Sports Dietetics — For Experts Only
Today’s Dietitan
By Kate Jackson
Vol. 7, No. 3, p. 46

Anyone can hang a shingle out and call themselves a sports nutrition expert. One group is working hard to create standards and require certification to be a sports dietitian.

Sports nutrition, like sports medicine, is big business. Career opportunities in sports nutrition are expanding. To reap the rewards in this growing field, however, highly skilled dietitians must successfully compete with those who are less qualified. The challenge, many suggest, is to develop standards of competency and a meaningful professional credential. Fortunately, that challenge may soon be met.

Unlike those who specialize in diabetes or pediatrics, for example, RDs who are experts in sports and cardiovascular nutrition have no certification process to distinguish themselves from others who practice in the field without similar proficiency. In recent years, however, RDs with a stake in the future of the field—members of Sports, Cardiovascular and Wellness Nutritionists (SCAN), a dietetic practice group of the American Dietetics Association (ADA)—have taken the matter into their own hands, lobbying for and developing a certification process that will elevate sports dietitians and give them the same recognition as other highly trained RDs who work in specialized fields.

Addressing the Need
Patti Steinmuller, MS, RD, SCAN’s secretary and a sports nutrition instructor at Montana State University-Bozeman, points to compelling circumstances that underlie the need for certification. Chief among them are a growing body of complex knowledge and research in sports nutrition and a rising tide of competition among sports nutrition practitioners.

As sports nutrition and dietetics grow more responsive to a burgeoning body of evidence-based research, the field has become more demanding and more specialized. Dietitians working in this increasingly sophisticated realm must meet continually expanding demands. Says Steinmuller, “Even savvy, sports-minded dietitians need postbaccalaureate education, training, and experience to integrate nutrition with the varied physical activities and sports in which their clients are engaged.” RDs must have highly targeted education and training to meet the needs of individual athletes and sports teams who require specialized nutrition support to optimize performance, prevent injury, enhance recovery, control body weight, and boost stamina and endurance.

Today, in the absence of expert standards and certification, sports nutrition is a field that can be mastered by dedicated professionals or dabbled in by dilettantes with little or no specialized training. According to Steinmuller, “Nutrition for performance enhancement is a hot topic and everyone wants part of the action. Despite licensure and similar laws in some states, all sorts of people offer sports nutrition advice for free or for profit. Taking one nutrition course, attending a workshop, reading a nutrition article, or working in the dietary supplement industry is enough to convince some individuals that they are qualified to offer sports nutrition services.”

Nancy Clark, MS, RD, sports nutrition author and counselor at Healthworks, Chestnut Hill, Mass., contends that personal trainers commonly lack the proper education and knowledge to answer nutrition questions to their clients’ best interests. Beyond providing advice based on fads or misinformation, some who guide athletes advocate dietary supplements that may be unsafe and ineffective. Additionally, a lack of quality control results in the sale of sports supplements that may be contaminated with substances banned in athletic training and competition.

Nancy DiMarco, PhD, RD, professor, nutrition and food sciences, Texas Woman’s University, adds that many untrained and inexperienced people practice sports nutrition, providing a public eager to improve performance with guidance that’s “ill-informed, misleading, or downright dangerous.”

A client looking for guidance must choose from a provider pool that includes untrained or poorly trained individuals, as well as qualified dietetics professionals with special education in sports-related matters. Yet, there’s little to help them choose wisely. Certification that dictates educational requirements and standards of practice will ensure that dietitians who practice in the field are the most highly trained professionals. This not only benefits the RDs, who can be assured that they possess comprehensive and current knowledge, but it also gives the public rigorous standards by which they can judge and select competent professionals and ensure their safety. By turning to certified dietitians, coaches, athletes, teachers, parents, and sports and fitness-minded clients will be able to gauge the value and reliability of sports nutrition guidance.

