HEALTHIER HABITS
Significant increase in amount of fruits and vegetables consumed.
DOES BRIGHTER BITES WORK?
Brighter Bites is a USDA SNAP-Ed and CDC approved evidence-based intervention. Brighter Bites is also designated by the National Cancer Institute as an Evidence-based Cancer Prevention and Control Program.
Researchers at the UTHealth School of Public Health conducted a two-year study evaluating the impact of Brighter Bites on 760 students and their families at nine schools in Houston during the 2013-15 school years. Results from this study have been published in a scientific peer-reviewed journal called Preventive Medicine.
Suffice it to say, science finally proves what we’ve suspected all along:
Brighter Bites works—and works well.
Study results show that, as compared to participants in the control group (not receiving Brighter Bites), children and parents who did receive Brighter Bites demonstrated:
LESS ADDED SUGAR
Significant decrease in amount of added sugars consumed among children.
MORE HOME COOKING
Twofold increase in cooking meals from scratch
HEALTHIER SNACKING
Significant increase in serving more fruits and vegetables as snacks.
MORE FAMILY MEALS
Significant increase in eating produce-heavy meals together at home
SMARTER DECISIONS
Twofold increase in using nutrition labels to guide grocery purchases
“Brighter Bites is a theory-driven, evidence-based health promotion program that mitigates fruit and vegetable waste and converts it into a public health opportunity by systematically sourcing and channeling primarily donated produce into underserved communities.”
“The overarching goal of Brighter Bites is to increase the demand for, and intake of, fruits and vegetables among low-income children and their families. To ensure this happens, our model provides comprehensive nutrition education for students and their parents and creates exciting opportunities for children to practice healthy eating behaviors in school and at home. Ongoing evaluation allows us to critically assess program efficacy, while pushing the scientific dialogue forward to understand how to healthfully feed our families.”
DR. SHREELA SHARMA, CO-FOUNDER
SUSTAINED CONSUMPTION
94% of participating parents reported their family ate all or most of the fruits provided, and 87% ate all or most of the vegetables.
HIGH PROGRAM FIDELITY
Participating families reported attending 7 of 8 available distributions on average in each of the fall and spring semesters.
LOW COST OF PRODUCE
On average each week, Brighter Bites families received 57 servings of fruits and vegetables, which cost the program $2.65 per family per week.
BRIGHTER BITES INTERVENTION LOGIC MODEL, HOUSTON, TEXAS 2013-2015
THE FRAMEWORK BEHIND THE FRUIT
How we built our three-part formula, developed our messaging and materials, and continue to evaluate program success.
FEATURED PROJECT
FOOD IS MEDICINE
A Prescription for a Healthier Future: Unlocking Health Through Fresh Produce
THE POWER OF PRODUCE RX: Our Produce Rx program bridges the gap between healthcare and nutrition. Doctors prescribe fresh fruits and vegetables to patients in need, promoting healthier diets and preventing chronic illnesses.
WHY BRIGHTER BITES?
• Proven Success: In our 11 current markets, we’ve delivered thousands of pounds of produce to patients, improving their well-being and reducing healthcare costs.
• Community-Centric: We work closely with local communities to ensure our programs meet their unique needs.
• Scalable Model: Our approach is ready for expansion, and with your support, we can reach even more families in need.
WHO BENEFITS?
• Patients: Receive fresh, nutritious food as part of their treatment plan, leading to better health outcomes.
• Insurance Payers: Reduced healthcare costs and improved patient well-being.
• Pediatric Practitioners: An effective tool for preventative care and healthier outcomes.
GET IN TOUCH:
Brighter Bites is seeking partners for its expansion outside of Houston. Join us in making healthcare more holistic and accessible. To learn more about how you can support this initiative, email us today:
ProduceRx@brighterbites.org
Together, we can turn fresh produce into medicine and transform lives!
CONTINUED RESEARCH
Translating research into practice, and practice into research.
