This week I received an email from a current dietetic student wondering how it is ‘possible’ to be a Paleo dietitian and promote the lifestyle, even though it doesn’t exactly ‘jive’ with the USDA Food Plate and dietary guidelines. I often receive emails and inquiries like this from students, current registered dietitians, nurses, health professionals and ‘nutritionists’. Here’s how the story goes:
Hi Amy!
I came across your blog, and it was just what I was looking for. I am a senior Nutrition and Dietetics student, just about to graduate, and am feeling very stressed. Besides the obvious reasons, much of my stress is coming from the fact that I do not agree with what I am being taught to teach! I’m sure you understand how I feel. The paleo lifestyle has improved my life drastically. I’m in the process of applying for dietetic internships and cannot get this topic off my mind. I feel that I should continue to my goal of becoming registered, as I feel I could help more people that way.
I have one major question: how do you work and teach paleo style and not get reprimanded by the ADA/AND? I’m not sure how much liberty you can take with your title as an RD. Does simply focusing on what you do recommend, not what you do not, fly?
Thank you so much for taking time to read this,
-Allison
Well Allison, there’s a short answer and long answer. I’m going to give you the short answer first; yes, that does mean you’re getting the long answer too; (you can’t say I didn’t warn you…).
The Short Answer
Ultimately, a paleo eating style is a ‘real food’ based approach. There are no fancy supplements, pills, injections, surgeries, or shady tactics (think colonics and sweat wraps). As a ‘paleo RD’, I do not sell anything, I do not make recommendations that will endanger lives, nor do I recommend a lifestyle that is unsustainable or that I do not practice. Yes, it is true that paleo eating requires the ‘elimination’ of grains and dairy – but how does this differ from recommendations to eliminate all animal products (meat, dairy, eggs, honey, etc.) as a vegan diet does. Additionally, raw, macrobiotic, and fat free vegan diets (yes, they exist – Exhibit A the “Helpful Tools” are quite useful… ; Exhibit B) are even more limiting. I’m not saying that if, in fact you have ethical, moral and or religious beliefs that mandate these eating styles or if you are truly healthy and passionate about your way of life that you must convert to paleo – but as a comparison, if these diets are acceptable, how can paleo be argued? It’s simple, real food with absolutely no agenda. There is peer-reviewed science behind the recommendations and the support from the academic community is growing every day. I simply advise my clients to eat high quality meats, lots of non-starchy vegetables, good fats, and some fruit while staying away from processed and/or packaged foods – and that, is hard for anyone to argue.
The Long Answer
This is a complex issue and much of what is and is not okay to do depends less on the ADA/AND (as long as acting within the Code of Ethics for the Profession of Dietetics) and more upon the internship or worksite that you are at. Unfortunately, the “when in Rome, do as the Romans do” rule applies when someone else is signing your paycheck.
One thing that all current students, RDs, health professionals, etc, need to keep in mind is that for the most part – (there may be cases of ‘knowing the right people’ and pure luck) – you will need to work for an organization or establishment that adheres to the dietary guidelines. In these circumstances you will need to follow the policies and procedures as enforced if you wish to stay employed. With that being said, is it possible to somewhat incorporate some paleo principles? The answer is YES!
Okay, personal experience story time… Since my conversion to a paleo lifestyle (um, no I was not born paleo – that is prime content for another blog post…) – I have been employed both as a civilian military dietitian and as food service director for an adjustment training center. Working for the military, I was responsible for delivering nutrition education classes and counseling services to soldiers and their dependants. The classes that I taught consisted of template material and required that certain items be discussed and recommended. Did I follow these ‘guidelines’? You better believe I did – a girl’s gotta eat!! What I was able to do though, is emphasize the importance of selecting “real”, “whole” foods as opposed to processed, packaged fare. It was a case of doing the best that I could within the requirements and constraints of my job.
Next up, food service director; as the ‘boss’ you may think I could do whatever I wanted with the menus. Well, not so much. The facility that I worked at received government funding for meals ala the National School Lunch Program. Yes Virginia, French fries and pizza are considered vegetables… If I wanted to keep feeding the individuals we supported, the menus that I put together HAD to comply with NSLP requirements (2 grain servings, 2-3 ounces of protein, 1 fruit, 1 vegetable, 1 dairy) if funding was to continue. Additionally, there were some MAJOR budgetary constraints and minimal staff available to prepare meals (over 800 meals/day and only 15 staff on a ‘good’ day). Most of the commodity foods that we received were less than ideal – but the price was right… It is sad that this is the case in most school systems and things definitely need to change.
