A groundbreaking clinical trial has demonstrated that a culturally tailored food-is-medicine program, featuring traditional Navajo foods, significantly reduces hospitalizations and emergency room visits among patients with heart failure in the Navajo Nation. The study, funded by the American Heart Association's Health Care by Food initiative, was published today in The Journal of the American Medical Association Internal Medicine.
Among 206 adults with heart failure receiving care at two Indian Health Service sites in rural Navajo Nation, those who received eight weeks of medically tailored meals were less likely to visit the emergency room or require hospitalization. Within 90 days, 40.6% of participants in the intervention group experienced a hospitalization or emergency room visit, compared with 57.0% of those receiving usual care—a 28% relative reduction in risk. All-cause hospitalizations were cut by more than half (12.3% vs. 26.0%), and heart failure-specific hospitalizations were significantly lower (3.8% vs. 13.0%).
Participants who received the tailored meals also lost an average of 6.3 pounds more than those in the control group and experienced significant reductions in systolic blood pressure. The MUTTON-HF (Medically Utilized Tailored Traditional foods to Optimize Nutrition in Heart Failure) program was developed through extensive community engagement, including listening sessions and surveys with Navajo Nation community members. It brought together Navajo dietitians, local farmers and ranchers, and Tocabe, a Native-owned kitchen, to create meals that honored traditional foods while meeting heart-healthy nutrition guidance.
“This trial provides strong evidence that a culturally grounded, medically tailored Indigenous food is medicine intervention can improve both health outcomes and social determinants of health,” said Kevin Volpp, M.D., Ph.D., American Heart Association’s Health Care by Food scientific lead. “Food is medicine programs are most effective when they are not only medically appropriate, but also culturally relevant and well designed with relevant stakeholders.”
To ensure participation across the geographically large reservation, the program established food distribution hubs, mini-hubs and home delivery options. Participants also received appliances when needed, including microwaves, freezers and propane-powered refrigeration for households without reliable electricity. The study was funded by the Heart Association’s Health Care by Food initiative, which has received anchor funding from The Rockefeller Foundation.
“This study shows the power of leveraging the strengths and priorities of communities to advance health,” said Lauren Eberly, M.D., MPH, lead author of the study. “By combining traditional Indigenous foods with evidence-based nutrition support, we were able to improve health outcomes while honoring culture, identity and community knowledge.”
Beyond reducing hospitalizations, participants who received the culturally tailored meals reported meaningful improvements in quality of life, including better physical functioning and social participation. The findings underscore the importance of integrating cultural relevance into food-is-medicine programs to address health disparities in underserved communities.
