July
2007
Hot
New Careers in Dietetics
By Mary Franz, MS, RD, LD
Today’s Dietitian
Vol. 9 No. 7 P. 52
Looking to enhance your skill set or explore
a different area of nutrition? consider herbalism, culinology,
or nutritional genomics, for starters.
Until recent times, career choices for dietitians
focused mostly on traditional practice settings. However, developments
in technology, healthcare, and the food industry, as well as
evolving trends in consumer behavior, are changing the face
of dietetics and opening new doors for dietitians. Opportunities
exist in three cutting-edge areas—herbalism, nutrigenomics,
and culinology—for RDs looking to practice outside the
scope of mainstream nutrition.
Herbalism
Herbalism, also known as herbal medicine and phytotherapy, is
the art and science of treating disease and promoting health
through the use of plant-based substances. It is an ancient
treatment modality dating back thousands of years to countries
such as China and India.1 Once dismissed as folklore, the validity
of herbal medicine is now widely recognized. It is estimated
that plant-based healing is utilized by 80% of the world’s
population.2 In the United States, the practice of herbalism
was common until the 20th century, when the arrival and rapid
growth of the pharmaceutical industry supplanted interest in
natural healing methods. Consumer demand for alternative therapies
has once again sparked interest in herbalism in the United States.
Herbalism is a broad term referring to the identification,
cultivation, preparation, and administration of therapeutic
plants. The practice encompasses a variety of orientations,
including Chinese, Ayurvedic, and Native American philosophies.
In the United States, clinical herbalism, the use of plant-based
remedies to increase the body’s energy and natural healing
power and decrease inflammation and pain, is widely practiced.
The basic tenet of herbal medicine is that an
individual’s ailments stem from an imbalance in the body.
Herbal medicine practitioners look for the commonalities underlying
symptoms and prepare botanical formulas designed to treat the
whole person vs. isolated illnesses. Herbal remedies may be
ingested as whole plants; consumed as teas, tinctures, infusions,
or pills; or applied externally as salves or powders.
Training to become a certified clinical herbalist
is offered by a number of schools in the United States and consists
of both distance and on-site learning (see sidebar). Coursework
includes physiology, pathology, nutrition, botany, plant identification,
and herbal medicine and formulation and leads to certification
at the introductory or advanced level, depending on the number
of hours of study (200 hours for basic study, 400 or more hours
for advanced study). Practitioners certified at the advanced
level often enter private consulting practices or work in medical
centers and clinics. Completion of a master’s degree in
herbal medicine provides the additional study and clinical training
needed to work in industry and research.
Herbalists need strong assessment and counseling
skills, a working knowledge of disease pathology, and a thorough
understanding of the interactive effects of herbs, as well as
drug-nutrient interactions—the same expertise required
by dietitians. An increasing number of dietitians are recognizing
the utility of incorporating herbal medicine into their nutrition
practices.
Anne Thiessen, RD, is a certified clinical herbalist
in private practice in Boulder, Colo., where she also teaches
clinical nutrition at the North American Institute of Medical
Herbalism. Thiessen acquired her interest in herbal healing
from her father, who treated her childhood stomachaches with
peppermint and ginger which he learned from his great-grandmother,
a physician and herbalist in Germany.
Trained first as an RD, Thiessen was distressed
by the failure of traditional dietary therapy to relieve the
gastrointestinal ailments experienced by her patients with eating
disorders and saw potential in the use of medicinal herbs to
alleviate these complaints. After completing basic and advanced
study and clinical training at the Rocky Mountain Center for
Botanical Studies in Boulder, Thiessen set up her consulting
practice where she works with clients with eating disorders.
Thiessen helps them set nutrition goals, using herbal formulas
to reinforce food goals and bolster energy and general health.
She typically sees four to eight clients per day, juggling her
clinical practice with the demands of her teaching schedule.
Karen Siegel, MPH, MS, RD, LD, LAC, is board-certified
in Texas in both acupuncture and Chinese herbal medicine and
is licensed to dispense Chinese herbs and foods in her private
practice in Houston. Like Thiessen, Siegel began her dietetics
career in eating disorders, working in private practice with
clients while also developing and presenting national conferences
on the topic.
The demands of her hectic professional life
pushed Siegel to think about other ways she could interact with
her patients. After working with psychotherapists to learn about
the mind-body connection, Siegel hit on herbal medicine as a
means to add another dimension to her practice. Siegel estimates
that she sees 10 to 15 patients daily and prepares herbal remedies
for approximately 25% of her nutrition patients and 75% of her
acupuncture clients. Her goal is to use the proper combination
of healing foods and herbs to help her patients restore their
health. For Siegel, the melding of Western clinical nutrition
with the Eastern disciplines of herbal medicine and acupuncture
allows her to offer clients treatment plans that integrate mind
and body.