While in this position, I did everything I could to make meals as healthy as possible: replacing corn and peas with broccoli, green beans, lettuce, raw carrots; using corn tortillas and rice to meet the grain requirement as often as possible; incorporating as many fresh fruits and vegetables as I could within the budget and our storage space; etc. What did I learn – kids (and adults) really like chicken nuggets, mac & cheese, pizza, and French fries. On the days we offered the less processed foods like pork loin, turkey, sweet potatoes, broccoli without cheese sauce, etc – the number of meals we served was SIGNIFICANTLY (100’s) less. The end result – wasted food (due to last minute ‘not eating’ decisions), and lost revenue. Unfortunately, both of these were benchmarks of my performance as director and our (food services’) overall image.
Breaking free from the “gig that was paying my bills”, took YEARS. I didn’t walk out of my internship and straight into being a ‘paleo dietitian’. The move to be ‘self-employed’ and do what I love took time, dedication, planning and saving my $$. Contrary to what you may all be thinking – this self-employment thing does not come with a guaranteed paycheck every two weeks, there’s no health insurance, no retirement plan and it will likely not result in early retirement. It’s scary and I am not ‘getting rich’ (food service management pays better) – but I am helping people get healthy and doing what I love. That is PRICELESS!
So, there you have the ‘long and short of it’. It may not be the answer that you were hoping for – but it is the reality. If the person signing your paycheck says pizza is a vegetable and ‘MyPlate’ is the answer then so be it for bill paying purposes. Do as much as you can to steer the current toward ‘real food’. Don’t ever give up and someday (hopefully very soon) – we’ll have more people believing that “Paleo is the Solution”.
At least MyPlate has half the plate veggies/fruit instead of grains like it used to be. Not that that helps the two grain servings to one veggie serving issue.
I’m already plotting how to get around similar restrictions in my daycare. I *think* I can pull a technicality with starch=grain at least some of the time. Perk… you might not think so, but the younger kids are much less picky.
I tend to think if the teachers could/would actually sit down with them, they’d eat better. A lot of school systems have such broad ratios that the kids are basically raising each other. It’s really sad, and not even remotely something I blame the teachers for.
You are so right! I also had cases where teachers, parents and the ‘lunch ladies’ would make remarks about the ‘healthy’ foods being ‘gross’. We need buy-in on ALL levels if this is going to work. It truly does ‘start at home’. We’ll keep fighting!!
When my youngest daughter was in daycare they provided lunch. That was before we were paleo. Yes their were chicken nuggets some days and corn dogs but most days it was soup with veggies and meat and they always served the fresh veggies and fruit family style in a big bowl. No it was not always the best quality meals that I prepare at home but you are right about the little kids being less picky. The big bowl was ALWAYS empty when I often saw the main dishes discarded (too processed maybe). I loved that they all (teachers too)sat down together and shared a meal. I was very lucky in that aspect. As far as the kids raising eachother too true and sad. The poor teachers are underpaid and under appreciated. America is pretty ass backwards in respect to teachers. Most are treated worse than babysitters. That is my political rant for the day. Whew. Keep doing what you are doing Amy.
That was a great rant!!
Great piece! I actually took another route. I completed my undergrad in nutrition and began looking for employment. The only place that called me back was WIC. This was good and bad. I could get my 1200 hours unpaid internship there and then walk into a job. The bad part was I just started paleo about a year prior and was super gung ho. Ethically I couldn’t handout packets telling women struggling to feed their children milk and bread. This made me realize I had to do it on my own. Some states do not require licensing to practice as a nutritionist. I do not normally recommend this, but if you promote nothing but whole foods, like Amy stated in the beginning, chances are no one will get hurt. I wasn’t super comfortable practicing without insurance so I looked further. The National Association of Nutritional Professionals certifies people as holistic nutritionists. They require a degree in nutrition, or current RDs. From there you can get insurance and practice the paleo diet safely. They have a board certification that you can take once you tally 500 clinical hours, which can be done on your own preaching paleo. I went this route and do my own thing. I was tied in the Crossfit community where I am from and I have been a strength coach for 6 years so I have good networks. If you are brave enough to do this on your own and see where it takes you I encourage this route. Sucking it up and doing the RD thing is much much safer because no hospital or health center will hire you without it. Like Amy said you got to eat!!!
Awesome Kevin!! 🙂
I’m not an RD, just a Paleo advocator. But I wonder what might be all of the ways you could endorse a Paleo lifestyle without actually suggesting one?
