Ch 1 and 2: Scope of Practice Flashcards by Troy Selby

Profile of a Certified Nutrition Coach

Motivator
Nutrition Architect
Communicator
Guide
Authenticator
Educator
Protector

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Builds strong relationships with clients
Leverage nutrition education to increase success, reduce turnover, and maximize adherence

Motivator

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Develop customized, evidence-based nutrition guidance for clients
Provide actionable, proven methods for clients to reach their nutrition goals

Nutrition Architect

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Engage in successful interactions with clients
Perform Consultations and Coaching sessions with clients face-to-face and online

Communicator

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Host Seminars and Events
Provide helpful recommendations for clients to navigate real-world nutritional challenges

Guide

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Separate Nutrition Fact from Fiction

Authenticator

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Evaluate clients’ dietary patterns and behaviors using tools and assessments
Provide nutritional education to clients

Educator

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Provide safe, comprehensive, empowering and professional nutrition programs
Work within the scope of practice

Protector

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As a nutrition coach you will do the following:

Have an actionable, proven method for helping clients reach their personal health and wellness goals with your professional guidance.
Leverage nutrition education to increase client success, reduce turnover, and maximize adherence.
Work with face-to-face or online clients.

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The actions, procedures and processes a professional is allowed to undertake in keeping with a professional’s credential or license

Scope of Practice

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Professionals that provide nutrition advice

MDs, Certified Diabetes Educators (CDE), ARNP, PAs and PharmDs

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Credentialing arm of the Academy of Nutrition and Dietetics for the purpose of establishing and enforcing certification standards for registered dieticians and other licensed nutrition professionals and issues credentials to those who successfully meet said standards The CDR also provides a professional code of ethics and recertification standards.

Commission on Dietetic Registration (CDR)

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A licensed healthcare professional or certified allied health professional who works with those who have Diabetes
- 1000 contact hours in diabetes education is required for certification

Certified Diabetes Educator (CDE)

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Typically provided on the state or Federal Level, Common prerequisites include formal education/training, supervised contact hours and passing a standardized test

Licensing

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Grated to a person who has completed an educational course and a standardized test and/or practical.

Certification

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Generic term for someone who provide nutrition counseling, Certification and Licensing parameters are vague

Nutritionist

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Nutrition Coach CANNOT:

Provide specific meal plans and daily menus.
Prescribe specific supplements or recommend vitamins and/or mineral dosages.
Suggest drastic caloric restriction.
Promote fasting, detoxification, or other extreme nutritional practices.
Prescribe diets that omit or severely restrict certain food groups.
In anyway, go against recommendations of licensed healthcare professionals.
Provide detailed nutritional plans for athletes who participate in extreme training programs (i.e., Ironman triathletes or ultra-marathoners).
Prescribe dietary plans for those with chronic health conditions (i.e., diabetes or heart disease).
Provide nutrition therapy to treat or prevent disease.
Provide exercise prescriptions or detailed programming (unless already certified as a personal trainer).

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A Nutrition Coach CAN:

Evaluate current eating plans and provide general guidance.
Recommend the client discuss supplement use with their personal registered dietitian nutritionist, physician, or pharmacist.
Promote caloric guidelines outlined by the USDA’s MyPlate, the United Kingdom’s Eatwell Guide, or other acceptable entities.
Recommend gradual dietary modifications and consistent dietary practices.
Discuss the importance of a balanced intake of macronutrients.
Refer back to the client’s personal healthcare provider when necessary.
Offer nutritional guidelines for anyone wanting to participate in typical athletic pursuits (i.e., masters swimming or a 10K run).
Provide guidance for healthy populations.
Offer advice on eating behaviors and/or macronutrients that are known to reduce the risk of disease or slow disease progression.
Offer exercise and physical activity guidelines.

