Week 1 Day1a Introduction to the Profession of Dietetics

Historical Perspective Diet in treatment of disease— “ancient practice”. Food and health linked early, although knowledge was only theoretical. “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” - Hippocrates

Historical Perspective Understanding of digestion, respiration, metabolism developed as forerunners for discovery of nutrients. –Fats, carbohydrates and amines known by mid-1800s –Vitamins and minerals known by early 1900s

James Lind “Treatise of Scurvy” “Of this they drank half a pint every day, and sometimes more or less, as it operated, by way of gentle physic. Two others had each two oranges and one lemon given them every day. These they ate with greediness, at different times, upon an empty stomach.” -Dr. James Lind ( )

Early Practice of Dietetics Cooking schools – NY Cooking Academy founded in 1876 Hospital Dietetics - Florence Nightingale ( ) credited with improving food and sanitation in hospitals Clinics – Frances Stern Clinic, Boston, provided diets for the sick poor, served as model clinic Military – in Civil War, WWI, WWII

Founding of American Dietetic Association (ADA) 1899: subgroup of American Home Economics Assn. coined word “dietitian” 1917: ADA founded in Cleveland with 39 charter members and dues of $1.00. Lulu Graves first president.

Four Original Areas of Practice Dieto-therapy Teaching Social welfare Administration

Areas of Practice Today Dieto-therapy became Diet Therapy, then Clinical Dietetics, Medical Nutrition Therapy or Clinical Nutrition. Education—same. Social welfare became Community Nutrition. Administration became Instit. Administ, Foodservice Management, Management of Food and Nutrition.

Membership 1927: 1,000 members 1947: 8,000 members 1967: 19,382 members 1973: 24,280 members 1995: 66,171 members 2009: 70,000 members 2012: 72,000 members 2013: 75,065 members

Influential Leaders Sarah T. Rorer – 1 st American dietitian ( ) L. Frances Cooper – Director, School of Home Economics at Battle Creek Health Care Institution, 1st dietitian on US Surgeon General’s staff (1875–1961) Mary Barber – Consultant to military in WWII, tasked with feeding 1.5 million soldiers Mary deGarmo Bryan – began training programs for directors of School Lunch programs ( )

Characteristics of a Profession: a. Specialized knowledge b. Continuing education of members c. A Code of Ethics d. Commitment to service for others Discussion?

Specialized Knowledge Education Standards set in 1919 for college degree and hospital training. 1987—Standards of Education focused on outcomes of educational process. 2013—most recent Standards.

Continuing Education Accreditation and registration of members—1960s. Requirements of 75 clock hours of continuing education each 5 years. Specialized areas of practice now recognized with descriptive titles.

Code of Ethics Established for the profession in Updated regularly and now includes standards for Professional Conduct.

Service to Others Aims of profession: Optimum health for the public. Improvement in quality of life. Outreach to communities and beyond.

Growth of the Profession and Historical Milestones 1917—lenient requirements for members. Later, membership based on specified education and practice. Categories of Membership: active, honorary, international, retired, student, Associate. 2012: Name changed to Academy of Nutrition and Dietetics. 2012: Journal name changed to Journal of the Academy of Nutrition and Dietetics.

Registration and Licensure Title “Registered Dietitian” (RD) eligibility based on education and practice. National testing required and maintenance of registration status through continuing education. Licensure is governed by states.

ADA Foundation Solicits and accepts monies for scholarships, research and projects. Established as an educational arm of the Association, non-profit, and 501-C-3- status. Funds research for members advancing research goals of the Association.

Dietetic Technicians and Managers Hospital, Educational, Institutional Food Service Society (HEIFSS) formed in Independent society but tied to ADA. Now, AMFO, Association for Managers of Food Operations. Voluntary certificate program leading to “Certified Food Manager”. Dietetic Technician Registered (DTR), requires educational standards and practice and a national exam.

Legislative Activity Military rank for dietitians in world wars. 1950’s—Standards for employment in Veterans Administration. School Lunch Act and Maternal and Child Health Bill. Medical Nutrition Therapy. Washington, D.C. office.

Dietetic Practice Groups Established in 1978 with 9 groups. In 2012, 28 groups, with sub-units. Open membership to dietitians with a special interest and/or practice in an area. Provide networking, newsletters, annual meeting programs, and continuing education for members. Member Interest groups formed.

Professional Partnerships Liaison with over 140 allied groups Joint projects with Am Public Health Assn, Am. Diabetes Assn U.S. Public Health Association Am Society for Clinical Nutrition Am. Hospital Association Food and Nutrition Science Alliance (FANSA)

National Level Participation RDs serve on Dietary Guidelines Committee and to develop DRIs with Food and Nutrition Board. Members work at USDA, USHHS, NIH, U.S. Congress.

International Associations International Confederation of Dietetic Associations composed of 34 dietetic Associations. American Overseas Dietetic Association (AODA). Affiliated with ADA. International Congress of Dietetics meets each 5 years.

Reaching out to the Public Website: Toll free number: National Nutrition Month in March Media Spokespersons Congressional testimony/lobbying contacts