A new study published in The Journal of the American Medical Association Internal Medicine found that a culturally tailored food-is-medicine program featuring traditional Navajo foods significantly reduced hospitalizations and emergency room visits among adults with heart failure in the Navajo Nation. The MUTTON-HF (Medically Utilized Tailored Traditional foods to Optimize Nutrition in Heart Failure) trial, funded by the American Heart Association's Health Care by Food initiative with anchor funding from The Rockefeller Foundation, included 206 adults receiving care at two Indian Health Service sites in rural Navajo Nation.
Participants were randomized to receive either eight weeks of medically tailored meals incorporating traditional Navajo ingredients and recipes or usual care with dietary advice but no meals. Within 90 days, 40.6% of those in the meal intervention group experienced an all-cause hospitalization or emergency room visit, compared to 57.0% in the usual care group—a 28% relative reduction in risk. Hospitalizations were cut by more than half (12.3% vs. 26.0%), and heart failure-specific hospitalizations dropped from 13.0% to 3.8%.
Beyond reduced hospitalizations, the intervention led to significant physical health improvements. Participants receiving the tailored meals lost an average of 6.3 pounds more than the control group and experienced significant reductions in systolic and diastolic blood pressure. The study also observed healthier eating patterns, including increased daily consumption of fruits and vegetables.
The MUTTON-HF program was developed through extensive community engagement, including listening sessions, focus groups, 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 the American Heart Association's heart-healthy nutrition guidance. To ensure participation across the geographically large reservation, the program established food distribution hubs, mini-hubs, and home delivery options, and provided appliances such as microwaves, freezers, and propane-powered refrigeration for households without reliable electricity.
Lead author Dr. Lauren Eberly, an assistant professor of Cardiovascular Medicine at the Perelman School of Medicine at the University of Pennsylvania and a staff cardiologist for the Indian Health Service, stated: “This study shows the power of leveraging the strengths and priorities of communities to advance health. By combining traditional Indigenous foods with evidence-based nutrition support, we were able to improve health outcomes while honoring culture, identity and community knowledge.”
Dr. Kevin Volpp, the American Heart Association’s Health Care by Food scientific lead, added: “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. This is a compelling proof point that food is medicine programs are most effective when they are not only medically appropriate, but also culturally relevant and well designed with relevant stakeholders.”
The findings underscore the potential of culturally tailored food-is-medicine interventions to address health disparities in underserved communities. The American Heart Association's Health Care by Food initiative continues to support research and policy analysis to advance such interventions. More information about the initiative can be found at heart.org.