“To enhance their value in the marketplace, those who desire full- or part-time employment in sports nutrition need to acquire the education, skills, and experience to practice competently in a variety of sports settings and at high levels of expertise,” says Steinmuller. “As students, registered dietitians, and dietetics educators better understand both the competitive nature of the job market and the potential for high-level positions, support for advanced education and credentialing in sports dietetics will increase.”

Sports Dietetics-USA (SD-USA), a newly formed subunit of SCAN, has proposed attaining certification for sports dietitians and is partnering with the ADA’s credentialing agency, the Commission on Dietetic Registration (CDR), to make certification a reality. SD-USA was formed, says DiMarco, “to promote nutrition practices that enhance lifelong health, fitness, and sports performance and to advance the vocation of sports dietetics.” The organizers and working group members—in addition to DiMarco (coordinator), Clark, and Steinmuller—are Michele Macedonio, MS, RD, SCAN chair; Ellen Coleman, MS, RD, SCAN past-chair; Melinda Manore, PhD, RD; Cindy Dallow, PhD, RD; Shawn Dolan, PhD, RD; Nanna Meyer, PhD; Susie Parker-Simmons, MNUT & Diet, MEd, RD; James Stevens, PhD, RD; Katherine Beals, PhD, RD; and Bob Seebohar, MS, RD, CSCS.

An International Movement
In Australia, an education and certification program developed by Sports Dietitians Australia has been highly successful, and dietitians in the United Kingdom are working toward the same goal with the Nutrition Society, an internationally recognized professional nutrition organization. With help from their international counterparts, American dietitians are striving for similar recognition.

Parker-Simmons, sports dietitian, United States Ski and Snowboard Association, and a founding member of Sports Dietitians Australia, is networking coordinator of SD-USA. Noting that sports dietetics is a recognized and developed profession in her home country of Australia, she says she aligned herself with Americans in the field who had a similar vision for the profession’s future and, having been through the same process previously, acts as an advisor to the newly formed group.

History and Progress
While the collaboration advocating certification is new, the seeds of the campaign for specialty certification were sown by others. “In the early 1990s,” says Steinmuller, “Gail Butterfield, PhD, RD, Melinda Manore, PhD, RD, Kristine Clark, PhD, RD, and other ADA members worked diligently with exercise scientists from the American College of Sports Medicine [ACSM] to develop a certified sports nutrition specialty that would serve the public and the members of ADA and ACSM.”

According to DiMarco, “An alliance was recommended between the ADA and the ACSM, but the timing was not right and the proposal was put aside.” Although this early coalition did not succeed, it stimulated and inspired those working today for certification. “We are indebted to the vision and work of these dedicated pioneers,” says Steinmuller.

The interest was rekindled and the effort begun anew at SCAN’s 2003 Symposium, where DiMarco spoke about the development of the Exercise and Sports Nutrition graduate program at the Texas Woman’s University in Denton and reviewed the rise of sports nutrition programs at universities across the nation. In her presentation, says DiMarco, she called for the development of a discrete organization—a subunit of SCAN—dedicated to the advancement of the practice of sports nutrition in the United States.

“A roundtable discussion at the symposium followed with Steinmuller, Parker-Simmons, Barbara Rodriguez Graf, MS, RD, and others, and we agreed to continue talking to make the organization happen,” says DiMarco. She met with Clark in May 2003 at ACSM meetings in San Francisco and proposed such an organization. “Everyone was enthusiastic but cautious since it had been tried once before,” she says. Clark, DiMarco recalls, put together a potential core of workgroup members and organized a conference call to begin to develop a proposal with mission and vision statements—an effort that took the group most of the summer.

SD-USA became an official subunit in June 2004, and DiMarco was named inaugural coordinator. At a workshop sponsored by the Gatorade Sports Science Institute, the new group forged its identity, determined its structure, drafted a statement of purpose, and formulated its strategic goals.

The effort, of course, requires the partnership of the CDR. Steinmuller explains that the CDR confers board certification in some specialty areas to RDs who demonstrate appropriate education and practice experience and who pass a specialty examination. “The ADA commands widespread respect and recognition in food and nutrition issues, policies, and practices,” says Steinmuller. For members of its practice group SCAN, she says, “seeking certification through the CDR is both logical and strategic.” Its goal is the creation of a designation for a board certified specialist in sports dietetics: RD, CSSD. “Having credentials such as these after our names will be an asset in marketing our profession,” says Steinmuller.

