When I first embarked upon the journey that would ultimately propel me to the competitive bodybuilding stage, there was quite a bit for a newbie like myself to learn about this exciting undertaking. Probably the most crucial piece of advice given to me by my Coach had little to do with dumbbells, repetitions, and numbers of sets. I recall being told that successful bodybuilding required focus and discipline in 2 very different arenas: the gym and the kitchen.

I soon came to discover that this was not an equitable, 50/50 split, either. As it turns out, decisions in the kitchen comprised about 70% of the equation. I am often one to learn things the hard way, unfortunately; thus, it was only through extensive trial and error that I arrived at the realization of just how important proper nutrition and the timing of nutrient intake can be for a successful bodybuilder.

I obtained my Health Coaching certification and I was able to offer meal plan guidance to those clients who were seriously dedicated to changing their health through lifestyle modifications. Since that time, a contentious debate seems to have evolved regarding just which professionals are deemed legally qualified to dispense nutritional counseling; and personal trainers have come under a great deal of scrutiny on this very topic.

As it turns out, the laws governing which individuals are working within their legal scope of practice when dispensing nutritional guidance vary from state to state. One case in particular, involving the work of a food blogger in North Carolina, brought this to the forefront of public awareness. The North Carolina Board of Dietetics/Nutrition attempted to send this individual to jail for publicly recounting his personal battle against diabetes and encouraging others to follow his lifestyle.

Chapter 90, Article 25 of the North Carolina General Statutes makes it a misdemeanor to offer nutrition guidance without a license. According to the law, “practicing” nutrition includes “assessing the nutritional needs of individuals and groups” and “providing nutrition counseling.” As such, any individual wishing to share his or her insight or personal journey of overcoming serious health issues by adopting a cleaner meal plan cannot legally put the information into public circulation.

When the blogger in question was hospitalized with diabetes in February 2009, he feared suffering the same fate as his grandmother, who eventually died of the disease. To combat this, he embraced the low-carb, high-protein diet known as the “caveman” or “hunter-gatherer” diet. Within 30 days, he claimed to have become insulin-free. Three months later he had lost 45 pounds, which prompted him to start a blog about his success.

However, the North Carolina Diatetics and Nutrition Board decided the blog violated state law, claiming that any nutritional advice provided on the site amounted to “practicing nutrition,” for which a license was required. The blogger was told that unless he took down or rewrote his blog he ran the risk of being sued by the Licensing Board. If he lost the lawsuit he could face up to 120 days in jail. The Board’s director claimed that while the author had a First Amendment right to blog about his diet, he was not free to encourage others to adopt it unless the state had first certified him as a dietitian or nutritionist.

In 2012, an article appeared in Forbes magazine, describing what seemed like an attempt by the Academy of Nutrition and Dietetics to unfairly limit competition through legislation and other regulatory actions.

The Academy is pushing for strict enforcement of the following Act (known as Illinois SB2936, the “Dietitian Nutritionist Practice Act”):

“Any person who practices, offers to practice, or holds oneself out as being able to provide dietetics and nutrition services without being licensed under this Act shall… pay a civil penalty to the Department [of Financial and Professional Regulation] in an amount not to exceed $10,000.”

According to professionals in the field, Registered Dietitians are known as the food and nutrition leaders. Given that there is a significant difference between providing general nutrition guidance, medical nutrition therapy, and general lifestyle/bodybuilding meal plan suggestions, this matter becomes very complicated. In states where licensure has been enacted and enforced, consumers can be secure in the knowledge that any information they receive from such professionals is coming from a qualified individual and not someone with a few weeks of education, or worse, no education at all. The query in our field then becomes one of debating just how much nutritional background/education a Certified Personal Trainer ought to possess before he/she may be looked upon as knowledgeable, if not “legally” certified by a Dietetics or Nutrition Board.

We as trainers often feel as if we are adrift in a sea of “gray area”: if we do not give out at least a modicum of nutritional advice, might we be doing our clients a grave disservice? Yet if we dispense too much knowledge, are we putting our clients at risk? Consider the differences between these 2 statements:

1. “Lean turkey breast is a good source of high quality protein.”
2. “You should be eating more lean turkey breast for protein.”

The first is a true statement, based upon the generally accepted beliefs and scientific evidence regarding nutritionally dense protein sources. The second, however, tends to be viewed as a nutritional recommendation, which very likely is outside the scope of practice for the majority of personal trainers.

We can best understand and clarify this by realizing that while an individual seeking a personalized exercise plan is best served by contracting the services of a certified trainer, those seeking personalized nutritional plans and counseling are still better off being referred to a registered dietitian. Keep in mind, too, that we can be held accountable if a client’s medical condition or physical health deteriorates based upon any nutritional advice we may have dispensed.

Currently, more than 46 states have specific laws in place regarding the certification requirements of those professionals employed in the area of nutritional counseling. Well-respected personal training certifying bodies require that trainers “…refer clients to other healthcare professionals when nutritional and supplemental advice is requested.”

One way of fully servicing a client’s needs without risking a breach of professionalism might be to ask him/her to write down the foods most frequently chosen when building meals. From there, you may offer suggestions, alternatives, and even perhaps reasons for these suggestions, without getting into the details of recommended ounces/grams/servings per day.

If you discover that a client professes to enjoying white bread for sandwiches, it is perfectly acceptable for you to explain how whole-grain breads contain more vitamins, minerals and fiber than most of their bleached flour counterparts, and even perhaps engage in a brief discussion regarding complex carbohydrates versus simple carbohydrates in terms of providing sustained energy. This action differs vastly – and legally – from instructing the client to stop eating white bread altogether and only consume a specific brand of whole-grain bread.

If we stick to what we ourselves currently practice in terms of a healthy nutritive lifestyle, we can be fairly certain that engaging clients in general conversations regarding meal plan ideas is safe. The legal basics to which we should adhere are fairly straightforward:

• Encourage clients to modify their dietary habits to encompass evidence- based healthy eating guidelines.
• Avoid dispensing advice based on fads, trends, or celebrity endorsement.
• Avoid any suggestion of omitting entire food groups, as this may be perceived as encouraging restrictive eating behaviors.
• If asked for a certified nutritional referral, be prepared with names of Registered Dietitians or professional websites (myplate.gov, etc.)

Knowing the scope of practice as fitness professionals, and adhering to the legal parameters outlined by nutritional licensing boards, will ultimately help clients respect personal trainers for their honesty. This goes a long way in forging a strong and healthy client-trainer relationship.

REFERENCES:

1. http://www.menshealth.com/fitness/legal-diet-advice
2. http://www.diabetes-warrior.net/wp-content/uploads/2012/01/Website_Review_Cooksey_Jan._2012.pdf
3. http://www.nutritionadvocacy.org/virginia
4. http://blog.fooducate.com/2012/06/08/should-nutrition-counseling-be-provided-solely-by-registered-dietitians
5. http://www.ideafit.com/fitness-library/the-elephant-in-the-room-nutrition-scope-of-practice
6. https://www.carolinajournal.com/news-article/state-threatens-to-shut-down-nutrition-blogger/

Cathleen Kronemer

Cathleen Kronemer is an NFPT CEC writer and a member of the NFPT Certification Council Board. Cathleen is an AFAA-Certified Group Exercise Instructor, NSCA-Certified Personal Trainer, ACE-Certified Health Coach, former competitive bodybuilder and freelance writer. She is employed at the Jewish Community Center in St. Louis, MO. Cathleen has been involved in the fitness industry for over three decades. Feel free to contact her at trainhard@kronemer.com. She welcomes your feedback and your comments!