I have a pt I’m seeing for preDM (A1c 5.8%). BMI 21 and he is an avid runner training for a marathon. He runs 5 days a week with some days longer runs 10-15 miles and some days shorter runs. I don’t have a lot of GI experience but he asked about diarrhea or looser BMs following runs. Eats belvita crackers right before running. We started logging BMs and he noticed he has more looser BMs (4-7 on Bristol).

We’ve added a little more fiber to his diet thru f&v. He is drinking water (80-96oz). I do think this needs to be increased with how much he’s running. Are these r/t the BMs or are they common with running? Only meds he is taking is Descovy which was started few months back. Could this be causing the loose BMs in addition to the running? Anyone have experience with this?

Do you guys think I should major in nutritional dietetics or major in bio with a nutrition major? I’m already a sophomore in college and only have 5 semesters left. I don’t want to graduate late, but I also want a job as a dietician.

If anyone can provide insight on - what are good internship/starting off jobs for a nutrition major?

Thank you for your time!!!! :)

I was on threads last night and there was a post from a dentist whose solution to a common patient complaint (“doctors don’t get enough/any nutrition training”) is to “laterally upgrade” another non-physician specialty.

Ignoring the fact that lateral upgrade sounds like an oxymoron, I was just like… “HELLO! No one needs to be upgraded, RDs already exist for precisely this reason!” It’s still bothering me today. Trying to let it go but it’s just weighing on me today.

I’m still a grad student but it’s already so frustrating to see how little respect RDs get. Between the general public deferring to pseudoscience and chemophobic influencers, admin/HR thinking paltry pay is acceptable, and most other healthcare professionals dismissing what RDs know and do, I’m feeling beaten and broken before I even start 😭

Rant* because I've been a dietitian for 3 + years and I tried various fields, outpatient counseling, pediatrics, clinical, hospital, nursing home. We're essentially useless and overlooked, unless we're doing outpatient or counseling. We write extremely long lengthy notes that no one reads or make recommendations that minimally impact patients. I'm currently at a nursing home right now because the pay is good, but they keep piling work up on me when it makes no difference/impact on my patients at all. I'm just the girl you go to for ensures if someone isn't eating well because the food is bad. I guess my only saving grace is being to do enteral feed orders.

I plan on working here for a few more years, save up and go to PA school where I can actually have an impact on the patients I care for. I don't need any comfort about trying different things or people who actually enjoy this, just would like to be on the same boat as others.

Hello!

I work in an outpatient setting that has me consulting patients of all kinds and conditions.

For you outpatient RD’s in pediatric settings, what do you use to most accurately estimate energy/nutrient needs? I’ve been comparing the Nutrition Care Manual and standards provided by my hospital, but sometimes I feel like the estimations are completely off. More specifically, teenagers who meet BMI-for-age above the 95th percentiles.

I work at a certain dialysis company whose name means “to give life” and I swear this company has drained me from my life force. Well, not necessarily the company rather my specific clinic…….. I don’t want to get to into the specifics but somehow my job duty has also come to include ordering catering and birthday treat deserts, something that I’ve been told that the FA (facility advisor aka clinic manager) or at the very least the AA (administrative assistants, essentially the ASSISTANTS to the FA….. sheesh) take care of that.

Oh and I’ve been wrapped up into being the home dialysis lead, which I don’t even want to get into because I know there was a presidential executive order signed that wants 1 in 5 patients to get transplanted or go to a home modality, which I don’t mind educating patients about their options but my manager thinks that I can somehow magically get the patients who can’t even read on board with doing their dialysis treatment at home. Again, trying not to dox myself but I work in a very low income area with the majority of the patients the who are monolingual NON ENGLISH speakers. So now I’m the middle man of trying to get the patients scheduled for peritoneal dialysis catheter appointments and making sure they go to their appointments and following up…. which is hilarious because our AA is our access manager - so she’s already making appointments for fistulas but has said to my face, “I don’t do the PD access appointments”. Have I mentioned she’s been at this specific clinic for 25 years?

I told my manager yesterday that I can’t be the lead for home dialysis anymore and was basically told “well we only have 3 patients on the pipeline” and jeeze do you wonder why those patients aren’t moving further along the pipeline? Probably because I’m trying to make sure everyone has their assessments in timely manner, teaching new patients, reinforcing fluid restrictions and also going over phosphorus lab results.

I also don’t trust our nurses, at all. Which is horrible because the team does not work as a team. They never actually go through the patients medications with them, only once when the patient is new and then they do their monthly med reconciliation. AND TO TOP IT ALL OFF, I spent time putting together special little gift bags of dialysis friendly candies for halloween (something that the AA could’ve done) and I get to work and I see that patients have mini REESES, TWIX, SNICKERS all given to them. I literally had to tell the nurses that that’s like giving them poison because of the phosphorus content and also the miseducation because now they’re gonna think that it’s okay to eat that because THEIR FUCKING DIALYSIS CLINIC GAVE IT TO THEM.

