Why Work with a Dietician?

We do not think often about what we eat, unless we are on a diet or debating what we are going to eat for supper at home or at a restaurant. We mainly eat out of habit. We generally eat at certain times, and to a large extent, we eat what we like. For many individuals that works out fine. For others it doesn’t. They eat too much of the wrong foods much too often. The result is obesity and unfortunately other co- morbidities like diabetes.

A diabetic and an obese individual have something in common, even if they are not one and the same. They cannot afford to be casual about their food. They cannot retain the old diet and old lifestyle behaviors. It is truly a matter of life and death. Diabetics need to change diets and lifestyles, and become more motivated to make healthy dietary choices. Many need to find a new approach to managing food. In order to do this it might be necessary to rely on the skills and training of a dietician.

What is a Dietician?

A dietician is an expert in what is called “medical nutrition therapy (MNT).”[1] The dietician is a highly trained professional, and may even have a Masters Degree. A dietician is a trained health professional who may work as part of a Diabetes Education Center (DEC).[2] A dietician may be licensed (LD) or be a registered dietician (RD). A license is required in many states.

What Does the Dietician do?

The dietician focuses on food and nutrition and applies the science of nutrition to the feeding and dietary education of groups of people and individuals interested in achieving good health and managing disease. An important part of this role is offering medical nutrition therapy.

What is Medical Nutrition Therapy?

MNT is what is referred to as a goal-oriented approach. Its purpose is to not only develop, but also to implement, a well-designed nutritional diet plan to be used in the treatment of individuals with diabetes. All the members of a diabetic’s team – doctors, nutritionists, specialists, diabetic educators – need to be involved in developing such a plan and in implementing it. The major role in dietary formulation and in setting specific nutrition-related goals is, however, the dietician. The dietician needs to be registered and to fully understand the nature and role of MNT. In many instances, it will be the dietician who assumes the role as coordinator.

The role of the dietician in MNT is also to make sure the therapy addresses 3 key areas of diabetes prevention and treatment.[3] These roles are:

  • Weight loss
  • Improvement of glycemic control and prevention or stoppage of diabetes related complications
  • Prevention of diabetes through diet

The Dietician and the Diabetic

A dietician is responsible for helping the diabetic or any other clients with their dietary planning including menu planning and food choices. The professional will work with you to help create a personalized meal plan that fits your needs[4]. It is based on:

  • Your food preferences
  • Your current weight
  • Your specific goals – long and short term
  • Your lifestyle
  • Your specific drugs or medication
  • Your diabetes medication
  • Any other relevant factors

The dietician works with you throughout the implementation and management of the plan on an ongoing basis and is not there to simply initiate the original dietary plan. As your goals, requirements, medications and situational factors change, so too can your diet.

A dietician possesses many skills and applies them to help you to manage and control your diabetes. These skills consist of:

  • Selecting a meal plan that is designed for you
  • Discovering how the foods you prefer affect your overall diet
  • Turning any recipe you offer into one that will work in a diabetic meal plan– i.e. reduce the amount of fat and/or sugar in a way that allows you to still enjoy the recipe while adhering to a diabetic management plan
  • Helping you locate diabetic cookbooks, recipes, web sites and guides that may act as self-guides for your particular situation
  • Providing you with instructions on how to look at a restaurant menu and read what it is actually saying. In this manner you can eat out without destroying your carefully managed diabetic plan
  • Going through such basics as label reading
  • Helping you with a sick-day menu

The Purpose

A dietician and the implementation of a MNT plan are intended to be specifically beneficial to the individual diabetic. It is intended not to remove control from people with diabetes but to empower them. By educating diabetics on what foods to eat as well as how different types of food affect diabetes by impacting blood glucose levels, a dietician helps diabetics take control of a major element in the management of diabetes.

Research indicates that having a dietician can prove to be quite effective. At times the weight loss and reductions in HbA1c can be modest but beneficial.[5] At other times, the effect of a directed medical team approach that includes a dietician can be significant and very successful.[6] Overall, the growing body of evidence indicates that the use of Medical Nutrition Therapy is beneficial to individuals no matter what type of diabetes they may have. To some researchers, MNT is the single, most significant intercession for not only preventing but also managing type 2 diabetes. As a result, this would make it an essential and integral component of all forms of diabetes self-management programs.

Conclusion

Most people faced with managing diabetes require specialized help when it comes to food and meal planning. A team of professionals can provide this help through Medical Nutrition Therapy. Working together with a dietician, diabetics can become involved in their personal treatment plan and learn to manage and control their glycemic levels.  A dietician does not do everything for you. The dietician gives you the tools you need to take effectively manage diabetes for a lifetime.

References

[1] Warshaw, HS; and Pape, J (2009). Real-Life Guide To Diabetes. Alexandria, VA: ADA.

[2] Meltzer, SJ; and Belton, AB (2009). Diabetes in Adults. Toronto: Key Porter Books.

[3] Kordonouri, O; Apovian, C; Kuhn, L; Danne, T; and Mantzoros, CS (2009). “Medical Nutrition Therapy in the Treatment of Type 1 and Type 2 Diabetes.” In Nutrition and Metabolism: Underlying Mechanisms and Clinical Consequences. CS Mantzoros (ed). New York: Humana Press: 245-260.

[4] American Diabetes Association (2009). Type 2 Diabetes. Your Healthy Living Guide. Alexandria, VA: ADA.

[5] Harding, S (2010). “Dietitians in Primary Care Promote Weight Loss and Glycated Haemoglobin Reductions.” Journal of Human Nutrition and Dietetics, 24 (4): 389–390.

[6] Coppell, KJ; Kataoka, M; Williams, SM; Chisholm, AW; Vorgers, SM; and Mann, JI (2010).

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.