Both Thiessen and Siegel believe that nutrition
and herbal medicine are a natural fit and are enthusiastic about
the prospect of dietitians combining traditional nutrition practice
with herbal medicine in clinical, outpatient, and educational
settings. “We dietitians have a great starting platform
with our medical knowledge and ability to discern fad from science.
Dietitians can take their nutritional knowledge and move into
the study of herbs to further a client’s progress,”
says Thiessen.
Nonetheless, Thiessen and Siegel share frustration
with conventional medicine’s skepticism about the efficacy
of herbalism and suggest that RDs wishing to practice in nontraditional
settings be open to learning about complementary medicine and
abandon the notion of “one-size-fits-all” dietary
therapy. “Let your mind become an open slate to learn.
Let go of rigid belief systems about drugs and health. Open
the door to learn about the healing nature of foods rather than
protein, fat, and carbohydrate content. Herbal medicine is about
food as medicine and as a form of healing,” says Siegel.
Culinology
Culinology blends the art of fine cooking with the science of
food technology. Fueled by an exploding demand for healthier,
tastier, and safer foods, culinology is poised to become one
of the hottest career paths in the food industry.
Culinology professionals, known as culinologists,
work at food companies, restaurants, and research and development
facilities where they utilize their food science skills and
expertise as trained chefs to formulate new food products and
develop innovative food handling, processing, and packaging
techniques. In addition, culinologists are often involved in
food marketing and sales. Positions in the field are varied
and include research and development (R&D) chefs, technochefs
(chefs with food design and manufacturing experience), formulation
chefs, quality assurance and development managers, R&D directors,
culinary research technologists, and culinary lab managers.3,4
Since 1996, the development of culinology has
been fostered by the Research Chefs Association (RCA), a diverse
group of food professionals committed to setting standards for
education, research, and development within the food industry.
The RCA has been the driving force in establishing educational
and certification criteria for individuals working in the field
of culinology.
The RCA oversees eligibility requirements for
two culinology-related credentials: the CRC (certified research
chef) and CCS (certified culinary scientist). CRCs are experienced
in food product development, cooking, and foodservice. Certification
as a CRC requires completion of a bachelor’s degree in
culinary arts or culinology and up to five years of experience
cooking and supervising in a commercial kitchen. Individuals
seeking certification as a CCS must obtain an undergraduate
degree in food science and complete an average of five years
of food research and product development. Accreditation for
both the CRC and CCS require passing a written validation exam.
Graduate and undergraduate degrees in culinology
are available at several universities and colleges in the United
States (see sidebar). Undergraduate course work includes study
in the biological and physical sciences; food chemistry and
engineering; foodservice, nutrition, and business and technical
writing. Graduate programs offer tracks in human nutrition and
food safety, engineering, and microbiology. Doctoral candidates
may specialize in one of several areas: agricultural, veterinary,
and horticultural science; processing and packaging systems;
and biomedical engineering.
Dietitians interested in culinology without
the CRC or CCS credential may find that their food and nutrition
expertise is a valuable asset when seeking employment.
Cindy Showalter, RD, parlayed her love of foodservice
and interest in research into a successful career in culinology.
Showalter began her career as a quality assurance manager for
a frozen food company, where she also worked in product development,
and fell in love with R&D. Now, as director of R&D at
Surlean Foods in San Antonio, Showalter is responsible for bringing
new food items from benchtop to production. Her work begins
with Surlean clients, most of whom are from the foodservice
industry, who come to Showalter seeking specialized food products.
Showalter works closely with them to create recipes, testing
and reformulating until the product fits the client’s
specifications, a painstaking process that may take one year
to complete. She then presents the final product to the client
and begins work on the next phase: taking the newly created
food to production.
Showalter enthusiastically refers to her position
at Surlean Foods as “the best job in the world”
and urges other RDs to consider careers in culinology. “Dietitians
can work in so many capacities in the manufacturing side of
the industry. There are R&D positions, product development,
nutritional labeling, sales, or strictly culinary. We bring
a different mindset to culinology, falling in between chefs
and technical people. We are not strictly science-driven; we
also have an understanding of food being not just a necessity
but its enjoyment as well,” she says.
Alexa Hart Bosshardt, MPS, RD, LDN, agrees that
dietitians have what it takes to excel in the field of culinology.
