The term dietitian is a protected job title for a medical or health profession. Dietitians have special qualifications in dietetics and nutrition and are used in therapy, rehabilitation, nursing and health promotion. They treat both healthy and sick patients in nutritional therapy.
What is dietetics?
The term dietitian is a protected job title for a medical or healthcare profession. Dietitians possess special qualifications in the fields of dietetics and nutrition. The state-recognized profession of “dietician” includes various sub-areas. A distinction is made between clinical dietetics and nutrition, catering management (guidance of the kitchen, management of the diet kitchen, guidance of the staff according to nutritional therapy aspects), prevention and health promotion (public health) as well as teaching and research (support in the training of health professions, implementation of and cooperation in studies). Dietitians work with healthy and sick people in an educational and advisory capacity according to medical prescription, since nutritional aspects can influence many diseases. In addition, in the clinical field, they also care for seriously ill patients who are no longer able to take nourishment on their own, through the professional application of feeding tubes. Accordingly, the dietician’s field of activity covers a variety of topics: primarily the implementation of individual diets and qualified nutritional counseling, but also the documentation and evaluation of findings, the preparation of diet plans, nutritional value calculations, and participation in ward rounds in the clinical-inpatient area. They are experts in all those matters concerning nutrients in food and their effect on the body. Often, dietitians specialize in areas such as diabetology.
Treatments and therapies
Diet can have far-reaching health consequences. Many diseases are due to malnutrition or overeating. However, a healthy, balanced dietary intake can also prevent or positively influence diseases. For this reason, dietitians are predominantly involved in nutritional counseling, which they perform based on medical diagnoses. Such diagnoses may include: Diabetes, elevated blood lipid or uric acid levels, osteoporosis, food allergies and food intolerances, or health sequelae caused by eating disorders such as anorexia. They work with patients to develop diets that suit their specific dispositions by educating them about foods and their properties, providing cooking recipes, or advising on shopping. Often, dietitians are concerned with reducing body weight in a healthy way. Since diet-related overweight and obesity, with all their subsequent symptoms, are among the most important diseases of civilization, dietary assistance often starts here by calculating the patient’s nutritional requirements and advising him or her on this basis. This may involve groups as well as individuals. However, it is a mistake to think that dietitians are only concerned with healthy weight loss, although this is a primary concern of many who seek advice. It is also conceivable that patients develop precarious underweight due to alcohol or drug abuse, or that anorexia is the reason for a critically low body mass index. Dieticians intervene in such cases to ensure that a healthy body weight is restored in a medically acceptable manner and that the body is supplied with all nutrients. In the clinical setting, patients can often be found who are unable or unwilling to eat on their own. These can be patients affected by anorexia, patients who are in a coma or who can no longer eat on their own for other health reasons. Dieticians are in demand here, as they are qualified to place feeding tubes professionally. Due to the facts described, this professional group often works in clinics, rehabilitation facilities, etc., although there are more and more independent dietitians with their own practice who specialize in certain nutrition-related ailments.
Diagnosis and examination methods
If dietitians are called in on medical advice, the medical diagnosis (for example, diabetes mellitus) is the basis for further action.Various methods are available to the dietitian to determine the patient’s nutritional status. Currently, the body mass index (BMI) is usually used first, although this is not without controversy because it does not provide information about the exact distribution of fat and muscle mass. In order to determine the proportion of water, fat and muscle in the body, special measuring devices exist that provide information about this and give the dietician important clues about the patient’s condition. In addition, as part of the nutritional counseling, an actual state is first worked out as far as food intake is concerned: What does the patient eat and how much? What would his needs be? Which nutrients does he particularly need, which food components should he avoid? On the basis of the medical diagnosis and on the basis of this actual state, a diet plan is worked out that is ideally tailored to the person seeking advice and his or her psyche. Together with the patient, we calculate what his or her optimal nutritional status would be and develop a concept for achieving this goal. After determining the BMI and the distribution of fat in the body, dieticians often use diagrams to help the patient understand what a healthy, balanced diet looks like (for example, the “food pyramid” of the German Nutrition Society). In the clinical setting, this professional group sometimes works with feeding tubes if independent food intake is not possible or is refused and the patient is in a life-threatening condition. Conceivable options here are enteral nutrition (the placement of a tube in the nose or mouth through the throat and esophagus into the gastrointestinal tract) or parenteral nutrition, in which nutrients are administered directly into the blood via infusions. Medications may be added to these nutrient mixtures, but only physicians are responsible for prescribing them. Dietitians limit themselves to nutritional aspects. However, they often work closely with physicians, psychologists, etc.
