A culturally tailored food is medicine program featuring traditional Navajo foods significantly reduced all-cause hospitalizations or emergency room visits among patients with heart failure, according to findings from the first randomized clinical trial to evaluate an Indigenous food is medicine intervention for cardiovascular health. The study was funded by the American Heart Association, with anchor funding from The Rockefeller Foundation.
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. 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 a hospitalization or emergency room visit, compared with 57.0% in the control group—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 were significantly lower (3.8% vs. 13.0%).
Program participants lost an average of 6.3 pounds more than those in the control group and experienced significant reductions in systolic blood pressure. Researchers also observed healthier eating patterns, including increased daily consumption of fruits and vegetables. The study published in The Journal of the American Medical Association Internal Medicine.
“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. “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 MUTTON-HF 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 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 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 is part of the American Heart Association’s Health Care by Food initiative, launched with foundational support from The Rockefeller Foundation, which funds research and policy analysis to advance food is medicine interventions. The findings underscore the potential of culturally relevant dietary interventions to improve cardiovascular health and reduce health disparities in Indigenous communities.
