Nutrition Practice Laws: Overview
The law can be really confusing, especially when it differs from state to state. We've put together this little guide to help you better understand those laws, the different types, and how they impact your ability to practice.
State laws on nutrition are broken up into different types:
None/Certification
States without laws regarding the practice of nutrition are the easiest, of course, but they are few. Some states have a certification law which provides for state recognition and certification of specific individuals who meet a set of defined criteria, such as a private certification, education, etc. This certification does not prevent anyone else from practicing nutrition, but it may protect certain titles, such as "dietitian" or "nutritionist" and abbreviations, such as "RD" or "CD".
Title Protection
The next level of restriction are Title Protection laws. While these states do not restrict the practice of nutrition, they do place strict limitations on who may use certain titles. A Title Protection law may or may not contain a scope of practice, defining the practice of dietetics and nutrition, but that scope will not be defined exclusively to one group. Other states may simply restrict the title, along with abbreviations, etc. Only those who meet certain requirements under the law may receive permission to use those protected titles.
Licensure with a Defined Scope of Practice
Nineteen states require a license to practice nutrition, and along with this license, the law defines a scope of practice - exclusive privileges - reserved only for those who hold a license. This is the most strictest form of the law and with it comes the greater threat to holistic practices.
The main elements of a licensure law with a define scope of practice is that the state REQUIRES that you to meet very specific education and other criteria in order to be granted a license, which then gives you the exclusive right to practice nutrition. These laws tend to have very narrow exemptions, and can be quite broad in their application. The requirements to become licensed, and thus take advantage of the exclusive privileges of licensure, are almost always limited for just dietitians.
For example, the state of Ohio specifically defines what the "Practice of dietetics" means within the law, and then it reserves that exclusively for those with a license: "..no person shall practice, offer to practice, or hold himself forth to practice dietetics unless he has been licensed..."
Exemptions
Most restrictive states contain some standard exemptions within the law. These exemptions generally allow for persons to practice nutrition and dietetics if they are employed by one or more of the following:
Some states have explicit religious exemptions for those practicing the tenets of a bona fide religion, however the religious exemption varies greatly from state to state.
For the sale of food, food materials, and dietary supplements in a retail establishment, an exemption generally exists so long as the salesperson does not hold themselves out to be registered or licensed in any way.
General Health and Wellness
In many states the law allows for an exemption for providing general health and wellness information and education to individuals and groups. This term is rarely defined, and varies from state to state. For example, Illinois law allows an unlicensed person to provide "general nutrition information and encouragement of general healthy eating choices." North Carolina allows "general nutrition information on food, food materials, and dietary supplements." In Iowa this is written as "routine education and advice regarding normal nutritional requirements and sources of nutrients."
Out of an abundance of caution, we interpret all general health and wellness exemptions to mean the providing to individuals or groups, information, education, and guidance, that would apply to everyone, as a whole.
If it can be found in a book, journal, or website, then it can be said to apply to everyone. The key consideration is if the information, education, or guidance is specific to an individual, as that would not be considered "general health and wellness." For example: You could not create a meal plan that is specific to an individuals tastes and wants, but you could provide meal plans from a book, journal, or article that will meet the client's goals.
Cautions
Even if you are practicing in a state with no law, certification, or title protection, you should be aware of certain limitations and pitfalls.
While the law may vary from state to state, and not every state has broad exemptions, avenues for holistic practice do exist. Please review the State Law and Policy for more information.
State laws on nutrition are broken up into different types:
- None
- Certification
- Title Protection
- Licensure with a defined scope of practice
None/Certification
States without laws regarding the practice of nutrition are the easiest, of course, but they are few. Some states have a certification law which provides for state recognition and certification of specific individuals who meet a set of defined criteria, such as a private certification, education, etc. This certification does not prevent anyone else from practicing nutrition, but it may protect certain titles, such as "dietitian" or "nutritionist" and abbreviations, such as "RD" or "CD".
