INTRODUCTION
In today's world, virtually every sector of the economy – as well as economies around the world – has been impacted by the processes of rationalization, and the healthcare industry is no exception. In particular, the nutritionist profession has experienced significant rationalization. The commitment of healthcare professionals to improve the field of nutrition has made the profession more efficient, predictable, calculable and even more controlled. It is these dour forces of rationalization that have, not only in the past but in the present as well, both modernized and standardized the nutrition profession while at the same time spawning multiple irrationalities such as the demonization of certain foods and the oversimplification of nutrition advice.
The history of defined professional nutritionists begins in the early 20th century, with the emergence of scientific research on nutrition and its effects on health. Prior to this, the concept of nutrition was not well understood, and dietary advice was often based on folklore and personal beliefs. In the early 1900’s, scientists began conducting experiments to understand the role of various nutrients in the body and how deficiencies or imbalances could lead to disease. This led to the development of the field of nutrition science, which focused mainly on understanding the relationship between diet, health, and disease. As this knowledge base grew, the need for professional nutritionists emerged.
WHAT IS RATIONALIZATION?
Max Weber - Sociology, Books & Quotes
The theory of rationalization originates from the mind of social theorist, Max Weber (right), a man who began his career as a historian only to become a sociologist. Weber argued that by loosening the hold of custom and tradition, rationalization “led to new practices that were chosen because they were efficient rather than customary” (Lippmann, 134). He describes the process by listing “not one but four different features as characterizing the latter [rationalism] - namely “depersonalization of social relationships [predictability], the refinement of techniques of calculation[calculability], the enhancement of the social importance of specialized knowledge[efficiency], and the extension of technically rational control over both natural and social processes[control]”” (Wallace, 199).
ORIGIN OF NUTRITION
The concept of “nutrition” as a scientific field of study is a relatively recent development, and there is some debate over who should be considered the first professional nutritionist. However, one certain pioneer of modern nutrition science was Dr. Wilbur Olin Atwater, who can be credited with founding the first nutrition laboratory in the United States in the late 19th century. Atwater was a chemist and physiologist who conducted groundbreaking research on the metabolism of food and the human body’s energy needs. In 1894, Dr. Atwater founded the Office of Experiment Stations within the US Department of Agriculture, which was responsible for conducting research on agricultural and nutritional issues. He was also a strong advocate for the use of science to improve public health, and he worked to promote better nutrition through education and outreach.
The first nutrition education programs were established in the late 1920s into the early 1930s, and the American Dietetic Association (now known as the Academy of Nutrition and Dietetics) was established in 1917. These early and newly defined professional “nutritionists” worked primarily in hospitals and clinics, providing individualized nutrition counseling to patients with specific medical conditions. Over time, the field expanded to include public health nutrition, food service management, and community nutrition.
How a Wesleyan professor pioneered modern nutritional scienceHow a Wesleyan professor pioneered modern nutritional scienceThe concept of “nutrition” as a scientific field of study is a relatively recent development, and there is some debate over who should be considered the first professional nutritionist. However, one certain pioneer of modern nutrition science was Dr. Wilbur Olin Atwater, who can be credited with founding the first nutrition laboratory in the United States in the late 19th century. Atwater was a chemist and physiologist who conducted groundbreaking research on the metabolism of food and the human body’s energy needs. In 1894, Dr. Atwater founded the Office of Experiment Stations within the US Department of Agriculture, which was responsible for conducting research on agricultural and nutritional issues. He was also a strong advocate for the use of science to improve public health, and he worked to promote better nutrition through education and outreach.
In 1887, Atwater was given the opportunity to test his ideas when he conducted his first series of experiments based on nutrition when he tested the nutritive value of alcohol, which helped to establish the importance of protein and carbohydrates in the human diet. At this time, there was a widespread belief that alcohol had a significant nutritive value and could serve as a substitute for other types of food. However, Dr. Atwater’s experiments showed that this was not the case. In his studies, he had volunteers consume different amounts of alcohol and measured the effect on their metabolism. He found that alcohol was not a significant source of energy and did not provide the essential nutrients needed for good health. Furthermore, these experiments showed that alcohol could interfere with the absorption of nutrients from other foods, leading to deficiencies in the bodies needed vitamins and minerals.