For example: your push for whole, real, quality foods from natural sources is admirable and extremely fitting. My only concern here being there are a ton of people I talk to who consider “real whole grains” to be a ‘good source’ of ‘wholesome nutrition.’
So, what about taking it up a notch? This would obviously only really work for one-on-one clients, but: For more receptive clients, offer ‘elimination’ diet options to determine what they may or may not be intolerant to. Most of us will agree that after the whole30 we realize just how intolerant we are to gluten, soy, and dairy from inferior sources.
And in the end, everyone sort of comes out Paleo anyway, even if they didn’t know it. Win!
Jay, that is exactly how to play it! Getting as much buy-in as possible and break in where you can! Show them the difference in nutrition breakdown between vegetables and grains – give them the tools and resources and let them come with the questions!! Win for sure!! 🙂
The truth about how to achieve success is not pretty. Thanks for keeping it real!
I am a Paleo RD too and am still struggling to find a way to practice the Paleo way… slowly getting there… but as you said, applying the principles of the whole food approach, pointing out that some symptoms of your clients may be due to a gluten/grain intolerance and even preaching for a lower-carb approach (focusing on non-starchy vegetable, animal protein and fats) is the way to go… and there is plenty of studies to back us up!
Someday were going to be the ‘majority’ not the minority in this game!!! Go Team!! 🙂
I’m not an RD, but I’m a holistic health coach and a closeted paleo advocate. I say this because I gradually try to convert my clients to paleo without ever using the word at first. Many of my clients either have enormous amounts of weight to lose, autoimmune diseases, or both. Like you said, Amy, I start slowly with stressing whole, natural, unprocessed foods and then gradually get them to do a trial with no sugar and then no grains. By the time we get there, they’re into it, have lost weight and feel better. Then I bring out the word “paleo”. They’re already hooked.
I am lucky and unlucky that since I am a single practitioner working on my own for myself, I can do whatever I want, but you’re exactly right in that working for one’s self isn’t easy and money is not guaranteed.
It made me feel so great reading this post because I feel in my gut that I’m on the right track, doing the right thing and others are out there doing the same in their own fashion.
Thanks for the great post.
Awesome Jill!!! Keep spreading the ‘real food’ message! 🙂
Amy,
Being a Self-employed Paleo RD is heroic. Paying the bills while getting people to eat their vegetables is a big challenge.
I hope you continue to flourish.
Remember you have free lodging here in San Diego if you visit for work or play.
It’s the least I can do for all of your teaching.
Dana Law
San Diego
Thank you Dana! 🙂
I HATE this idea of “kids food”, i.e. mac and cheese, pizza, hot dogs, etc. Why can’t kids eat normal healthy food? (then again, why can’t all adults?). I don’t have kids yet so it’s easy for me to say anything, but I think if you only feed your kids real food, they will eat real food. But most people don’t, hence, the real food you serve gets treated as “gross” by the kids and adults alike. That’s sad.
I’m really hopeful that in the next 10-20 years the medical and nutrition establishment will eventually have to accept the paleo lifestyle and that soon it won’t be “crazy” to eat real food. Until then, we march on in our own, now healthier, bodies.
I hate the idea, too, and I have kids! I’m all for feeding them what we eat…the problems start with grandparents and continue with friends. Combine that with having a “special” event nearly every weekend with cake and frosting and soda. There are birthday parties (way to many, IMO), sports parties, dinner parties (lot’s of “kid food”) and holidays. The worst irony is watching someone on a diet to lose weight feed your kid all the unhealthy stuff they can’t eat cuz they’re on a diet! Why?! If you can’t eat it, my kids sure shouldn’t be eating it! (To me, this goes hand in hand with the comment I frequently get: You don’t need to lose weight so why are you eating healthy? That’s a topic for another rant…) Raising kids to eat healthy is very difficult and I try to educate my kids a little bit every day.
The problem also comes in if you don’t start early. I didn’t even know about paleo/clean/healthy eating until my ob/gyn recommended it after the birth of my 3rd child (because he had just discovered it and loved it). It took me years to even switch myself over to this way of thinking because I initially thought it sounded weird (until I started actually reading about it) – by then I had lost so much time with my kids and they were addicted to the processed/unhealthy foods that I had been giving them. So it has been a very slow conversion for them because they aren’t able to make the connection that they feel bad when they eat crap (although I try to help them see this). They bring their lunch to school and kids actually make comments about “why are you always bringing healthy stuff” – like they are freaks. I joined the lunch committee at school and we are fighting the school lunch program subsidies, lunch ladies who are set in their ways, and kids who prefer the bad stuff. But there are 2 other paleo moms on the committee and I feel like we have a chance to make small changes. If I only knew then what I know now…. so feel blessed that you are ahead of the game before you have children and you can start early!
