Who's the diet expert?

Good nutritional advice is important for all of us. But not every nutritionist has the hard-earned qualifications that they need

I have had a gastrectomy and have been told to go on a liquid diet, but the only information I have been given is to liquidise ordinary food, vegetables, meat and potatoes with some liquid.
Peter Begley, Bristol

I'd love to be able to talk you through the types of food you should eat but I feel I would be doing you a disservice, as it would be impossible, on the basis of one e-mail, to give you the therapeutic support you clearly need.

The fact that you have written to me suggests, though, that you haven't been offered the right support from a dietitian. I would strongly recommend asking your doctor to refer you to a dietitian with gastroenterological - ie, gut - experience.

Sadly, you are not alone: I receive masses of correspondence from people with complex health problems such as diabetes, cancer, heart disease, multiple sclerosis and obesity, who for some reason are not being cared for by dietitians. Some have doctors who seem not to believe in dietitians, others have paid large amounts of money to see unqualified nutritionists and have ended up with problems as a result of not receiving the right advice. That's why I want to explain the difference between dietitians and nutritionists, and to tell you how to get good nutritional support.

I know I'm going to upset some nutritionists, but unfortunately we still don't have a clear-cut way of distinguishing between someone who has done a weekend course in nutrition, put up a brass plaque and is now giving nutritional advice, and a nutritionist who has studied for a wellrespected degree.

While the British Association of Nutritional Therapists (BANT) and the Nutrition Society are working hard to establish theirs as a highly regulated professional body with well-qualified practitioners, even if not in the traditional dietitian way, and to make sure that no charlatans practise as nutritionists, the public currently has no obvious way of knowing if the person they see has the necessary qualifications and knowledge. If you would like to see a nutritionist who is regulated by the British Association of Nutritional Therapists, go to bant.org.uk or the Nutrition Society, www.nutsoc.org.uk.

Although I call myself a nutritionist I am technically a dietitian. Dietitians have to have completed a rigorous degree in dietetics, or a postgraduate diploma following a suitable science degree, and are governed by the Council for Professions Supplementary to Medicine (part of the British Medical Association) as well as by the British Dietetic Association (BDA). You can't call yourself a dietitian unless you have your state registration in dietetics (SRD).

I prefer to use the word "nutritionist" because it sounds nicer. Dietitians seem to be regarded as stuffy - the put-people-on-diets brigade - whereas the word nutritionist conjures up nourishment and nutrients. I'm not saying that all dietitians are great - some just seem to spout the same old eat-more-fruit-and-vegetables advice and can be under a great strain in the current NHS to give patients the time they need - but at least you know that the person you see has been degree-trained. And with something as important as having had your stomach removed, or suffering from ulcers, you should lobby your NHS practice for a referral to a specialised dietitian. Ask to see another one if you don't think that yours is good enough. Make a fuss about it, because your nutritional health is incredibly important.