Publications
Parthasarathy, Nivedhitha, Ranjit, Nalini, Chuang, Ru-Jye, Markham, Christine M., Pomeroy, Mike, Noyola, Jacqueline, Ernest, Deepali, Sharma, Shreela. Changes in Unhealthy Food Consumption Among Vulnerable Elementary-aged Children in the United States during the COVID-19 pandemic: A Serial Crosssectional Analysis. 2024 https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1468767/abstract
Haushalter, K, Burgermaster M, Hudson E, Landry M, Sharma S, Davis J. An Increase in Food Insecurity Correlated with an Increase in Plasma Triglycerides among Latinx Children, The Journal of Nutrition. 2023 https://jn.nutrition.org/article/S0022-3166(23)72813-7/fulltext#%20
Naylor Metoyer, B; Chuang, R-J; Lee, MinJae; Markham, Christine; Brown, Eric; Almohamad, Maha; Sharma, Shreela V. SNAP Participation Moderates Fruit and Vegetable Intake Among Minority Families With Low Income. Journal of Nutrition Education and Behavior. 2023 https://doi.org/10.1016/j.jneb.2023.08.005
Almohamad M*, Marshall A, Dave JM, Chuang RJ, Markham C, Sharma S. Dietary behaviours during COVID-19 among households at risk for food insecurity. Journal of Nutritional Science. 2023: 12:e54. https://doi.org/10.1017/jns.2023.36
Naylor Metoyer, B.; Chuang, R.-J.; Lee, M.; Markham, C.; Brown, E.L.; Almohamad, M.; Dave, J.M.; Sharma, S.V. Fruit and Vegetable Intake and Home Nutrition Environment among Low-Income Minority Households with Elementary-Aged Children. Nutrients 2023, 15, 1819. https://doi.org/10.3390/
Metoyer, B.N.; Chuang, R.-J.; Lee, M.; Markham, C.; Brown, E.; Almohamad, M.; Dave, J.M.; Sharma, S.V. Fruit and Vegetable Shopping Behavior and Intake among Low-Income Minority Households with Elementary-Aged Children. Children 2023, 10, 82. https://doi.org/10.3390/
Marshall, A.N.; Chuang, R.-J.; Chow, J.; Ranjit, N.; Dave, J.M.; Mathur, M.; Markham, C.; Sharma, S.V. Food Insecurity among Low-Income Households with Children Participating in a School-Based Fruit and Vegetable Co-Op. Children 2022, 9, 1250. https://doi.org/10.3390/children9081250
Parthasarathy N, Li F, Zhang F, Chuang RJ, Mathur M, Pomeroy M, Noyola J, Markham CM, Sharma SV. A cross-sectional study analyzing predictors of perceived stress among elementary school teachers during the COVID-19 pandemic. Accepted at Workplace health and safety.
Li F, Parthasarathy N, Zhang F, Chuang R, Mathur M, Pomeroy M, et al. Food Insecurity and Health-Related Concerns Among Elementary Schoolteachers During the COVID-19 Pandemic. Prev Chronic Dis 2022;19:210392. DOI: http://dx.doi.org/10.5888/
Haidar, A.; Markham, C.; Marshall, A.; Chuang, R.-J.; Spence, M.; Boone, J.; Pomeroy, M.; Dachman, R.; Davis, J.N.; Sharma, S.V. Innovative Partnerships to Address Food Insecurity during the COVID-19 Pandemic: The Brighter Bites Produce Voucher Program. Int. J. Environ. Res. Public Health 2021, 18, 9175.
Carstens CK*, Salazar JK, Sharma SV, Chan W, Darkoh C. Evaluation of the Kitchen Microbiome and Food Safety Behaviors of Predominantly Low-Income Families. Frontiers in Microbiology. 29, Sept, 2022.
Rushing M., Chuang RJ., Markham C., Sharma SV. (2021) Sociodemographic Factors Associated with Attendance to Brighter Bites, a School-Based Food Co-op Nutrition Intervention for Low-Income Families. J Health Dispur Res Pract. 14(3): 73-88.
Allison N. Marshall, Christine Markham, Nalini Ranjit, Gregory Bounds, Joanne Chow, Shreela V. Sharma Long-term impact of a school-based nutrition intervention on home nutrition environment and family fruit and vegetable intake: A two-year follow-up study. Preventive Medicine Reports 20 (2020) 101247
Sharma SV, Chuang R, Rushing M, Naylor B, Ranjit N, Pomeroy M, et al. Social Determinants of Health–Related Needs During COVID-19 Among Low-Income Households With Children. Prev Chronic Dis 2020;17:200322.
