The voice of a Malaysian Dietitian
”What’s your occupation?”
“I am a dietitian.”
The question following this will usually be “Die….what? Dietitian? What’s that? Is it same as a nutritionist?”
This is the common scenario in Malaysia where people do not know who a dietitian is and what is the difference between a nutritionist and dietitian.
A “dietitian” is someone who is qualified and being recognised in prescribing medical nutrition therapy to patients, in other words, providing dietary counselling or consultation for management of a disease in both acute or chronic condition. On the other hand, a nutritionist usually deals with healthy population, providing advice of healthy eating and nutrients, has little knowledge on disease, treatment and medications.
Dietetics is a 4 year degree programme in Malaysia which mandates the students to undergo industrial training in 3 different areas namely clinical, food service and community with a specific number of hours during the final year. According to the programme standards by MQA, in order to graduate as a qualified dietitian, one MUST complete at least 800 hours of clinical placement, 160 hours of community dietetics placement and 160 hours of food service placement, a total of > 1000 hours of industrial training in these settings. If one fails to meet this criteria, he/she is not a qualified dietitian. To date, there are only 7 universities (6 public and 1 private) in Malaysia that offer this course.
Studying nutrition and dietetics is very challenging as the nutritional science is ever changing. Take for example, the dietary advice of limiting 2 eggs per week for individuals with high cholesterol was pulled back recently as emerging research has found that eating one egg every day are not associated with an elevated risk of incident coronary heart disease. Thus, it means that a “real” nutrition textbook does not have a last page and it s content is constantly being updated.
A dietitian does not instruct you what you can eat and what you cannot eat. A dietitian perform his/her service by conducting assessment on the clients, determining the nutrition diagnosis, suggesting and discussing intervention for the clients and then following-up with them. Dietitian gives advice on your diet after considering your nutritional requirement, dietary restriction and food preference. Dietitian is able to provide a special nutrition care plan for individuals with special nutritional needs (e.g: patients with eating and swallowing difficulties, patients who are in coma, babies who are malnourished, patients who have just undergone surgeries).
Dietitian is also trained to conduct nutrition counselling to empower clients to make sustainable lifestyle behavioural changes in order to achieve respective health goals. Nutrition counselling is totally different from nutrition education as it does not only provides information, it requires skills to motivate the people to make the change, to think of the ways that is most likely for the clients to sustain the change. An evidence-based dietitian only shares information which is supported by true science and is able to distinguish between facts and fallacies and often they reveal the ugly truth where the people do not seem to like it.
There are many different types of short nutrition courses out there and people tend to claim themselves as “nutritionists” or “dietitians” after attending the courses and selling supplements for these companies. This makes it even more difficult for the public to differentiate the “real” nutritionists and dietitians. Hopefully the Allied Health Professions Act 2016 would be enforced as soon as possible, so that our profession will be protected.
A dietitian title is earned in exchange of a lot of hard work, effort and commitment, just like any other health care professionals. Therefore, no one should take it for granted.
Last but not least, a dietitian is not in a higher rank than a nutritionist. We are just DIFFERENT but we work closely together. I have full respect with a qualified nutritionist.