By Dr. Mercola
Many who have their own lives changed by diet are inspired to pursue an education in nutrition, but finding quality education can be bewildering, considering the outdated science and sometimes falsehoods still being taught in some quarters.
Michael Stroka is an attorney by training, but he also heads up a number of organizations that are responsible for educating, certifying, and advocating for nutrition professionals.
Here, he shares the latest in the field of nutrition credentialing, and how to earn advanced level certification as a Certified Nutrition Specialist.
A Passion for Nutrition Born from Severe Illness
I met Michael about 12 years ago, when he came into my office as a patient.
"I didn't know much about health until I got very sick," he says. "I was so sick I ended up having to quit my job. I was in a very high-level, high-stress job as a strategic business consultant traveling the world.
That's when I focused on my health. But I didn't know the system. I went through the traditional, conventional route, and ultimately exhausted all of those options. For me, it helped very little.
That's when I really started to look around for how I could truly regain my health, and I had the great good fortune to become your patient. That's where I was introduced to serious therapeutic nutrition."
Michael became truly passionate about nutrition and the healing power of food — so much so that it led to a whole new career.
“Talking to people about it and seeing the changes in my own life, it became clear that this is really what I was called to do. I needed to help to bring this information to other people,” he says.
He went back to school and earned a master’s degree in Human Nutrition. After doing an internship, he joined several organizations to become credentialed, and very quickly realized that the world of nutrition training and credentialing was in need of improvement.
"Very quickly, I got pulled into the organizational side with my background, as a businessman, strategist, and a lawyer. All of these skills were in quite desperate need in this field of the nutrition profession," he says.
Eventually, he was invited to join the leadership of the Board for Certification of Nutrition Specialists (BCNS), where he’s been the Executive Director for the last four years.
How to Take Your Passion for Nutrition to the Next Level
A question I frequently receive from people whose lives have been changed by nutrition and who want to share this knowledge with others is, “What field do I go into?”
There are many options, such as medical school, chiropractic, massage therapy, traditional Chinese medicine, and nutritional training to become a registered dietitian (RD), for example. But which one might be the best route for someone passionate about using nutrition to address disease?
Dietetics is a great field for people who want to go into more institutional environments that deliver acute or long term care within the medical model of those institutions, or manage large scale institutional food service.
But if your focus is on teaching people how to maximize health and prevent or reverse disease with nutrition, I recommend taking the route Michael did and attaining the Certified Nutrition Specialist credential.It ensures that you have an advanced level of real nutrition science competency as proven by education, internship, examination and continuing education. RD programs are primarily based on conventional medicine, and most of their understanding of health and nutrition is distorted, rather than looking deeply at underlying causes and addressing them through nutrition.
A major part of the problem is that the RD association, the newly named Academy of Nutrition and Dietetics, is sponsored and heavily influenced and even trained by major junk food corporations like McDonald’s and Coca-Cola.
They're slowly changing, but it's a tedious process for them.
Michael goes on to say:
“I knew I wanted to do this. So, I had to do all of that research and find out what training I should get, what credential I should get, and how I can practice. It became clear that it was still a rapidly evolving field, and without the institutions in place that needed to be in place.”
"As a strategist and attorney, I really thought through from a strategic standpoint: what are all the infrastructure pieces that need to be in place to ensure there can be a serious science-based, clinical nutrition profession? That’s really the work we’ve done over these last four or five years.”
The Best Option for Clinical Nutrition Professionals: Certified Nutrition Specialist
The Board for Certification of Nutrition Specialists (BCNS) has made sure that their Certified Nutrition Specialist credential is the best clinical nutrition certification.
They’ve achieved third party accreditation from the National Commission on Certifying Agencies (NCCA)—the same accreditation that the registered dietitian credential has.
They’re also listed with the Department of Labor. When you look at the Department of Labor’s definition of dietitian and nutritionists, for dietetics, they refer to the Registered Dietitian credential, and for advanced nutrition, they refer to the Certified Nutrition Specialist credential.
Another critical missing component that needed to be put in place was ensuring practice rights and benefits- making sure there’s a path toward legal practice and recognition in the states for clinical nutrition practitioners, and ultimately, insurance reimbursement for nutrition therapy.
The Center for Nutrition Advocacy was created by BCNS to advocate on behalf of all nutrition practitioners. The essence of that work is to ensure that all nutrition practitioners can practice to the level of their training.
The advocacy center works to make sure that states have inclusionary, regulatory regimes that do not exclude qualified people from practicing to the level of their training.
"We've had phenomenal success over the last four years through Center of Nutrition Advocacy and all of our allies that have helped us with that to defeat all attempts to achieve an exclusionary regulatory regime. Over the last four years there were 17 attempts, sometimes multiple attempts in a given state, [to achieve exclusionary regulation]," he says.
The BCNS’ Certified Nutrition Specialist credential is really the top level credential at this point. To become a registered dietitian (RD) you need an undergraduate degree. To become a Certified Nutrition Specialist, you need an advanced degree. According to Michael, many RDs are now going on to get additional training in clinical nutrition therapy, and then are able to become Certified Nutrition Specialists.
