July 2007

Hot New Careers in Dietetics
By Mary Franz, MS, RD, LD
Today’s Dietitian
Vol. 9 No. 7 P. 52

Looking to enhance your skill set or explore a different area of nutrition? consider herbalism, culinology, or nutritional genomics, for starters.

Until recent times, career choices for dietitians focused mostly on traditional practice settings. However, developments in technology, healthcare, and the food industry, as well as evolving trends in consumer behavior, are changing the face of dietetics and opening new doors for dietitians. Opportunities exist in three cutting-edge areas—herbalism, nutrigenomics, and culinology—for RDs looking to practice outside the scope of mainstream nutrition.

Herbalism
Herbalism, also known as herbal medicine and phytotherapy, is the art and science of treating disease and promoting health through the use of plant-based substances. It is an ancient treatment modality dating back thousands of years to countries such as China and India.1 Once dismissed as folklore, the validity of herbal medicine is now widely recognized. It is estimated that plant-based healing is utilized by 80% of the world’s population.2 In the United States, the practice of herbalism was common until the 20th century, when the arrival and rapid growth of the pharmaceutical industry supplanted interest in natural healing methods. Consumer demand for alternative therapies has once again sparked interest in herbalism in the United States.

Herbalism is a broad term referring to the identification, cultivation, preparation, and administration of therapeutic plants. The practice encompasses a variety of orientations, including Chinese, Ayurvedic, and Native American philosophies. In the United States, clinical herbalism, the use of plant-based remedies to increase the body’s energy and natural healing power and decrease inflammation and pain, is widely practiced.

The basic tenet of herbal medicine is that an individual’s ailments stem from an imbalance in the body. Herbal medicine practitioners look for the commonalities underlying symptoms and prepare botanical formulas designed to treat the whole person vs. isolated illnesses. Herbal remedies may be ingested as whole plants; consumed as teas, tinctures, infusions, or pills; or applied externally as salves or powders.

Training to become a certified clinical herbalist is offered by a number of schools in the United States and consists of both distance and on-site learning (see sidebar). Coursework includes physiology, pathology, nutrition, botany, plant identification, and herbal medicine and formulation and leads to certification at the introductory or advanced level, depending on the number of hours of study (200 hours for basic study, 400 or more hours for advanced study). Practitioners certified at the advanced level often enter private consulting practices or work in medical centers and clinics. Completion of a master’s degree in herbal medicine provides the additional study and clinical training needed to work in industry and research.

Herbalists need strong assessment and counseling skills, a working knowledge of disease pathology, and a thorough understanding of the interactive effects of herbs, as well as drug-nutrient interactions—the same expertise required by dietitians. An increasing number of dietitians are recognizing the utility of incorporating herbal medicine into their nutrition practices.

Anne Thiessen, RD, is a certified clinical herbalist in private practice in Boulder, Colo., where she also teaches clinical nutrition at the North American Institute of Medical Herbalism. Thiessen acquired her interest in herbal healing from her father, who treated her childhood stomachaches with peppermint and ginger which he learned from his great-grandmother, a physician and herbalist in Germany.

Trained first as an RD, Thiessen was distressed by the failure of traditional dietary therapy to relieve the gastrointestinal ailments experienced by her patients with eating disorders and saw potential in the use of medicinal herbs to alleviate these complaints. After completing basic and advanced study and clinical training at the Rocky Mountain Center for Botanical Studies in Boulder, Thiessen set up her consulting practice where she works with clients with eating disorders. Thiessen helps them set nutrition goals, using herbal formulas to reinforce food goals and bolster energy and general health. She typically sees four to eight clients per day, juggling her clinical practice with the demands of her teaching schedule.

Karen Siegel, MPH, MS, RD, LD, LAC, is board-certified in Texas in both acupuncture and Chinese herbal medicine and is licensed to dispense Chinese herbs and foods in her private practice in Houston. Like Thiessen, Siegel began her dietetics career in eating disorders, working in private practice with clients while also developing and presenting national conferences on the topic.

The demands of her hectic professional life pushed Siegel to think about other ways she could interact with her patients. After working with psychotherapists to learn about the mind-body connection, Siegel hit on herbal medicine as a means to add another dimension to her practice. Siegel estimates that she sees 10 to 15 patients daily and prepares herbal remedies for approximately 25% of her nutrition patients and 75% of her acupuncture clients. Her goal is to use the proper combination of healing foods and herbs to help her patients restore their health. For Siegel, the melding of Western clinical nutrition with the Eastern disciplines of herbal medicine and acupuncture allows her to offer clients treatment plans that integrate mind and body.

