Dietitians

Significant Points

Nature of Work

Dietitians and nutritionists plan food and nutrition programs, supervise meal preparation, and oversee the serving of meals. They prevent and treat illnesses by promoting healthy eating habits and recommending dietary modifications. For example, dietitians might teach a patient with high blood pressure how to use less salt when preparing meals, or create a diet reduced in fat and sugar for an overweight patient.

Dietitians manage food service systems for institutions such as hospitals and schools, promote sound eating habits through education, and conduct research. Many dietitians specialize, becoming a clinical dietitian, community dietitian, management dietitian, or consultant.

Clinical dietitians provide nutritional services to patients in hospitals, nursing care facilities, and other institutions. They assess patients’ nutritional needs, develop and implement nutrition programs, and evaluate and report the results. They also confer with doctors and other health care professionals to coordinate medical and nutritional needs. Some clinical dietitians specialize in managing the weight of overweight patients or in the care of renal (kidney), diabetic, or critically ill patients. In addition, clinical dietitians in nursing care facilities, small hospitals, or correctional facilities may manage the food service department.

Community dietitians counsel individuals and groups on nutritional practices designed to prevent disease and promote health. Working in places such as public health clinics, home health agencies, and health maintenance organizations, community dietitians evaluate individual needs, develop nutritional care plans, and instruct individuals and their families. Dietitians working in home health agencies provide instruction on grocery shopping and food preparation to the elderly, children, and individuals with special needs.

Increased public interest in nutrition has led to job opportunities in food manufacturing, advertising, and marketing. In these areas, dietitians analyze foods, prepare literature for distribution, or report on issues such as dietary fiber, vitamin supplements, or the nutritional content of recipes.

Management dietitians oversee large-scale meal planning and preparation in health care facilities, company cafeterias, prisons, and schools. They hire, train, and direct other dietitians and food service workers; budget for and purchase food, equipment, and supplies; enforce sanitary and safety regulations; and prepare records and reports.

Consultant dietitians work under contract with health care facilities or in their own private practice. They perform nutrition screenings for their clients and offer advice on diet-related concerns such as weight loss and cholesterol reduction. Some work for wellness programs, sports teams, supermarkets, and other nutrition-related businesses. They may consult with food service managers, providing expertise in sanitation, safety procedures, menu development, budgeting, and planning.

Work environment. Dietitians and nutritionists usually work in clean, well-lighted, and well-ventilated areas. However, some work in hot, congested kitchens. Many dietitians and nutritionists are on their feet for much of the workday.

Most full-time dietitians and nutritionists work a regular 40-hour week, although some work weekends. About 1 in 3 worked part time in 2006.

Qualifications

Dietitians and nutritionists need at least a bachelor’s degree. Licensure, certification, or registration requirements vary by State.

Education and training. Becoming a dietitian or nutritionist usually requires at least a bachelor’s degree in dietetics, foods and nutrition, food service systems management, or a related area. Graduate degrees also are available. College students in these majors take courses in foods, nutrition, institution management, chemistry, biochemistry, biology, microbiology, and physiology. Other suggested courses include business, mathematics, statistics, computer science, psychology, sociology, and economics. High school students interested in becoming a dietitian or nutritionist should take courses in biology, chemistry, mathematics, health, and communications.

As of 2007, there were 281 bachelor’s degree programs and 22 master’s degree programs approved by the American Dietetic Association’s Commission on Accreditation for Dietetics Education.

Licensure. Of the 48 States and jurisdictions with laws governing dietetics, 35 require licensure, 12 require statutory certification, and 1 requires registration. Requirements vary by State. As a result, interested candidates should determine the requirements of the State in which they want to work before sitting for any exam.

In States that require licensure, only people who are licensed can work as dietitians and nutritionists. States that require statutory certification limit the use of occupational titles to people who meet certain requirements; individuals without certification can still practice as a dietitian or nutritionist but without using certain titles. Registration is the least restrictive form of State regulation of dietitians and nutritionists. Unregistered people are permitted to practice as a dietitian or nutritionist.

Certification and other qualifications. Although not required, the Commission on Dietetic Registration of the American Dietetic Association awards the Registered Dietitian credential to those who pass an exam after completing academic coursework and a supervised internship. This certification is different from the statutory certification regulated by some States and discussed in the previous section. To maintain a Registered Dietitian status, workers must complete at least 75 credit hours in approved continuing education classes every 5 years.

A supervised internship, required for certification, can be completed in one of two ways. The first requires the completion of a program accredited by the Commission on Dietetic Registration. As of 2007, there were 53 accredited programs that combined academic and supervised practice experience and generally lasted 4 to 5 years. The second option requires the completion of 900 hours of supervised practice experience in any of the 265 accredited internships. These internships may be full-time programs lasting 6 to 12 months or part-time programs lasting 2 years.