I’ve already got a new job lined up for February and I’m giving my two weeks beginning of December. I love my patients but I’m at the end of my rope.

I am wondering if what I want to incorporate into my practice would require becoming a dietician or if it falls under generalized advice.

I am an esthetician and want to give advice about diet and acne, ex: pick low glycemic foods, avoid skim milk, etc. but don’t know if that would fall into the ‘treating a condition(acne)’ category since I focus on skin. But since it applies to all people, I don’t know if it’s covered in the generalized advice category and is okay to say. If someone could clarify what is or isn’t okay to say that would be very helpful

I know for example in Texas I just can’t represent myself as a dietitian, but want more clarity in case I move to a state with more strict guidelines. Thanks in advance

I am a second year student and will go onto placement next year. Just wanted to ask which specialisms are the most interesting. I am currently considering exploring both gastro and diabetes.

Anyone Else Dressing Up Today? I've been a Pizza for the last five Halloweens

This sub doesn't allow picture posts so here is an Amazon Link of my Costume: https://a.co/d/dOAFwUT (NOTE: not an affiliate link; also product no longer available)

A 9 year old male in picu, wt :35 kg | ht:130 cm Severe hypoxia caused by drowning several years ago, he has a gastrostomy tube I calculated his energy needs 1800 kcal/day And his protein needs 43-57g/d (I calculated it by his IBW 28.7 kg) And tube feeding 200mlq3hrs (pediasure)

Do I have to adjust anything? Increase or decrease anything? It’s my first time with a pediatric pt and I’m not very confident of my work in pediatric.. Also what about flushing water for this pt ?

Thank you 🙏🏼

Why can people who sell nothing but detox kits and so called health drinks, use nutrition in the title of their business? I can’t go around saying I provide medical services without being a doctor. Why can people imply they are providing nutrition services without being an RDN?

What are some of y’alls favorite books written by RD’s? Can be for fun or informational based. Thank you!

Has anyone previously transferred? I'd like to get the point of view of someone who has already done it. I am wondering, how is the process, does your comp time also transfer? Thank you.

Today I had a patient who drinks 60 oz of coffee a day (2 large pots he said) and like 30 oz of water. So at the end of the session when we set goals one of the ones I set was to increase water intake and decrease coffee to more like 20 oz and he was not happy. He kept questioning why he had to decrease it and I explained it’s a diuretic so it offsets the water you’re taking in and dehydrates you but he still wasn’t buying it. This was at the end of the session and time was already up but he kept trying to ask questions so I told him we can just talk about it next time. But I have a feeling this guy is gonna come in with research supporting the fact he can drink gobs of coffee as he currently is. So my question is what concrete evidence can I use to support him limiting caffeine since he seems so hesitant and seems like the kind of person who needs hard facts.

I’m currently working as a RD in an outpatient setting but have started looking into applying for telehealth roles. There’s a lot of RD companies providing these services but is it as great as it seems on the job description??

My concern is the pay will only be for a few patients a week rather than a “full time” role. Anyone have insight on what a week really looks like seeing virtual patients and is it a sustainable full time job?

I suppose this isn't really just a dietetics issue. However, I have to regularly send letters and assessments to other professionals e.g doctors. I haven't long been in the job, and I'm getting increasing anxiety over this.

I worry about typing the wrong patient number, or any other detail like date they were assessed. I check details several times before sending, mostly excessively , although at times I do spot little mistakes. If whatever it is involves calculations I find myself constantly double checking that what I've calculated is correct. I find myself worrying if I will receive an email telling me that the information I have sent is incorrect etc.

It's getting to the point where my heart is beating fast and I feel sweaty before I press send.

Just wondering if you guys have any tips on now to deal with this?

Nutrition is nuanced. For all the different stages of life, health conditions, diet restrictions, lifestyles, cultural backgrounds, moral/religious structures…. The world of nutrition is HUGE and ever evolving, and honestly it can be challenging to restructure our own view point as we come across new research over the years. It’s our job to allow that nuance in. Having a specialized approach for each client or patient is a major part of our job and allows us to learn more every day about what health can look like!

I just wanted to put that out there because I was getting some HEAT in a previous thread for daring to suggest butter to my clients 😂

Best of luck to you and your patients! ✌️ ❤️

Hi all. I’m wondering… my hospital has been without a Clinical Nutrition Manager (CNM) for almost a year now so the dietitians are pretty much running themselves. The hospital is being so cheap about hiring someone that no one has accepted the “supervisor” (not manager) position. The hospital director now seems to think we can run ourselves (meaning take on manager duties for no extra pay and still be expected to see all the patients we have to see daily) and likely won’t want to hire anyone. I’ve tried looking it up but does anyone know if there’s a joint commission requirement for hospitals to have a CNM? Thank you!