Title Protection
The next level of restriction are Title Protection laws. While these states do not restrict the practice of nutrition, they do place strict limitations on who may use certain titles. A Title Protection law may or may not contain a scope of practice, defining the practice of dietetics and nutrition, but that scope will not be defined exclusively to one group. Other states may simply restrict the title, along with abbreviations, etc. Only those who meet certain requirements under the law may receive permission to use those protected titles.
Licensure with a Defined Scope of Practice
Nineteen states require a license to practice nutrition, and along with this license, the law defines a scope of practice - exclusive privileges - reserved only for those who hold a license. This is the most strictest form of the law and with it comes the greater threat to holistic practices.
The main elements of a licensure law with a define scope of practice is that the state REQUIRES that you to meet very specific education and other criteria in order to be granted a license, which then gives you the exclusive right to practice nutrition. These laws tend to have very narrow exemptions, and can be quite broad in their application. The requirements to become licensed, and thus take advantage of the exclusive privileges of licensure, are almost always limited for just dietitians.
For example, the state of Ohio specifically defines what the "Practice of dietetics" means within the law, and then it reserves that exclusively for those with a license: "..no person shall practice, offer to practice, or hold himself forth to practice dietetics unless he has been licensed..."
Exemptions
Most restrictive states contain some standard exemptions within the law. These exemptions generally allow for persons to practice nutrition and dietetics if they are employed by one or more of the following:
- Federal, state, county or municipal agency;
- Military;
- Another political subdivision;
- Elementary or secondary school; or an
- Accredited institution of higher education.
Some states have explicit religious exemptions for those practicing the tenets of a bona fide religion, however the religious exemption varies greatly from state to state.
For the sale of food, food materials, and dietary supplements in a retail establishment, an exemption generally exists so long as the salesperson does not hold themselves out to be registered or licensed in any way.
General Health and Wellness
In many states the law allows for an exemption for providing general health and wellness information and education to individuals and groups. This term is rarely defined, and varies from state to state. For example, Illinois law allows an unlicensed person to provide "general nutrition information and encouragement of general healthy eating choices." North Carolina allows "general nutrition information on food, food materials, and dietary supplements." In Iowa this is written as "routine education and advice regarding normal nutritional requirements and sources of nutrients."
Out of an abundance of caution, we interpret all general health and wellness exemptions to mean the providing to individuals or groups, information, education, and guidance, that would apply to everyone, as a whole.
If it can be found in a book, journal, or website, then it can be said to apply to everyone. The key consideration is if the information, education, or guidance is specific to an individual, as that would not be considered "general health and wellness." For example: You could not create a meal plan that is specific to an individuals tastes and wants, but you could provide meal plans from a book, journal, or article that will meet the client's goals.
Cautions
Even if you are practicing in a state with no law, certification, or title protection, you should be aware of certain limitations and pitfalls.
- Diagnosing or Treating a Disease: Investigators and observers of holistic practice are watching carefully for anything which may give the impression, directly or implicitly, that a holistic practitioner is treating or providing for a specific disease or medical condition. Most states do not allow this, and extra care and disclosure statements should be used when working with clients.
- Display of public notice: California and Rhode Island require the display of certain information in your place of business. See the website for each of these states under Laws and Policy for more details. These public notices may require client notification, and agreement, prior to working with them.
- Individualized Care: Probably the most contentious issue in nutrition care is when services become "individualized" to a specific person. Restrictive states with an exclusive scope are always on the look out, and will punish harshly, the providing of individualized services. In these states it is best to stay within the bounds of general health, wellness, and lifestyle information, as it pertains to everyone. Avoid anything in your practice, or marketing materials, which may give the impression that services are individualized.
- Board certification provides absolutely no additional benefit or qualification for working in a restrictive state.
While the law may vary from state to state, and not every state has broad exemptions, avenues for holistic practice do exist. Please review the State Law and Policy for more information.