The role of natural health products (NHPs) in dietetic practice: results from a survey of Canadian dietitians.

Kristine Hirschkorn,Heather Boon,Rishma Walji

doi:10.1186/1472-6882-13-156

Abstract

BackgroundRegistered dietitians (RDs) play a key role in disseminating information about nutrition and intervening in nutrition-related disorders in the Canadian context. Natural health products (NHPs) are increasingly associated with nutrition in patient and health professional discussions. For this study, NHPs were divided into three categories: nutritional supplements (NS); functional foods/nutraceuticals (FF/N); and herbal preparations (HP). The objective was to explore RDs’ perceptions about their professional roles and responsibilities with respect to three categories of natural health products (NHPs).MethodsThis research consisted of an on-line survey of registered dietitians (RDs) in Ontario.Surveys were distributed electronically to all practicing RDs in Ontario by the College of Dietitians of Ontario. There were 558 survey respondents, a response rate of 20%.ResultsThe vast majority of RDs reported being consulted by clients about all product categories (98% for NS; 94% for FF/N; 91% for HP), with RDs receiving the most frequent questions about NS and the least frequent about HP. 74% of RDs believed that NS are included within the current scope of practice, compared to 59% for FF/N and 14% for HP. Even higher numbers believed that these products should be included: 97% for NS, 91% for FF/N and 47% for HP. RDs who report personally ingesting FF/N and HP were significantly more likely to report that these products should be in the dietetic scope of practice. In contrast, RDs who provide one-on-one counselling services or group-level counselling/workshops were significantly less likely to believe HP should be in the dietetic scope of practice.ConclusionsOpinions of RDs indicated that NS and FF/N (and possibly HP) fall within, or should fall within, RDs’ scope of practice. Opportunity exists for RDs to undertake a professional role with respect to NHPs. Policy clarification regarding RD roles is needed.

Highlights

Results are presented in four main categories: response rate and respondent demographics, dietitians and natural health products (NHPs), demand for NHPs in dietetic services, and views about inclusion of NHPs in dietetic scope of practice
In light of the high level of demand for dietetic services in the area of NHPs – with more than half of registered dietitians (RDs) reporting receiving questions from clients on at least a monthly basis about herbal preparations (HP) alone, and higher numbers reported for nutritional supplements (NS) and FF/N -- it would appear that the opportunity exists for RDs to undertake a professional role with respect to NHPs
Notwithstanding the potentially overlapping roles of other health care providers in this area, RDs need to articulate their particular role. This opportunity is most relevant to RDs who undertake individual level counselling or provide group-level counselling/workshops: they were the largest group who responded to the survey and are considered the most likely to experience a greater demand for their services/ expertise with respect to NHPs

Summary

Introduction

Doi:10.1186/1472-6882-13-156 Cite this article as: Hirschkorn et al.: The role of natural health products (NHPs) in dietetic practice: results from a survey of Canadian dietitians. National guidelines for the use of dietary or nutritional supplements for specific population groups exist (e.g., folic acid for women capable of becoming pregnant) [2,3] While these guidelines are published for the general public, dietitians play an important part in patient education. According to the former American Dietetic Association ( the Academy of Nutrition and Dietetics), “[t]he expertise of dietetics practitioners is needed to help educate consumers on safe and appropriate selection and use of dietary supplements, including nutrient supplements” They are consumers’ bridge between evidence-based research and optimal health” (p. 736) [5]

Objectives

Methods

Results

Conclusion