With the economy in distress and medical expenses edging higher, more people are turning to nutritionists for help with everything from making healthy meals for less to shedding pounds and treating diabetes. But the industry was already growing before the recession hit: The American Society for Nutrition, an industry group, says its membership has risen 40 percent over the past eight years. Clients seeking help from a nutritionist typically pay $50 to $350 a visit, scheduled perhaps once a week for someone with type 2 diabetes, or two to three visits total to shed 10 pounds.

Regardless of your goal, it's important to find someone with the right credentials: CCNs (certified clinical nutritionists) or a Ph.D. in nutrition are solid choices. Even better, say experts, are registered dietitians. RDs have met strict criteria, including a bachelor's or master's degree, internships and exams. What to avoid? Says Katherine Tallmadge, nutritionist and spokesperson for the American Dietetic Association: "If I found someone calling himself a nutritionist and doing hypnotherapy, I would run fast in the other direction." To find an RD in your area, visit www.eatright .org; for CCNs, go to www.iaacn.org.

Americans are certainly taking their vitamins these days. In fact, sales of vitamin and mineral supplements reached $10 billion as of 2008, according to the Nutrition Business Journal. But are they worth it? Many nutritionists strongly promote them, says Bonnie Taub-Dix, a nutritionist in New York City, "but they can be very expensive and very unnecessary." For most people, vitamins are consumed to compensate for deficiencies in their diet.

But some nutrition experts have recommended them for everything from fighting colds to preventing Alzheimer's, heart disease and cancer.
Recent studies have begun to clarify the limitations of vitamins' curative powers. Government-funded research has repeatedly found, for example, that multivitamins don't protect against heart disease or cancer; by contrast, people whose diets are rich with fruits and vegetables showed lower rates of both. And a 2008 study found that, contrary to popular belief, vitamin E and selenium fail to prevent prostate cancer. Says Taub-Dix, "There's more nutritional benefit to be found in the whole-food form." Bottom line: Be wary of nutritionists who emphasize pills over food.

As concern over portfolios and the job market continue, more of us are turning to food and drink for solace. When people are stressed, they secrete the hormone cortisol, which sparks a craving for sweets and other comfort foods. And according to studies using mice, an increase in cortisol creates more and bigger fat cells, leading researchers to believe that when people feel stress, they're more vulnerable to gaining weight. Cheryl Forberg, nutritionist for NBC reality series The Biggest Loser, estimates that 70 percent of her client base struggle with emotional eating. But nutritionists can only do so much: "Often a psychologist is also needed," she says.

If you find yourself compulsively or excessively overeating in times of emotional distress, seek a nutritionist with a degree in psychology, or ask your nutritionist for a referral to see a psychologist as well, says Forberg. Also, take steps that help you feel in control, says Stephen Gullo, author of The Thin Commandments. That includes exercising, taking charge of your finances, meditating and not keeping tempting foods around. "A pyromaniac shouldn't live in a house with matches," he says.

Almost two-thirds of adults are overweight or obese, according to the Centers for Disease Control and Prevention. Last year alone, the weight of the average adult increased in 37 states, says health advocacy nonprofit Trust for America's Health. And nutritionists are profiting: "About 95 percent of my clients come to me because they're overweight," says Forberg.

Losing weight is one thing, but only 3 to 5 percent of overweight people can keep 20 to 100 pounds off over a five-year period, according to Gullo. And with the fast-food industry's ubiquitous marketing, temptation is hard to fight, says Gene-Jack Wang, chair of Brookhaven National Laboratory's medical department, in Upton, N.Y. "Every time we turn on the TV, there's a new advertisement egging us on," he says. But when it comes to fighting obesity, environment isn't the only challenge. Eating can be addictive, and certain foods can "hijack the brain in a similar fashion to drugs and alcohol," Wang says. Recent studies show that the craving center in the human brain that reacts to crack cocaine and alcohol also reacts to salt and sugar.

With all the varying information out there on nutrition body-mass index, glycemic index, food pyramid and so forth many consumers don't know where to begin on the path to healthy eating. In fact, 41 percent of those surveyed said they don't do more to achieve a balanced diet because they don't understand the information, according to a 2008 ADA study. Take the "Dietary Guidelines for Americans," put out by the U.S. government, which suggests eating a host of nutrient-dense foods from the basic food groups. Says Marion Nestle, a nutrition professor at New York University, "You'd need a calculator, scale and reading glasses" to see the labels on food and shop accordingly.

Time to talk to an expert, right? But even nutritionists admit they don't always trust what's out there and are sometimes confused by it themselves.

Before agreeing to work with a nutritionist, ask about his approach to coming up with a healthy diet. And keep a food diary that details what you eat from day to day; this information will provide a starting point for introducing small, educated changes to your diet and saves a lot of time spent on trial and error, says Taub-Dix.

