We’ve supported Brighter Bites since the start, because it has attempted to address something that most school based consumption programs have failed to address – a rigorous scientific process showing the effectiveness of their program.
Now the research isn’t over yet, it can’t be. After all what we really want to know is not if a program impacts a child during the program or even for a short time after the program. What we really want to do is be able to study 25 year old’s and ascertain if they were influenced in their youth by programs such as Brighter Bites. In other words does childhood intervention alter long term purchasing and eating habits.
This is the kind of work that takes decades but, of course, it will never happen if we don’t start – and Brighter Bites hasThis year begun with the kind of rigor that might well set the stage for great success in the years to come.
It is not much spoken about but, this year, there is an extra reason for the world too support nutrition programs focused not just on giving out food, but giving out the right kind of food and diet education.
The statistics are not all in but one just has to look at the photos published in the media of those who have died or been hospitalized with covid to see they fall into two groups: The elderly and the obese.
I’m not a doctor but my personal response to covid was to get fully vaccinated and, to focus on losing weight.
The unwillingness of government officials to emphasize the truth about covid, that personal responsibility about things such as physical fitness, is an important criteria if you want to make yourself safer in the face of covid is a serious problem.
The government can adopt many policies but, very often, decisions that individuals make about health and fitness can have an even greater impact.
By introducing poor children and their families to healthy fresh produce, brighter Bites gives a nudge toward the kind of diet changes that can make life better for these children and their families.
Hopefully, with a few more years of research, the program will have results so compelling that public health authorities will want to fund a national rollout.
We asked Pundit investigator and special projects editor, Mira Slott, to find out more:
Shreela Sharma, PhD, RD, LD
Brighter Bites
Co-Founder
Professor of Epidemiology
Department of Epidemiology, Human Genetics and Environmental Sciences
School of Public Health
University of Texas Health Science Center of Houston
Q: Hi Shreela, it’s great to reconnect for a pre-Show talk. Let’s touch on all the facets and impacts of this unique program, and how it aligns with produce industry executives and supply chain partnerships. Ultimately, Brighter Bites is designed to conquer the elusive challenge of long-term behavioral change in produce consumption.
Rich Dachman (Brighter Bites CEO, and former VP of Produce for Sysco), provided an in-depth look at the challenges the Brighter Bites team undertook during the pandemic, employing resourceful, multi-tiered strategies to ensure the program continued to thrive and extend its reach with the rising plight of families in need. [You can read the full piece here: While Brighter Bites Steps Up with Retail Voucher Program, And Participation In USDA’s Farmers-To-Families Food Box Project, Produce Industry Heroes Are Needed to Provide Product, Distribution And Funding]
Co-founder Lisa Helfman pulled you in at the genesis of Brighter Bites, necessitating a science-based, data-driven approach at its core and woven through the operation, to intricately track and measure the program’s effectiveness.[Editor’s note: Shreela and Lisa made the case for peer-reviewed research scrutiny to validate strategies in an exclusive presentation at the NY Produce Show in 2018: Non-Profit Brighter Bites Takes Scientific Approach to Increase Produce Consumption And Create Long Term Consumers]
A: All right, maybe we should start off with the ethos of Brighter Bites. The mission is to create communities of health through fresh food. And essentially the idea evolved from a place of where we live in a country where childhood obesity is on the rise and a lot of people are struggling with chronic conditions, while on the other side food waste continues to be a problem and food insecurity is also on the rise. So, with Brighter Bites, our thought was, how do we connect all these dots in a way that we can create a sustainable solution to address food insecurity, improve healthy eating habits and ultimately improve health among those who are most vulnerable.
The formula for Brighter Bites is simple. It’s produce distribution, plus nutrition education, plus what we call a fun food experience. Once a week in the schools the families come and pick up their beautiful bag of colorful fruits and vegetables. They get to try a tasty recipe and take educational materials in the form of tools and tips on how to use the produce they’re given. This happens on a continuous basis, 16 weeks during the school year, and eight weeks during the summer. There is this ongoing exposure to fruits and vegetables that they probably didn’t have before, and a substantial amount of fruits and vegetables.