Both Thiessen and Siegel believe that nutrition and herbal medicine are a natural fit and are enthusiastic about the prospect of dietitians combining traditional nutrition practice with herbal medicine in clinical, outpatient, and educational settings. “We dietitians have a great starting platform with our medical knowledge and ability to discern fad from science. Dietitians can take their nutritional knowledge and move into the study of herbs to further a client’s progress,” says Thiessen.

Nonetheless, Thiessen and Siegel share frustration with conventional medicine’s skepticism about the efficacy of herbalism and suggest that RDs wishing to practice in nontraditional settings be open to learning about complementary medicine and abandon the notion of “one-size-fits-all” dietary therapy. “Let your mind become an open slate to learn. Let go of rigid belief systems about drugs and health. Open the door to learn about the healing nature of foods rather than protein, fat, and carbohydrate content. Herbal medicine is about food as medicine and as a form of healing,” says Siegel.

Culinology
Culinology blends the art of fine cooking with the science of food technology. Fueled by an exploding demand for healthier, tastier, and safer foods, culinology is poised to become one of the hottest career paths in the food industry.

Culinology professionals, known as culinologists, work at food companies, restaurants, and research and development facilities where they utilize their food science skills and expertise as trained chefs to formulate new food products and develop innovative food handling, processing, and packaging techniques. In addition, culinologists are often involved in food marketing and sales. Positions in the field are varied and include research and development (R&D) chefs, technochefs (chefs with food design and manufacturing experience), formulation chefs, quality assurance and development managers, R&D directors, culinary research technologists, and culinary lab managers.3,4

Since 1996, the development of culinology has been fostered by the Research Chefs Association (RCA), a diverse group of food professionals committed to setting standards for education, research, and development within the food industry. The RCA has been the driving force in establishing educational and certification criteria for individuals working in the field of culinology.

The RCA oversees eligibility requirements for two culinology-related credentials: the CRC (certified research chef) and CCS (certified culinary scientist). CRCs are experienced in food product development, cooking, and foodservice. Certification as a CRC requires completion of a bachelor’s degree in culinary arts or culinology and up to five years of experience cooking and supervising in a commercial kitchen. Individuals seeking certification as a CCS must obtain an undergraduate degree in food science and complete an average of five years of food research and product development. Accreditation for both the CRC and CCS require passing a written validation exam.

Graduate and undergraduate degrees in culinology are available at several universities and colleges in the United States (see sidebar). Undergraduate course work includes study in the biological and physical sciences; food chemistry and engineering; foodservice, nutrition, and business and technical writing. Graduate programs offer tracks in human nutrition and food safety, engineering, and microbiology. Doctoral candidates may specialize in one of several areas: agricultural, veterinary, and horticultural science; processing and packaging systems; and biomedical engineering.

Dietitians interested in culinology without the CRC or CCS credential may find that their food and nutrition expertise is a valuable asset when seeking employment.

Cindy Showalter, RD, parlayed her love of foodservice and interest in research into a successful career in culinology. Showalter began her career as a quality assurance manager for a frozen food company, where she also worked in product development, and fell in love with R&D. Now, as director of R&D at Surlean Foods in San Antonio, Showalter is responsible for bringing new food items from benchtop to production. Her work begins with Surlean clients, most of whom are from the foodservice industry, who come to Showalter seeking specialized food products. Showalter works closely with them to create recipes, testing and reformulating until the product fits the client’s specifications, a painstaking process that may take one year to complete. She then presents the final product to the client and begins work on the next phase: taking the newly created food to production.

Showalter enthusiastically refers to her position at Surlean Foods as “the best job in the world” and urges other RDs to consider careers in culinology. “Dietitians can work in so many capacities in the manufacturing side of the industry. There are R&D positions, product development, nutritional labeling, sales, or strictly culinary. We bring a different mindset to culinology, falling in between chefs and technical people. We are not strictly science-driven; we also have an understanding of food being not just a necessity but its enjoyment as well,” she says.

Alexa Hart Bosshardt, MPS, RD, LDN, agrees that dietitians have what it takes to excel in the field of culinology. “Dietitians generally have an excellent ‘break-it-down’ ability when it comes to food. We can look at foods in terms of color, texture, cooking method, and portion sizes but can also run numbers in our heads to determine the nutrient density and nutritional balance of a recipe.”

