Feeling unhealthy? Just need to eat better? Numerous nutritionists are here to help.

But not all nutrition professionals are equal, which could make choosing one a little confusing.

You could seek nutritional counseling from a registered dietitian, a nutritional therapist or a lifestyles educator. Or, you can turn to your established physician, naturopath or chiropractor.

Whoever it is, check into their nutrition credentials before deciding how much credence to give their advice. There are various levels of qualifications in nutrition-related care. And, different credentials might represent different philosophical approaches.

Nutritionists

First thing to know: The oft-used title “nutritionist” is a meaningless term.

“In Oregon, it is legal for anybody to call themselves a ‘nutritionist,’ ” said Connie Georgiou, a registered dietitian and emeritus associate professor at Oregon State University’s department of nutrition and exercise science.

“Many people with little to no training use this term, but a lot of us who do have training also use it because it’s a term consumers are attracted to,” said Julie Hood Gonsalves, a registered dietitian and associate professor of health at Central Oregon Community College. “That term alone doesn’t lead consumers to a trained professional, and may be considered a red flag if no other credentials are given.”

Registered dietitians

“Nationally, the registered dietitian professional credential is the one accepted by the medical professions as the standard for providing scientifically sound nutrition information for the public and providing medical nutrition therapy for patients,” Georgiou said.

Registered dietitians translate nutrition research into individualized diets or larger-scale meal plans.

People see registered dietitians for all sorts of problems: cardiovascular, blood pressure, digestive, weight and so on.

Registered dietitians work in both private in public settings, in clinical environments such as hospitals, and in food service industries such as restaurants and school districts. Some are hired to run corporate wellness programs. Many focus on a specialty, such as diabetes or sports performance.

Unlike many other nutritionists, registered dietitians’ nutrition counseling can, in some cases, be covered by insurance. Different insurance plans cover varying amounts of nutrition consultation, said Lori Brizee, a registered dietitian who has her own practice.

Nutritional therapy practitioner

Registered dietitians’ association with insurance companies, government agencies and medical institutions has drawn some nutritionists to advocate for alternative approaches.

Gina Bailey, a nutritional therapy practitioner in Bend who has her own business called The Health Connection, said those establishments don’t seem to be working for most Americans, who in general are not that healthy.

For example, Bailey said, registered dietitians often seek ways to cut calories and fat, even if that means allowing foods that nutritional therapy practitioners consider poor choices, such as artificial sweeteners or processed, low-fat alternatives.

Weight loss is not a focus in her nutritional therapy work, she said. Rather, her focus is on metabolic dysfunction, nutritional deficiencies, improving digestion and identifying food allergies. She believes in using nutritional supplements, from vitamins to hydrochloric acid supplements, to aid in healing when needed, she said. She said she uses many lines of supplements, including those from Biotics Research Corp., depending on the dysfunction. The president of Biotics Research Corp., a supplement manufacturer, founded the Nutritional Therapy Association, which certifies nutritional therapy practitioners.

The Nutritional Therapy Association’s philosophies are aligned with the Weston A. Price Foundation, a nutrition education group that advocates a diet of nutrient-dense foods, which include fats such as butter and beef, as well as whole grains and vegetables. They shun sugar and refined grains.

And that suits Dr. Lisa Uri, a family practice doctor at High Lakes Health Care in Bend, who is adding the nutritional therapy training to her Western medicine training.

In medical school, Uri said, “Nutritional training was next to nothing, which is really unfortunate.” It would be ideal if the medical community could help people understand nutrition better, she said, but doctors rarely have enough time to deal with serious issues from chronic diseases to acute pain, so it’s hard to include a thoughtful discussion about nutrition in most visits.

Processed foods, artificial sweeteners and refined sugar account for a lot of illnesses Americans are experiencing, Uri said.

“We always tell patients fat and cholesterol make you fat and give you high cholesterol. Unbeknownst to most of us, low fat usually means high sugar,” said Uri. “Ever since the low-fat craze, trends in heart disease, diabetes and obesity have skyrocketed.”

She said some of these diseases are preventable, and what she’s learned in the training made her step away from the low-fat paradigm.

Complementary credentials

Like Uri, many health-related professionals build on their education with additional nutrition training.

There’s a chiropractor in Bend who has supplemented his education with a nutrition certification by Firstline Therapy, a program for health practitioners offered by a supplement company called Metagenetics.

There’s a “certified nutrition specialist” who works for a local naturopath. She also has a master of science degree in herbal medicine from the Tai Sophia Institute, an accredited graduate school in Maryland. The naturopathic office’s website says she consults patients about health and healing.

Bari Liebowitz is a chiropractor in Bend who earned a master’s degree in human nutrition because she thought it would integrate with her chiropractic practice. Patients often ask her about nutrition and supplements, weight loss, food intolerances and food allergies. Her nutrition education included courses on the biochemistry of nutrition, which she said helped her understand how food and supplements play a role in fatigue disorders and how she could help people feel better. She learned about sports nutrition and nutritional needs for working out and recovery.

“I wanted to be able to give my patients the best possible care in not just chiropractic, but holistic medicine,” she said. “This type of education fits great into a chiropractic office or even a medical office where they want to incorporate nutrition. These programs focus less on the meal plans, etc., that a (registered dietitian) would do, and more on organic foods, superfoods and supplements.”

Be a skeptic

Consumers need to ask questions of their health care providers and look into their credentials. Be wary of titles such as “life coach” or “wellness coach,” said Gonsalves. They don’t always ensure the provider had adequate training in safe, effective nutritional therapies, she said.

Many people who use those titles have degrees in some kind of wellness field, from nursing to chiropractic. But some don’t.

“Coaching is a contemporary word, kind of like ‘nutritionist,’ ” Gonsalves said. “Lots of people use it to promote themselves. That doesn’t mean they aren’t competent, but it is certainly ‘buyer beware.’ ”

What’s in a name?

Here are some of the nutrition credentials you may come across, and what their title represents:

Nutritionist

An unprotected term that does not signify any specific training in Oregon.

Registered dietitian

Someone who has at least a bachelor’s degree with specific courses in biological science and nutrition from an accredited institution; has completed a supervised internship at a university or health care facility or agency; has passed an exam from the Academy of Nutrition and Dietetics (www.eatright.org) which regulates this job title. Requires continuing education.

Licensed dietitian

A state license only available for registered dietitians. In Oregon the license is optional.

Nutritional therapy practitioner

Someone who has completed nine months of training about diet, nutrition and lifestyle, available as a noncredit certificate at Central Oregon Community College and other colleges around the country. Training follows guidelines from the Nutritional Therapy Association. (www .nutritionaltherapy.com)

Certified nutrition specialist

A credential for professionals with an accredited master’s or doctoral degree and clinical experience, who have passed an exam offered by the Certification Board for Nutritional Specialists (www .cbns.org), which was originally founded by the American College of Nutrition (www .americancollegeofnutrition .org). Requires continuing education.

Certified clinical nutritionist

A credential offered through the Clinical Nutrition Certification Board (www.cncb.org), it includes 56 hours of online training and an exam for nutrition professionals who have at least a bachelor’s degree or a professional degree in a licensed health care field. Emphasis is on alternative medicine and supplements.