick from yoga who did a 2-week course on the internet and now runs her own nutrition business. Nutritionists tend to be more generalist than dietitians. Some choose to register with a professional body like the Nutrition Society of New Zealand, and they log points every year the same way dietitians do.
Let’s get into how to spot the dodgy ones.
1. Their qualification is from a place you’ve never heard of, with a really specific-sounding name.
My bachelors and masters degrees are from the University of Otago. It’s a great big university that run more than just nutrition courses. They have a med school, a health sciences department, your co-worker studied accounting there, etc. Standard stuff.
If your potential nutritionist has a diploma from something like ‘The Centre of Holistic Nutrition and Wellness’ (I’m just making that up, but it sounds good, right?) and they only teach nutrition there, it’s a red flag. It’s too specific. It’s probably not a registered tertiary education institution.
Your nutritionist/dietitian should list their qualifications on their website. If they don’t, or even if they do but you’re not sure what exactly they mean, contact them and ask. They should not be afraid to have their qualifications asked for and explain how many years they studied for and where. In fact, they should be pleased to get a chance to tell you all about it.
2. They’re not registered with a professional body, or their professional body is dodgy af.
The Dietitians Board of New Zealand and the Nutrition Society of New Zealand are standard. But anyone can come up with a name that sounds legit. The devil is in the detail here. Check the website of the professional body and try to find what EXACTLY you have to do to be a member. If they only give vague terms like “our members must hold a nutrition qualification” or “members must have undergone clinical training” but they don’t say exactly what kind of qualification, or exactly what ‘clinical training’ is, it’s dodgy.
3. They list way too many specific conditions on their website.
A good dietitian/nutritionist has a few areas of interest that they’ve made an effort to upskill in over the years. They’ll probably list these on their website, like I’ve listed mine: disordered eating, lifestyle medicine, teen athletes and feeding kids. They’re all fairly connected things and there are only a handful of them. If you want advice on irritable bowel syndrome, I would refer you to someone else, because I don’t know anywhere near enough about it to help you without accidentally harming you in the process.
In contrast, a dodgy dietitian/nutritionist will list way too many things. I originally copy/pasted a random nutritionist’s website listing for you here, but now I’m second-guessing the legality of doing that (can they sue me for slander or something?). So instead I’ve bastardized a couple of them into one.
Services offered include (but are not limited to):
- Sports nutrition
- Chronic conditions (diabetes, coeliac disease, thyroid issues, IBD)
- Hormonal imbalances (endometriosis, PCOS, PMS, peri-menopause, menopause)
- Depression/anxiety/mood disorders/fatigue
- Autoimmune conditions
- Skin conditions (acne, eczema, rosacea, psoriasis)
- Children’s health (ADHD, ASD)
- Pre-conception/pre- and post-natal nutrition/lactation
- Food allergies/intolerances
- Nutrition for children and teenagers
- Meal plans
- Gastrointestinal disorders (reflux, leaky gut, SIBO, IBS)
- Eating disorders
- Weight loss
Do you see what I mean? I highly doubt this person is an expert in all of these areas. A good dietitian/nutritionist knows where their scope of practice ends and when they need to refer on to someone with more knowledge and experience in that area. A dodgy dietitian/nutritionist will see anyone for any ailment.
Now say you’ve done your due diligence on their website and you think you have someone who’s qualified. Let’s move on to red flags in your actual consult, because even some of the most highly qualified dietitians/nutritionists can still give out dodgy advice…
4. They push you to get random, expensive blood tests or genetic testing
Sometimes blood tests can be useful. If a dietitian/nutritionist tells you they suspect you might be low in iron, for instance, it’s perfectly acceptable for them to recommend you ask your GP (family doctor) to order you a blood test next time you go in. Or maybe you get a really upset tummy when you eat gluten and the dietitian/nutritionist says it could be useful talking to your GP about testing for coeliac disease. The GP is usually hooked into these sorts of conversations.
But asking you to get a whole panel of blood tests or genetic testing at your own expense is dodgy because what will they do with the results? How will the results change their nutrition advice to you? Maaaaaaybe, if you’re really into numbers and are super curious and you’re just fine tuning things after months of solid lifestyle change, you might find it useful. But I doubt it. It might be interesting to see that you have a gene that means you’re not great at processing carbohydrates, but I bet you already knew that. You’re the expert in your own body, and you probably don’t need a super expensive test to tell you that you should eat more vegetables. If you get told in your first session that you need a whole panel of blood tests or genetic testing and you have to pay for it yourself, run for the hills because your dietitian/nutritionist is dodgy af.
5. They push branded supplements on you
Dietitians and nutritionists should be all about food – it’s called a food-first approach. If they’re recommending supplements, it should only be because the food-first approach isn’t meeting your needs (e.g. sometimes my young teen athletes are waking up hungry in the night because it’s physically hard for them to eat enough food to fuel their growing bodies and their training load. In this case, I may recommend they try some smoothies with added milk powder or a protein powder). The key is that they’ve advised food first.
A good dietitian/nutritionist doesn’t give a shit what brand you choose. In fact, dietitians are forbidden from recommending only one brand. Their code of ethics states they need to give options. So if your nutritionist tells you to get a certain brand of supplements or, even worse, they happen to sell that supplement or work for the company that makes that supplement, by god, get up and walk out of that consult.
6. They use a personal transformation story to sell you on a specific way of eating
This is what the dietitian did to the personal trainers at the start of this post. Just because eating a certain way ‘worked’ for them, does not mean it will work for you. Not everyone should go low-carb. Not everyone should go vegan. There’s good foundational nutrition – eating mostly whole foods and not too much processed crap – and there’s solid advice about how to eat, e.g. not late at night, with loved ones, mindfully, etc. But beyond that, your dietitian/nutritionist should be taking their cues from you.
What’s your lifestyle? What’s important to you? What are you willing to change and what are you not gonna touch? A good dietitian/nutritionist should be doing far more listening than talking. And they should be working with you to create a plan together. If they’re not listening to you, if they try to give you some generic “you should do this diet”, it’s a huge red flag. In fact, if their sentences start with “You should”, just stop listening right then and there.
7. They get way too specific with the meal plan
Telling you that you need to have three low-carb pancakes with coconut sugar and whatever the f is trendy right now for breakfast, is too specific. Remember, a good nutritionist/dietitian will be working with you to tweak what you currently do. They’ll want ideas from you, they’ll want to know it’s realistic for you, etc. If your dietitian/nutritionist is dictating a meal plan to you, and it’s full of random shit you’d never eat, I’m afraid you’ve got a bad apple.
Hopefully these red flags help you in your search for a good dietitian/nutritionist. I am so saddened by the (many) stories I hear about terrible experiences with dodgy dietitians/nutritionists, who ultimately harm their clients and give the profession a bad name. Please don’t despair! There are many good ones out there. You just need to weed through the dodgy ones to find them, is all. Good luck!