A former director of menu development for Arby’s and now head of recipe development at Phillips Foods, a seafood-based foodservice company in Baltimore, Bosshardt sees enormous potential for RDs in the food industry. She attributes her success to her educational background—she holds a master’s degree in hotel and restaurant management with a concentration in food science, as well as a certification in culinary arts. She urges dietitians interested in culinology to seek formal culinary training and develop a working knowledge of the principles of food science. Bosshardt also stresses the importance of teamwork and flexibility in a work environment that is often driven by deadlines and cost controls.

Rebecca Cameron, RD, has found a unique venue to market her nutrition background and culinary skills. Creator and owner of Haute Nutrition (www.hautenutrition.com), a culinary-based nutrition consulting business, Cameron offers a wide variety of services—menu development and nutrition fact analysis for restaurants, cooking classes, and personalized nutrition coaching.

A self-proclaimed foodie and graduate of the Culinary Institute of America in New York, Cameron works hard to dispel the myth that RDs don’t care about good-tasting food. She also sees tremendous potential for dietitians to use their expertise in helping the public navigate hot-button topics in nutrition, citing the campaign to remove trans fat from foods as a key area where RDs could get involved with consumers. Although sometimes frustrated when working with chefs slow to accept the input of dietitians, Cameron believes the partnership is a good fit that will evolve in time: “Dietitians are the food and nutrition experts. Our skills complement the skills of chefs very well. In culinology, they need us and we need them.”

Nutritional Genomics
Nutritional genomics consists of two separate but related disciplines. Nutrigenetics explores the manner in which genes influence diet and nutritional status (ie, a gene acting on an enzyme in a metabolic pathway), whereas nutrigenomics relates to the effect of dietary components on gene activity (the ability of a particular nutrient to affect gene expression). Nutritional genomics uses knowledge of the interaction of genes, diet, and lifestyle factors to build a repertoire of nutrition strategies targeting the prevention or reversal of chronic disorders, such as cardiovascular disease, diabetes, and cancer.5,6

Although still a young science, nutritional genomics has begun to change the way we think about nutrition, genetics, and disease prevention. Research labs around the world are working feverishly to identify genetic disease biomarkers and refine the technology used in genetic profiling. At the clinical level, practitioners utilize genetic and biochemical risk factor profiles to develop personalized care plans for individuals diagnosed with nutrition-related chronic disease.6

One such practitioner is Ruth DeBusk, RD, PhD, who combined a passion for genetics with her love of food and nutrition to create her own niche, providing genetic testing and counseling and nutrition therapy to patients in a gastroenterology practice. For DeBusk, it was a dream come true and the culmination of years of study and hard work. A home economics teacher by training, DeBusk was drawn to genetics to satisfy her curiosity about the determinants of disease. After obtaining a doctorate in genetics and molecular biology, DeBusk taught at Florida State University and then worked with her husband to establish several genetic technology companies. Eventually, her desire to use her science expertise in a clinical setting led her to become a dietitian. (For an in-depth look at DeBusk’s career path, see “Pioneering the Frontier of Nutrigenomics” in the September 2004 issue of Today’s Dietitian.)

In her Florida practice, DeBusk works with patients with gastrointestinal disorders, including celiac disease, irritable bowel syndrome, ulcerative colitis, lactose intolerance, diverticulitis, colorectal cancer, and Crohn’s disease, as well as individuals with liver disease and liver transplant patients. She uses family history, lifestyle behaviors, biochemical data, and genetic testing to develop personalized dietary interventions for her patients. The driving force in DeBusk’s practice is her belief that our genes are not our fate; she focuses on providing patients with information about dietary choices that will improve their health and overall quality of life.

DeBusk envisions that the potential for qualified dietitians in the field of nutritional genomics is immense, ranging from clinical practice and education to research and the development of products and functional foods. She offers this advice: “I’d like to encourage dietitians to begin now to get comfortable with this area. Genetics is intimidating to a lot of people, but once you learn the language and a key set of rules, it’s actually quite logical. Practice critical thinking skills. Stretch yourself. Dietetics professionals should consider advanced degrees in genetic counseling. Courses like biochemistry and metabolism that may have seemed to be a lot of memorization that didn’t appear to be very relevant are critical in the coming era of molecular nutrition because you have to know what’s going on if you want to develop interventions that will correct dysfunction or head off a coming train wreck. The more you take this type of approach, the more effective your client outcomes will be, and the more clients and respect from your colleagues you’ll attract.”