“Dietitians generally have an excellent ‘break-it-down’
ability when it comes to food. We can look at foods in terms
of color, texture, cooking method, and portion sizes but can
also run numbers in our heads to determine the nutrient density
and nutritional balance of a recipe.”
A former director of menu development for Arby’s
and now head of recipe development at Phillips Foods, a seafood-based
foodservice company in Baltimore, Bosshardt sees enormous potential
for RDs in the food industry. She attributes her success to
her educational background—she holds a master’s
degree in hotel and restaurant management with a concentration
in food science, as well as a certification in culinary arts.
She urges dietitians interested in culinology to seek formal
culinary training and develop a working knowledge of the principles
of food science. Bosshardt also stresses the importance of teamwork
and flexibility in a work environment that is often driven by
deadlines and cost controls.
Rebecca Cameron, RD, has found a unique venue
to market her nutrition background and culinary skills. Creator
and owner of Haute Nutrition (www.hautenutrition.com), a culinary-based
nutrition consulting business, Cameron offers a wide variety
of services—menu development and nutrition fact analysis
for restaurants, cooking classes, and personalized nutrition
coaching.
A self-proclaimed foodie and graduate of the
Culinary Institute of America in New York, Cameron works hard
to dispel the myth that RDs don’t care about good-tasting
food. She also sees tremendous potential for dietitians to use
their expertise in helping the public navigate hot-button topics
in nutrition, citing the campaign to remove trans fat from foods
as a key area where RDs could get involved with consumers. Although
sometimes frustrated when working with chefs slow to accept
the input of dietitians, Cameron believes the partnership is
a good fit that will evolve in time: “Dietitians are the
food and nutrition experts. Our skills complement the skills
of chefs very well. In culinology, they need us and we need
them.”
Nutritional Genomics
Nutritional genomics consists of two separate but related disciplines.
Nutrigenetics explores the manner in which genes influence diet
and nutritional status (ie, a gene acting on an enzyme in a
metabolic pathway), whereas nutrigenomics relates to the effect
of dietary components on gene activity (the ability of a particular
nutrient to affect gene expression). Nutritional genomics uses
knowledge of the interaction of genes, diet, and lifestyle factors
to build a repertoire of nutrition strategies targeting the
prevention or reversal of chronic disorders, such as cardiovascular
disease, diabetes, and cancer.5,6
Although still a young science, nutritional
genomics has begun to change the way we think about nutrition,
genetics, and disease prevention. Research labs around the world
are working feverishly to identify genetic disease biomarkers
and refine the technology used in genetic profiling. At the
clinical level, practitioners utilize genetic and biochemical
risk factor profiles to develop personalized care plans for
individuals diagnosed with nutrition-related chronic disease.6
One such practitioner is Ruth DeBusk, RD, PhD,
who combined a passion for genetics with her love of food and
nutrition to create her own niche, providing genetic testing
and counseling and nutrition therapy to patients in a gastroenterology
practice. For DeBusk, it was a dream come true and the culmination
of years of study and hard work. A home economics teacher by
training, DeBusk was drawn to genetics to satisfy her curiosity
about the determinants of disease. After obtaining a doctorate
in genetics and molecular biology, DeBusk taught at Florida
State University and then worked with her husband to establish
several genetic technology companies. Eventually, her desire
to use her science expertise in a clinical setting led her to
become a dietitian. (For an in-depth look at DeBusk’s
career path, see “Pioneering the Frontier of Nutrigenomics”
in the September 2004 issue of Today’s Dietitian.)
In her Florida practice, DeBusk works with patients
with gastrointestinal disorders, including celiac disease, irritable
bowel syndrome, ulcerative colitis, lactose intolerance, diverticulitis,
colorectal cancer, and Crohn’s disease, as well as individuals
with liver disease and liver transplant patients. She uses family
history, lifestyle behaviors, biochemical data, and genetic
testing to develop personalized dietary interventions for her
patients. The driving force in DeBusk’s practice is her
belief that our genes are not our fate; she focuses on providing
patients with information about dietary choices that will improve
their health and overall quality of life.
DeBusk envisions that the potential for qualified
dietitians in the field of nutritional genomics is immense,
ranging from clinical practice and education to research and
the development of products and functional foods. She offers
this advice: “I’d like to encourage dietitians to
begin now to get comfortable with this area. Genetics is intimidating
to a lot of people, but once you learn the language and a key
set of rules, it’s actually quite logical. Practice critical
thinking skills. Stretch yourself. Dietetics professionals should
consider advanced degrees in genetic counseling. Courses like
biochemistry and metabolism that may have seemed to be a lot
of memorization that didn’t appear to be very relevant
are critical in the coming era of molecular nutrition because
you have to know what’s going on if you want to develop
interventions that will correct dysfunction or head off a coming
train wreck. The more you take this type of approach, the more
effective your client outcomes will be, and the more clients
and respect from your colleagues you’ll attract.”