Sharma SV, Haidar A, Noyola J, Tien J, Rushing M, Naylor BM, et al. (2020) Using a rapid assessment methodology to identify and address immediate needs among low-income households with children during COVID-19. PLoS ONE 15(10):e0240009
Amier Haidar BS , Amelia Khoei BS , Saira Alex BS , Christina Blick BS , Elyse Lopez BS , Sydney Wendt BS , Ramesh Ghanta BS , Maha Almohamad PhD , Stefanie Cousins MPH , Jacqueline Noyola BS , Jacqueline Tien BS , Christine Markham PhD , Shreela V. Sharma PhD, RD, LD, Community-academic partnerships to promote health literacy and address social needs among low-income families during COVID-19, Journal of Nutrition Education and Behavior (2020)
Marshall, A., Bounds, G., Patlovich, K., Markham, C., Farhat, A., Cramer, N., Oceguera, A., Croom, T., Carrillo, J., & Sharma, S., Study Design and Protocol to Assess Fruit and Vegetable Waste at School Lunches. Behavioral Sciences. 2019, Volume 9, Issue 9, pp 101-116.
Sharma, S.V., Markham, C., Ranjit, N., Marshall, A., Bounds, G., Chow, J., & Hearne, K., Impact of a school-based nutrition intervention on fruit and vegetable waste at school lunches – Results from the Brighter Bites pilot plate waste study. Journal of Nutrition, Education, and Behavior. 2019, Volume 000, pp 1-9 .
Sharma, S.V., Upadhyaya, M., Bounds, G., & Markham, C., A public health opportunity found in food waste. Preventing Chronic Disease. November 2017, Volume 14:160596.
Alcazar, L., Raber, M., Lopez, K., Markham, C., & Sharma, S.V., Examining the impact of a school-based fruit and vegetable co-op in the Hispanic community through documentary photography. Appetite. 2017, Volume 116, pp 115-122.
Sharma, S. V., Chow, J., Pomeroy, M., Raber, Salako, D. O., & Markham, C. Lessons learned from the implementation of Brighter Bites: a food co-op to increase access to fruits and vegetables and nutrition education among low-income children and their families. Journal of School Health. April 2017, Volume 87, Number 4, pp 284-296.
Raber, M., Sharma, S. V., Pomeroy, M., Mody, A., Markham, C., & Lopez, K. K. Brighter Sights: Using Photovoice for a Process Evaluation of a Food Co-op Style Nutrition Intervention. Journal of Health Disparities Research. Fall 2016, Volume 9, Issue 3, pp 20-34.
Sharma, S. V., Markham, C., Chow, J., Ranjit, N., Pomeroy, M., & Raber, M. Evaluating a school-based fruit and vegetable co-op in low-income children: a quasi-experimental study. Preventive Medicine. 2016, Volume 91, pp 8–17.
Sharma, S. V., Markham, C., Helfman, L., Albus, K., Pomeroy, & M, Chuang, R.J. Feasibility and acceptability of Brighter Bites: A food co-op in schools to increase access, continuity and education of fruits and vegetables among low-income populations. Journal of Primary Prevention. 2015, Volume 36, Issue 4, pp 281-286.
PRESENTATIONS
Sharma, S., Pomeroy, M., Noyola, J. (December 2020) Supporting Families in Crisis: A rapid assessment methodology to address needs in low-income houses during COVID-19. Webinar presentation through Michael & Susan Dell Center for Healthy Living.
Sharma, S.V., Scott, L. (February 2020). Brighter Bites: Improving Community Health by Creating a New Generation of Produce Consumers. Oral presentation at the Association of SNAP Nutrition Education Administrators (ASNNA) Winter Conference in Arlington, VA.
Sharma, S.V. (February 2020). The Impact of Diet on Gut Health and Overall Wellness. Invited Speaker at UTHealth Spring Luncheon in Houston, TX.
Cousins, S., Sharma, S.V. (November 2017). Brighter Bites: Marketing as a catalyst for change. Oral presentation at the American Public Health Association 2017 Annual Meeting in Atlanta, GA.
