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Conclusion

Main question:
How can a foreign dietician or nutritionist start off as an adequate professional in the Japanese healthcare system?

This report shows the enormous diversity and difference between the Japanese and Dutch culture yet what is described here is but the tip of the iceberg. There is so much more to be told and to be learned about Japan. It is a country more than 9000 kilometres away from Holland and is very different in a lot of aspects. To start off as an adequate professional this report shows the importance of adaptation. When a foreign dietician or nutritionist goes to Japan to work there that person needs to adapt to the Japanese culture in order to be successful. This is expected from you as an adequate professional.
This does not mean that a dietician going there needs to be 100% adapted to their culture before even going but learning some Japanese and showing intent to truly master it and to adapt to their cultural ways will be respected.

Japan is quite mountainous and more than 90% of the population lives in urban areas. With the highest life expectancy in the world and a decreasing amount of newborn babies Japan faces complex challenges in the future. The percentage of people dying in Japan due to lifestyle related  diseases is over 60 % so a dietician could still many good there.
The position of a dietician in Japan is changing and becoming better through involvement of the government. They created a new system to make the dietician more professional and so making them more of an authority to listen to. This means that there is still much possible for a dietician in Japan in chances and opportunities.

The dietary recalls and the questionnaires confirm what is described in this report but they also give some new insights such as their rule system which they maintain highly. This is perhaps interesting to investigate further for future additions to this overview. 

To become an adequate professional in Japan you need to have knowledge, knowledge about their culture, the food they eat, the habits they follow and the language they speak. This can be done in small steps but by mastering this knowledge you increase the chance you will become a successful professional in Japan. And if you keep in mind what is written in this report you have already taken a big step forward in becoming a successful dietician in Japan.