- Most jobs are in hospitals, nursing care facilities, outpatient care centers, and offices of physicians or other health practitioners.
- Dietitians and nutritionists need at least a bachelor's degree; licensure, certification, or registration requirements vary by State.
- Applicants with specialized training, an advanced degree, or certifications beyond the particular State's minimum requirement should enjoy the best job opportunities.
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 healthcare 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 healthcare 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 healthcare 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 standard 40-hour week, although some work weekends. About 19 percent worked part time in 2008.
Performs duties in various specialized areas of dietetics for the purpose of developing knowledge and skill in the profession.
Assists the administrative dietitian in the planning of master menus, studies of local area food products, evaluation and revision of procedures. Contacts patients to obtain their opinion as part of the evaluation of the quality of the product.
Assists the clinical dietitian in developing nutritional care plans. Contacts patients to orient them to the meal procedures, and to ob serve their acceptance of the diet.
Assists in the staff development and nutrition clinic functions.
Serves as the clinical dietitian providing nutritional care to wards where patients require standard diets.
Interviews new patients, collects and records pertinent dietary information. Plans the dietary regimen based on the physician's diet prescription. Instructs the patient and family concerning the food service procedures.
Prepares the diet order, and coordinates the food production and service functions for assigned wards.
Evaluates and modifies the patient's diet plan, as required. Makes entries into the patient's medical record, and prepares reports of activities.
The clinical dietitian provides nutritional care for patients in as signed medical wards of a hospital.
The dietitian interviews newly admitted patients and pertinent background information and diet history. Develops, implements, and monitors the nutritional care plan, based on the physician's diet prescription and the dietitian's nutritional assessment of the patient. Records findings and plans in the medical record.
Participates with the health team on clinical rounds. Advises and informs the multidisciplinary health team about the patient's diet and progress. Coordinates the food service function for assigned wards.
Serves as nutritionist in a regional office responsible for carrying out management evaluations of State agency operations of Federal food assistance programs in terms of nutritional goals.
Reviews or assists in the review of plans for nutrition services or nutrition education submitted by States under food and nutrition or other programs.
Conducts or assists in on-site management evaluations of State agency operations of food programs with respect to nutritional standards, nutrition education, and food service management.
Guides or trains State agency personnel in proper interpretation of regulatory requirements for food packages, nutrients, or food patterns, and nutrition education for such programs.
Develops program aids and nutrition-related educational materials to be used by Federal and State agencies, program participants, or the general public. Maintains relationships with other Federal, State, and local governments, agencies, colleges, and universities to bring about a greater exchange of ideas, experiences, cooperative assistance and support for programs.
Assists higher level nutritionist in planning, monitoring, and collecting data for nutritional studies to be conducted in the region.
Makes presentations to groups, such as students, school administrators, community civil associations, or trade associations about the nutritional aspects of agency programs.
Serves as administrative dietitian in a work situation where the complexities of the hospital's dietetic program range from low to moderate, such as long-term patient care, a complex food service system, affiliation with a medical school, specialized medical pro grams, or other complexities.
Plans, schedules, and coordinates the functions of the section, including budget and menu planning, food production and service, safety and sanitation, space and equipment, and investigative studies in these areas for improving the economy of operations and the quality of service.
Provides direction to one or two subordinate dietitians, and through subordinate supervisors, to a large number of food service workers.
Serves as a public health nutritionist for an Indian Health Service unit, which furnishes a comprehensive health program for Indians residing within the designated area. The nutritionist works within the community, which is frequently remote or isolated, and lacks many of the modern conveniences.
Develops a nutritional health program for Indians in the area served, based on the nutritional needs identified, cultural patterns, and available resources.
Provides technical assistance in planning and implementing tribal health programs with a food and nutrition component and provides in-service training for tribal staff.
Evaluates dietary habits, food purchasing practices and food re sources of the Indians or special groups, and uses pertinent findings in planning practical nutrition services.
Coordinates the nutritional program with other health agencies, programs, and services to assure optimal nutritional care.
Identifies nutritional problems, establishes short and long-range objectives, sets priorities, plans the methods to be used, and evaluates progress.
Prepares the budget for the nutrition program in the service unit.
Provides consultant services on nutrition to health unit staff, hospital staff, community groups, clinics, families, schools, and others.
Serves as a nutritionist in the central office responsible for pro viding technical assistance in nutrition, food science, and institutional food service management to agency and regional organizations, and State agencies.
Develops and coordinates the scientific, technical, and administrative or food service management aspects of child nutrition programs administered by the agency.
Develops guidance materials, such as menu planning guides, food buying guides, quantity recipes, food service management manuals, fact sheets and training packages, for use in Federally funded child nutrition programs by program participants, administrative government agencies, and the food industry. Areas of responsibility include, but are not limited to, menu planning, nutritional requirements, food and equipment purchasing, food labeling, recipes, cost control, and interpretation of government regulations.
Develops and coordinates workshops and training sessions in nutrition and institutional food service management and operations for Federal program staffs. Interprets nutrition, food science, and food management research findings; evaluates impact of research on program operations; prepares position papers and reports to disseminate results.
Maintains contact with a variety of organizations, such as professional organizations and trade associations, in the development of nutritional aspects of regulations; with industry in relation to products to be used; and with colleges and universities to obtain current information and provide data for research contracts.
Recommends revisions or modifications to agency policies in nutrition, food science, and institutional food service management as the need arises during the course of the work.