So I been back in outpatient for 2 years, and starting to experience burnout with diabetes outpatient. Any tips? I feel like these calls are so prolonging the process. Like I honestly which I can do two PRNs but the way my bills set up. I just can't do that lol. Plus a lot of patients either don't answer or don't have the will power to change what they are doing. It's like I'm beating a dead horse

Hey everyone! I recently got the opportunity to take over the neuro ICU as the lead dietitian, and while I’m excited, I’m also a little nervous about diving into this specialized area. I’ve handled clinical cases before, but I know neuro ICU can come with some unique challenges, especially with critical care patients and complex nutrition needs.

If you’ve worked in neuro or another critical care unit, what are your go-to tips for success? Specifically, I’d love advice on:

1.	Assessment Priorities: What labs, vitals, or other indicators are most critical to monitor daily for neuro ICU patients?
2.	Nutrition Support Strategies: Any preferred formulas or nutrient adjustments you find effective with TBI, stroke, or other neuro cases?
3.	Communicating with the Care Team: Tips for collaborating with neurosurgeons, intensivists, and nursing staff when it comes to nutrition interventions?
4.	Survival Strategies: Any routines or time management tricks that make a difference when juggling high-acuity patients?

Thanks in advance for sharing any wisdom! I’m determined to do my best for these patients and would really appreciate any insights from those who’ve been in the trenches!

So I'm just about to complete my degree in Human Nutrition, I really can't stand studying anymore and I really just want to get into the workforce. At the moment I'm finding it hard to find jobs that are specific to my degree. Any suggestions at all?

Hi everyone, I am currently getting my bachelors in Human Nutrition and Foods but I decided I don’t want to be a dietitian anymore. I was thinking about getting my masters in exercise physiology and then getting into nutrition research in an area where diet and exercise intersect each other. I know that I wouldn’t be giving medical nutrition therapy or anything like that if i do it this way which I’m totally fine with. I guess I am just trying to figure out different routes I could take to still have a career in nutrition without becoming a dietitian. Is it possible to study nutrition research without being a dietitian. I am getting stressed about this!

Thank you for your responses and guidance.

Hi all, I’m a new dietitian here and just got put onto the oncology unit at my hospital.

What are some of your favorite resources for oncology MNT?

I work at a primary care clinic, where I get referrals for a wide range of needs, but most often for weight loss. I’m finding it tough to cover everything in the short time I have. Going through each part of the plate method in detail, plus gathering a background and a 24-hour recall, feels overwhelming for a first visit. When I ask clients about their weight loss challenges and goals, most just say they want to ‘lose weight’ without specific goals.

What essentials would you focus on in that first session? How do you balance getting a meaningful history with setting actionable goals that go beyond just ‘lose weight’?

TLDR: what generic flow can I do during an initial visit for a patient who wants to lose weight?w

Anyone here do inpatient and outpatient DM as dietitian? Do you work on insulin pumps? I’m currently a student who loves DM especially education and diet, the only thing I do not enjoy in the world of DM is insulin pumps… and I know many CDE’s work with these everyday setting up the pumps and managing the insulin regimen, so I was curious if there’s such a thing as specializing in DM without being a CDE? Is it possible to focus just on the diet education with patients? I know insulin and meds will be apart of the education & assessment, however, just wondering if setting up the insulin pumps and managing regimen would be?

• Does anyone here do inpatient and outpatient PEDS in a non- PICU setting? Would love to hear pros, cons and what you like most that you get to do and discuss with patients?

• anyone here do inpatient and outpatient GI as dietitian? What conditions do you see most? What do you like most that you get to do and discuss with patients?

Hello, I'm currently an undergraduate student at UofT in my 4th and final year. I'm double majoring in Political Science and Health Studies (renamed to Public Health now). I've worked part time in the nutrition field since I was 16 and I really love it, and I wanted to continue my education after completing my BA and become a Registered Dietician in Ontario. I've been researching the different programs and universities since September and I've been in contact with many universities. I'm looking for a program that I can complete in around 2 years. Including the practicum. Unfortunately not every university has an integrated program and there are so many factors to consider with every program that I feel extremely lost and at a breaking point. I don't want to get into the details of why I did politics and public health as my undergrad instead of nutrition which I should have done from the start.
From what I've learned, my best options are the following:

