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RESEARCH PERSPECTIVE
Brighter Bites – Creating Communities Of Health Through Fresh Food
by shreela sharma, phd, rdn, ld
Since starting in Houston in 2012 and by partnering with local food banks, for-profit food distribution companies
such as Sysco and growers nationwide, Bright- er Bites has distributed more than 20 million pounds of fresh, donated produce as well as hands-on, evidence-based nutrition education to a cumulative 53,000-plus families across Texas (Houston, Austin, Dallas), New York City, Washington DC and Southwest Florida.
Brighter Bites is now a 501c3 non-profit organization with programming efforts spanning the six regions. What is particularly compelling about Brighter Bites is the ongoing partnership with academic institutions. For example, the UTHealth (University of Texas Health Center at Houston) School of Public Health has been a partner since inception of the program, leading operationalization of the framework of the program, and conducting research and evaluation.
A non-randomized controlled trial of Brighter Bites in Houston across 760 first-grade children and their parents in six intervention and six comparison schools conducted in 2013- 2015 demonstrated statistically significant increases in child and parent intake of fruits and vegetables, and decreased intake of added sugars among children. Moreover, there were significant improvements in the home nutrition environment, including a two-fold increase in frequency of cooking using basic ingredients, utilizing nutrition fact labels in making grocery purchasing decisions, and eating more meals together as a family with increased fruits and vegetables available at those meals.
Subsequently, we conducted a two-year, follow-up study in 2017 among those children and parents in the intervention schools to deter- mine the long-term maintenance effects of the program. Results show that even at two-year post-intervention follow-up, there is a sustained increase in vegetable intake among children and their parents, with a concurrent sustained decrease of added sugars, sugary beverages and eating out at restaurants. Given an average family size of five in our study sample, this corre- sponds to 19 additional servings of fruits and vegetables per week consumed by families
Results from the parent surveys across the three years demonstrate that more than 85 percent of parents reported using all or most of the fruits and vegetables provided, and more than 83 percent reported the fruits and vegetables to be effective in improving their child’s intake.
exposed to Brighter Bites. These results speak to the long-term impact of Brighter Bites on creating consumers of fruits and vegetables and demand for produce that currently doesn’t exist.
Brighter Bites also has institutionalized a robust, ongoing process and outcome eval- uation efforts using a real-time, cloud-based monitoring platform and visualization dash- board to track program implementation efforts. A case study assessing the reach of Brighter Bites across three school years in Houston (2012-2016), showed that, across the three years, on average, families consistently received 53.6 to 61.3 servings of 8 to 12 different types of fruits and vegetables each week. More than 90 percent of the produce distributed was donated produce that was procured from production and retail sources locally and nation- wide. Cost of the produce decreased with increasing number of families served, starting with $2.67 in the 2013–2014 school year to $2.29 in the 2015–2016 school year.
Results from the parent surveys across the three years demonstrate that more than 85 percent of parents reported using all or most of the fruits and vegetables provided, and more than 83 percent reported the fruits and vegetables to be effective in improving their child’s intake, thus demonstrating consistency and replication of findings. Qualitative data from parent focus groups support these find- ings. Parents reported Brighter Bites allowed them to become familiar with new types of produce and use healthier recipes without the fear of waste, and importantly, it afforded them an opportunity to introduce their chil- dren to new flavors and make eating fruits and vegetables normative. And, more recently, in
the 2017-2018 school year, 69 percent of the teachers (n=593) across all six cities reported that Brighter Bites has significantly increased parental engagement at their schools.
To meet the need that exists in every commu- nity nationwide, Brighter Bites continues to grow rapidly, with 24,000 families enrolled across 92 sites in the six regions in the current 2018-2019 school year. By combining nutrition education with food provision, Brighter Bites demystifies produce for the families so they can shop, cook and eat healthier.
The maximum capacity of the surplus produce in the United States is more than sufficient to meet the needs of the program and scale up. Also, the partnerships with local food banks, food distributors, food retailers and growers are in place for successful sourcing and distribution of the produce, as evidenced by the rapid replication of Brighter Bites across six regions in the United States.
The purpose of Brighter Bites is to expand, not limit or redistribute, availability of fruits and vegetables. Finally, it meets children and families where they already are (i.e., schools, preschools), going the last mile to put the produce into the hands of families that need it the most. By linking food growers, distributors, food banks, schools and families, and having strong partner- ships with academic institutions, Brighter Bites is feeding with impact and creating communities of health through fresh food.
Shreela Sharma is associate professor
of epidemiology, University of Tex- as Health Science Center at Houston (UTHealth) School of Public Health and co-founder, Brighter Bites. For more information, turn to page 112.
18 / MARCH 2019 / PRODUCE BUSINESS