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Dietitians and Nutritionists

(D.O.T.  077 except .117-010 and .124-010)

Nature of the Work

Dietitians and nutritionists plan nutrition programs and supervise
the preparation and serving of meals.  They help prevent and treat
illnesses by promoting healthy eating habits.  They scientifically
evaluate clients' diets and suggest modifications such as less salt
for those with high blood pressure or reduced fat and sugar intake
for those who are overweight.

   Dietitians run food service systems for institutions such as
hospitals and schools and promote sound eating habits through
education and research.  Major areas of practice are clinical,
community, and administrative (management) dietetics.  Dietitians
also work as educators and researchers.

   Clinical dietitians provide nutritional services for patients in
institutions such as hospitals and nursing homes.  They assess
patients' nutritional needs, develop and implement nutrition
programs, and evaluate and report the results.  They also confer
with doctors and other health care professionals in order to
coordinate medical and nutritional needs.  Some clinical dietitians
specialize in the management of overweight patients, care of the
critically ill, or care of renal (kidney) and diabetic patients.  In
addition, clinical dietitians in nursing homes or small hospitals
may also manage the food service department.

   Community dietitians counsel individuals and groups on nutritional
practices designed to prevent disease and to promote good health.
Working in such places as public health clinics, home health
agencies, and health maintenance organizations, they evaluate
individual needs, establish nutritional care plans, and instruct
individuals and their families.  Dietitians working in home health
may also provide instruction on grocery shopping and preparation of
special infant formulas.

   Popular interest in nutrition has led to opportunities in food
manufacturing, advertising, and marketing, where dietitians analyze
foods, prepare literature for distribution, or report on issues such
as dietary fiber or vitamin supplements.

   Administrative or management dietitians oversee large-scale meal
planning and preparation in such places as health care 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.

   Dietitians promote healthy eating habits.

Working Conditions

Most dietitians work a regular 40-hour week, although some work
weekends.  About 1 dietitian in 5 works part time.

   Dietitians and nutritionists spend much of their time in clean,
well-lighted, and well-ventilated areas.  However, some dietitians
spend time in hot, steamy kitchens.  Dietitians and nutritionists
may be on their feet for most of the workday.

Employment

Dietitians and nutritionists held about 50,000 jobs in 1992.  About
half were in hospitals and nursing homes.

   State and local governments provided about 1 job in 6 in prisons,
health departments, and other public health related areas.  Other
jobs were in social service agencies, residential care facilities,
diet workshops, physical fitness facilities, school systems,
colleges and universities, and the Federal Government mostly in the
Department of Veterans Affairs.  Others were employed by firms that
provide food services on contract to such facilities as colleges and
universities, airlines, and company cafeterias.

   Some dietitians were self-employed, working as consultants to
facilities like hospitals and nursing homes and seeing individual
clients.

Training, Other Qualifications, and Advancement

The basic educational requirement is a bachelor's degree with a
major in dietetics, foods and nutrition, food service systems
management, or a related area.  Students take courses in foods,
nutrition, institution management, chemistry, biology, microbiology,
and physiology.  Other courses are business, mathematics,
statistics, computer science, psychology, sociology, and economics.

   Thirty States have laws governing dietetics 19 require licensure, 10
require certification, and 1 requires registration.  The Commission
on Dietetic Registration of the American Dietetic Association (ADA)
awards the Registered Dietitian credential to those who pass a
certification exam after completing their academic education and
supervised experience.

   As of 1993, there were 240 ADA-approved bachelor's degree programs.
Supervised practice experience can be acquired in two ways.  There
are 51 ADA-accredited coordinated programs that combine academic and
supervised practice experience in a 4-year program.  The second
option requires completion of 900 hours of supervised practice
experience either in one of the 95 ADA-accredited internships or in
one of the 139 ADA-approved preprofessional practice programs.
Internships and preprofessional practice programs may be full-time
programs lasting 9 to 12 months or part time programs lasting 2
years.  Graduate programs are available for those interested in
research, advanced clinical positions, or public health where a
graduate degree is usually needed.

   Recommended high school courses include biology, chemistry,
mathematics, health, and home economics.

   Experienced dietitians may advance to assistant, associate, or
director of a dietetic department or become self-employed.  Some
dietitians specialize in areas such as renal or pediatric dietetics.
Other dietitians leave the occupation and become sales
representatives for equipment or food manufacturers.

Job Outlook

Employment of dietitians is expected to grow as fast as the average
for all occupations through the year 2005 as demand grows for meals
and nutritional counseling in nursing homes, schools, prisons,
community health programs, home health care agencies, diet
workshops, and health clubs.  Public interest in nutrition and the
emphasis on health education and prudent lifestyles will add to the
demand.  Many job openings will also result from the need to replace
experienced workers who leave the occupation.

   Employment of dietitians in hospitals is expected to grow slowly
because of anticipated slow growth in the number of inpatients
(those who stay overnight), and as hospitals contract out food
service operations.  On the other hand, rapid growth in employment
is expected in nursing homes as the number of very old people rises
sharply; in contract providers of food services; in residential care
facilities; in offices and clinics of physicians; and in other
social services.

Earnings

According to the American Dietetic Association, full-time registered
dietitians with 5 years or less experience earned a median annual
salary of $28,500 a year in 1991; those with 6-10 years of
experience, $32,900; 11-15 years, $36,000; 16-20 years, $38,400; and
20 years or more, $40,000.  Management and self-employed dietitians
earned more than clinical and community dietitians.  Salaries also
vary by educational level, geographic region, and size of community.

   According to a University of Texas Medical Branch survey of
hospitals and medical centers, the median annual salary of
dietitians, based on a 40 hour week and excluding shift or area
differentials, was $29,973 in October 1992.  The average minimum
salary was $25,122 and the average maximum was $37,467.

Related Occupations

Dietitians and nutritionists apply the principles of nutrition in a
variety of situations.  Workers with duties similar to those of
administrative dietitians include home economists and food service
managers.  Nurses and health educators often provide services
related to those of community dietitians.

Sources of Additional Information

   For a list of academic programs, scholarships, and other information
about dietetics, contact:

   The American Dietetic Association, 216 West Jackson Blvd., Chicago,
IL 60606-6995.