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!