Alcazar, L., Sharma, S.V. (November 2016). Brighter Bites Photovoice: Perspectives from Hispanic participating parents towards the Brighter Bites program. Oral presentation at the American Public Health Association 2016 Annual Meeting in Denver, CO.
Sharma, S., Markham, C., Chow, J., Ranjit, N., Pomeroy, M., & Raber, M. (November 2016). A comparative effectiveness study of Brighter Bites: A food co-op intervention to improve access to fresh F&V and nutrition education among low-income children and families. Oral presentation at the American Public Health Association 2016 Annual Meeting in Denver, CO.
Pomeroy, M. (November 2016). Brighter Bites: Implementing a Food Co-op Concept in Underserved Schools. Oral Presentation at the Southern Obesity Summit in Houston, TX.
Past, Present and Future of SNAP: Evaluating Effectiveness and Outcomes in SNAP-Ed: Hearings before the Committee on Agriculture, House of Representatives, 114th Cong. (June 2016) (Testimony of Shreela Sharma, PhD, RD, LD).
Sharma, S., Markham, C., Chow, J., Pomeroy, M., & Raber M. (October 2015). Efficacy of Brighter Bites: a School-Based Food Co-op Intervention. Poster presentation at The Obesity Society Annual Meeting, Los Angeles, CA.
Sharma, S., Markham, C. Helfman, L., Albus, K., Chuang, R.J., & Pomeroy, M. (May 2014). Feasibility and acceptability of Brighterbites, a program increasing access to fresh fruits and vegetables and nutrition education among low-income children and their families. Poster presented at the International Society for Behavioral Nutrition and Physical Activity Annual Meeting in San Diego, CA.
Albus, K., Sharma, S., Markham, C., Helfman, L., & Pomeroy, M. (May 2014). Process evaluation of Brighter Bites pilot study: A community-academic partnership promoting fruit and vegetable intake among low-income, minority populations. Oral presentation at the International Society for Behavioral Nutrition and Physical Activity Annual Meeting in San Diego, CA.
ONGOING RESEARCH PROJECTS
Brighter Bites dissemination and scalability study across all Brighter Bites cities.
Healthy Eating Active Living (HEAL) with pregnant women, mothers, and infants. Collaborators: part of THRIVE coordinated efforts spearheaded by UT Physicians.
The impact of food insecurity on food shopping behaviors and dietary intake behaviors among Brighter Bites participants.
The impact of food insecurity on Brighter Bites families’ program attendance and participation.
FOOD IS MEDICINE
ARTICLES:
- New clinic program adds colorful bites for brighter futures
- BRIGHTER BITES AND UT PHYSICIANS PRODUCE PRESCRIPTION PROGRAM SPOTLIGHT
- Food Is Medicine: A Primer on Health System Initiatives in Texas
- The Gus Schumacher Nutrition Incentive Program (GusNIP) awards $483,612 to School-Based Produce Prescription evaluation
- White House Challenge to End Hunger approves UTHealth Houston innovative commitments to Food Is Medicine
PAPERS:
- Design and protocol of a clinic-based comparative effectiveness randomized controlled trial to determine the feasibility and effectiveness of food prescription program strategies in at-risk pediatric populations (read here)
PRESENTATIONS:
- Mathur, M., Marshall, A., Prabhu, V., Yeragi, P., Markham, C., Chuang, RJ., Pomeroy, M., Gaminian, A., McKay, S., Hall, Megan., Preston, A., Stark, K., Kow, R., Sharma, S. (November 2023). Oral Presentation. Lessons learned from the field for a comparative effectiveness RCT assessing the impact of produce prescription on overweight and obese children and their families. American Public Health Association (APHA) 2023 Annual Meeting. Atlanta, GA.
- Marshall, A., Mathur, M., Prabhu, V., Yeragi, P., Markham, C., Chuang, RJ., Pomeroy, M., Gaminian, A., Hall, Megan., McKay, S., Preston, A., Stark, K., Kow, R., Sharma, S. (November 2023). Poster Presentation. Design and recruitment strategies of a comparative effectiveness randomized control trial to evaluate the impact of produce prescription program strategies among low-income overweight and obese children and their families. American Public Health Association (APHA) 2023 Annual Meeting. Atlanta, GA.
OUR SCIENCE ALLIANCE
The Fruit Loop
