A groundbreaking study published in The Journal of the American Medical Association Internal Medicine demonstrates that a culturally tailored food is medicine program incorporating traditional Navajo foods can significantly improve outcomes for patients with heart failure. The MUTTON-HF (Medically Utilized Tailored Traditional foods to Optimize Nutrition in Heart Failure) trial, funded by the American Heart Association with anchor funding from The Rockefeller Foundation, enrolled 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 featuring traditional Navajo ingredients and recipes, or usual care with dietary advice but no meals. Within 90 days, those in the meal intervention group experienced a 28% relative reduction in all-cause emergency room visits or hospitalizations (40.6% vs. 57.0%). Hospitalizations were cut by more than half (12.3% vs. 26.0%), and heart failure-specific hospitalizations were nearly 70% lower (3.8% vs. 13.0%).
Beyond reducing acute care visits, participants receiving tailored meals lost an average of 6.3 pounds more than the control group and had significant reductions in systolic and diastolic blood pressure. They also reported better overall health status, physical functioning, and social participation, as measured by the Kansas City Cardiomyopathy Questionnaire.
“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. “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.”
The MUTTON-HF program was developed through extensive community engagement, including listening sessions and focus groups with Navajo Nation members. Navajo dietitians, local farmers and ranchers, and Tocabe, a Native-owned kitchen, collaborated to create meals that honored traditional foods sourced through Native producers while meeting American Heart Association heart-healthy nutrition guidance. To ensure access across the geographically large reservation, the program established food distribution hubs, mini-hubs, and home delivery, and provided appliances like microwaves and propane-powered refrigeration for households without reliable electricity.
“This study shows the power of leveraging the strengths and priorities of communities to advance health,” said lead author Lauren Eberly, M.D., MPH. “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 study was funded by the Heart Association’s Health Care by Food™ (HCXF) initiative, which has received anchor funding from The Rockefeller Foundation. This initiative is conducting scientific research, public policy analysis and stakeholder education to advance food is medicine interventions. More information is available at heart.org.