Serves as dietitian responsible for the dietetic function in a general medical and surgical hospital when the program presents difficulties in the dietary treatment of patients, including several specialized medical programs, including renal dialysis and intensive care units; a substantial portion of the patients requiring treatment for chronic problems, such as liver disorders, alcoholism, carcinoma, diabetes, infections, and tuberculosis; and the hospital has an active nutrition clinic for outpatients, and provides advisory services for community facilities.
Plans, organizes and directs the activities of one or two subordinate professionals, as well as nonprofessional staff. Directs and/or performs the functions of planning food production and service, patient therapy, staff development, nutrition clinic and other responsibilities in the dietetic service.
Coordinates the activities of the dietary service with those of other departments within the hospital. Provides advice concerning dietary matters to hospital staff.
Serves as a nutritionist with responsibility for the development, implementation, administration, and coordination of a nutrition pro gram for an Indian Health
Service district composed of several service units, or the equivalent. The work involves travel within the district to remote, isolated, and primitive communities.
Plans and directs the nutritional program for the district. Provides consultation service on nutritional matters to professional and allied health staff of public health and related agencies.
Evaluates the nutrition and dietary services for district and recommends policies, standards, and programs to meet needs. Coordinates the nutrition services with other operating programs of the public health agency.
Provides technical assistance to the staff within the district, including developing guidelines, interpreting policies and procedures, reviewing program plans, and reviewing contacts for nutrition services.
Develops, conducts, and evaluates in-service training programs and participates in study projects.
Plans for, and provides, nutrition and food service management consultation and technical assistance to institutional facilities and evaluates operations.
Interprets public health nutrition programs and research findings, and maintains cooperative relations with civic, educational, governmental, research, and other groups concerned with food and nutrition. Stays abreast new developments within the profession, and of current services available to the target groups served.
Serves as an expert at the agency level, participating in the development and administration of the nutritional program nationwide.
Formulates operational standards and policies for the nutrition and dietetic service. Assures conformance with overall policies of the agency, and coordination with other health care services in the total health program.
Develops plans for research activities relating to nutrition and dietetics for the agency and interprets research results in terms of practical applications.
Provides technical assistance to the regional staff, including developing guidelines, interpreting policies and procedures, reviewing program plans, advising on floor plans for construction changes, reviewing contracts for nutrition services.
Evaluates the nutrition and dietary services through on-site visits, review of operational reports, studies of trends, and similar methods, to identify program needs and problems, and to recommend improvements.
Stays abreast of new developments within the profession, and of current services available to the target groups served.
Plans and/or conducts orientation, training of dietetic and other health services staff, workshops, and conferences.
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 2008, there were 279 bachelor's degree programs and 18 master's degree programs approved by the American Dietetic Association's Commission on Accreditation for Dietetics Education.
Licensure. Of the 46 States and jurisdictions with laws governing dietetics, 33 require licensure, 12 require statutory certification, and 1 requires registration. Specific 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 September 2009, there were 51 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 243 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.
Average employment growth is projected. Applicants with specialized training, an advanced degree, or certifications beyond the particular State's minimum requirement should enjoy the best job opportunities.
Employment change. Employment of dietitians and nutritionists is expected to increase 9 percent during the 2008-18 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 healthcare agencies. Public interest in nutrition and increased emphasis on health education and prudent lifestyles also will spur demand, especially in food service management.
Also, with increased public awareness of obesity and diabetes, Medicare coverage has been expanded to include medical nutrition therapy for renal and diabetic patients, creating job growth for dietitians and nutritionists specializing in those diseases.
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.
Finally, 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.
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. Applicants with specialized training, an advanced degree, or certifications beyond the particular State's minimum requirement should enjoy the best job opportunities. Demand for dietitians should be particularly strong in outpatient care facilities, offices of physicians, and food service management. Applicants 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.
Median annual wages of dietitians and nutritionists were $50,590 in May 2008. The middle 50 percent earned between $41,060 and $61,790. The lowest 10 percent earned less than $31,460, and the highest 10 percent earned more than $73,410. Median annual wages in the industries employing the largest numbers of dietitians and nutritionists in May 2008 were:
|Outpatient care centers||$52,120|
|General medical and surgical hospitals||51,390|
|Nursing care facilities||51,110|
|Special food services||45,410|
According to the American Dietetic Association, median annual wages for registered dietitians in 2007 varied by practice area as follows: $60,008 in consultation and business; $64,002 in food and nutrition management; $66,061 in education and research; $52,000 in clinical nutrition/ambulatory care; $53,997 in clinical nutrition/long-term care; $48,006 in community nutrition; and $48,984 in clinical nutrition/acute care. Salaries also vary by years in practice, education level, and geographic region.
For a list of academic programs, scholarships, and other information about dietitians, contact:
- The American Dietetic Association, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Internet: http://www.eatright.org
For information on the Registered Dietitian exam and other specialty credentials, contact:
- The Commission on Dietetic Registration, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Internet: http://www.cdrnet.org
Information on obtaining Dietitian or Nutritionist positions with the Federal Government is available from the Office of Personnel Management through USAJOBS, the Federal Government's official employment information system. This resource for locating and applying for job opportunities can be accessed through the Internet at http://www.usajobs.gov or through an interactive voice response telephone system at (703) 724–1850 or (703) 724–1850 or TDD (978) 461–8404 and (978) 461–8404. These numbers are not toll free, and charges may result. For advice on how to find and apply for Federal jobs, download the Insider's Guide to the Federal Hiring Process” online here.
- Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition; and
- Office of Personnel Management, Position Classification Standards.