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Description of Degrees/Credentials

  • Certified Nutritional Specialist (CNS): a Certified Nutrition Specialist is a highly qualified nutritional professional with an advanced degree (graduate or doctorate) from a fully accredited university in nutrition plus 1,000 hours of a supervised internship and must pass the rigorous exam administered by the Board for Certification of Nutrition Specialists [11]. |The CNS certification is fully accredited by the National Commission for Certifying Agencies (NCCA) which distinguishes the CNS for its robust and reliable process for development, implementation, maintenance and governance of the certification. It is the most widely recognized nutrition certification by federal and state governments. It is the only non-dietetics credential and examination widely named in state nutrition licensure laws. It is listed by the US Government's Department of Labor as an advanced nutrition credential in the definition of the "Dietetics and Nutritionists" profession in its Occupational Outlook Handbook. It is listed by the Centers for Medicare and Medicaid as among those potentially eligible to order therapeutic diets in hospitals.
  • Certified Clinical Nutritionist (CCN): a CCN is a highly qualified nutritional professional with a 4-year bachelor's degree and a 900-hour internship, a 56-hour post-graduate intensive study in clinical nutrition or a master's degree in human nutrition from the University of Bridgeport or Bastyr University and must pass the national board exam issued by the CNCB [7]. The CCN focuses on how foods are digested, absorbed, and assimilated, and ultimately how food affects the body biochemically. Among the many aspects of nutrition research considered within this context are by-products of digestion, gastrointestinal health, neurotransmitter response, immune function, metabolic shifts and balance, allergic or sensitivity reactions, and systems and pathways of detoxification. The CCN's approach to diet structure is developed according to what is best for the individual-not necessarily what is a standard recommendation for the general public at large, or for all people experiencing a particular health concern. Rather than strictly advocating a pyramid or food-group-style diet, the CCN will determine the healthiest and most effective program for the individual according to the latest nutrition research and the unique biochemical make-up of the individual [8].
  • Registered Dietitian (RD): an RD is a food and dietary professional, usually with a 4-year bachelor's degree and 900-1200 hours in a dietetic internship through an accredited program and passing a dietetics registration exam. Dietitians focus on calories (energy), quality of food in regard to freshness, sanitation and freedom from spoilage and contamination, meal planning, evaluation of standard measurements of foods, specific diets for certain conditions, and eating patterns based primarily on food groups, such as the food pyramid, and other guidelines based on daily food intake strictly outlined by health organizations [10]. Dietitians often work in health institutions as clinical dietitians, management dietitians, but can also work as community or consultant dietitians.
  • Certified Nutritional Consultant (CNC): a CNC is provided by the AANC after completion of an open book exam [12].
  • Certified Nutritionist (CN): a CN can be obtained after a two-year college level or distance learning six-course program and passing a proctored exam [13].
  • Medical Doctor (MD): a licensed allopathic doctor must attend a 4-year accredited medical school and must past the USMLE board exams. Following medical school they must complete a residency program and take certification board exams. The philosophy of the conventional medical doctor is to treat disease using evidence-based medicine [1].
  • Osteopathic Doctor (DO): a licensed osteopathic doctor must attend a 4-year accredited medical school plus additional training on manipulative medicine techniques and disease prevention and must pass the COMPLEX exam with the option of taking the USMLE. After medical school they must complete an osteopathic or allopathic residency. More recently it has been suggested that osteopathic doctors and allopathic doctors are indistinguishable. Osteopathic doctors abide by the Hippocratic oath as well as 4 core principles. These principles are [2]:
  1. The body is a unit, and the person represents a combination of body, mind, and spirit.
  2. The body is capable of self-regulation, self-healing, and health maintenance.
  3. Structure and function are reciprocally interrelated.
  4. Rational treatment is based on an understanding of these principles: body unity, self-regulation, and the interrelationship of structure and function.
  • Chiropractic Doctor (DC): a licensed chiropractic doctor must attend a 4-year accredited chiropractic college and pass 4 examinations from the national board of chiropractic examiners. They are considered a complementary and alternative health care practitioner with the ability to order lab tests, x-rays, and diagnose but cannot perform surgery or prescribe pharmaceutical drugs. Chiropractors focus of mechanical techniques to affect the nervous system such as spinal adjustments and soft-tissue manipulations to treat disorders relating to the spine and musculoskeletal system [3].
  • Naturopathic Doctor (ND): a licensed naturopathic doctor must attend an accredited 4-year naturopathic medical school and pass the comprehensive NPLEX board exams. There are only five accredited schools in the U.S. (NCNM in Portland, SCNM in Tempe, Bastyr Univ. in Seattle, Univ. of Bridgeport in Bridgeport, and NUHS in Chicago). They are considered complementary and alternative health care practitioners and are often primary care physicians. Currently naturopathic physicians are fully licensed in 15 states (AK, AZ, CA, CT, District of Columbia, HI, ID, KS, ME, MN, MT, NH, OR, UT, VT, WA, U.S. territories Puerto Rico and Virgin Islands). They focus on holistic and nontoxic therapeutic modalities while emphasizing disease prevention and optimal health. Naturopathic physicians routinely practice manual therapy, hydrotherapy, homeopathy, acupuncture, nutritional counseling, orthomolecular medicine and botanical medicine, as well as, order laboratory testing, diagnose, perform minor surgery (some states), and have access to a limited formulary of synthetic medicines (some states) [4]. The following six tenants govern naturopathic physicians [5]:
  1. Do No Harm
  2. The Healing Power of Nature
  3. Treat the Whole Person
  4. Treat the Cause
  5. Doctor is Teacher
  6. Prevention is the best cure
  • Traditional Naturopathic Practitioner (TNP) or a Certified Traditional Naturopath (CTN): a traditional or classic naturopath does not practice medicine, diagnose or treat disease but rather concentrates on prevention and education. Their education consists of distance learning or online courses in herbology, iridology, energy techniques, mind-body medicine, manual therapies: massage, reflexology, & acupressure and homeopathy, to name a few [6]. Their philosophy is similar to the naturopathic doctor but the scope of their practice is limited.

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