Advancement. Experienced dietitians may advance to management positions, such as assistant director, associate director, or director of a dietetic department, or may become self-employed. Some dietitians specialize in areas such as renal, diabetic, cardiovascular, or pediatric dietetics. Others leave the occupation to become sales representatives for equipment, pharmaceutical, or food manufacturers. A master’s degree can help some workers to advance their careers, particularly in career paths related to research, advanced clinical positions, or public health.

Employment

Dietitians and nutritionists held about 57,000 jobs in 2006. More than half of all jobs were in hospitals, nursing care facilities, outpatient care centers, or offices of physicians and other health practitioners. State and local government agencies provided additional jobs—mostly in correctional facilities, health departments, and other public-health-related areas. Some dietitians and nutritionists were employed in special food services, an industry made up of firms providing food services on contract to facilities such as colleges and universities, airlines, correctional facilities, and company cafeterias.

Other jobs were in public and private educational services, community care facilities for the elderly (which includes assisted-living facilities), individual and family services, home health care services, and the Federal Government—mostly in the U.S. Department of Veterans Affairs. Some dietitians were self-employed, working as consultants to facilities such as hospitals and nursing care facilities or providing dietary counseling to individuals.

Job Outlook

Average employment growth is projected. Good job opportunities are expected, especially for dietitians with specialized training, an advanced degree, or certifications beyond the particular State’s minimum requirement.

Employment change. Employment of dietitians and nutritionists is expected to increase 9 percent during the 2006-16 projection decade, about as fast as the average for all occupations. Job growth will result from an increasing emphasis on disease prevention through improved dietary habits. A growing and aging population will boost demand for nutritional counseling and treatment in hospitals, residential care facilities, schools, prisons, community health programs, and home health care agencies. Public interest in nutrition and increased emphasis on health education and prudent lifestyles also will spur demand, especially in food service management.

Employment growth, however, may be constrained if some employers substitute other workers, such as health educators, food service managers, and dietetic technicians, to do work related to nutrition. Also, demand for nutritional therapy services is related to the ability of patients to pay, either out-of-pocket or through health insurance, and although more insurance plans now cover nutritional therapy services, the extent of such coverage varies among plans. Growth may be curbed by limitations on insurance reimbursement for dietetic services.

Hospitals will continue to employ a large number of dietitians and nutritionists to provide medical nutritional therapy and plan meals. But hospitals also will continue to contract with outside agencies for food service and move medical nutritional therapy to outpatient care facilities, slowing job growth in hospitals relative to food service, outpatient facilities, and other employers.

The number of dietitian positions in nursing care facilities is expected to decline, as these establishments continue to contract with outside agencies for food services. However, employment is expected to grow rapidly in contract providers of food services, in outpatient care centers, and in offices of physicians and other health practitioners.

Finally, with increased public awareness of obesity and diabetes, Medicare coverage may be expanded to include medical nutrition therapy for renal and diabetic patients, creating job growth for dietitians and nutritionists specializing in those diseases.

Job prospects. In addition to employment growth, job openings will result from the need to replace experienced workers who retire or leave the occupation for other reasons. Overall, job opportunities will be good for dietitians and nutritionists, particularly for licensed and registered dietitians. Job opportunities should be particularly good in outpatient care facilities, offices of physicians, and food service management. Dietitians and nutritionists without a bachelor’s degree will face keen competition for jobs.

Dietitians with specialized training, an advanced degree, or certifications beyond the particular State’s minimum requirement will experience the best job opportunities. Those specializing in renal and diabetic nutrition or gerontological nutrition will benefit from the growing number of diabetics and the aging of the population.

Projections Data

Earnings

Median annual earnings of dietitians and nutritionists were $46,980 in May 2006. The middle 50 percent earned between $38,430 and $57,090. The lowest 10 percent earned less than $29,860, and the highest 10 percent earned more than $68,330. Median annual earnings in the industries employing the largest numbers of dietitians and nutritionists in May 2006 were:

According to the American Dietetic Association, median annualized wages for registered dietitians in 2005 varied by practice area as follows: $53,800 in consultation and business; $60,000 in food and nutrition management; $60,200 in education and research; $48,800 in clinical nutrition/ambulatory care; $50,000 in clinical nutrition/long-term care; $44,800 in community nutrition; and $45,000 in clinical nutrition/acute care. Salaries also vary by years in practice, education level, and geographic region.

Related Occupations

Workers in other occupations who may apply the principles of dietetics include food service managers, health educators, dietetic technicians, and registered nurses.

Sources of Additional Information

Source: Bureau of Labor Statistics Occupational Outlook Handbook