Nutrition is a big business. Careers related to the field are projected to grow in the next decade. According to the most recent Bureau of Labor statistics, dietitians and nutritionists will have a 20 percent growth rate between 2010 and 2020. The average growth rate for all occupations is 14 percent.
With weight loss programs, books and health food specialty stores, Americans are not short on information about what they should be eating.
“Nutrition is a relatively new science and everybody wants a piece of that,” said Sara Upson, a registered and licensed dietitian. “There's a lot of money in nutrition.”
In fact, the nutrition industry garnered $117 billion in sales in 2010, according to the Nutrition Business Journal.
“There's more interest in it,” said Susan Bennett, a retired dietitian. “I think it was a spinoff of the obesity problem in this country and because of that people are much more aware of the importance of nutrition.
She added, “The other side of that coin is people are very confused. They hear from one side, 'coffee is good for you.' Or they hear 'coffee is not good for you.' So they don't know what to believe.”
In addition, with the growth in the industry, they say health gets lost in all of the messages.
In this country, registered and licensed dietitians have authority in the field of nutrition. Some choose to work outside of the typical clinical setting and instead work on community-based health initiatives.
“When you say nutrition and dietetics, it is a broad spectrum of specialties,” Ms. Erlandson said. “You can't possibly be an expert in all of them.”
People don't have to leave East Texas to become a dietitian. Classes can be taken at a community college then transfer to The University of Texas at Tyler for undergraduate training. To meet the requirements for eligibility to apply to a dietetic internship, they can go to Stephen F. Austin University in Nacogdoches.
Most dietitians in East Texas are affiliated with hospitals, clinics, school districts, and other companies.
At the three large hospitals in Tyler — East Texas Medical Center, Trinity Mother Frances and The University of Texas Health Science Center at Tyler — they have 19 registered and licensed dietitians, collectively on staff.
But very few dietitians here have an independent private practice. It's a situation that differs from larger cities, even though East Texas has growing numbers of obesity and chronic health problems that would warrant the help of a dietitian outside of the clinical setting.
It's a trend some dietitians would like to see change in order to close that gap in service.
Ms. Upson opened her company, My Signature Nutrition, last spring. There, she provides typical nutrition services, in addition to medical nutrition therapy, weight management and sports nutrition.
After a career in music was cut short by a hand injury, she became a yoga instructor. As she taught yoga, she became more interested in the physiology of the body and the impact nutrition had on performance. Thus, she began her formal training in nutrition.
What sets her apart is an interest in eating disorders. She is the only private practicing dietitian who helps patients with the disorders in Tyler.
“In my mind, eating disorders and obesity are on a spectrum,” Ms. Upson said. “As a society, as we focus more and more on obesity, the incidences of eating disorders are going to increase because we're only focusing on weight loss. We're not focusing on health.”
In Texas, licensed dietitians cannot get reimbursed by Medicare for writing medical diets to patients. And with large, low-income communities in East Texas unable to afford that type of service, it may be difficult for dietitians to sustain a business, they explained.
State of nutrition
More than two-thirds of the nation is overweight or obese. Meanwhile, people are starving for information about health, nutrition and exercise, leading to a cycle of yo-yo dieting and misguided efforts.
“The thing that makes me crazy is everybody is looking for the next fast, easy, quick weight loss solution,” Ms. Upson said. “The magic pill you can take to lose weight and you can eat what you want to eat and don't have to exercise … It doesn't exist.”
In recent years, obesity awareness campaigns have educated millions of people. But Ms. Upson said it's difficult for many to apply it to their daily lives.
The problem, Ms. Upson said, is that some people do not prioritize health.
“People are so focused on losing weight that the picture of health is out the window,” she said. “You can lose weight on any type of diet but that doesn't mean that it's healthy… Health is the goal, even with weight loss.”
Measuring food and counting calories aren't as important as being mindful of what the body needs, she added.
Neither is having a whatever-it-takes approach to weight loss.
“We have people who are overweight who are skipping meals, using laxatives, purging, and smoking to lose weight — all of these inappropriate behaviors. But because they are overweight people are telling them, 'good job', when that is not healthy by any means.”
The key part of any dietitian's practice is to tailor a plan, based on the client's lifestyle and genetics. They have a health-based approach which gives power to the individual.
“Intuitive eating and mindful eating is teaching each person to be an expert of their own body,” Ms. Upson said. “While I can tell somebody how much to eat only they can tell what their body needs.”
Ms. Upson said even if there isn't weight loss, people should not discount the importance of a healthy diet and exercise.
FINDING accurate NUTRITION ADVICE
“We don't really recommend diets because they're temporary by nature and we need something that people can actually live with,” Ms. Bennett said.
Dietitians also don't attempt to overhaul a person's habits at once. If they are not used to cooking or eat out, there are ways to improve their lifestyle.
“If they are going to buy frozen dinners anyway, we advise them to look at the labels,” Ms. Bennett said. “That's the mindset of most dietitians. We're not going to try to make them go on a diet. We're not going to try to change their culture.”
If seeking nutrition information, dietitians advise that people question how much training a person has had. Dietitians undergo rigorous training after college, which include supervised practice, a registration exam, active registration and continuing education.
They are registered through the Academy of Nutrition and Dietetics and in most states, must be licensed by the state health department.
If unable to consult with a dietitian, information is still abundant through the local public health district, Texas A&M University's Agrilife Extension Service and local Texas Department of State Health Services offices. Government sponsored websites are also helpful.
“One of the best things people can do is go to choosemyplate.gov,” Ms Bennett said.
“What we're really concerned about is how is the quality of that advice going to measure up?” Ms. Bennett said.
She also said to be wary of anyone who simply endorses products and supplements instead of encouraging getting nutrition from food.
“I think you have to be careful about that,” she said.