In short, a Registered Dietitian Nutritionist (RD/RDN) is an expert in food and nutrition. To be able to call yourself one, one must graduate with a Bachelor of Science in nutritional science with a concentration in dietetics through an Accreditation Council for Education in Nutrition and Dietetics (ACEND).
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Biochemistry, human physiology, microbiology, behavioral social sciences and foodservice systems are just a few examples of college course work. Next, a supervised practice/experience must be completed through an ACEND-credited Dietetic Internship program. Last but not least, one has to pass a state exam administered by the Commission on Dietetic Registration. To maintain the credential, RDNs must continue with professional educational requirements.
What is the Role of an RDN?
Contrary to part of the credential name, RDN’s do not focus solely on promoting weight loss. Their role encompasses a wide range of nutrition-related guidance tailored to individual health needs. They can provide medical nutrition therapy which is the practice of providing nutrition-based treatment plans to manage health conditions such as heart disease, kidney disease, and diabetes through personalized counseling, dietary interventions, and nutrition education. There are many different avenues of work a RDN can choose, which makes this field of work diverse and exciting!
RDNs can work in:
- Hospitals, clinics, nursing homes
- Sports nutrition and corporate wellness programs
- Food/nutrition related businesses and industries such as public relations, product development, school cafeterias, culinary schools & consulting with chefs in restaurants
- Private practice
- Community and public settings
- Universities and medical centers teaching physicians assistants, nurses, dietetic students, dentists and others about the sophisticated science of food and nutrition
- Research areas
Supporting Adult IDD population Through Nutrition
RDN’s play an essential role working with Individuals with Intellectual and Developmental disabilities (IDD). According to the Academy of nutrition and Dietetics’ Association position statement on Nutrition Services for the IDD Population, “Registered Dietitian Nutritionists are essential components of comprehensive care for all adults with intellectual and developmental disabilities and children and youth with special health care needs“². Below are just a few of the nutritional risk factors commonly found in the adult IDD population that can benefit from nutrition interventions led by an RDN.
Preventative Health & Nutrition
Preventive health is a cornerstone of outpatient care, and RDN’s play a crucial role in empowering individuals with intellectual and developmental disabilities to achieve better health and prevent chronic disease. Individuals with IDD are at a higher risk for chronic diseases such as obesity, diabetes, cardiovascular and gastrointestinal issues due to multiple factors but to name a few, limited mobility, medication use, and dietary challenges¹.
Chronic Disease Management
For chronic disease management, RDN’s develop individualized nutrition plans that address specific medical conditions such as diabetes, heart disease, or renal disease while considering each person’s unique sensory preferences, cultural background and lifestyle. Completing a nutrition assessment provides essential information to help the RDN identify a nutrition diagnosis (if present) and personalize a nutrition intervention that may include nutrition education and counseling to empower individuals and circle of support to make informed food choices, manage portion sizes and navigate real-world situations like dining out or tips for grocery shopping².
Mealtime assistance & Working in a Multidisciplinary Team
Some individuals in the IDD population may require a wide range of mealtime support. This could mean a family or caregiver having to cut their food into smaller pieces or assist with feeding. A study found that as individuals with IDD aged, half required increasing levels of support at mealtimes, with 82% of them needing moderate to full support at mealtimes, with 18% needing a small amount of support such as with adaptive equipment or setting up a plate4.
Dysphagia is common in adults with Down Syndrome as they age and about one-third of adults with cerebral palsy have dysphagia. This is where the dietitian works with the interdisciplinary team such as the SLP to meet the clients’ feeding needs while ensuring nutritional adequacy. RDN’s can work with the individuals’ circle of support to ensure proper nutrition education and reinforce understanding.
Weight Management
As adult individuals with intellectual and developmental disabilities transition from institutional facilities and programs to community and independent living, their patterns of physical activity and dietary habits often mirror those of the general population, which has resulted in a rise in overweight and obesity in this population. In fact, “the prevalence of obesity in adults with IDD is approximately twice the general population”³ .
Poor diet quality, combined with low levels of fitness and obesity puts one at increased risk for heart disease, diabetes and high blood pressure. On the other hand, adults with diagnoses such as Cerebral Palsy or Rett syndrome and those who have developed Alzheimer’s disease are at risk for being underweight. Unintended weight loss leading to underweight status & mobility impairment are risk factors for developing pressure ulcers and specific nutrition deficiencies. Through personalized nutrition care plan, an RDN can help with weight management4.
Meeting Each Person’s Unique Needs
When working with the IDD population, everyone is unique, and it is essential to recognize and honor their preferences, medical diagnoses, and circumstances when developing a nutrition care plan. At Jay Nolan, the individual’s choice and autonomy are essential, even in structured plans and this is no different when it comes to creating a nutrition care plan. Personalizing nutrition care ensures the individual receives respectful and effective care that helps them reach their nutrition goals and quality of life.
Services Through Jay Nolan Community Services
For any individual being supported through Jay Nolan Community Services that is interested in working on their nutrition whether for preventative or management reasons can put in a nutrition referral. The RDN will not only work with the individual, but their circle of support as well to create a comprehensive and sustainable framework for an individual’s success in achieving their nutrition goals.
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References:
1. Bershadsky, J., Taub, S., Engler, J., Moseley, C. R., Lakin, K. C., Stancliffe, R. J., Larson, S., Ticha, R., Bailey, C., & Bradley, V. (2012). Place of residence and preventive health care for intellectual and developmental disabilities services recipients in 20 states. Public health reports (Washington, D.C. : 1974), 127(5), 475–485. https://doi.org/10.1177/003335491212700503
2. Position of the Academy of Nutrition and Dietetics: Nutrition Services for Individuals with Intellectual and Developmental Disabilities and Special Health Care Needs. Ptomey, Lauren T. et al. Journal of the Academy of Nutrition and Dietetics, Volume 115, Issue 4, 593 – 608
3. Melville CA, Hamilton S, Hankey CR, Miller S, Boyle S. The prevalence and determinants of obesity in adults with intellectual disabilities. Obes Rev. 2007;8(3): 223-230
4. Ball, S. L., Panter, S. G., Redley, M., Proctor, C. A., Byrne, K., Clare, I. C., & Holland, A. J. (2012). The extent and nature of need for mealtime support among adults with intellectual disabilities. Journal of intellectual disability research : JIDR, 56(4), 382–401. https://doi.org/10.1111/j.1365-2788.2011.01488.x