BCNS is also working toward ensuring that nutritional professionals will be reimbursed by insurance companies for their nutrition-related services. As noted by Michael, nutrition simply isn’t recognized as being an important part of health care, and this is a systemic issue that is being tackled by many different groups, including BCNS and its Center for Nutrition Advocacy.
Four Areas Of Focus in the Field of Nutrition
If you've decided that you are passionate about nutrition and this is the work you want to do, then there are four basic areas you can get into:
- Sports nutrition. For example, you can become an athletic trainer and then get specialty certification around sports nutrition.
- Health coaching. This is for those who want to help people make healthier choices on a day-to-day basis. It’s not about medical nutrition therapy and clinical nutrition therapeutics, which is what BCNS’ Certified Nutrition Specialists focus on. Health coaching focuses more on the preventive side of nutrition, diet, and lifestyle, and you don’t need as deep a scientific-based training to be a health coach.
- Registered dietitian, which includes institutional food management and menu planning and acute care in institutions like nursing homes, hospitals, and prisons. This work may include intravenous feeding. “Some registered dietitians end up doing similar work that we do in clinical nutrition therapy, but they don’t have the advanced training to do the advanced work that we do,” Michael explains, unless they go on to pursue additional training.
- BCNS' Certified Nutrition Specialist. As an advanced clinical nutrition professional, you don’t only work with nutrition to prevent disease onset years down the road, you actually work with people who already have a health condition, and help use nutrition in targeted ways to reverse that condition. So it’s really a health care profession. “What we do is called medical nutrition therapy,” Michael explains.
The Two Paths to Becoming a Certified Nutrition Specialist
BCNS encourages universities to develop their curricula to make sure they are adequate for the practice of clinical nutrition. It’s a rapidly evolving field, but at present, there are about a dozen master’s degree nutrition programs available. However, an advanced nutrition degree is not the only entry point into the BCNS program. Michael explains:
“There are two different groups. There are people who are nutrition professionals. Then, there are people who use nutrition as a tool. They are health care providers who use nutrition as a big part of what they do. They might call themselves an MD, DO, chiropractor, a naturopathic physician, or advanced practice registered nurse, but they have a significant knowledge of and specialty in nutrition.
We credential both of those parties...That means the people who are already in the health care field and have developed a passion for nutrition can become certified as certified nutrition specialist. But also people who may be in a different field altogether and then develop a passion for nutrition and who want to become [a full-time] nutritionist, can also get our credential.
Our requirements are that you need to have … an advanced degree, either in nutrition or a related health care field such as a Doctor of Osteopathy degree, a Medical Doctor degree, or the like. You need to have 30 credits of deeply nutrition-focused work around biochemistry, metabolism, or nutrition courses. Some of these can be undergrad courses, but most of them are graduate courses. Then, you need 1,000 hours of supervised experience. It’s a very intense internship.
Then, you sit for our board exam. We have a four-hour, very rigorous … board exam around the science of nutrition and therapeutic nutrition. Once you pass that, you need to get 75 credits of continued education every five years to remain certified.”
Additional Educational Resource for Nutrition Professionals
The American College of Nutrition (ACN) offers an additional way nutrition professionals can collaborate with like-minded colleagues in the nutrition field. ACN has been around for 56 years; it’s an esteemed professional society for nutrition researchers and clinicians. I’m actually a member. One of my most cherished professional designations is being a Fellow of the American College of Nutrition (FACN). The work they do bridges the gap between research and nutrition and the clinical application.
About half of the membership is researchers in the field of nutrition, typically PhDs, MDs, and DOs, who do important clinical research. The other half of the membership is clinicians who want cutting edge nutrition science information. The ACN publishes the Journal of the American College of Nutrition (JACN), which is a bi-monthly peer-reviewed medical journal. (Next year, they will publish eight editions per year.)
To become a member of ACN, you need to be a nutrition professional with nutrition experience. It’s not just for physicians though. It’s also for nutritionists. Somebody who’s professionally in the field of nutrition can qualify and become a member of the College. The Fellow of the American College of Nutrition designation is a very important research-based designation. It’s not a clinical designation. Those who have published research in the field of nutrition and have a great deal of experience can apply and become a Fellow of the American College of Nutrition.
It's very exciting to see more avenues opening up for people who are passionate about applying nutrition within the field of medicine, free from concerns about legal repercussions. Michael has played an enormously important role in making this happen.
"It's really a privilege," he says. "Sometimes I have to pinch myself because this is what I love. The content that I'm doing, I love it. The people that I'm around, I absolutely love them. I'm doing what I feel is meaningful work and moving nutrition to the core of health care... We need more people doing nutrition, not fewer. So, I'm trying to make a pathway to make that happen."
For more information, please see NutritionAdvocacy.org. That’s the Center for Nutrition Advocacy, where you will find information about the regulatory framework. Do that homework first, to find out what the rules are where you’re planning to practice. Then, to learn more about becoming a Certified Nutrition Specialist, visit NutritionSpecialists.org. Here, you can also find a list of the universities that offer qualifying programs.
As a side note, another alternative — especially if you just want to improve your own knowledge about nutrition to help yourself and your family be healthier — is the Academy of Comprehensive Integrative Medicine (ACIM), developed by Dr. Lee Cowden. ACIM offers high quality courses on nutrition for professionals and non-professionals alike. Much of it is available online, and it's relatively inexpensive.