Historically, many fitness pros have avoided nutrition discussions for fear of straying beyond their scope of practice or have gone overboard, exceeding their professional limits by recommending nutritional supplements or individualized meal plans.
There is a better way: Staying within scope of practice while adopting a coaching philosophy that uses proven methods of behavior change.
Recognizing this reality, IDEA has expanded its education, training, resources and official stand on nutrition. IDEA defers to the American Council on Exercise’s position statement urging fitness professionals to talk nutrition with their clients (ACE 2013). At least 10 fitness organizations offer additional training in nutrition. Clearly, fitness professionals are a key ally and resource for helping Americans to make healthy dietary choices.
Many fitness professionals have expanded their knowledge of nutrition best practices but are still unsure how to do all they can to integrate nutrition into their work while staying within their scope of practice. Furthermore, most health and fitness professionals now recognize that it’s one thing to merely recommend the right way to eat; it’s quite another to provide the coaching and support that produce meaningful health changes.
This article addresses key questions about scope of practice and coaching techniques; it also provides resources and links for further information, practice and training.
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Nutrition Coaching 101
Nutrition coaching starts with an understanding of the science of nutrition, the key federal dietary guidelines and the methods of conveying dietary information so that it is readily understood and actionable. The coaching component requires an understanding of how to help people identify, nurture and act on their internal motivations to change their behavior.
The Nutrition Coach: Scope of Practice Defines the Role
Nutrition scope of practice is not just a matter of professional ethics. In some states it’s a matter of law, and violators can be prosecuted.
Most U.S. states regulate nutrition and dietetics with laws that provide guidelines for all health professionals who discuss nutrition with their clients. Typically, the scope of practice for registered dietitians includes individualized dietary counseling, individualized meal plans and medical nutrition therapy. More information can be found at the Academy of Nutrition and Dietetics.
Ultimately, scope of practice is determined by a combination of three factors: state laws; education, knowledge and skills; and willingness to accept responsibility for one’s actions, should something go wrong. State laws come in three forms:
Licensure. The majority of states have licensure, where people acting outside of their scope can be fined and prosecuted.
Certification. In states with certification, noncertified individuals (non-RDs for the most part) are forbidden from calling themselves nutritionists, but they can still legally practice the profession.
Registration. In the one state with registration (California), unregistered individuals should not call themselves nutritionists or dietitians, but registered exams are not given and enforcement of registration is minimal.
The ACE position statement, which is based on a review of the current licensure laws and the activities within the scope of practice of nonlicensed professionals, shows there are many ways in which people who are not registered dietitians can support their clients’ efforts in making nutrition changes. These ways include developing cooking demonstrations and recipe exchanges, sharing handouts and informational packets, offering individual or group classes and seminars, and engaging in one-on-one encounters.
For much more on this topic, please see “Nutrition Coaching: A Primer for Health and Fitness Professionals”.
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