From the Chair

February 21, 2016

By: Monique Richard

As DIFM chair, I'm asked all the time by fellow RDNs and students, "What is an Integrative RDN, what do they do?"

If you're considering the DPGs you would like to join for your 2016 Academy membership and wondering the same thing, I invite you to read on and see if what I've outlined below clarifies your question, speaks to you in some way, or raises more questions. If it does, then I invite you to join DIFM, take advantage of our many member benefits, and showcase the dynamic profession of dietetics.

What is an RDN?

In order to appropriately answer this common question, it is important to clarify that all dietitians are nutritionists, but not all nutritionists are dietitians.

The three steps required to become a nationally credentialed registered dietitian are:

1. Earn a bachelor’s degree with a curriculum accredited by the Academy of Nutrition and Dietetics’ Accreditation Council for Education in Nutrition and Dietetics (ACEND)
2. Complete an accredited dietetic internship (approximately 6-12 months long)
3. Pass a national examination administered by the Commission on Dietetic Registration (CDR)

The licensed dietitian nutritionist (LDN) credential depends on the state’s licensure laws but it is set up to protect the public from those that are not qualified to practice through these accreditation standards. It is not a requirement at this time for an RDN to hold a master’s degree, but approximately 50% of dietitians do have an advanced degree; in 2024 it will become a requirement to have a master’s degree.

This is not to say nutritionists or health coaches are not knowledgeable about nutrition, because they very well could be, depending on the programs they've completed. However, the distinct difference is the years of practice, breadth of experience, and specifically the ability to practice medical nutrition therapy (MNT). MNT delves into the clinical, metabolic, and systemic manifestations found in acute and chronic diseases such as diabetes, cardiovascular disease, celiac disease, food allergies, and hypertension. Registered dietitian nutritionists’ academic curriculum, internship, and experiences are tailored to train the dietitian well above and beyond macronutrients, micronutrients, and calories.

What is an Integrative RDN?

So now that we have clarified the difference between registered dietitians and nutritionists, let’s delve into explaining what is considered integrative and functional medicine.

The integrative component really focuses on the collaboration and communication between professional and patient, but also incorporating other professionals and modalities in order to achieve optimal health, healing and wellness. It is a holistic approach, individualized for every unique person’s needs. Functional medicine doesn’t just look to manage a disease, but takes a deeper look at the root causes, environmental impact, genetic predisposition, physiological, psychological and interdependent factors that contribute to the disease. Internal (mind, body, spirit) and external factors (physical and social environment) are taken into consideration in order to assess the intervention and treatment. These may include Western, or traditional medicine, along with more alternative and complementary care such as supplementing with herbs, probiotics or specific vitamins and minerals, eliminating specific foods , employing certain cooking methods , or using of Ayurveda, Chinese medicine, homeopathy and naturopathy, to name just a few.

Finally, this leads us to who integrative RDNs are and what they do. An integrative RDN puts all these components together—from the knowledge attained as a registered dietitian nutritionist to the many components of integrative and functional medicine—and combines it to take it a step further and dig a little deeper. Often working as a team, the integrative RDN collaborates with a physician in order to investigate clinical markers such as specific laboratory diagnostics that may be indicative of a vitamin, mineral, or nutrient deficiency. A specific whole-foods based plan can be developed and specific supplementation may be necessary.

Stress-management is also a focus and can be recommended with physical movement and release such as yoga, massage, Qi gong, energy healing, meditation, or simply identifying triggers and creating a plan to address them. An integrative RDN may recognize that a detoxification program may be beneficial for the individual as well. However, this is not to be confused with the pop-culture definition of a “detox.” An integrative RDN will explain the phases of cellular metabolism, how the body physically breaks down food, and how a build-up of toxins inhibits optimal function. Ridding the body of excess toxins, cleaning up the diet, and re-setting the mechanisms during a brief period are only some of the benefits of nutrition related interventions an integrative RDN may recommend.

Take a look at the Integrative and Functional Medicine in Medical Nutrition Therapy Radial below for a visual representation of how an integrative RDN works.

Many registered dietitian nutritionists naturally use various levels of integrative and functional medicine in their own private practice or clinical settings.

Dig deeper with DIFM and go farther to help your patients and clients. When it comes to integrative and functional medicine, we are the nutrition experts.