Certified Clinical Nutritionists: Today's Complementary-Alternative Nutrition Professionals

By: Joan Friedrich, PhD, MA, CDN, CCN, BCIAC
Last Reviewed on: April 16, 2002
In the 1970s, when I first became involved in alternative healthcare, most nontraditional healing systems were unapproved by Western medicine. Traditional institutions did not understand them, and subsequently these methods remained on the fringes of healthcare. Although growing numbers of consumers were beginning to explore these methods, traditional thinkers maintained a firm opposition.

Now, 25 years later, the tide of acceptance is finally coming in. In 1999 alone, the scientific community granted the National Institutes of Health (NIH) $50 million to evaluate complementary-alternative medicine (CAM). Today, traditional authorities can no longer ignore the benefits of natural healthcare. As studies supporting nontraditional approaches begin to flood medical literature, former skeptics are changing their views, and once-disparaged therapies are gaining serious recognition. The result is that alternative modalities are being elevated in esteem. They are now regarded as "complementary" or "integrative" therapies-healing methods that can synergistically blend with allopathic, mainstream medicine.

Although the struggles of complementary-alternative healthcare are far from over, enormous strides have been made. Political barriers continue to exist, but many mainstream institutions are attempting to understand nontraditional approaches. As they move forward, many of yesterday?s critics are now seeking ways to learn about the very therapies they once refused to accept.

America?s Need for Better Nutrition
One healthcare area gaining greater recognition of late is nutrition, and the specialty of complementary-alternative nutrition. Twenty-five years ago only a fraction of the population understood the value of good nutrition and nutritional supplementation. Today, greater numbers of people are becoming nutritionally savvy. Close to 50 percent of the population now use nutritional supplements on a daily basis. Whether to ensure adequate nutrition, prevent or treat health conditions, or to optimize health, we now understand why enhancing certain nutrients and using natural products can make a positive difference in health and well-being.


Studies by the U.S. Department of Agriculture (USDA) indicate reasons for this growing trend. Simply stated, our diets are grossly inadequate. Chronic disease accounts for 85 percent of our nation?s healthcare bill. Former Surgeon General C. Everett Koop?s "Report on Nutrition and Health." (1988), pointed out that diet has a vital influence on health. Five of the leading causes of death-heart diseases, cancer, strokes, diabetes, and atherosclerosis-are all linked to diet.

According to human nutrition expert, Jeffrey Bland, Ph.D., many Americans are "vertically-ill"-not sick enough to be confined to bed, but far from functioning at their optimal health potential. A major reason for this is our lifestyle. As convenience foods become more popular, healthy, nutrient-dense foods are being replaced with empty-calorie foods. Growing numbers of people are out of shape, overweight, and inadequately nourished.

Studies reveal that more than 80 percent of women and 70 percent of men eat less than two-thirds the Recommended Daily Allowance (RDA) of one or more nutrients. Amazingly, government statistics (U.S. Statistical Abstract of 1992) indicate that a whopping 98.5 percent of the U.S. population is unhealthy. Only 1.5 percent of us can actually be classified as healthy.

One thing remains clear. A tremendous need exists for better nutrition and better ways of enhancing wellness and preventing disease. These requisites have created an increasing demand for biochemically oriented nutritionists who are highly trained in complementary-alternative approaches. To meet these demands, a new field of nutrition science began in the 1980s. The first Certified Clinical Nutritionists (CCN) were introduced to the medical and healthcare community in 1991.

Before this date, registered dietitians (RD) were the only credentialed food and dietary professionals. However, the emergence of the CCN provided the consumer and healthcare community with a different type of credentialed nutrition professional, offering a different type of nutrition service.


Although both RDs and CCNs are highly qualified professionals, each provide distinctly different services based on two different types of nutrition research, two different philosophical perspectives, and two different professional orientations.

The Difference Between a Dietitian and Nutritionist
An excellent comparison of the dietitian and the nutritionist was made by the International and American Association of Clinical Nutritionists (IAACN ), a professional organization that represents CCNs in all the licensed healthcare fields. According to their informational materials, to understand the difference between dietitians and nutritionists, we must first look at the definitions of "diet" and "nutrition." In the simplest terms, "diet" refers to the foods we eat and beverages we drink, while "nutrition" refers to the biochemical processes that result from food or beverage ingestion.

Let?s look more closely. According to Taber?s Medical Dictionary, diet is "liquid and solid food substances, regularly consumed in the course of normal living." This can include typical foods such as fruits, grain, vegetables, proteins, and beverages.
Dieticians
Dietitians base their approach on dietetic-related research. Some work in academic settings, in industry or in private practice. However, most dietitians provide food and nutritional services within institutional settings (e.g., hospitals, schools, nursing homes).

The major focuses from the dietetic perspective are on calories (energy), quality of food in regard to freshness, sanitation and freedom from spoilage and contamination, meal planning, evaluation of standard measurements of foods, specific diets for certain conditions, and eating patterns based primarily on food groups, such as the food pyramid, and other guidelines based on daily food intake strictly outlined by health organizations.

Nutritionists
In comparison, nutritionists are defined by the concept of nutrition. Nutrition is defined as the "sum total of the processes involved in the taking in and utilization of food substances by which growth, repair, and maintenance of activities in the body as a whole or in any of its parts are accomplished-including ingestion, digestion, absorption, and metabolism (assimilation)." Certified Clinical Nutritionists base their approach on up-to-date science in nutrition research based on these concepts. One vital aspect of the CCN?s orientation is their highly sophisticated background in complementary-alternative healthcare.

The CCN?s food perspective focuses on the classification of food based on nutrient value (e.g., vitamins, minerals, EFAs (essential fatty acids), amino acids, enzymes, and accessory nutrients) of a food in its natural whole-food state. Certified Clinical Nutritionists look at the effects of food treatments (e.g., irradiation, hydrogenization) and chemicals (e.g., pesticides, preservatives, coloring, tenderizers). In addition, they consider how some foods are depleted or altered by cooking (e.g., microwaving, frying), the effects of refining and processing, and how food is actually handled and processed by the body.


A major role of the CCN is to consider how foods are digested, absorbed, and assimilated, and ultimately how food affects the body biochemically. Among the many aspects of nutrition research considered within this context are by-products of digestion, gastrointestinal health, neurotransmitter response, immune function, metabolic shifts and balance, allergic or sensitivity reactions, and systems and pathways of detoxification.

The CCN?s approach to diet structure is developed according to what is best for the individual-not necessarily what is a standard recommendation for the general public at large, or for all people experiencing a particular health concern. Rather than strictly advocating a pyramid or food-group-style diet, the CCN will determine the healthiest and most effective program for the individual according to the latest nutrition research and the unique biochemical make-up of the individual.
Continue at Women's-Health.com Health Library