Scope of Nutrition Coaches Components

Nutrition Guidance
Behavior Change and Motivation

Common Sources for information on Nutritional Guidelines

USDA (United States Department of Agriculture)
National Health Service (NHS) UK
Mediterranean Pyramid

Scope of the Nutrition Process

Assess, Educate, Implement

Written Questionnaires (Health History Questionnaire), Verbal Interview and Body Composition Assessment (Rule out Chronic Disease that is not in the Scope of Practice

Assess

Examples of Assessments in Questionnaires

Client nutritional goals
Personal stumbling blocks
Food aversions, preferences, known allergies, etc.
Hydration
Food triggers
Exercise habits
Daily activity patterns

Nutrition Coach Physical Assessment

Height
Weight
Body composition
Anthropometric measures of girth (arm, neck, chest, waist, hip, thigh, and calf)

Food Journals

Formal Assessment of Client Diet 3 - 5 Days (My Fitness Pal)

General advice on what constitutes a healthy diet according to current scientific evidence

Educate

Nutrition Education should be:

- Highly Relevant - Based on Prior Experience - Practical - Perceived to be important

Dietary Strategies and Tactics. Nutrition Plans

Implement

When to refer an Athlete to a Specialist

Unexplained decline in performance, unexplained Fatigue, A change in health status (chronic pain or discomfort)

Reasons to refer a nutrition client

Pregnant or lactating, Disordered Eating

Warning Signs of Disordered Eating

Drastic Weight Loss, forced vomiting, use of laxatives

Quick Assessment of an Eating Disorder

SCOFF Questionnaire (5 basic questions)

Questions in the SCOFF Questionnaire

1. Do you make yourself SICK because you feel uncomfortably full? 2. Do you worry that you have lost CONTROL over how much you eat? 3. Have you recently lost more than ONE stone (14 lbs) in a 3-month period? 4. Do you believe yourself to be FAT when others say you are too thin? 5. Would you say that FOOD dominates your life?

What Score of the SCOFF Questionnaire suggests Anorexia Nervosa or Bulimia

2 or More

Significant Improvement with Patients with Type 2 Diabetes Mellitus (T2DM)

Loss of 5 - 10% of body weight

Signs and Symptoms of Hypoglycemia

Dizziness, Hunger, Lethargy, Sweating, Loss of Energy, Headaches and Extreme Thirst

Reason for Referral: Lack of progress toward weight loss or weight gain goals

RDN or personal physician

Reason for Referral: Decline in athletic performance

RDN who specializes in sports dietetics (CSSD credential) or personal physician

Reason for Referral: Extreme preoccupation with weight loss or weight gain

Psychiatrist, psychologist, eating disorder specialist, or RDN

Reason for Referral: Client with well-regulated chronic condition now wants to participate in athletic competition or extreme sports (i.e., a person with diabetes who wants to do an Ironman triathlon)

RDN, CSSD, or physician specialist (i.e., endocrinologist for the triathlete with diabetes)

Reason for Referral: Client with a chronic condition considering adding supplements to existing medications (i.e., herbs, homeopathy, etc.)

Personal pharmacist, physician, RDN, or alternative health practitioner (licensed by the state)

Nutrition Coach written policies and procedures

Client Information Forms, including confidentiality documents Assessment forms, including a Health History Questionnaire and a Dietary Assessment Evaluation forms that would include client measurement data (height, weight, BMI, anthropometric measurements, and body composition) Basic and advanced educational handouts that are goal-specific (i.e., Hydration 101, Eating the Rainbow, Quality Snacks, etc.) provided in paper or electronic versions List of appropriate books, magazines, or online content for the clients to read Personal online content or regular newsletters that represent the vision and character of the business owner List of human resources for referral: Licensed Healthcare Professionals (RDN, MD, or mental health experts) and fitness experts (personal trainer or running shoe experts) List of community resources: healthy restaurants, healthy grocery store options, cooking classes/demonstrations, and quick-prep dinner-in-a-box solutions Marketing assets including flyers, business cards, digital advertisements, social media pages, and websites

Scrutiny for Nutrition Articles

Reliability and Validity