The role of the nutrition coach in the field of health and fitness is going to expand over the next several decades as the role of nutrition in our society becomes more important. One of the essential pieces to successfully work with clients in our roles as nutritionists or nutrition coaches is to understand our scope of practice and how we can best serve our clients.
Here are some of the most important “dos” and “don’ts” to remember as you engage and work with clients.
1) Don’t prescribe meal plans.
I think it is essential to start with this one first, as it is perhaps the most common request from clients or potential clients but also the stickiest situation.
Many clients come to us as nutritionists, nutrition coaches, or personal trainers with nutrition certifications and want us to tell them what to eat, how much, and when to eat it. Indeed, that is a large part of our job, but it is crucial to understand how you can fulfill those needs of your clients.
In most circumstances, anyone other than a Registered Dietitian (RD) or a licensed physician, is not legally allowed to prescribe meal plans. This means that you should not provide a detailed meal plan to your client and indicate that they must follow that meal plan. In many cases, giving a client a meal plan can be deemed “prescribing” a meal plan.
2) Provide guidance and some structure around meals.
Just because you are unable to prescribe a meal plan does not mean you cannot, or should not, give guidance, advice, and structure around a client's meals.
Instead of prescribing a meal plan for a client, you can provide them with guidance and structure around a meal. You can tell a client for dinner they should aim to have a serving of something rich in protein (e.g., salmon, chicken, or beef), along with a nutrient-dense, starch source (e.g., potatoes, sweet potatoes, lentils), a fat source and vegetables (e.g., a salad with a vinaigrette dressing).
3) Don’t prescribe specific supplements and/or dosages.
Clients will often have questions about supplementation, including vitamins and minerals. For example, clients may ask how much vitamin D they should be supplementing with daily. As a nutritionist/nutrition coach, it is outside our scope of practice to prescribe a specific supplement or a particular dosage to our clients. In this scenario, it would be outside our scope of practice to tell a client to take 5000 IU of vitamin D per day during the winter.
4) Do educate your clients on supplements and refer them to a dietitian or physician.
While prescribing specific supplements and doses is outside the scope of practice for a nutritionist/nutrition coach, educating your clients is an essential aspect of your profession.
Expanding on the example from above, while you cannot prescribe a dosage of vitamin D, you can provide education. If a client asks you about supplementing with vitamin D, you may respond with something along the lines of, “Research suggests that if you are deficient in vitamin D, supplementing with it may reduce your risk of getting sick. If you feel like you would be interested in this, we can work with a physician to get you the right type and dosage”.
5) Don’t treat disease with nutrition.
Often, clients come to us with medical conditions or disease. Given its prevalence, many clients may come to us with existing cardiovascular disease or a family history of cardiovascular disease. Also, clients may come to us with metabolic diseases, such as diabetes. It is outside our scope of practice to treat these diseases with nutrition.
For example, if a client who is working with you does have cardiovascular disease, it would be outside our scope of practice to attempt to “treat it” by utilizing a very-low-carbohydrate or very-low-calorie diet.
6) Provide education around nutrition and disease.
While treating a disease is outside our scope of practice, providing education and insight into how nutrition has been shown to impact a client’s condition/disease. If a client comes to you with established cardiovascular disease, you might be able to educate them on how weight loss and exercise can reduce the risk of a major cardiovascular event and provide advice around food choices and habits that can result in weight loss. It would also be essential to direct them to a physician to help them manage their disease and provide further insights on meals that might fit their needs.
The Wrap Up
This list had a motif running through it that you can use as a “litmus” test of what your scope of practice is as a nutritionist/nutrition coach. Your role is to provide guidance, advice, and support to your clients; it is not to prescribe meal plans, supplements, or to treat disease. When in doubt about your scope of practice, you can reach out to your professional governing bodies (i.e., NASM) or your state legislature for additional guidance or insights.