They get 20 pounds on average, which is 50 servings of produce, 8 to 10 different kinds of fruits and vegetables each week, week after week.
Q: How important is this continuity in the Brighter Bites equation? Can you talk about the quandary of changing eating behaviors?
A: The theory is how can we flood their pantries with all this fresh produce so that it becomes part of the fabric of their lives? And how can we then concurrently teach them how to use it. Especially vegetables, there’s very much a thing called intimidation by produce.
Q: That’s a memorable phrase!
A: So, how can we demystify vegetables for them by really teaching them. How do you clean and store the produce you’re getting, how do you cut it and cook it in an easy and simple way and then make it tasty, because ultimately what’s going to really change people’s behavior is the taste. We want people to get excited about the food they’re eating. It has to be colorful, it has to be beautiful, it has to be tasty. And it has to enough, sufficient quantity so that everybody can have a taste. That’s sort of the theory or the ethos behind Brighter Bites.
Q: Could you talk more about who you’re targeting. You’re channeling this through schools and looking to reach those that are underserved, because that’s an important part, right?
A: Yes. The program specifically targets schools that serve primarily low-income communities and children and their families. More than 75 percent of the children in the schools are on the free or reduced lunch program. They’re predominantly lower income and we know that these are the same communities that struggle with high rates of food insecurity, and high rates of chronic disease that are diet related. So, that’s our target population.
Q: Could you address this seeming dichotomy, where there’s an obesity epidemic and widespread food insecurity. I remember you talking about this phenomenon in an earlier interview, where some of the poorest people are severely malnourished, yet also struggle with obesity…
A: I think the challenge of our times is that on one hand a substantial portion of the food that we grow dies in the landfill…But on the flipside, we now have 20 to 30 percent of our families who are food insecure. At Brighter Bites, 70 percent of our families are food insecure, which means that 7 out of 10 of our families do not have regular access to food, period. What that results in is what we call disordered eating patterns. Essentially, if you’re hungry, you’re going to eat food when you get it and when it’s available to you regardless of the quality of the food that you’re getting.
A lot of the food that is consumed is not fresh. It’s processed. It’s junk food, and over time, the same families then struggle with chronic diseases. When I say chronic conditions, I’m including obesity there because of bad disordered eating patterns that they’ve engaged in now for a prolonged period of time.
In fact, it is so interesting that we see, especially the children, they don’t look malnourished because they’re obese, but they have the same nutrient deficiency as a malnourished child because of the unhealthy eating patterns. Over time, as these children grow up, they struggle with chronic conditions at a very young age, such as obesity and diabetes and hypertension, which we all know have lifelong implications in terms of academic achievement, health, employment and productivity and everything. So, it actually makes economic sense for us as a country to pointedly address this. How can we set children on the right path early on? That’s what we’re trying to do at Brighter Bites.
Q: I wanted to circle back on the stats you referenced on food insecurity in the U.S. Those numbers sounded high…
A: Let me look it up. Yes, according to data from the USDA Economic Research Service, we were at about 11 percent pre-COVID, and now food insecurity has more than doubled. During the pandemic, Northwestern did a study and identified that food insecurity in the U.S. affected about 30 percent of the population.
Q: What role does the produce industry play within the Brighter Bites’ structure and in accomplishing its mission?
A: Yes, that’s very important. With Brighter Bites, essentially what we were attempting to do way back when is create an alternative supply chain framework, not reinvent the wheel but work with growers and distributors and the produce industry to help funnel a lot of the excess produce to communities that need it the most.