Thank you for posting this Amy. (I know I’ve asked you about this before since I work for WIC). You are so right about at least being able to advocate for whole, real foods. I did want to share with you that I had a client a few weeks ago with PCOS who was already consuming a “low carb” diet, or last attempting too. I felt that situation was appropriate for me to share paleo with her, and she was very grateful!
Awesome Laura!! We’ve definitely got to take em’ when we can get em’!! 🙂
I’d just like to voice my personal “Thank You!” to all those (a growing number) professionals who are willing to “buck the system” and speak the truth as they see it, rather than as it has been scripted for them 🙂
You’re welcome!!!
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Allison, at least avoid working for a major corporation or non-profit, writing letters to the editor fighting other people’s attempts to make positive changes. I hope someday there will be a new organization for diabetics that will be based on science and not self protection like the ADA. I also wrestled with moral issues in my work (high tech) and changed jobs. I hope you can find something where you can be honest and tell the whole truth. With more dietitians like you, maybe other people won’t waste years on a “healthy” diet that causes health problems and months on a treatment that only maintains their poor health.
Hi Amy,
Many thanks for writing this post and putting things in black and white for those of us who are following this path. I don’t know how bad is the “food pyramid” situation here in Australia but my guess is that I’ll be faced with similar constraints once I graduate and work in a corporate setting. Instead of getting frustrated, I’ll keep in mind your advice and do as much as I can to spread the word. Many people get discouraged about becoming a RD or MD when they realise their scope of action is restricted by what the government/corporate environment says, but in my opinion having a degree in those areas allows you to reach more people than you normally would be able to.
You are exactly right Gaby!!! The education and degree will help you reach so many more people! Stay the course!! 🙂
Hi Amy!!
This is a wonderful and timely post! Like Jill who commented earlier, I am also not an RD.
I was working in Engineering and hated my job. I found it unrewarding, and found it increasingly difficult to work with some of the huge (and frequently unwarranted) egos. I had always been rabidly interested in nutrition and had discovered the Paleo way. I decided that I would make nutrition my next career.
However, when researching the RD path, I was lucky enough to meet a couple of RD’s who gave me the straight dope about the expectations to conform to imposed guidelines and the consequences for not doing so. I was disappointed and felt that my hopes were dashed. I knew that I simply could follow through with giving bad dietary advice because I was being forced too. That was an unhappy time for me!
Then I discovered programs in “natural nutrition”, that would allow me to learn about nutrition, would allow me to earn a designation and, most importantly, allow me to make recommendations based on recent research and epidemiological findings, rather than on poorly advised blanket recommendations.
Sometimes, because I am considered an “alternatitive practioner”, I am not taken seriously. But, I am continuing to slowly build my own business where I promote Paleo nutrition guidelines and encourage clients to take back control of their health. I also do not use terms like “Paleo” or “holistic”… As soon as I do, people think that I am going to have them eating nothing but kelp and tree bark! Perception is everything! LOL!
Amy,
Like many here, I love nutrition and believe Paleo is the way to go for optimal health. I also considered becoming an RD, did my research, and ended up pretty disappointed with my options.
You mentioned programs in “natural nutrition.” Would you mind sharing which programs you’ve looked into? I am still interested in going back to school, but I want it to be worth the time and the cost (to me, and RD program is not worth it. I won’t be able to sit through lectures about the “vitrues” of whole wheat without losing it).
Thanks!
Jesssica
…woops. I mean to open with “Barb,” not Amy :). Sorry, Barb!
Amy,
I have currently adopted the paleo lifestyle and would love for my 3 year old to be in that as well. Unfortunately I can only do so on the weekends and during dinner because she goes to the day care. I thought about packing her lunch but I know for a fact that if she sees the other kids eating fries/nuggets, she will reach for those…so how do I or how can I enforce a Paleo lifestyle to a three year old in a day care setting? Is there hope?
I appreciate any advice you can provide 🙂
Here’s a few ideas to try… You could let her “make her own lunch” with foods that you pick out together. This might help her feel ‘special’ and in control of what she has. Take her to the store and let her pick her meat/fruits/vegetables, etc. Make her lunches fun and interactive – think kabobs, dipping, ‘meat Caterpillar roll-ups with veggies in the middle, etc. This might make the other kids jealous that she has ‘fun’ lunch!! Make paleo versions of chicken nuggets, sweet potato fries, meat loaves and/or eggs in mini muffin cups, etc. Have fun, be creative and she’ll come around!! 🙂
Don’t give up!!
