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vulnerable consumers, information specific to higher-risk
foods to be avoided and lower-risk alternatives should be
provided (31).
The provision of food safety information for consumers
A need for targeted food safety information for particularly
vulnerable consumers has been identified (33), and provision
of targeted food safety advice to these groups may reduce
the impact of subsequent infections (24). For example,
appropriate food safety education for cancer patients may
prevent further cases of foodborne infections (39). However,
a review of food-related patient information resources
available in the UK (17) has established that many resources
fail to highlight the importance of food safety for patients
during chemotherapy treatment; substantial information
gaps exist in food-related information sources, particularly in
relation to listeriosis prevention practices. Overall, existing
information has been determined to be inconsistent, with
significant variations between resources (17). There is a
need for food safety education specifically intended for
vulnerable patient groups, and consideration is required as
to how and when this might be best placed. If vulnerable
consumers could receive adequate food safety information
from adequately trained, credible healthcare professionals
such as dietitians, this could emphasize the importance of
food safety.
Trusted sources of food safety information
Trust is an important factor to individuals receiving
information on the basis of which they may change their
attitudes or behaviors (45) and information provided by a
credible source may be more likely to influence the public
(19). The professional's level of knowledge in itself does
not lead to trust; trusted sources are instead seen to be
characterized by positive attributes such as accountability
(21). A large European study found that the effectiveness
of food safety information largely depended on the source
and its perceived reliability (34); trust in the information
provider is an important factor for consumers in evaluating
sources of food safety information (34, 45).
In Europe and the U.S., consumers see healthcare professionals such as doctors and dietitians as the most trusted
sources of food safety information (42, 45). Several qualitative studies have found that consumers prefer healthcare
providers such as dietitians as their information source for
food safety information (3, 26). Indeed, verbal communication from healthcare professionals, including dietitians, is a
preferred method of food safety advice delivery by transplant
patients (13) and such have been professionals mentioned
frequently as credible sources of food safety advice to at-risk
consumers such as those living with HIV (26), individuals
living with cancer (36) and people receiving chemotherapy
treatment (17).

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What is a dietitian?
The title 'dietitian' is protected, meaning that dietitians
are the only qualified healthcare professionals who are
regulated by law to assess, diagnose and treat dietary and
nutritional problems and are governed by an ethical code
of conduct, and performance standards (5, 8). In 2004,
the International Confederation of Dietetic Associations
(ICDA), in consultation with member associations
representing dietetics around the world (27), such as the
Health and Care Professions Council (HCPC) in the UK and
the Academy of Nutrition and Dietetics in the U.S., agreed
upon an international definition for a dietitian: "The dietitian
applies the science of nutrition to the feeding and education
of groups of people and individuals in health and disease. The
scope of dietetic practice is such that dietitians may work in a
variety of settings and have a variety of work functions" (4).
Regulations for the title of dietitian mean that the dietetic
practitioner accepts the obligation to promote high standards
of professional practice and to protect the public and the
profession by upholding them. This includes engaging
with continuing professional educational requirements to
maintain registration (2, 19).
All registered dietitians (RDs) in the U.S. are also by
default nutritionists, but it is important to note that not all
nutritionists are RDs; additional training is required for this
title (9). In the UK and some other European countries,
it is possible to train as either a nutritionist or a dietitian,
but again, to obtain the title of dietitian a student must
have been trained in an accredited program and shown
competency in certain areas of clinical practice before
qualifying, by completion of either clinical placements
or an internship (25). Internationally, it is accepted that
dietitians will have received a minimum level of a bachelor's
degree and a period of supervised professional practice of
at least 500 hours that meet the international competency
standards for dietitians (27).
In the UK, the profession is regulated by the HCPC, which
works with the UK professional body, the British Dietetic
Association (BDA) to promote the profession, represent its
members, develop curriculum frameworks, and deliver postregistration education, training and continuing professional
development (25). Membership to the BDA is open to
anyone working in the areas of nutrition and dietetics, diet or
food, including trained dietitians, researchers, educators and
students (6). Similarly, in the U.S., The American Dietetic
Association (ADA) works together with the credentialing
agency, the Commission on Dietetic Registration (CDR), to
maintain appropriate curriculum frameworks, education and
training (14). In Sweden, the Dietisternas Riksförbund (the
Swedish Association of Clinical Dietitians) works to protect
the professional interests of members and ensures high
standard of dietetic training and research (16). It is difficult
to quantify accurately the number of registered dietitians
globally, but it is a growing profession. The ICDA states that
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