What we have done over the years through the program is partnered with Sysco foods, for example, and several growers, packers and distributors, Lippman Farms, D’Arrigo Brothers in New York, Hardee’s Foods… so many growers around the country that essentially donate produce and excess produce they may have to Brighter Bites, and the food distributors we have bring those pallets of produce to our distribution partners. [See a list of Brighter Bites partners here]
So, we don’t have a single warehouse, not a single truck. We partner with local food banks. We partner with local growers and distributors to then do the produce inventory for us, and then deliver it to the schools. So, each school one day a week will have the trucks drop off these huge pallets of produce. Then it’s implemented like a food co-op in the school. Parents can come in and participate with children in the bagging and distribution of the produce. Everybody in the school can participate in the program, including teachers and staff.
Q: How is the buy in? Do a lot of people participate, and is that a factor in its success?
A: Yes. That’s important because again, we want to create communities of health. Everybody must feel like they can be a part of it, and we want the language of health and nutrition and fresh food to be part of their ecosystem. We train the teachers in implementing nutrition education in the schools so everything that the kids are talking about at home, they’re also learning about in school. What a novel idea that we surround the children with the same language in both the school and the home, which are the two primary environments that children reside in, right?
And then finally going the last mile in terms of bringing the produce into the hands of the families that need it the most. We’ve partnered with Avocadoes from Mexico, for instance, and with grocery retail companies like HEB. What this has allowed is for our families to have a broader knowledge of the produce offerings in their ecosystem so that they’re thinking about fresh produce all the time. That’s important to behavior change. And that’s the power of the produce industry, but I’ve never seen the produce industry truly embrace it.
Q: Please elaborate…
A: I grew up in India and moved to the U.S. when I was 21 years old. I remember going to a grocery store for the first time and thought I died and went to heaven. What stuck with me were these aisles and aisles of cereals and processed foods with all sorts of claims, no sugar, low fat, low cholesterol, or a green colored potato chip with vegetable flavoring promoted as healthy, but the produce industry is the pedestal of health. No other industry has a claim like that. I think that’s the power of the produce industry to own the conversation of health.
We have more science that has come out in the last five years that has demonstrated unequivocally, not only that fruits and vegetables improve health outcomes and reduce causes of mortality, the risk of dying, they increase your life expectancy.
Especially with COVID, we know your immunity and nutrition are closely linked. At the same time nobody wants to eat the sad salad just because it’s healthy. That’s where flavor and taste and our nutrition education is focused.
When you’re on a limited budget, you’re not going to spend that precious dollar on buying something that you don’t know how to cook, or you think your family’s not going to like. That is the demystification we have to work on with our families. Brighter Bites gives them a free trial with 20 pounds of produce each week, and the tools to experiment in a way that’s fun and flavorful. That’s the secret sauce. You’ve got to create the excitement, the community engagement. That’s when everybody wants to be a part of it. I could share many anecdotes from parents of transformational changes in their kids eating habits because of Brighter Bites.
Q: That’s a good segue, since anecdotes can be helpful, but not statistically meaningful. Let’s talk about the data side, a cornerstone of the program. What have you learned through your purposeful and extensive research? How do the goals of Brighter Bites match up to the reality on the ground…?
A: Yes, anecdotes feel good. For me as an epidemiologist, Lisa approached me with this idea. I was troubled by the obesity epidemic, that no matter what we are throwing at it, there’s just nothing that seems to work. With Brighter Bites, combining that access plus education, has been what I have seen as the catalyst and the game changer in these communities. From an evidentiary perspective, it is critical for us to be data driven and data informed. I love data but that’s not the reason why we collect it. It’s because how else do you know that you are implementing the program as planned and that you’re actually having an impact. And one without the other isn’t enough, if you’re not implementing the program as planned, even if you see an impact, that’s not because of your program.
Q: There are many different variables to consider, right?
A: Exactly. That’s what non-profit academic partnerships, like the one between our team at University of Texas and Brighter Bites accomplish. We can leverage expertise to bring that scientific approach to Brighter Bites. It’s the same philosophy with our produce partners, leveraging expertise.
