Dietitian wants more fresh produce in federal nutrition programs

Access to fresh produce remains a challenge for many U.S. families, particularly those relying on federal nutrition programs.

Tiffany Bruno, a registered dietitian and director of education for Switch4Good, is working to change that. By advocating for updates to the USDA Dietary Guidelines for Americans, as well as reforms in the National School Lunch Program and the supplemental nutrition program for women, infants and children, known as WIC, Bruno hopes to make fresh fruits and vegetables more accessible to those who need them most.

In an interview with The Packer, Bruno shared insights about barriers to fresh produce access, the policy changes she’s championing and how these improvements could transform public health.

As director of education for the nonprofit Switch4Good, Bruno says she focuses on public policy work as well as working with health care providers such as other registered dietitians and pediatricians, predominately.

Bruno’s work as a dietitian has led her push for the USDA to improve the Dietary Guidelines for Americans.

“It frustrates me that a lot of people can’t see a dietitian to help them improve their diet," she said. "It would be great if everybody could, but they do not. So, instead, I feel as if by improving public policy — and increasing access to food as a result — it’s a way to indirectly improve public health.

“I have passion for this, which I bring to Switch4Good," she continued. "And while one person can’t do much, when you have an organization behind you and its supporters behind you, that really amplifies your voice."

Food deserts are a significant barrier to fresh produce accessibility, Bruno says, but there’s also the challenge of prohibitive cost and how some consumers may not realize the value of fresh produce.

One way to increase awareness is by improving the USDA Dietary Guidelines, Bruno says.

“The dietary guidelines inform every other nutrition policy in this country," she said. "If you look at something like WIC, Meals on Wheels, National School Lunch Program … they all follow the guidelines set by the dietary guidelines.

“For example, say Meals on Wheels wants to change something based on research showing that there’s some benefit for that population. If this change strays from the dietary guidelines, they essentially cannot make it," Bruno continued. "So, I feel like the only way to have a downstream effect is to start at the top with the dietary guidelines.”

One item the group is pushing for this year is to have the dairy category, which is currently its own category on MyPlate, pushed to be categorized as part of the protein group.

“When they’re pushing dairy three times a time, that just limits the variety you have during the rest of the day," Bruno said.

The USDA is currently working on its 2025-2030 guidelines, which are updated every five years. While Bruno said the guidelines are crucial for nutrition assistance programs, she doesn’t think they influence the choices of anyone else.

“I think the average person has no idea the guidelines exist," she said. "They don't care what the government has to say about their nutrition. They'd rather listen to an influencer, unfortunately. So, I think the person who is privileged enough to be making their own decisions, it does not affect.”

In WIC, for example, Bruno says participants were getting up to 128% of their dairy needs met, but that leaves less room to purchase items such as fruits and vegetables.
Still, Bruno says WIC has made a couple of positive changes.

“WIC updated their packaging — (WIC food packages provide supplemental foods designed to address specific nutritional needs) — which I think is the first time in 10 years. But they did. They also increased the cash value benefit within the WIC program for fruits and vegetables.”

One benefit of this increased cash value, Bruno says, is that WIC programs allot a certain amount exclusively for fruits and vegetables, so it allows people to purchase more produce than they might have if it was lumped together within the general fund.

“It allows participants more access to fruits and vegetables, as well as the opportunity to possibly try new items," Bruno said. "If, for example, at the end of the month they still have $10 left over, they can go try blueberries that are maybe out of season, but they look really good this week and are on sale. Or try a vegetable they’ve never had before — because they’re not going to get that money back. It really incentivizes people to maybe go to a second grocery store, because they have a better selection of produce. These are some of the reasons we advocated for more access to fresh produce so to see this increase is very good.”

In pursuit of promoting accessibility to fresh produce, Bruno says the consequences from the lack of accessibility are measurable.

“[Without accessibility to fresh produce], the health consequences include many diseases such as obesity and diabetes," she said. "We know that lifestyle habits such as smoking or not exercising contribute as well, but nutrition, in my opinion, is the biggest factor in that.

“When we see people who are not prioritizing fruits and vegetables — which in many cases people don’t unless it’s convenient for them to get — we’re seeing negative health impacts," Bruno continued. "We’re seeing increasing rates of Type 2 diabetes. We’re seeing increasing rates of obesity and metabolic syndrome. Everything is more difficult for your health when you're not prioritizing the nutrients and the fiber that comes along with fresh produce."

Bruno says she was called to her work as a dietician because she was "frustrated with there being so many lifestyle diseases that could be prevented when people understood nutrition just a little better. It could prevent, or at least reduce the severity of many of those, and it’s frustrating that people have that power to make their own nutrition decisions and don’t — because they don’t have the knowledge and understanding of how to make healthy choices.”