A new randomized clinical trial has demonstrated that a culturally tailored food is medicine program featuring traditional Navajo foods significantly reduces all-cause hospitalizations or emergency room visits among patients with heart failure. The study, funded by the American Heart Association and published in The Journal of the American Medical Association Internal Medicine, provides strong evidence that food is medicine interventions are most effective when they are both medically appropriate and culturally relevant.
The MUTTON-HF (Medically Utilized Tailored Traditional foods to Optimize Nutrition in Heart Failure) 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 post randomization, the intervention group experienced a 28% relative reduction in all-cause emergency room visits or hospitalizations (40.6% vs. 57.0%). Hospitalizations were reduced by more than half (12.3% vs. 26.0%), and heart failure-specific hospitalizations were nearly 70% lower (3.8% vs. 13.0%).
In addition to reducing acute care utilization, participants who received the tailored meals lost an average of 6.3 pounds more than the control group and experienced significant reductions in both systolic and diastolic blood pressure. Researchers also observed healthier eating patterns, including increased daily consumption of fruits and vegetables. Overall quality of life, measured using the Kansas City Cardiomyopathy Questionnaire, improved significantly in the intervention group, with benefits seen in physical functioning and social participation.
The MUTTON-HF program was developed through extensive community engagement, including listening sessions, focus groups, and surveys conducted with Navajo Nation community members. The program brought together Navajo dietitians, local farmers and ranchers, and Tocabe, a Native-owned kitchen, to create meals that honored traditional foods sourced through Native producers 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.
“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 and well designed with relevant stakeholders.”
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 that incorporate healthy food into health care to treat, manage, and prevent diet-related diseases. The study highlights the potential of such programs to address health disparities in underserved communities.
“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.”