Over the past few years, soy protein has been heavily marketed by soy growers and distributors as a "miracle" food, prompting Americans to stock up on soy milk, soy energy bars, veggie burgers and other foods rich in soy.

But some experts have recently suggested that soy can potentially be harmful to the thyroid and the reproductive and immune systems. "People are under the impression that soy is really healthy, but excess soy has major health risks," warns Kaayla Daniel, nutritionist and author of The Whole Soy Story.

Studies have shown soy contains plant estrogens that may cause hormonal disturbances, particularly in middle-age women with thyroid problems; another recent study found soy significantly reduced men's sperm count. The Soyfoods Association of North America rejects the data, saying soy reduces cholesterol and colorectal cancer in postmenopausal women and has no significant impact on sperm count. And nutritionists? As a whole, says Daniel, they're increasingly aware of problems associated with soy, while some still recommend it to their clients. "There's certainly not a consensus," she says.

According to the United Nations Food and Agriculture Organization, Americans eat an average of 3,770 calories a day the highest in the world. But they're spending only $7 a day on food, which suggests the bulk of what they're consuming is fast food and processed foods, which tend to be inexpensive.

When it comes to cooking healthier meals with raw ingredients at home, says Nestle, people often don't have a clue. That's where services like grocery-store tours and cooking-preparation courses come in. "Nutritionists are doing whatever they can to help clients learn how to get back into the kitchen," says Mary Aram, a nutritionist in Chico, Calif.

It's also a cheaper way to eat in the long run. "We must go back to the basics and find nutrition at an affordable cost," says Adam Drewnowski, director of the Center for Public Health Nutrition at the University of Washington. That includes lean ground beef, cheeses and beans. To keep costs down and health benefits up, Tallmadge suggests buying produce that's in season, buying in bulk and looking for store brands.

Looking for a quick fix for your unhealthy diet? Seeing a nutritionist might be a recipe for disappointment. Any reputable nutritionist knows that a real effort is required on both sides of the relationship. "People in our health care system are used to walking into a doctor's office and leaving with a prescription to treat their symptoms," says Aram. But when working with a nutritionist, clients should know that they're going to have to work hard if they expect to see any lasting results.

Aram equates changing eating and lifestyle habits with the way you would approach a new hobby like fly-fishing, where going in, you'd expect to put in a lot of time and money. "People need to look at modest changes in their diet as something that requires some front-end investment," Aram says. They expect fast, tangible results; instead, they need to practice patience.

Success comes to those who "jump into their lifestyle changes with both feet," she says.

It's no secret that physical inactivity is a major flaw in many Americans' lifestyle. A recent survey by the Centers for Disease Control and Prevention showed that one-third of adults fail to meet the U.S. Health and Human Services Department's recommended 150 minutes of moderate activity per week.

"No amount of nutritional counseling can will away calories without the help of exercise," says Pamela Peeke, assistant professor of medicine at the University of Maryland at Baltimore.
But nutritionists have varying opinions on what's needed to keep you fit.

According to Peeke, most people must burn an average of 400 calories a day that's roughly 10,000 steps, or 4 miles. And finding every opportunity to increase the activity of daily living, like opting for the stairs instead of the escalator or volunteering to haul things down to the garage, provides benefits that add up, she says. But Forberg argues that even the best nutritional guidance won't be complete without adding a balance of cardio and weight-bearing exercises at least five days a week. Either way, if your nutritionist isn't working to get you in motion as well as eat right, you might want to reconsider. Even better: Combine working with a nutritionist and a certified personal trainer. "When I refer my clients to a personal trainer, we can work closely to evaluate and stay on top of each client's progress," Forberg says.

Fortunately, maintaining a healthy diet isn't about shunning every cr me br l e or chocolate truffle that meets your eye. There are some scrumptious treats that do, indeed, bring nutritional value to the table.

Consider this your rule of thumb: Don't let your sweets exceed 10 percent of your calories per day, says Tallmadge.

In terms of chocolate, look for bars that contain 70 percent or more cacao, says Aram. You'll find a selection at places like Whole Foods or Trader Joe's; they're often marked "true organic chocolate." Cacao beans' antioxidants and theobromine, flavonoid and catechin compounds have been proven to provide cognitive and mood enhancement. Desserts with low-fat cr me and fresh purple berries like blueberries, blackberries and acai are also healthy treats. The berries provide antioxidants, vitamins and brain benefits, and acai also has omega-3 fatty acids that boost cardiovascular health. Sweets in general amp up dopamine levels, thus increasing pleasure, according to Peeke. But that doesn't justify overindulgence. "Just remember that although there are therapeutic benefits, it's important to eat anything in moderation," Peeke says. "Don't let that ounce of chocolate turn into 8 ounces."