Friday, April 22, 2011

How to become a Paleo Dietitian (and is it worth it?)

On Robb Wolf’s podcast I occasionally hear people write in to ask him where they should go to school to become a dietitian that has a paleo slant. Robb tells them there is no such place and that if they want to become an RD they are going to suffer through a lot of food pyramid nonsense and that they might be better off just taking some biochemistry classes to get a better background. He is not wrong. My experience though, was better than it would have been at most places. Now granted, I am new to paleo, but in the late 90s I read the original Zone Diet books and Barry Sears’ detailed explanation of the biochemistry of what food does in the body is what inspired me to study nutrition. It was the first time I had ever had an interest in science—it lit a fire in me like few things ever have (all this from a commercial diet book!). Throughout the early 2000s I experimented with the Zone, Atkins, Fat Flush (which is actually fairly paleo) and eventually the Weston A. Price foundation. I had a few years experimenting with being a vegan, but even then it was the grain-free variety as described in Eat to Live by Joel Fuhrman. Paleo made all of that information make SENSE. It was with this background that I entered Bastyr University, a natural health oriented University that trains Naturopaths, Midwives, Acupuncturists, Herbalists and Nutritionists, located Northeast of Seattle. Obviously the Bastyr curriculum is not teaching a paleo diet--but it does teach a whole food, local food approach that is skeptical of the food pyramid. Bastyr graduates are not afraid of saturated fat or red meat, and even sometimes scan the farmer’s market for lard (my friend spent an entire summer trying to figure out the perfect ratio of lard to butter for a pie crust). It was because of my education at Bastyr that I learned how to do an elimination diet and learned of my allergy to gluten (I already knew about the dairy). I learned about leaky gut (granted, not about Robb Wolf’s assertion that legumes and all grains can lead to it, but I did learn what it is and about the 8 most common food allergies and that I most likely had it). I took whole foods cooking classes, I had four intense quarters of biochemistry, both of the macro and micronutrient variety and maybe even most beneficial—I learned how to read scientific articles critically. This is a skill that is missing from a lot of people in my field—they simply take the conclusions of a scientific article as fact (if they read them at all), without being able to evaluate whether the study was well conducted or biased.

Now for the bad parts: sometimes you have to memorize things you do not believe in and other things that are horrendously boring (I’m sorry but Food Service Management was the bane of my existence). Particularly if you are going to become a Registered Dietitian, there are things you have to do because the American Dietetic Association says so, particularly doing a 1200 hour internship after you get your degree, which is fiercely competitive to even get into, during which time you will learn all about how to be a hospital dietitian and calculate how much corn syrup and soybean oil based liquid food sick people should be administered, you will probably have to teach a class on the food pyramid (that was not fun—the curriculum told me to tell people that soybean oil is good because it lowers cholesterol. I think I said it really fast so no one heard me). You will spend anywhere from 4-8 weeks learning about how hospital kitchens are run and a couple weeks having your heart broken at WIC educating low income young women about how to use government coupons that are mostly for dairy products and juice how to feed their children. It was a rough year and ultimately I use very little of what I experienced in that year in my job. You then have to take an expensive and scary exam on all of the stuff you wish you weren’t required to know in order to get your credential. The only thing that was really great about my internship (through Washington State University) was that our clinical instructor was a whizz in biochemistry and our lecture portion had a good review of those topics. That instructor also ultimately helped get me my current job, which is in research at the hospital where I did my internship and that made it all worth it, but seriously, it was a torturous year.

Then if you do become an RD and what you want to do is help people with paleo you are going to need to go into private practice, which is no guarantee of making any money, at least for the first five years. This is something I would eventually like to do, but right now I need to work and pay off my student loans and anyway I really like my job—but I don’t see patients on a day to day basis so I’m not really spreading the paleo word. If you think you are going to be able to instruct people in paleo at your average hospital outpatient clinic though I would take pause. You *might* be able to get away with some level of that, but I guarantee you if anyone overseeing your work got wind of you telling people not to eat grain or even worse, that saturated fat is not the devil, you will probably get fired. (The outpatient clinic where I did a rotation was still telling people they could have no more than 2 eggs a week and had a whole wall of cholesterol lowering margarine product examples. One of my friends heard a dietitian tell a patient that if a food was fat-free and cholesterol-free it didn’t matter what it was. Yikes!) Your best bet is to partner with a gym, probably of the crossfit variety to get clients.

Have I scared you off this endeavor? I hope not because there aren’t that many of us out there with this slant and I could use some company! (Note: one of my good friends from my internship is a hard core paleo crossfitter, so other RDs out there do exist—and she was into paleo way before I was!).