Later in 1894, Atwater founded the Office of Experiment Stations (right) within the United States Department of Agriculture, which was responsible for conducting research on agricultural and nutritional issues. At this time, there was a growing recognition of the need for more scientific research on agricultural and nutritional issues. In 1887, Atwater organized a conference of state agricultural experiment station directors at Wesleyan University, where he was a student and professor. The conference discussed the need for more systematic research on agriculture and nutrition and resulted in the creation of the Association of American Agricultural Colleges and Experiment Stations (AAACES) where Atwater served as the first secretary.
NUTRITION DURING WWI
The First World War created food shortages and rationing in many countries, including those at the center of the conflict such as Germany, France and the United Kingdom. Governments implemented rationing systems to ensure that the limited food supply was distributed fairly. The distribution of food and available rations varied but country, but typically included restrictions on items like meat, sugar, butter, and bread. In some cases, civilians were encouraged to grow their own crops of items such as vegetables to supplement their diets. More so, soldiers on the front lines faced even greater challenges with available food. Armies often struggled to provide adequate nutrition to their troops, resulting in malnutrition and weakened immune systems.
Despite these challenges, the countries worked to persevere. The United States Army developed the “iron nation”, which was a compact, high-energy package that could sustain soldiers for several days. Additionally, scientific research being done throughout the world was on the rise and led to a better understanding of how diet impacted health and performance of both soldiers and civilians.
Food rationing was introduced during the war to ensure that troops and civilians had access to sufficient food supplies. This created a need for experts in nutrition to help develop and implement food policies, and to educate the public about the importance of good nutrition.
In the United States, the Office of Home Economics within the USDA played a key role in promoting nutrition education during the war. The office organized programs to teach women about food conservation and healthy meal planning and distributed educational materials such as pamphlets and cookbooks. In the United Kingdom, the government established the Ministry of Food in 1916, which was responsible for managing food supplies and implementing food policies during the war. The ministry employed nutritionists and dietitians to advise on food rationing and to develop nutritional guidelines for the population.
Various organizations and government agencies took steps to promote rationalization in the field of nutrition. One important development during this time was the establishment of the American Dietetic Association in 1917. This organization was formed in response to a need for standardized education and training for dietitians and worked to promote the professionalization of the field. The association established a code of ethics and professional standards for dietitians and nutritionists and helped to establish formal education and training programs dedicated to this profession. In addition to the American Dietetic Association, government agencies such as the United States Department of Agriculture (USDA) also played a role in promoting efficiency and control within this profession. The USDA established the Office of Home Economics to promote further education around nutrition and research to support these studies being done. This agency worked with other government agencies to establish such food policies and regulations. During WWI, the USDA worked alongside countless individuals, such as Caroline Hunt, to ensure soldiers and civilians were provided with access to sufficient resources and food supplies.
IMPACT OF WWI AND WWII ON NUTRITIONISTS
During World War I, the importance of proper nutrition for soldiers was not only recognized but emphasized and nutrition research and education became essential to the war efforts. Nutritionists not only played a crucial role in developing and implementing dietary plans for soldiers, but they helped maintain the public health and increase chances of survival on the battlefield and within the economy. This led to the establishment of the first nutrition research laboratory in the United States at the University of Wisconsin in 1917 when the Surgeon-General's office established a Food Division for “safegaurding the nutritional interests of the Army”. This division instructed that nutritional surveys should be conducted to assess food requirements and economy. From these nutritional surveys, scientists found that garrison (anybody of troops stationed in a particular location, originally to guard it) rations were providing an excess of food, which were nutritionally unbalanced and had a high fat content. Furthermore, this led to a new development of “training ration[s]” to avoid waste of food. After the establishment of this laboratory, the American Institute of Nutrition was formed in 1928.
Similar to World War I, during World War II, nutrition science and the work of nutritionists became even more crucial as society expanded. The need for more adequate nutrition became not only emphasized for soldiers but for the public affected by the war as well. The war led to the establishment of government programs and policies aimed at improving the nutritional health of populations, such as food rationing and the fortification of foods with essential vitamins and minerals. The war spurred advancements not only in nutrition research but also pushed for the development of new technologies, such as the creation of synthetic vitamins like penicillin.
