Traditional Navajo meals slash heart failure hospitalizations in landmark trial

In a groundbreaking study published in The Journal of The American Medical Association Internal Medicine, researchers found that a culturally tailored food is medicine program incorporating traditional Navajo foods significantly reduced hospitalizations and emergency room visits among 206 adults with heart failure in the Navajo Nation. 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, showed a 28% relative reduction in all-cause hospitalizations or ER visits within 90 days. Specifically, 40.6% of participants receiving eight weeks of medically tailored meals experienced such events versus 57.0% in usual care. Hospitalizations were cut by more than half (12.3% vs. 26.0%), and heart failure–specific hospitalizations dropped nearly 70% (3.8% vs. 13.0%).

The program, developed through extensive community engagement with Navajo Nation members, Navajo dietitians, local farmers, and Tocabe (a Native-owned kitchen), provided 14 meals per week using Native-sourced ingredients that met American Heart Association heart-healthy guidelines. To overcome geographic barriers, the program established food distribution hubs and home delivery, even providing appliances like microwaves and propane-powered refrigeration for households without reliable electricity. Participants also lost an average of 6.3 pounds more than the control group and experienced significant reductions in systolic blood pressure, along with improved quality of life 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. Lead author Lauren Eberly, M.D., MPH, added, “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 underscore the potential of food is medicine programs when they are culturally relevant and co-designed with stakeholders, offering a replicable model for other Indigenous communities and beyond.