A new study published in The Journal of The American Medical Association Internal Medicine reveals that a culturally tailored food-is-medicine intervention significantly improved heart failure outcomes among Navajo Nation residents. 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, found that participants who received eight weeks of medically tailored meals incorporating traditional Navajo foods were nearly 29% less likely to visit the emergency room or be hospitalized within 90 days compared to those receiving usual care.
The study enrolled 206 adults with heart failure 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 14 meals per week of culturally and medically tailored traditional Navajo meals, 100% of which included Native-sourced ingredients. Within 90 days post randomization, 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 in risk. Notably, all-cause 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 utilization, participants in the intervention group experienced significant physical health improvements. They lost an average of 6.3 pounds more than the control group and showed 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 and the Mark V. Pauly Professor at the Perelman School of Medicine and the Wharton School. “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 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 address geographic barriers across the 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 and assistant professor of Cardiovascular Medicine at the Perelman School of Medicine at the University of Pennsylvania. “By combining traditional Indigenous foods with evidence-based nutrition support, we were able to improve health outcomes while honoring culture, identity and community knowledge.”
Participants also reported meaningful improvements in quality of life, as measured by the Kansas City Cardiomyopathy Questionnaire. Improvements were seen in overall health status, physical functioning, and social participation, suggesting that participants felt better physically and were better able to engage in everyday activities.
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 identifying effective food is medicine interventions. The initiative also supports public policies to advance scientific research and educate health care professionals about the potential of food is medicine to improve public health.
For business and technology leaders, this study underscores the growing evidence that food is medicine programs can yield significant reductions in costly hospitalizations and emergency visits, particularly when designed with cultural relevance. As health systems seek value-based care models, integrating such interventions could lower costs and improve outcomes for underserved populations, with potential applicability beyond Indigenous communities. The use of community engagement and local sourcing also highlights opportunities for technology platforms to streamline meal distribution and nutrition tracking in remote areas.
