David Holben: A Community Nutritionist's Perspective on Hunger

David Holben

Ohio is the 15th state in our Facing Hunger in America journey. At Ohio University in Athens, OH, we interviewed David H. Holben, PhD, RD, LD, and Professor of Food and Nutrition in the School of Applied Health Sciences and Wellness.

Dr. Holben teaches courses in dietetics, community nutrition, and research methods, and has co-authored (with Marie A. Boyle) the comprehensive textbook Community Nutrition in Action – an Entrepreneurial Approach. (5th edition, 2010, Belmont, CA: Wadsworth) We asked Dr. Holben to share with us how he thinks about hunger and the programs meant to alleviate it. Here’s a taste of what we learned.

Food insecurity is most often associated with poverty. In Canada, the term is “income-related food insecurity.” But Dr. Holben pointed out that not all people below the poverty line are food insecure. Some have developed self-sufficiency skills that keep them food secure -- at least until something happens, such as a job loss, illness, or an increase in the number of people they need to feed.

Food insecurity has very far-reaching physical and psychological health effects. Although not all the causal relationships are clear, food insecurity is highly correlated with factor such as

• Increased levels of overweight, obesity, and type 2 diabetes, especially in women
• Increased levels of depression and stress
• Increased birth defects
• Lower classroom performance and attendance in children
• More discipline problems, counselor visits, and suicide attempts among children
• Loss of family rituals such as holiday meals

The relationship between food insecurity and obesity may appear paradoxical, but Dr. Holben explained it like this. (See also Community Nutrition, page 331).

• Food insecure families may stretch their food budget and keep from feeling hungry by purchasing foods that cost less, are higher in calories, and are less nutritious. Sometimes such foods (for example, ramen noodles, sweetened cereals, and soda) are more readily available to people living in poverty than are more healthful options (for example, fresh fruits and vegetables).
• Food insecure families are likely to prefer foods that make them feel full, possibly sacrificing food quality for food quantity.
• Cycling between times of adequate food and times with inadequate food, may lead people to overeat and gain weight when food is available (such as right after SNAP benefits are received). When adequate food is not available, the person’s body may become more efficient and resist losing weight. This cycling may be more extreme for mothers, who may provide food for their children at the expense of food for themselves. Remember the scene in the movie, Erin Brockovich, when she lies to her children and tells them that she’s already eaten?

Damaging effects of food insecurity like these make it imperative for our country’s overall well-being that we effectively address the issue of hunger in America.

So what are the programs that Dr. Holben prefers?  When we asked him this question, he responded by comparing WIC (the USDA Food and Nutrition Service's Program for Women, Infants, and Children) with SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps). He prefers WIC because recipients qualify partly based on nutritional risk as determined by a healthcare professional, because only certain nutritious foods can be obtained with WIC support, and because WIC carefully measures outcomes such as iron levels and height and weight of the participants. By contrast, SNAP benefits are based mostly on financial need and can be used for all foods.

Dr. Holben said, “While I believe that people have the right to buy whatever food they want, I don’t agree that some of the foods allowed to be purchased with food stamps are appropriate. … If food stamps are meant to be a supplement to your food dollar, I think it would be OK to say you can’t buy foods such as pop with food stamps.”

One promising improvement to SNAP, called HIP (Health Incentive Pilot), is to be tested by the USDA in Hampden County, MA, beginning in December of 2011.  HIP will test whether SNAP recipients increase their purchase of fresh produce if they receive a rebate on their SNAP card for 30% of the cost. If this pilot produces positive results, Dr. Holben hopes it will become a national program.

In addition to federal entitlement programs such as WIC and SNAP, Dr. Holben sees an extremely important role for smaller, more local community nutrition efforts. He demonstrates his belief in producing some of his own food by gardening and keeping bees and chickens. He’s also personally involved in a huge set of community projects such as:

• Athens Community Food Initiatives
• Organic gardening courses for Live Healthy Appalachia
• ECOhio Garden—Everyone Can [in Ohio] Garden plants And Rake Dirt to Enhance Nutrition, a project to help individuals learn to garden, to improve their food access, and to enhance the nutrient density of their diets.
• With student Lori Gromen, a project to plant fruit trees at community gathering places in Athens. We checked out about a dozen of the trees shown on the tree map and found them looking healthy and ready for spring to come! For more information see these articles in The Post  and in Planet OHIO News.

Dr. Holben concluded our interview by saying, “I think America is very generous. It’s impressive how people do work tirelessly to feed people.”