In some states (Washington is one) you can also practice as a “Certified Nutritionist” with a Master’s Degree in nutrition, without having to do the RD internship process. I have a couple friends who went this route and it was definitely tempting. If you know you will only ever have a private practice and will only ever live in a state where this is allowed do it. (But know that the Washington State Dietetic Association is pushing hard for licensure, not just certification for RDs, which depending on how the legislation ends up being worded, could cause problems for CNs down the road). Many states only allow you to practice as a licensed dietitian. It’s also very hard to get a job as a CN, thus the need for private practice.

I do really recommend the Bastyr Masters Degree program if you are going to take this on (I didn’t do an undergrad degree there so I can’t speak to that program). You will find a more open-minded, whole foods approach there, even if they are pretty enamored with grains, at least they tend to be on the whole grain, gluten free side of things. You can’t have everything!


Aglaée said...

Hi! I am a RD and am very happy to have found you! I also have a blog at I am trying to form a group of RD interested in the Paleo diet and non-conventional nutrition. If you are interested, let me know by contacting me on my blog!

Anonymous said...

I have to say I enjoyed this article. I wish more came out and spoke about this. As a patient I wished just one of my docs had mentioned this diet to me. Not a one.

I am hell bent on finding a doc who get this diet and will support me on the Paleo diet.

My guess just as I am looking for docs in my area to support me on this diet there are others up there in North King County or South Snohomish that are looking for RD like you.

Hey I have the same cuisinart saute pan with the lid and love it too. I see you are part of Lynnwood Crossfit an old stomping grounds area of mine decades ago. The last time I came up there I hardly recognized it.

Ali said...

I'm an RD and currently working on my PhD where my dissertation topic is a paleo intervention on patients with PCOS. I waited to do an internship and am starting it in the Fall and am NOT excited (mainly not excited to work for free, but also because I don't believe any of the crap they teach you in school).

I plan to be a professor so that I can do research and add to the body of literature that the paleo diet is the way to go.

Glad to meet a fellow RD (well, I will be one) that seeks out the truth.

Ali said...

Sorry, just realized that I said I was an RD. I will be but I am not yet.

Marissa said...

Sabrina, I love this article. I echo your thoughts about the internship and recall days that my skin would just crawl listening to an "old school" RD tell clients that LF this and that are the better options and that we can have only a couple of eggs per week, etc. I also despised teaching the Food Guide Pyramid in the schools. Boy do I have some horror stories:)

I cannot stomach having to disseminate this sort of information and sure hope that I will be able to put my own spin on nutrition education without suffering the consequences!

Arsy said...

This was a great article. Going back to school for nutrition is something I have been considering for awhile, and this article really helped answer some questions. Great job on your blog! It's really informative and fun to read!

Laura said...

I really liked this post. I have been considering going into the nutrition field because I have so much passion for it, but I have been worried that there wouldn't be much of a place for me with all of the information I already know and how much it disagrees with the more politically correct info. This, along with alot of other info I am finding out, is only furthering my doubts. I am thinking it might be a better career choice for the next life;)

PaleoRD said...

Hello! I too am a "Paleo RD". I am currently doing research on Paleo and Multiple Sclerosis. I have noticed a few RDs comment on your page about getting a network going- I think that would be GREAT! Here is my email for all RDs interested:

Gina said...

I know it's over a year later, but what a great post. I have had the same thoughts for a career change in order to help people "see the light", but now I'm just depressed. LOL! Keep up the good fight!

Mrs. T said...

Just found this post! I am a RD and I'm no longer a believer in traditional nutrition either. I'm hoping to further my education in holistic nutrition and paleo. You pretty much summed up my whole graduate/internship experience, but back then I did not know what I know now and I just believed it. Personal experience and good research changed my mind. I hope to one day have my own consulting business! Thanks for sharing this!

Leo said...

Hello Sabrina,
I'm very interested in the training that you received when you worked at Pharmaca. I'm working with a small supplement distributor and heard that Pharmaca has a 77-page training manual they give to their employees on what they can say or not.
If you could please contact me at it would be tremendous help.

mermama said...

Thanks, Sabrina, for your article. It is so useful for those wanting to help people take LEAPS towards their health goals, rather than tiny steps!

I am a fellow RD who practices and teaches Paleo, and currently drafting a highly interactive, train-the-trainer curriculum on the Paleodiet for gyms, healthcare facilities, consultants, etc. (about 8 hours total). My website is if anyone would like to contact me with ideas, suggestions, or questions.

Angeli Yuson said...

I am glad i stumbled across your blog. I was looking at studying to become a Nutritionist with a paleo field. This is a two year course or 4 years part-time.

Still doing research on the course but your blog post was really helpful.


KC1343 said...

I see that I'm late to the party but I'm so happy I stumbled upon this site (and everyone's comments!). I'm considering a career change to be an RD (after success for Whole30 and Paleo for multiple health issues). I'm a bit discouraged given the education you get doesn't always jive with the low carb/high fat stuff. The one thing I was thinking was if there was an independent part of the internship that I could focus on Paleo and even possibly do a thesis around low-carb/high fat vs high carb/low fat.