In this effort, she explains, the first order of business was to gauge interest in the specialty certification through a market survey, followed by submission of a formal petition. Last year, 94% of 108 SCAN members who took part in a pilot market survey to gather opinion indicated a belief that the proposed certification would enhance the profession, and 57% were convinced that the lack of such certification put the public at risk. Perhaps most significant, 87% were eager to become CDR board-certified specialists in sports dietetics.

Early this year, the CDR will survey the broader SCAN membership about this issue. Based on the enthusiastic responses received so far, an official market survey was created, and SCAN members are invited to participate either by mail or online. That participation, says Steinmuller, is crucial to the survey’s success and, ultimately, to the creation of the certification. “To attain certification, we need to establish standards of practice, competencies, and education requirements for sports dietitians,” says Steinmuller. “We must enhance marketing efforts and connect with potential partners who share our goals of a ‘food-first’ approach to sports nutrition education and services.” The alliance is highly optimistic, yet, as an all-volunteer effort, faces challenges, including communicating among SCAN members, encouraging SCAN members to sign up for SD-USA membership (a free benefit of SCAN membership), enlisting assistance of new SD-USA members, and connecting with potential partners.

The goal is to obtain 500 to 1,000 completed market surveys. If the results indicate interest in certification, work with the CDR will continue to conduct a job analysis and develop education and experience requirements and a certification examination, which, says DiMarco, would have to be retaken every five years to ensure that a dietitian’s knowledge is current. In addition, DiMarco says issues concerning grandfathering and acceptance of other types of experience will have to be dealt with and resolved.

DiMarco expects that the alliance will achieve its goal within two years and the profession will begin to see the rewards. Anticipating a bright future, SCAN and SD-USA also plan to establish scholarships for students seeking careers in sports dietetics. “We live in a market-driven, competitive society,” Steinmuller says. Certification, she insists, is a win-win proposition from any angle. “It’s an excellent way for highly educated and skilled sports dietitians to display their value, set themselves apart from those less qualified, gain recognition, serve a sports-minded clientele, expand job opportunities, and secure increased compensation.”

— Kate Jackson is a staff writer for Today’s Dietitian.

Sidebar
What’s in a Name?
One of the questions the certification proponents have faced has concerned terminology. “Why use the term sports dietitian instead of sports nutritionist?” It’s a valid question, says Patti Steinmuller, MS, RD, SCAN’s secretary and a sports nutrition instructor at Montana State University-Bozeman, but she points to two reasons for selecting sports dietitian as a professional designation.

The first involves branding and carving out a special niche in the marketplace. “Since the term nutritionist has no legal definition, this term is used widely to apply to those practitioners who are highly skilled and qualified, as well as to those with little or no education and skills. In contrast, registered dietitian does have a legal meaning. Sports dietitian is a relatively new term—one that’s less likely to be used by non-RDs and one that can enhance our viability and competitiveness in the marketplace.” Sports dietitian, she adds, will replace sports nutritionist in the text of the fourth edition of SCAN’s sports nutrition manual Sports Nutrition: A Practice Manual for Professionals, to be released this summer.

The second argument in favor of sports dietitian is that it’s the term increasingly used on the international level by other countries such as Australia and the United Kingdom. “Networking with these groups and adopting similar terminologies, standards of education, training, and practice is advantageous for us all,” says Steinmuller.

— KJ

To Join Sports Dietetics-USA, complete SCAN’s “Getting to Know You Better” form in the Volunteer Opportunities- Members’ area on SCAN’s Web site.

SCAN members who would like to participate in the survey but have not yet received an invitation can contact the SCAN office by phone at 719-635-6005, send a message to scanoffice@scandpg.org, or visit SCAN’s Web site at www.scandpg.org.

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