Dietistas, nutricionistas e terapeutas nutricionais: qual é a diferença?

What do they do?

Dietitians (also 'dieticians'), nutritionists, and nutritional therapists all work with people and diet but there are some key differences in the work they do.

Dietitians

Dietitians are the only qualified diet professionals who can work both with healthy and with ill people. They can evaluate, diagnose and treat medical conditions such as diabetes, colesterol alto e síndrome do intestino irritável (IBS). Furthermore, dietitians use the most recent scientific evidence on nutrition to help people make healthier lifestyle and dietary changes.

Unlike 'nutritionist' and 'nutritional therapist', 'dietitian' is a protected title and only someone with the correct training and registration can practise as one.

Nutritionists

Nutritionists are only able to provide information about food and diet. Some nutritionists work under the supervision of a dietitian, and in this instance, they may give advice for specific medical conditions.

Nutritional therapists

Nutritional therapists make recommendations for diet to improve or prevent illnesses, often based on little scientific evidence. Their advice is often based on personal opinions or beliefs.

They use nutritional supplementation as natural medicine. The NHS recommendation is that most people do not need to take vitamin supplements and can get all the vitamins and minerals they need by eating a healthy, balanced diet. While nutritional supplementation is recognised as valid treatment in conventional medicine for small numbers of people with serious medical conditions or in at-risk groups, it is not recognised for the majority of people.

To become a dietitian, you must complete a minimum of a bachelor's degree (BSc) in Nutrition and Dietetics or a related science degree with a postgraduate degree in Dietetics.

There are no specific educational requirements for nutritionists, as different courses are available. However, many have a nutrition degree such as Human Nutrition, Public Health Nutrition or Food and Nutrition.

Similarly, there are no qualification requirements to become a nutritional therapist.

Dietitians

Dietitians are the only nutrition professionals to be protected and regulated by law. To call yourself a dietitian, you need to meet the qualification requirements and have to be registered with the statutory regulator called the Health and Care Professions Council (HCPC).

The HCPC assures that healthcare professionals, including dietitians, keep up to date with continuing professional development, and that they adhere to an ethical code of practice to the highest standard.

Nutricionista

Nutritionist is not a protected title, nor is it regulated by law. This means that anyone can call themselves a nutritionist.

However, you can check if a nutritionist is registered with the UK Voluntary Register of Nutritionists (UKVRN) held by the Association for Nutrition (AfN) to find out if a nutritionist is qualified to provide you with nutritional advice. Only those on the register are allowed to call themselves an associate nutritionist or, with at least three years of experience, a registered nutritionist.

To be eligible to register with the UKVRN, a nutritionist must have completed courses meeting high standards of professional education in nutrition, accredited by the AfN. Registrants must also complete further professional development.

Nutritional therapists

Nutritional therapists are not regulated by UK law and so anyone can call themselves a nutritional therapist. However, there are voluntary registers nutritional therapists can join to demonstrate professionalism, training level and adherence to a code of ethical conduct.

Nutritional therapists may register with or become members of, for instance:

• A Complementary and Natural Healthcare Council (CNHC).

• A General Regulatory Council for Complementary Therapies.

• A Naturopathic Nutrition Association.

• A British Association of Applied Nutrition and Nutrition Therapy (which now requires a degree accredited by The Nutritional Educational Commission).

Some training is also provided by the Institute of Optimum Nutrition (ION). The ION grants a 'Foundation Degree' to those who complete certain courses, but these are not recognised by universities. As registration is voluntary and as the title isn't protected, it is recommended that a client check the CNHC register to ensure a level of training and competence before seeking advice from a nutritional therapist.

Naomi Leppitt, registered dietitian at Nutrition Synergy, says that a key part of being a dietitian is communicating evidence and research on health and disease to patients and clients, as well as working collaboratively to apply the evidence and make goals to better health or treat disease. As the advice or treatment provided must be in line with the latest evidence, a dietitian can offer dietary advice you can trust.

It is against regulation for a dietitian to give advice which provides them with monetary gain, or is not evidence-based. If a patient or client is not satisfied with their treatment, the dietitian will be investigated by the HCPC and may have to pay damages or compensation. If the dietitian is a member of the British Association of UK Dietitians (BDA) they can receive legal advice and are covered with professional indemnity insurance.

Similarly, if a nutritionist gives false or wrong advice, the client could complain to the AfN and it would be investigated.

Nutritional therapists may offer a complementary-medicine approach to a specific medical condition - for instance, recommending high vitamin doses or avoiding certain foods. The evidence behind these approaches is more limited, and would serve to complement, not replace, traditional medicine. Nutritional therapists should avoid making claims which are not substantiated by evidence, advises Leppitt.

Some self-titled nutrition experts may give false advice, as they've not had years of rigorous training and practice. If an individual took this advice and suffered harm, it may be difficult to prove liability as it is also the individual's responsibility to come to an informed decision.

In summary, nutrition professionals can serve clients or patients in a variety of ways to suit their needs. The individual using their service should be able to trust their advice if they're registered with the appropriate bodies and have the relevant practice in that area.