DeBusk is now developing educational and training
programs for dietitians and other healthcare professionals through
a Web site she is creating (www.GeneSmartLiving.com). She will
also be offering an online graduate course in nutritional genomics
through the University of Medicine and Dentistry of New Jersey
beginning in September, which will be available for continuing
education credit. DeBusk is also the author of Genetics: The
Nutrition Connection, an introduction to the science of nutrigenomics,
as well as It’s Not Just Your Genes.
Colleen Fogarty, MS, RD, combined her background
in nutrition and clinical and pharmaceutical research to create
a career in nutritional genomics. As project manager at Interleukin
Genetics, a biotechnology firm in Waltham, Mass., that develops
genetic testing devices, Fogarty wears many hats: designing
and coordinating clinical research ventures, overseeing financial
and operational planning, and producing documentation and technical
communication for the company’s nutritional genomics product
line. Fogarty received her genetics training on the job from
Interleukin scientists and believes that completion of premed
coursework along with her dietetics education gives her an edge
in mastering the complexities of the science.
Fogarty notes that keeping up with the field
is challenging. “I have to admit I spent a lot of time
outside of work really fine-tuning my technical knowledge. This
stems from my passionate interest in human genetics,”
she says. “A book by Phil Reilly, MD, JD [geneticist and
former CEO of Interleukin], or a recent article published by
Jose Ordovas, PhD [senior scientist and director of nutritional
genomics at Tufts University], is always near my bedside.”
Like DeBusk, with whom she collaborated on a nutritional genomics
paper, Fogarty sees tremendous potential for RDs in the field,
particularly for those with an entrepreneurial spirit: “The
dietitians [who] find themselves in this field sooner than later
will be pioneers, willing to dive into the unknown, take risks,
and practice good decision making.”7
Dietitians practicing today are fortunate to
have access to an expanding reservoir of career possibilities.
Developing new skills, keeping abreast of dynamic changes in
science and technology, and remaining open to unconventional
and innovative ideas will help prepare RDs for the challenges
ahead.
— Mary Franz, MS, RD, LD, is a research
dietitian at Harvard University and freelance writer from Boston.
Resources
Schools Offering Instruction in Herbal Medicine
•
The North American Institute of Medical
Herbalism, Inc., Boulder, Colo.
• Rocky Mountain Herbal
Institute, Hot Springs, Mont.
• Tai Sophia Institute, Laurel,
Md.
Colleges and Universities Offering Degrees in
Culinology
• Cal Poly Pomona, Orange Coast
College, Pomona, Calif. — e-mail jgolden@mail.occ.cccd.edu
or mfsancho@csupomona.edu
• Clemson
University, South Carolina — e-mail
johnny@clemson.edu
• Kendall College, Chicago
• Southwest
Minnesota State University — e-mail chengm@southwestmsu.edu
• University
of Cincinnati/Cincinnati State & Technical College —
e-mail margaret.galvin@uc.edu
• University
of Massachusetts at Amherst — e-mail edecker@foodsci.umass.edu
• University
of Nebraska at Lincoln — e-mail kkildare2@unl.edu
Nutritional Genomics Resources
• Centre
of Excellence in Nutrigenomics (New Zealand)
• The Dutch
Nutrigenomics Consortium — e-mail michael.muller@wur.nl
• The European Nutrigenomics
Organisation — e-mail ben.vanommen@tno.nl
• The
NCMHD Center of Excellence for Nutritional Genomics
References
1. Alternative Medicine Foundation. “Herbal
Medicine — An Alternative and Complementary Medicine Resource
Guide.” Available here.
2. Tai Sophia Institute. “Herbal Medicine.”
Available here.
3. Research Chefs Association. Available here.
4. Cornwell L. “New degree programs produce
chef-scientists.” USA Today. August 14, 2005.
Available here.
5. Elliot R, Ong TJ. Science, medicine, and
the future — Nutritional genomics. BMJ. 2002;324:1438-1442.
6. Afman L, Müller M. Nutrigenomics: From
molecular nutrition to prevention of disease. J Am Diet
Assoc. 2006;106(4):569-576.
7. DeBusk RM, Fogarty CP, Ordovas JM, et al.
Nutritional genomics in practice: Where do we begin? J Am
Diet Assoc. 2005;105(4):589-598.
