A new study published in The Journal of The American Medical Association Internal Medicine reveals that a culturally tailored food is medicine program 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, is the first randomized clinical trial to evaluate an Indigenous food is medicine intervention for cardiovascular health.
The study included 206 adults receiving care at two Indian Health Service sites in rural Navajo Nation, spanning northern New Mexico and Arizona. Participants were randomized to receive either usual care or eight weeks of medically tailored meals incorporating traditional Navajo ingredients and recipes. Within 90 days, 40.6% of the intervention group experienced an all-cause emergency room visit or hospitalization, compared to 57.0% in the control group—a 28% relative reduction. All-cause hospitalizations were cut by more than half (12.3% vs. 26.0%), and heart failure-specific hospitalizations dropped nearly 70% (3.8% vs. 13.0%).
Beyond reducing acute care utilization, participants receiving the tailored meals lost an average of 6.3 pounds more and experienced significant reductions in systolic and diastolic blood pressure. They also reported improved quality of life, including better physical functioning and social participation. The program addressed food insecurity, which affected 53.4% of participants at baseline, by establishing food distribution hubs, mini-hubs, and home delivery across the geographically large reservation. Participants also received appliances such as microwaves, freezers, and propane-powered refrigeration where needed.
The meals were developed through extensive community engagement, including listening sessions, focus groups, and surveys. Navajo dietitians, local farmers and ranchers, and Tocabe, a Native-owned kitchen, collaborated to create meals that honored traditional foods, sourced through Native producers when possible, while meeting the American Heart Association’s heart-healthy nutrition guidance. “This study shows the power of leveraging the strengths and priorities of communities to advance health,” said Dr. Lauren Eberly, lead author and 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. “By combining traditional Indigenous foods with evidence-based nutrition support, we were able to improve health outcomes while honoring culture, identity and community knowledge.”
The findings underscore the importance of culturally relevant interventions in addressing diet-related diseases. Dr. Kevin Volpp, the American Heart Association’s Health Care by Food scientific lead, noted, “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 Health Care by Food initiative, launched in 2023 with foundational support from The Rockefeller Foundation, has funded 23 early-stage clinical research studies focused on food is medicine interventions.
The results have significant implications for health care policy and practice, particularly for Indigenous communities facing high rates of heart failure and food insecurity. By integrating traditional foods with medical nutrition therapy, this model offers a scalable approach to improving cardiovascular outcomes while respecting cultural identity. The study adds to growing evidence that food is medicine interventions can reduce health disparities and health care costs, as highlighted in the American Heart Association’s scientific statement on dietary guidance and its presidential advisory on food is medicine.