We’ve established this data backbone that’s entrenched within everything Brighter Bites does. There are key performance indicators that go all the way, top to bottom, across the team. And that allows real-time feedback. We have so much technology now to work with, it’s mind blowing. Why not use it.
We’ve created these real time feedback loops so by the time the program coordinator is done with their distribution, they know who came, who didn’t come, exactly what product went out to the families today, a five-pound bag of oranges, a pound of broccoli…They know how their program performed. That feedback loop is critical for troubleshooting, for addressing any issues and keeping that program fidelity. If you think about food as medicine, well, do you take your medicine half dose one day and three times the dose the next? No, it’s not going to work. You must be consistent in your medicine and we think about food as medicine.
So, we want to be consistent in our dosage and that’s what our fidelity metrics are set along and with that level of rigor, as we track what our staff is doing across all the cities. We’ve taken deep dives in our research.
We’ve followed our families before and after the program and compared those results to families that don’t participate. We found of course they’re eating more fruits and vegetables while they’re in the program, but then we followed them for two years afterwards to track their maintenance.
Q: How did that turn out? Can Brighter Bites be a bridge to supermarket produce departments for these families to purchase more fresh fruits and vegetables. And if so, is this confined to the time period during their participation in the free produce program, or are the impacts long term, leading to significant behavior change in produce consumption… Does your research validate this phenomenon?
A: Yes. You ask the right question, and that is why the data side of the Brighter Bites formula is paramount. We found that the families were consuming 19 additional servings of fruits and vegetables each week as compared to when they started the program.
Q: How does that compare with the quantity of produce servings they were eating during the program?
A: If you think about it like a slope across the three timepoints from before, during, and two years after, it was a slope going upwards across all three timepoints. It was honestly surprising to me.
They were in fact eating more servings two years later. Both the children and their parents. Once you create the demand for a product and you know you might be on a limited budget, but you’re going to spend it on what your family likes and wants to eat.
Q: So, in addition to helping the underserved and tackling health issues, you’re broadening the produce industry’s customer base, and building more demand for produce purchases…
A: Yes. That’s important for the produce industry from an economic/business side. While our research study focused on a smaller sample size of about 700 families, if you take that 19 additional servings per week and you translate that to the total number of Brighter Bites families, it becomes a significant amount of retail dollars since they will be buying that produce at the grocery store, it’s certainly not coming from Brighter Bites. Rich Dachman provided retail estimates of around $5.3 million in additional retail sales when we were serving 22,000 families per week.
Q: How many total families are you reaching now?
A: This school year, which started around September, we enrolled 27,000 plus families and on average, the family size was about five.
Q: You’re building a new market…
A: That’s right. Our baseline when we tracked the children, they were consuming less than one serving of fruit and vegetable per day. So, we’re talking about a huge area of growth potential. That’s my call to action for the produce industry. You can change the course of their life, increase their quality of life and life expectancy, quite literally. What other food can do that?
Q: Can we delve more into your peer-reviewed scientific research, and how you arrived at these impacts…I know we don’t have time to discuss the body of work in detail here, but it will be great to give New York Show attendees a preview that can spur further discussion at the Show.
A: Yes, of course, and I can provide the full studies for those that are interested… The way I talk about the data side of things, there’s the individual behavior change, and then how does Brighter Bites impact schools and the families as a whole…
From the produce industry perspective, we did an interesting plate waste study, where we measured impacts. Plate waste is a serious problem; the amount of fruits and vegetables wasted on a child’s plate at school lunch is huge, you’re talking about 80 percent wastage. That’s money in the trash, literally. What we did for the plate waste study, we followed the families participating in Brighter Bites, and those that weren’t. We objectively measured how much produce these kids were wasting at their school lunch at four time points through the school year for each child.
