The demand of nutrition professionals has increased over the years in Bangladesh. But nutrition profession has been losing its credibility since the country has no code of ethics to guide or recognize nutrition professionals by a statutory body. Often they are titled as Dietician, Clinical Dietician, Clinical Nutritionist, Nutritionist etc. and which is why confusion arises among people to differentiate their professional title. Doctrines of the profession of Nutritionists and Dieticians are different in terms of their education, qualification and responsibilities. As there is no regulation over using their title employers also become confused. On top of that, there is no recruitment policy for these professions in Bangladesh.
The major differences between Nutritionist and Dieticians are reflected through their professional title. Dieticians can work as Nutritionists, but Nutritionists cannot work as Dieticians. After completing graduation, post-graduation and PG diploma in Nutrition and Food Science, anyone may be termed as a Nutritionist but to be a Dietician, registration from a statutory body is necessary. The Dieticians mainly work in health centres and as a team can treat complex clinical conditions such as diabetes, food allergy and intolerance, IBS syndrome, eating disorders, chronic fatigue, cancer, malnutrition, kidney failure, bowel disorders, heart diseases, hypertension, stroke etc.
On the other hand, Nutritionists are qualified to provide information about food and healthy eating, overweight and obesity management, but not about special diets for medical conditions or those living in the community requiring therapeutic interventions without supervision from a dietitian.
Dieticians’ title must be protected by law but no attempt has been taken by the relevant authorities to incorporate a professional body to regulate the registration procedure of license for practice, approval of curriculum, code of ethics and maintain standards. The proposed body can guide and monitor this profession to maintain standards. Medical & Dental Council (BM&DC) is only the statutory body to recognize and approve the curriculum of medical professions in Bangladesh.
How other countries address the professional objective of Nutritionists and Dieticians
The UK Law is very strong and set the principles and values guiding the professions to maintain standards. Health and Care Professions Council (HCPC) is the statutory regulator for registration of dieticians as well as approves the curriculum developed by the British Dietetic Association and Trade Union for dietitians. Dieticians are legally able to provide and administer diet related prescription. Nonetheless, the nutritionists are qualified to provide information about food and healthy eating, but not about special diets for medical conditions. There is a process of registration of Nutritionist under UK Voluntary Register of Nutritionists (UKVRN) and those registered address as Registered Nutritionist (RNutrs). The registered nutritionists do not call them registered Dieticians. Nutritionist registration is only required depending on the employer demand.
In Australia earlier, there was no legal protection over the terms ‘dietitian’ and ‘nutritionist. Now, The Dietitians Association of Australia (DAA) has developed credentialing systems for the credentials ‘Accredited Practising Dietitian’ (APD) which is protected by law. In comparison, the term nutritionist is not regulated as APD. The registration of nutritionist is also voluntary like UK.
In USA- the Academy of Nutrition and Dietetics (AND), and its credentialing agency, the Commission on Dietetic Registration (CDR), provide certificate and develop the code of ethics which guide the nutrition and dietetics practitioners in their professional practice and conduct.
In Canada, The terms “Dietitian” and “Registered Dietitian” are protected by law and must be registered with a dietetic regulatory body within their province.
There is a need to a constitute professional
body for dieticians’ registration. We need to
formulate a code of ethics and standards for dieticians to
serve their clients with proper guidance and direction
In India, after completing the graduation, post-graduation, PG diploma, anyone can be termed as Nutritionist. In order to be termed as a dietician, it is important to register with the Indian Dietetic Association as a Registered Dietician. Post Graduate Diploma in Nutrition & Dietetics or a M.Sc. in Food & Nutrition, followed by a 6-months internship after graduation is required to be eligible for participation in the examination for registration. Those who are registered, they may address themselves as Clinical Dieticians, Pediatric Dieticians, Sports and Health Dieticians or Community Dieticians.
When the review found that other countries have their accredited or statutory body with a responsibility to maintain standards of nutrition and dietetics education and recognition of their qualification, registration or license for practices, we are still far more behind. Due to lack of attention towards the code of ethics and standards, the nutrition and dietetic profession is losing its credibility in Bangladesh. As the Dieticians are not guided by any principals, they are engaging them in different malpractices for their own benefits:
For instance, promotion of diet pills is widely used in Bangladesh by Nutritionists. Also they receive cash from various companies for promoting them. However, in 2011, the writ petition was filed by Bangladesh Dietary Supplementary Association seeking the High Court directives on the government to make a policy and create a specialized regulatory body for selling, distributing and manufacturing the food dietary supplementary products.
It needs no emphasizing that professional doctrines of Dieticians should be regulated by law and a set of code of ethics. Therefore, the sufficient attention of authorities concerned on this issue has become the demand of time. There is a need to incorporate a professional body for Dietician’s registration.
We need to formulate a code of ethics and standards for Dieticians to serve their clients with proper guidance and direction. The Employer should have the written policy for recruiting Dieticians to set their title like other counties depending on the scopes of work.
Dr Shamim Hayder Talukder is Chief Executive Officer (CEO), Eminence Associates for Social Development (EASD and Dina Farhana is Coordinator,
Eminence Associates for Social Development (EASD)