1. UofM's B.Sc. in Human Nutritional Sciences Second Degree Program. They will acknowledge my current BA and I will be able to complete the program in 2-2.5 years. But, I will still need to do a Master's program and practicum in order to write the national exam and become an RD. I have to complete one more first year Chem course and one more first year bio course. https://umanitoba.ca/agricultural-food-sciences/sites/agricultural-food-sciences/files/2023-06/HNS%20Second%20Degree.pdf

2. UOttawa Honours Bachelor of Science in Nutrition and Dietetics. This program is in French, and while I speak French I don't want to deal with French professors and assignment and scientific language in French. UOttawa hasn't answered back my emails or my calls so I don't know if it is possible for me to complete this program in under 4 years. My family lives in Ottawa so this would save me a ton of money but not time. I will still have to do a practicum which is usually from a Masters. So 6 more years of education. https://www.uottawa.ca/faculty-health-sciences/nutrition/undergraduate-studies/honours-bachelor-science-nutrition-dietetics

3. UBC's Master of Nutrition and Dietetics (MND). Master's program so I don't have to stupidly do another undergraduate degree, I have the grades to make it in, and they are holistic. Deadline is November 15th, in around 15 days. So I don't have a lot of time to decide. They need prerequisite courses however. I am missing the physiology courses and two nutrition courses (aren't offered at UofT), so I contacted TMU to see if I may take them as a non-degree student. I'd take them in the winter semester and summer before starting the MND in September. They allow ANY undergrad degree to enroll, unlike Dalla Lana's MPH: Nutrition and Dietetics. I would LOVE to make it into the MPH but they need an entire accredited undergraduate degree from a nutrition program, and won't accept my BA. https://vancouver.calendar.ubc.ca/faculties-colleges-and-schools/faculty-graduate-and-postdoctoral-studies/degree-programs/nutrition-and-dietetics

4. McGill's Master's in Human Nutrition - Dietetics Credentialing. This is my least likely option. I don't make the grade cuttoff of 3.5 but with the courses I'm taking right now and next term I can do my best to raise my GPA with a chance of making it at the cutoff. But it is competitive so I'm probably not going to make it in with the minimum requirements. Also, they require a BSc. or other related health field. I don't know if public health from UofT counts. Probably not.

5. I would much rather do a Masters than a second undergrad. My ideal option is the MPH at Dalla Lana because I don't have to relocate out of my current studio apartment in downtown Toronto. And Toronto is close enough to Ottawa that I can regularly visit my family. The MPH program director said there is no way for me to be considered without an accredited degree. I thought Public Health at UofT directly tied into Dalla Lana's MPH programs but apparently not. That's why I changed from sociology and economics minors to health studies(public health) in my 3rd year. So now I feel like my public health major is useless.

I'm so lost honestly. I feel like breaking down. I've sunk so much time into my BA and its practically useless for what I want to work as in the future. MPH: Nutrition and Dietetics would be the best option if I was allowed to take it with my current BA but I'm not (understandably, not complaining, I know the regulatory body maintains a high standard). Wouldn't I have a better salary with a Masters than a second Bachelors? Regardless if I do a second Bachelors I'll have to still do a practicum and most are through masters programs. I'd be looking at around 3 years for a BSc plus another 2 for a masters. I'd be 26 years old before I started working full-time and my debt would be insane.

This is all because I'm trying to legitimately do my job. I've been employed by a health food store as a retail nutritionist for the past year. There are clients who come in specifically asking to see me. I've helped many people lose weight or reach a health goal by recommending resources and almost everyone I speak to say that I should be working in a clinical setting. I care so much about my clients. Nutritionist isn't a regulated title in Ontario. I want to do things the right way, I want to help my clients with their nutrition and diet and health goals legitimately. I turn away so many clients at my current job because I feel like an imposter giving any kind of health advice (I only give eating healthy tips and very basic health advice right now, like eat less and move more if you want to lose weight, nothing more than what you'd hear an online influencer say).

I'd really appreciate any advice on what to do. UofT's grad office and academic advising have brushed me off completely and I can't find anyone at my institution to help me. This is like highschool all over again where my counsellor suggested I leave Ottawa and go to UofT because I had good highschool grades. It was the worst advice I've ever gotten and I wanted to initially do Health Sciences at UOttawa.

Hey fellow RD’s! I’m looking for ideas, courses, volunteering ideas etc to boost my resume.

I have completed an integrated masters (4 year undergrad) in nutrition and dietetics, practicums and exams, and am a registered dietitian in BC. I haven’t worked as an RD since graduation as I had my daughter. Now I’m applying for entry level RD jobs but my resume is sparse!

Any ideas?

Thanks! 🙂

For telling a patient to eat deli meat.

That on its own is so absurd but this patient is hardly eating and meets criteria for malnutrition.

Edit: just saw the patient saw this doctor due to fatigue and lightheadedness. Cool cool.

are there benefits towards this? like a 401k and insurance? is it easy to find a job?