A new study published in The Journal of The American Medical Association Internal Medicine demonstrates that a culturally tailored food is medicine program significantly improves outcomes for American Indian adults with heart failure. 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 usual care or eight weeks of medically tailored meals incorporating traditional Navajo ingredients and recipes. Within 90 days, 40.6% of those in the intervention group experienced an emergency room visit or hospitalization, compared to 57.0% in the control group, representing 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 dropped from 13.0% to 3.8%.
Beyond reducing hospitalizations, 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. Researchers also observed healthier eating patterns, including increased daily consumption of fruits and vegetables. “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.
The 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 American Heart Association 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 like microwaves, freezers, 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 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.”
The findings have significant implications for addressing health disparities in Indigenous communities, where food insecurity and diet-related diseases are prevalent. At baseline, 53.4% of participants were food insecure. The study highlights the potential of food is medicine programs that are not only medically appropriate but also culturally relevant. The American Heart Association’s Health Care by Food initiative, launched in 2023 with foundational support from The Rockefeller Foundation, has funded 23 early-stage clinical studies focused on identifying effective food is medicine interventions. More information about the initiative can be found at heart.org.
Participants in the intervention group also reported significantly better overall health status, physical functioning, and social participation, suggesting meaningful improvements in quality of life. The study was published today in JAMA Internal Medicine.