The World War II penicillin project prioritized scientific attainment through extensive collaboration and exchange of scientific resources. During this period of time, nutritionists working with the Food and Drug Administration ran early trials in an attempt to establish the drug’s efficacy and treatment guidelines. These trials yielded data about the drug’s use among humans, proving its therapeutic and commercial significance at a time when capital was limited. Penicillin was found to be created from a mold known as Penicillium notatum, which requires specific nutrients to grow and produce the nutrients. Nutritionists worked to analyze the chemical makeup of the mold’s growth medium to identify the key nutrients necessary for growth. Thus, the countless work put into the production of this drug by nutritionists and health professionals saved countless lives during the period of WWII.
THE FIGHT AGAINST INFECTIOUS DISEASES
Those in the public health professions played a key role in the prevention of spreading infectious diseases. Outbreaks of diseases like influenza, tuberculosis, and cholera were common, and these diseases highlighted the critical importance of proper nutrition in maintaining a healthy immune system and preventing illness. Nutritionists began to play a crucial and increasingly important role in public health efforts to prevent and control infectious diseases. As public health professionals, they developed specialized diets and nutritional supplements to help patients recover from illnesses and supported public health campaigns to educate the public about the importance of maintaining proper nutrition. Regulatory bodies were established to oversee the profession of nutrition and ensure that nutritionists were practicing within ethical and professional standards. Professional standards were established to ensure that nutritionists had the necessary education and training to provide effective nutritional care to their clients. The development of evidence-based practices in nutrition accelerated in response to the impact of infectious diseases on society. Nutritionists began to rely more heavily on scientific research to inform their practices and recommendations, helping to ensure that their interventions were effective in the prevention and treatment of disease.
One evidence-based practice that has been praised by health professionals for some time now is promoting a healthy and balanced diet, including a variety of nutrient-dense foods. This pushes the body to support the immune system and plays a crucial role in fighting off infections. Research has shown that certain nutrients, such as Vitamin C, Vitamin D, Zinc, and Selenium may have immune-boosting properties and can help reduce the risk of infections. Nutritionists worked with individuals and civilians in order to recommend incorporating foods rich in these nutrients such as citrus fruits, leafy greens, fatty fish, nuts, seeds, and legumes. With promoting a healthy diet from this research, nutritionists recommend going one step further and using proper food safety practices such as washing hands and surfaces, cooking food to safe temperatures, and storing food in the proper containers. This reduces the risk of foodborne illnesses that can lead to infections and sickness.
EMERGENCE OF PROFESSIONAL ORGANIZATIONS
The emergence of professional organizations in the nutritionist profession has been driven by several factors. One of the most significant factors is the growing recognition of the importance of proper nutrition in promoting health and preventing disease. As the field of nutrition has evolved and expanded, there has been a growing need for professional organizations to provide guidance, support, and education to nutrition professionals. Another factor driving the emergence of professional organizations is the need for standards and regulations within the profession. As the field of nutrition has become more complex, it has become increasingly important to establish standards for education and practice to ensure that nutrition professionals are qualified and competent to provide nutritional advice and support to patients and clients.
AMERICAN INSTITUTION OF NUTRITION
Founded in 1928, this organization was primarily focused on research in the field of nutrition and aimed to promote the advancement of nutritional science. In the late 1940s, as the field of nutrition began to expand into practical applications, the American Dietetic Association was founded. The organization aimed to bring together nutrition professionals with diverse backgrounds, including dietitians, nutritionists, and other health professionals, to promote the science and practice of nutrition. The organization also established standards for education and practice in the field of nutrition.
THE AMERICAN SOCIETY FOR NUTRITION (ASN)
Founded in 1928, ASN is the premier organization for nutrition researchers, clinicians, and educators, and has been instrumental in advancing the field of nutrition science. ASN’s mission is to promote excellence in nutrition research and practice through education, advocacy, and collaboration. The organization aims to support the development of new knowledge in the field of nutrition, and to promote its application to the maintenance of health. Made up of 5,000 members, including nutrition scientists, researchers, clinicians, and educators from around the world. The society publishes several peer-reviewed scientific journals, including the American Journal of Clinical Nutrition, Advances in Nutrition, and Current Developments in Nutrition. These journals provide a forum for nutrition researchers to share their work and calculate their advancements within the field. This organization also hosts an annual scientific meeting, which brings together nutrition researchers and professionals from around the world to share their latest research and learn more from each other. The meeting includes keynote lectures, symposia, workshops, and poster sessions to cover a wide range of topics in nutrition research. In addition to their research and education efforts, ASN is involved in advocacy and policy work. They work to advance policies that promote research and education and ensure that nutrition research is appropriately funded and supported.
