Do you "C" the Difference?

“I eat well. What are you asking? About my diet? Ohh, well I’m not on a diet. I mean, I’m not trying to lose weight. I know I should be walking more. I used to do diets. I eat vegetables. I don’t have much of an appetite so I don’t overeat, ya know?” states the 80 year old patient without any major past medical history.

There’s this funny misconception that a “diet” is what people know of as a “fad diet” or a “diet that results in weight loss.” There is also the misconception that “diet” is something that has a definite time limit and that is strictly based on nutrition. I believe that “one year older and one year wiser” claim, partly because that’s the direction I’m headed and I need for it to be true, but really because my 80 year old patients typically know more about what a dietitian is and does than do my peers. Well, my 80 year olds with significant past medical histories, that is. Precisely the reason why I immediately knew my patient hadn’t spent much time in a gown with a call button. 

I’m not exactly sure when the word “diet” became the connotation it is today. There are indeed weight loss diets but there are also consistent carbohydrate diets, low sodium diets, high protein/high calorie diets, pureed diets, celiac diets, renal diets, post-gastrointestinal-surgery liquid diets-not to be confused with the water-lemon-syrup-cayenne-concoction-“detox”-disaster diet that causes slight euphoria due to drops in blood sugar with the extra bonus of lean body mass loss…

This doesn’t even touch on calorie needs, food preferences, access to food, cooking ability, hand–to-mouth coordination, chewing and swallowing issues, etcetera. So where “diet” became “A diet” is unbeknown to me.

And to be honest, makes it very difficult for me to explain what a “dietitian” actually does to a person without past medical history or understanding of healthcare. I mean the first three letters spell “die”…a major turn off. And the first four letters are sometimes heard as a “you think you’re better than me?” Let alone the fact that every other allied health field uses the word “therapy” after their profession: respiratory therapy, physical therapy, occupational therapy, speech therapy…dietitian?

Maybe if it were “nutrition therapy” people wouldn’t assume “diet” as “A diet” and we could skip over the whole, “I know my hospital badge says “dietician” but it’s actually, officially spelled “dietitian” by the dietetics professionals” situation. I mean, hospitals, which are required by law to staff dietitans, can’t even get the spelling of my profession [w]right, how can I expect the public to understand what it is I am?

• It's correctly spelled dietiTian because it is the practice of dieteTics, likewise, a physiCian is the practice of physiC, or the art of healing.

One major problem is that the word “nutritionist” isn’t even a credible title, however; it is far more recognized by the public than “dietitian.” A dietitian must complete a 4 year undergraduate degree in nutrition, be matched to an American Dietetic Association accredited internship (comparable to a residency), and sit for the Registered Dietitian Board Examination while a “nutritionist” can be Joe Shmo who took one nutrition class online from Jane Doe “the Nutritionist”. 

My food science class’ final project was to develop a new or alternative food product to meet consumers’ needs and acceptance. Usually students create products for the heart healthy and diabetic population by finding ways to reduce calories and sugar. Every project done this year was exceptional but the one that tickled me most was the quick bread product. The type of fat used in the bread was altered to enhance fat absorption meeting the needs of cystic fibrosis patients. I can’t say the general public, who came to taste-test and evaluate the acceptability of the products, were as happy with this particular development as I was considering some may have been under the impression that they were taste testing food from “A diet”itian student.