DeBusk is now developing educational and training programs for dietitians and other healthcare professionals through a Web site she is creating (www.GeneSmartLiving.com). She will also be offering an online graduate course in nutritional genomics through the University of Medicine and Dentistry of New Jersey beginning in September, which will be available for continuing education credit. DeBusk is also the author of Genetics: The Nutrition Connection, an introduction to the science of nutrigenomics, as well as It’s Not Just Your Genes.

Colleen Fogarty, MS, RD, combined her background in nutrition and clinical and pharmaceutical research to create a career in nutritional genomics. As project manager at Interleukin Genetics, a biotechnology firm in Waltham, Mass., that develops genetic testing devices, Fogarty wears many hats: designing and coordinating clinical research ventures, overseeing financial and operational planning, and producing documentation and technical communication for the company’s nutritional genomics product line. Fogarty received her genetics training on the job from Interleukin scientists and believes that completion of premed coursework along with her dietetics education gives her an edge in mastering the complexities of the science.

Fogarty notes that keeping up with the field is challenging. “I have to admit I spent a lot of time outside of work really fine-tuning my technical knowledge. This stems from my passionate interest in human genetics,” she says. “A book by Phil Reilly, MD, JD [geneticist and former CEO of Interleukin], or a recent article published by Jose Ordovas, PhD [senior scientist and director of nutritional genomics at Tufts University], is always near my bedside.” Like DeBusk, with whom she collaborated on a nutritional genomics paper, Fogarty sees tremendous potential for RDs in the field, particularly for those with an entrepreneurial spirit: “The dietitians [who] find themselves in this field sooner than later will be pioneers, willing to dive into the unknown, take risks, and practice good decision making.”7

Dietitians practicing today are fortunate to have access to an expanding reservoir of career possibilities. Developing new skills, keeping abreast of dynamic changes in science and technology, and remaining open to unconventional and innovative ideas will help prepare RDs for the challenges ahead.

— Mary Franz, MS, RD, LD, is a research dietitian at Harvard University and freelance writer from Boston.

Resources

Schools Offering Instruction in Herbal Medicine
• The North American Institute of Medical Herbalism, Inc., Boulder, Colo.
• Rocky Mountain Herbal Institute, Hot Springs, Mont.
• Tai Sophia Institute, Laurel, Md.

Colleges and Universities Offering Degrees in Culinology
• Cal Poly Pomona, Orange Coast College, Pomona, Calif. — e-mail jgolden@mail.occ.cccd.edu or mfsancho@csupomona.edu
• Clemson University, South Carolina — e-mail johnny@clemson.edu
• Kendall College, Chicago
• Southwest Minnesota State University — e-mail chengm@southwestmsu.edu
• University of Cincinnati/Cincinnati State & Technical College — e-mail margaret.galvin@uc.edu
• University of Massachusetts at Amherst — e-mail edecker@foodsci.umass.edu
• University of Nebraska at Lincoln — e-mail kkildare2@unl.edu

Nutritional Genomics Resources
• Centre of Excellence in Nutrigenomics (New Zealand)
• The Dutch Nutrigenomics Consortium — e-mail michael.muller@wur.nl
• The European Nutrigenomics Organisation — e-mail ben.vanommen@tno.nl
• The NCMHD Center of Excellence for Nutritional Genomics

References

1. Alternative Medicine Foundation. “Herbal Medicine — An Alternative and Complementary Medicine Resource Guide.” Available here.

2. Tai Sophia Institute. “Herbal Medicine.” Available here.

3. Research Chefs Association. Available here.

4. Cornwell L. “New degree programs produce chef-scientists.” USA Today. August 14, 2005. Available here.

5. Elliot R, Ong TJ. Science, medicine, and the future — Nutritional genomics. BMJ. 2002;324:1438-1442.

6. Afman L, Müller M. Nutrigenomics: From molecular nutrition to prevention of disease. J Am Diet Assoc. 2006;106(4):569-576.

7. DeBusk RM, Fogarty CP, Ordovas JM, et al. Nutritional genomics in practice: Where do we begin? J Am Diet Assoc. 2005;105(4):589-598.