THE NATIONAL ASSOCIATION OF NUTRITION PROFESSIONALS (NANP)
Founded later in 1985, the NANP is an organization made up of holistic nutrition professionals, including nutritionists, dietitians, and other healthcare practitioners who share a common interest in the holistic and integrative nutrition. The NANP provides a platform for its members to share knowledge, network with each other, and advance their careers in the field of nutrition. This organization promotes the use of whole, organic, and locally sourced foods, as well as other holistic approaches to nutrition and wellness. They seek to educate both the public and healthcare professionals about the benefits of holistic nutrition and integrative medicine, further promoting a collaborative approach to healthcare and emphasize prevention, education, and natural healing. The organization offers a variety of certification programs and continuing education courses that help its members stay up to date with the latest research and trends in the field of holistic nutrition. Collaborating with other organizations and associations in the field of holistic health, they advance the goals of the profession and promote the health and wellbeing of the public.
THE IRRATIONALITIES
Irrationalities are consequences of biasing toward rationalization, consequently leading to the opposite of a desirable outcome. The nutritionist profession is a field that has seen increased attention over the past few years due to the growing public interest in healthy eating habits. However, despite the wealth of scientific research available, there are still a few irrational issues within the profession that need to be addressed. Two major issues present in this profession come from the demonization of certain foods and the oversimplification of nutrition advice.
DEMONIZATION OF CERTAIN FOODS
In recent years, certain foods have been labeled as “bad” or “unhealthy” by not only nutritionists but society as well. This labeling of nutrients has led to the demonization of entire food groups, such as carbohydrates, fats, and sugars. While it is true that excessive consumption of these foods could cause dangerous health implications, demonizing an entire food group is not only irrational, but harmful to the eyes of public health. This is because it creates confusion and fear around food, which can lead to disordered eating habits and poor nutrition. Furthermore, labeling certain foods as “bad” can lead people to believe that they need to eliminate these foods from their diet entirely, which can lead to nutrient deficiencies and other problems.
The demonization of certain foods has had a significant impact on the job of a nutritionist. On one hand, it has created a public perception that certain foods are inherently bad for one’s health, thus leading to confusion and fear around food. This can make it difficult for nutritionists to provide balanced and evidence-based nutrition advice, as many people become resistant to incorporating different foods into their diets. Additionally, the demonization of certain foods can lead people to adopt restrictive diets, which are often not based on sound nutritional principles. On the other hand, the demonization within this profession has created opportunities for nutritionists to educate the general public about the importance of balance and moderation in their diets. By providing evidence-based information about the nutritional benefits amongst a variety of foods, nutritionists can help to dispel myths about individual foods.
OVERSIMPLIFICATION OF NUTRITION ADVICE
Nutrition is a complex and multifaceted field, and oversimplifying nutrition advice can lead to misinterpretations and harmful behaviors. For example, some nutritionists may recommend a “one-size-fits-all" approach to nutrition and health, however, this fails to consider individual differences in dietary needs and preferences. This oversimplification can lead to people following diets that are not nutritionally adequate or sustainable to one’s health. Similarly, some nutritionists may overemphasize the importance of others. This can lead people to adopt unbalanced diets that are not optimal for their health. Furthermore, with the miscommunication amongst nutrition, myths and mistrust are created upon the field of nutrition, making it harder for nutritionists to provide evidence-based advice to those who are unwilling to believe what they are saying. Amongst the irrationalities in this field of work, it is important for nutritionists to take a holistic and evidence-based approach to education, taking into account the differences between individuals.
ETHICAL CONSIDERATIONS IN NUTRITION
The major issues of the health care field are increasingly the result of acute and chronic conditions related to poor nutrition. Nutrition counseling can provide prevention of nutrition related conditions such as the need for weight management. It can be altered to meet the treatment needs of patients with diagnoses of illnesses, reduce complications and/or side effects, and can improve the general wellbeing. Nutrition counseling is the “ongoing process in which a Registered Dietitian/Nutritionist (RD/RDN) works with an individual to assess his or her usual dietary intake and identify areas where change is needed” (ACMH).
