Q & A with a Food Allergy Dietitian-Nutritionist!

Updated: Oct 13, 2020

1. What is the role of a dietitian?

The role of a dietitian is to provide evidenced based medical nutrition therapy. We are consultants for doctors and essentially, we are the food experts. This means our profession is the most versed on food and your health!

Our job is to do a thorough assessment of nutritional status and address gaps in nutrition related knowledge then, develop a plan for each patient and finally, intervene. In food allergy, the role of a dietitian who specializes in food allergy is essential. As a RDN who works with food allergy it is my job to assess the patients nutritional needs and teach them how to be creative. For example, if a patient needs to remove dairy from their diet they can no longer drink milk. It is our job to know that 1 cup of milk has the same nutritional benefits as 1 cup of soy milk. We are responsible for developing creative alternatives while ensuring the patient is meeting all nutritional needs they now have to replace.

We also teach them about food allergies in general such as what we know about diagnosing them, preventing them and treating them. It is key to make sure the patient has all the education at hand to make the safest decision for themselves. Food allergies can cause restrictive eating disorders, so it is vital the patient and dietitian build a good rapport together and a healthy relationship with food limiting fear as much as possible.

2. What type of training do dietitians have?

The 5 Steps

  1. Complete a bachelor's degree and receive a verification statement from an ACEND-accredited program (Didactic Program in Dietetics, Coordinated Program, Future Graduate Program, Foreign or International Dietitian Education Program) Note, effective January 1, 2024, a MASTERS degree will be required. – I completed my bachelor’s in nutrition and dietetics with Montclair State University then went onto apply to match to a dietetic internship.

  2. Complete an ACEND-accredited supervised practice dietetic internship program (1500 hours of supervised practice) – Mine was a 9 month clinical based program with Northwell Health

  3. Pass the Commission on Dietetic Registration's dietetic registration exam. – After you finish the internship you sit for the CDR exam

  4. Gain licensure in your state of practice, if applicable. – Once passed you begin to apply for state licensing. I practice in NYC and have an additional state license. So my credentials are RDN, CDN – the CDN part is New York verifying I met all the criteria to practice medical nutrition therapy in NY.

  5. Maintain continuing education. – Every year it is important to attend conferences and keep up with education! Medicine and nutrition are always changing it is our responsibility to keep up with the latest evidenced based guidelines.

3. Do dietitians work with other health care professionals such as allergists and family practitioners?

Yes of course! We are the food expert, so allergists and other doctors refer their patients to us constantly for as assessment, plan and education. My previous job I worked side by side with an allergist and physician assistant managing patient’s nutritional needs that were affected by food allergies. I would assist them with the diet recall to find a relationship between symptoms of food allergy and the triggering foods. This in turn helps them diagnosis a true IgE related food allergy.

4. Why should people with food allergies consider consulting a dietician?

When meeting with a registered dietitian who specializes in food allergies you can expect nutrition advice that is very specific to you and your food allergies / intolerances. The dietitian will do a complete assessment of your nutritional status, nutritional education and medical history. Then he / she will develop a plan that ensures you are getting a well balanced diet to achieve optimal health safely.

In regard to food allergies, a dietitian can help you pinpoint what foods need to be limited or even avoided. The dietitian and food history will also play a vital role in assisting the doctor in diagnosing a food allergy. The dietitian will make sure you know how to read nutrition labels, how to identify allergens, assist in menu planning, and help you replace missing nutrients with other foods or determine if supplements are needed. After meeting with a dietitian those with food allergies / intolerances will find a variety of foods they can eat to balance their health out.

5. Why did you want to specialize in food allergies? How did you get certified?

At this time there is no additional certificate for a dietitian or any healthcare provider to obtain for food allergies. However, it is based off experience. I personally worked with an allergist to form a nutrition program for his medical office. We treated pediatrics and adults and saw IgE mediated reactions, non-IgE mediated reactions and mixed IgE mediated reactions. Being in this environment I saw a tremendous need to teach others about food allergies and how to treat them with medical nutrition therapy. Ironically, as I turned 21 years old I myself develop multiple food allergies. Having to avoid fish, nuts, seeds and avocados has truly brought concern to my health. I was missing important nutrients. Being a dietitian has taught me ways to be creative to replace them and I learned how to safely avoid them as well as understand my allergies. For ex. I can tolerate peanut butter but cannot tolerate peanuts. I learned all signs and symptoms as well as treatment of anaphylaxis and vow now to teach others. The world of food allergies is so new! The 2010 guidelines in USA was the true start for this country. Being a part of this niche has been amazing and rewarding to help others.

6. What are some specific ways that a dietitian can help in regard to food allergies?

A dietitian will help you identify your food triggers, review signs and symptoms of a reaction, assess for nutritional deficiencies from adverse food reactions, understand the difference between a food allergy and adverse food reaction such as an intolerance, develop a meal plan to help you meet your needs while avoiding your allergies, monitor your weight and other health markers and reassure you of evidenced based guidelines!

7. How often should you see a dietitian?

Depending on your age and allergies of concern it is important to see a dietitian 1x a week for 1 month then once every 1-2 months after to address any barriers, determine new goal and establish expectations.

For babies with food allergies it is important to see a dietitian more often as well as an allergist. Here we touch based 1x a month and assessed what changed an what to change in relation to nutritional needs going forward.

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