Trouble In Paradise? Registered Dietitians and American Dietetic Association Work to Improve Nutrition in Hawaii

FOR RELEASE AUGUST 16, 2006

Media contacts:  Jennifer Starkey, Tom Ryan, Julia Dombrowski 
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CHICAGO – For registered dietitians, Hawaii is a microcosm for the world: People, cultures and foods from around the globe meet and blend in memorable ways. Traditional diets and lifestyles are changing and nutrition-related health problems are on the rise.

“Hawaii’s situation tells us that even paradise can have nutritional risks,” said registered dietitian Jeannie Moloo, a spokesperson for the American Dietetic Association.

“Many of the reasons for nutrition-related health problems in Hawaii are related to changes in lifestyle, particularly the shift from traditional diets to more Western diets, plus the decreased levels of physical activity that we see everywhere in the United States,” Moloo said.

The American Dietetic Association is holding its 2006 Food & Nutrition Conference & Expo in Honolulu September 16-19, bringing nearly 10,000 registered dietitians, researchers and other nutrition professionals to the Hawaii Convention Center for ADA’s first-ever national conference in Hawaii, where about 500 registered dietitians live and practice.

ADA’s conference is helping to shine a national spotlight on nutrition issues that affect Hawaii and beyond – from obesity and diabetes to protecting the public’s health through state licensure of RDs.

“Hawaii is far from immune to the rising health problems and disease trends seen throughout the nation,” writes Mae Kazu Isonaga, a registered dietitian at the University of Hawaii and the 2005-06 president of ADA’s affiliate Hawaii Dietetic Association, in a recent issue of ADA’s member publication ADA Times. “In fact, the state that calls itself ‘The Health State’ is quickly catching up to the rest of the country, and not in a good way.”

Recent data indicate that more than half of Hawaii’s adults are overweight or obese. While the population’s average body mass index is lower than the U.S. national average, that is likely because people of Asian descent have generally smaller body frames. In addition, the prevalence of diabetes in Hawaii is above the national average; native Hawaiians have one of the highest rates of diabetes of any group in the country and the highest mortality rate from diabetes.

Hawaii has served, in the words of nutrition researchers, as a “laboratory” for the study of connections between people’s diet and their risk for heart disease, cancer, osteoporosis and stroke, and on the health effects of changing dietary habits to match local cultures. “Studies of native Japanese and Japanese immigrants to Hawaii and San Francisco have shown that ‘acculturation’ can lead to higher rates of cardiovascular disease, obesity and hypertension,” Moloo said.

“The nutrition and health issues we see in Hawaii underscore the importance of registered dietitians, here and in any community, in providing high-quality nutrition services to everyone, no matter their heritage or life circumstances,” Moloo said.

“Hawaii also illustrates the importance of passing and strengthening state laws that regulate the practice of dietetics. Licensure provides a crucial level of protection for the public and practitioners alike, helping ensure that nutrition advice and therapy are provided by qualified professionals. For example, under federal law, medical nutrition therapy for Medicare beneficiaries must be provided by a registered or licensed dietitian, and many private insurers have similar requirements,” Moloo said.

The words “dietitian” and “registered dietitian” reflect specific education, training and credentialing – conveying information that is extremely important to patients and clients, especially those with serious acute and chronic diseases.

“Without licensure laws, anyone can call herself or himself a dietitian, whether or not they have qualifications or education,” Moloo said. “Along with increased recognition of registered dietitians’ expertise, licensure helps guarantee that anyone offering food and nutrition services in Hawaii must meet measurable standards for practice and be responsible for the advice they provide.”

To date, 45 states have enacted laws requiring licensure of RDs, including Hawaii. But since Hawaii’s legislation was passed and signed into law in 2000, the state has yet to see its first licensed dietitian.
 
Turnover in state government leadership followed elections that were held soon after the licensure law was passed. By the time things settled in 2002, the Department of Health and the Department of Commerce and Consumer Affairs were at odds over who should administer the licensure program, a situation that continued until early this year.

Following several meetings in recent months among representatives of the American Dietetic Association, the Hawaii Dietetic Association and the Hawaii Department of Health, plus communications with the governor’s office, the state’s Office of Health Care Assurance agreed to develop the rules and regulations and administer the dietetics licensure program. But state officials say it could take another year or more to get dietetics licensure up and running – even though the Hawaiian statute closely resembles licensure programs in at least 25 other states.

“To compare, that is five years longer than Pennsylvania and West Virginia needed to implement their licensure laws which were passed at the same time. And federal officials were able to start a totally new Medicare benefit providing nutrition services to seniors across the nation in a fraction of that period. Six years is a long time to interpret and carry out a statute with fewer than 800 words,” Moloo said.

“ADA hopes more efforts will be made to bring the state into compliance with the law, and all registered dietitians look forward to full implementation of licensure in Hawaii. These delays do not reflect well on the state’s government officials, who may be forgetting who the real winners will be if dietetics licensure is fully implemented: the residents of Hawaii,” Moloo said.

With approximately 65,000 members, the American Dietetic Association is the nation’s largest organization of food and nutrition professionals. The Chicago-based ADA serves the public by promoting optimal nutrition, health and well-being. To locate a registered dietitian in your area, visit the American Dietetic Association at www.eatright.org.

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