Nutrition specialist and dietitian doctor in Latviathe difference and what the state covers

The two titles are often used interchangeably, but they differ in both training and authority.

• TrainingNutrition specialist: Second-level professional higher education in healthcare with the nutrition specialist qualificationDietitian doctor: Medical degree
• StatusNutrition specialist: Registered healthcare professional, functional specialistDietitian doctor: Doctor
• MedicationNutrition specialist: Does not prescribeDietitian doctor: May prescribe medication
• When to chooseNutrition specialist: Assessing eating habits, building a meal plan, preventionDietitian doctor: More serious nutrition or weight-related health problems requiring medication

Public sources state that nutrition specialist is a relatively new profession in Latvia, and that over four years of a bachelor's programme students cover both core medical subjects and specific ones, including food composition and related conditions.

Consultations. The Latvian Association of Dietitians and Nutrition Specialists publicly states that state-funded nutrition consultations would matter for public health, and that the association is campaigning for them. It follows that a nutrition consultation in Latvia is normally a private service.

Special nutrition. The state funds special nutrition for people who suffer nutrient deficiency, or malnutrition, as a result of various illnesses. Laila Meija, head of the Nutrition and Dietetics Centre at Rīga East University Hospital, explains that special nutrition is intended for people who can eat but cannot meet their nutritional needs with ordinary food, and that consultations assess the patient's needs and explain exactly which formula and how much is required.

• A nutrition specialist is a registered healthcare professional and functional specialist holding second-level professional higher education in healthcare and the nutrition specialist qualification.
• Public sources state that the bachelor's programme lasts four years.
• A dietitian doctor completes medical training and then specialises in dietetics.
• Register entries must be renewed every 5 years.

• Whether medication may be needed. If drug treatment is possible, you need a dietitian doctor rather than a nutrition specialist.
• In the context of illness. If nutrition questions relate to a specific condition such as diabetes, bowel disease or cancer treatment, a specialist working within a healthcare provider is worth choosing.
• Personal rapport. Public sources emphasise that outcomes are better where a good personal rapport develops, much as when choosing a family doctor.
• Children. If the consultation is for a child, check when booking.
• Qualification. Check whether the specialist is a registered healthcare professional, since "nutrition consultant" is not protected in the way the nutrition specialist qualification is.

• The consultation reviews eating habits, health status and goals.
• Afterwards a certified specialist may produce an individual meal plan with recipes, or a standardised nutrition plan.
• Rīgas 1. slimnīca recommends receiving the individual plan at a follow-up consultation, so it can be discussed and adjusted if needed.
• Where nutrition questions relate to illness, the specialist works alongside the treating doctor.
• Bring recent test results and details of any medicines and food supplements you take.

A nutrition consultation in private practice and at health centres is a paid service, priced by the provider.

• Nutrition consultationPrice EUR: per provider price listSource: Rīgas 1. slimnīca
• Individual meal plan or standardised nutrition planPrice EUR: per provider price listSource: Rīgas 1. slimnīca
• Administration surcharge for an outpatient consultationPrice EUR: 1.00Source: Rīgas 1. slimnīca
• Administration surcharge for non-operated day hospital patients, once per treatment periodPrice EUR: 2.00Source: Rīgas 1. slimnīca
• Special nutrition for malnutritionPrice EUR: state-fundedSource: LSM

Not every difficulty involving food is a nutrition question. If eating has become a source of anxiety, if thoughts about food, weight or your body occupy much of the day, or if eating patterns have changed in ways that affect daily life, a different field provides the support.

• Eating disorders are among the diagnosis groups covered by state-funded psychological and psychotherapeutic help, on referral from a family doctor or psychiatrist.
• Psychiatrists in Latvia are direct-access specialists, and consultations in the state programme are free.
• The crisis line 116 123 operates around the clock across the European Union. For children and teenagers: 116111.

In these situations a meal plan alone is usually not the answer, and a conversation with your family doctor is a good starting point.

If you have doubts about the quality of a service received at a healthcare provider, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.

The field is represented by the Latvian Association of Dietitians and Nutrition Specialists, chaired by Guna Bīlande, and by the association "Latvijas Diētas ārstu asociācija", registration number 50008005811, registered address Ojāra Vācieša iela 4, Rīga, LV-1004, contact Andis Brēmanis.