As any type of counseling, there are ethical considerations that must be taken into account such as respecting the autonomy of the client. The counselor should provide information and advice, whilst allowing the client to make their own decisions about their diet. Furthermore, the counselor should avoid imposing on the individual’s personal values and beliefs, and rather consider the client’s cultural, religious, and personal preferences when providing recommendations.
Another important ethical consideration is patient-physician confidentiality. Nutrition counseling sessions often involve personal and sensitive information, such as the client’s medical history, eating habits, and weight. Making dietary changes is a gradual process in which everyone's situation and background must be “carefully considered” (ACMH). When beginning this process, it is important that this information be considered and kept confidential as well as also respecting the client’s privacy. Explanations of limits of confidentiality should be provided to the client, thus physicians should obtain their informed consent before sharing any information to third parties. Nutritionists must not only efficiently manage patient records but also ensure that the patient-physician confidentiality is respected during the provision of medical services. For example, physicians may need to quickly and efficiently exchange client information with other healthcare providers involved in the patient’s care, such as specialists or hospitals. In these situations, it is important to ensure that the patient confidentiality is maintained through the use of secure electronic communication systems, such as encrypted emails or secure messaging platforms.
Ritzer’s theory of rationalization supported by efficiency plays a major role in this confidentiality, nutritionists lack the control factor of rationalization. When using electronic communication systems that are so heavily relied on by society today, nutritionists lose the ability to perform a comprehensive assessment of their clients, limiting their ability to provide tailored nutrition advice. Not only that, but digital communication can sometimes be interpreted in the wrong way as it can become impersonal and prone to misunderstandings, further leading to misinterpretations by either the client or other healthcare providers involved. Nutritionists must ensure that electronic communication systems are secure and protect the client’s information. As nutritionists, however, they lack the ability to control electronic systems in which they may be susceptible to breaches, making it hard to trust and providing the possibility of compromising the patient's privacy.
GIG WORK
The staffing agency began shortly after WWII with small agencies in urban areas employing housewives for part time work as office workers. Over the years, many benefits have come from employing workers that could be hired and laid off on short notice and were exempt from paperwork and regulatory requirements which resulted in a gradual but substantial increase in the use of temporary workers. Technological advancement and the proliferation of the smartphone has reshaped the commercial landscape, providing consumers new ways to access the retail marketplace. A study, recently done by Brittany Lambert, Ksenia Keplinger, and Russell Cropanzano was inducted to account for the lived experiences of gig workers by giving them voice. This study suggests that main advantages of gig workers are flexibility in choosing their clients, projects, and work times and receiving the opportunity to reach full potential by using skills that would otherwise not be applied in a traditional workplace. However, the disadvantages of gig work were found to be the uncertainty of the amount of work and income, as well as the inability to use the enhanced flexibility for different reasons (Manning School of Business). This study concluded that the advantages outweighed the disadvantages and therefore is why so many push to stay in gig work rather than return to traditional work.
THE PROFESSION OUTLOOK
Since the 1940’s, when the public health field was first becoming important in society, the profession of nutritionist has undergone significant changes, both positive and negative. During the mid 20th-century the field of nutrition was still in its infancy, and there were relatively few job opportunities for nutritionists outside of academia and research. However, with the growing recognition of the importance of nutrition in public health, the demand for nutritionists began to increase in the latter half of the century.
During the 1960’s and 70’s there was a significant increase in federal funding for nutrition research, which led to the establishment of nutrition programs in multiple universities and research institutions. As a result, nutritionists began to gain more opportunities for jobs in more than just research and academia. Like the past, the job outlook on this profession has remained strong in recent years, as the importance of health continues to rise in recognition. According to the Bureau of Labor Statistics, employment of dietitians and nutritionists is projected to grow 7% from 2021 to 2031, about as fast as the average for other public health occupations. Approximately 5,600 job openings for nutritionists are projected each year primarily due to the need to replace workers who transfer to different occupations or exit the labor force, such as retiring.
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