Then we tracked in detail what produce that child was getting each week at Brighter Bites…OK, they’re getting broccoli eight times through the school year, how does that correlate with the broccoli they’re choosing and eating at the school lunch. Is there reduced waste for that broccoli. Does exposure matter? We believe exposure matters, but does it really?
Q: That’s why it’s important to do the science-based research…
A: The study revealed that frequency of exposure in fact did matter, with a positive correlation between the produce items received and the amount that the child ate at the school lunch for those specific produce items. In addition to exposure, the other question we were trying to get at, does variety matter? And for kids, it really does. We found a positive correlation of when a child received a specific produce item and the same one at school, where they would match what they got in the bag to what they picked at lunch and then how much they ate of that food. And then we looked at the exposure, the frequency of exposure, how did that correlate with the frequency of the amount consumed.
We didn’t know what we were going to find, to be honest with you. But we were pleasantly surprised to see these results, especially for vegetables, because fruits are an easier sell, especially for kids. It’s the vegetables that are a harder sell, and we really wanted to be intentional.
Q: Intentional is an intriguing point. This goes beyond just handing the kids free familiar produce items. Doesn’t the interplay between the education and fun components, as well as the family/community strategies of the Brighter Bites formula feed into these results?
A: We put in a lot of thought into our APP. I’d love to hear from the produce industry, what you think about it. We have tried to be very family friendly in accessing the information. I think that’s been the core of connecting with our families and giving them these tools in a way they want. As a dietician I can tell you that unfortunately many of us will end up focusing on the nutrients, Vitamin A, Vitamin B… However, that’s not how you eat. And nobody wants to eat a salad just because it’s healthy. So how do you make it culturally relevant? How do you make it tasty? How do you make it fun and engage the kids? How do you pack a fun lunch that’s also healthy so you’re not eating orange Cheetos every day?
Q: As you evolve the program, where is Brighter Bites headed in the future? And how can the produce industry help going forward?
A: What we’ve learned over the last nine years, is to be very, very thoughtful. The team is just incredible and passionate. Now where we sit, we have a model that we can scale, and we can ramp up rapidly with the right partnerships in place. We have a lot of those, and that’s the role the produce industry can play. We know there’s a need and we can do what we promised on a wide scale.
Q: That’s saying something, coming from you, with your expertise and science-oriented mentality…
A: Ask my friend Rich Dachman, I’m probably the most cautious and conservative when it comes to thinking about scale. We’ll be in nine cities by the end of the school year. This is a program that goes deep, serving 27,000 families each week in an impactful way. We have learned a lot and we have an equity-based approach with our schools that reaches a very broad population base, whether you’re talking socioeconomic, whether you’re talking racial, ethnic, various types of urban and rural. We have a model that we have tried and tested across all of this…
We’ve been doing one, two cities a year, which is fine, but the need is large, and we have a winning model that we can scale. That’s what I would like to see happen so we can serve families and reach them because so many kids are not going to have a second chance.
Q: Does this scale extend to retail? Will you continue your innovative retail voucher program that you instituted during the pandemic, when schools were shut down? Brighter Bites was resourceful in adapting quickly to find alternative distribution avenues, and create partnerships with retailers, where Brighter Bites families received vouchers for the equivalent amount of produce, they could use at participating retailers.
A: The voucher program is going to continue because one thing we realized in the pandemic is the need for an equity-based approach. How can we reach a broad group of people because some may not be able to come every week to the schools, and also the summer changes people’s schedules? The voucher program is another way to reach the families that need the produce. So, we will most certainly be continuing that. That’s a great partnership with the produce industry, where there could be a wraparound approach where Brighter Bites could start with the families in the schools and then once the Brighter Bites season ends, then the families could continue by getting vouchers from the retailers. So, it could be a win-win situation.
Q: You’ve given produce industry executives and NY Produce Show attendees a wealth of information and inspiration. It will be nice for people to have the opportunity to meet up with you at the Brighter Bites booth and throughout the Show.
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