Evangeline,
I know this is months later, but I thought I might share some thoughts with you. I “went Paleo” last April, and in May asked my family (hubby and then 5 year old daughter) to give it a shot. As her father and I both felt better eating and living this way, my daughter didn’t have much of a choice! I did feel a little challenged about fixing lunches for my daughter to take to preschool, but you should have seen how jealous her friends were when she got to eat BACON! for lunch!!
Dipping sauces, different presentations, and fun containers do help, at least in the beginning. I do allow my daughter more indulgences than I give myself. And, after almost six months, she is starting to realize that the indulgences come with a price.
Eat Like a Dinosaur has some good, kid friendly recipes (I know Amy reviewed it), but I just really fix her the same food we eat. Lunchbots are fun, stainless steel lunch containers that have helped make lunch fun.
Finally, your daughter’s preschool should not let her “reach for” food other than what you send with her. Let them know that she has food sensitivities (that you have recently discovered) and that she is not to eat anything that you don’t pack for her without your prior approval.
It hasn’t been easy, but transitioning my family to a more Paleo lifestyle has definitely been worth the effort. Hope it goes well (or is going well) for you.
This situation of compromise until you can afford to live your dream is something nearly every professional or business person has to deal with. Probably a reflection on modern life, yes? I can’t even tell you how many times my time in the ‘heathfood’ industry has caused me a serious moral dilemma. And yet, what are you going to do? Go out of business? When our company was tiny we often had to compromise on products that we didn’t feel 100% comfortable with (e.g. WPC that was a result of intensive dairying which pollutes the environment) just so that we could grow to the point that we could afford to NOT do that.
I’m a Postgrad Nutrition student and find that in this field we have actually a lot of leeway to follow more diverse ideas and research. As long as we link what we say to published research then generally, it’s ok. I have a friend doing her internship in Dietetics and she is currently depressed that most of her last few months have involved mixing up liquid feed for naso-gastric tube patients. However, she is going to walk into a highly paid hospital job and I’ll be trying to make it as a self-employed Nutritionist.
Thanks for this article. It’s a very interesting concept and I think some people judge too harshly what people have to do in their job. Most people don’t start out in a position to call the shots, and if you quit instead of compromise, then you’ll never get to that more powerful position.
This is where my chosen profession seems to be coming into conflict with my daily practices. After losing roughly 50 lbs. following Paleo, I fell off the wagon following a couple surgeries and gained it right back. Earlier this year I signed on with an Herbalife nutrition club as a Health Coach, primarily because I wanted to get myself back in shape while promoting good nutrition and make a little profit doing it. The before/after stories alone drew me in. What I have discovered in the last five months is that while Herbalife’s athletic line of protein shakes and post-workout supplements are second to none, in my body, the meal replacement shakes leave me feeling more bloated and full than satisfied. After a week of taking them out of my everyday rotation and going full Paleo again, I’ve found that I have better flow of energy, don’t experience excessive hunger, and am much less prone to insomnia and late night snacking. Now how I can be an Herbalife distributor and Health Coach but be practicing something else entirely creates some conflict for me, because I do have clients who are losing weight with the shakes, drinking two shakes a day and one colorful meal, with healthy snacks in between. The best I’ve been able to do is recommend that their “real meals” are Paleo loyal and colorful on the plate, without using the word ‘paleo’, and encouraging them to replace a second shake with an equally colorful meal once they’ve reached a maintenance stage. What chance of success do you think I would have if I made an attempt at a Paleo loyal nutrition club/cafe and continued a client/coach relationship with people looking to get healthier through less expensive, truly all natural means?
Well, it might take a bit more work to get started and established compared to being in a club like that, but there are a number of people who do it. If you’re in a good area for it, and you can get enough clientele, then I don’t see why not. Maybe try it out some on the side and see how it goes, then if it starts taking off just go with it.
I just came across this post and it is 2017. Has anything changed? I feel like more people are going paleo now, but maybe that is just me. I really would like to get certified as a paleo nutritionist and wonder if it would be easier now to get started.
I am a registered nurse in the state of Texas. I want to pursue a career to help families transition into the Paleo Lifestyle or just a healthy lifestyle (whole foods, no processed foods, etc). In order to pursue this type of business adventure, do I need to have some type of certification in nutrition? I appreciate any feedback you can give. Thanks!