Traditional food program reduces heart failure hospital visits in Navajo Nation

Nutrition insecurity—limited access to healthy, affordable food—is a major driver of cardiovascular disease in many Indigenous communities. The MUTTON-HF program was designed in partnership with community members to address these challenges while reinforcing cultural identity and traditional food systems.

Researchers found that within 90 days, 40.6 percent of patients receiving the tailored meals experienced a hospitalization or emergency room visit, compared to 57.0 percent in the usual care group—a statistically significant reduction. Hospitalizations alone were cut by more than half (12.3 percent vs. 26.0 percent), and heart failure–specific hospitalizations were markedly lower (3.8 percent vs. 13.0 percent).

Meals were developed in partnership with Navajo dietitians, farmers, and Tocabe, a Native-run kitchen, ensuring alignment with American Heart Association dietary guidance while incorporating locally sourced, culturally meaningful ingredients. Participants received two meals daily for eight weeks, along with support such as food distribution hubs and, when needed, appliances like microwaves or propane-powered refrigeration.

“Food heals in many ways: through good nutrition, culture, identity, and connection,” said Sonya Shin, MD, an associate professor of Medicine at Mass General Brigham and senior author of the study. “This intervention demonstrates that culturally grounded approaches are not only respectful but also clinically effective.”

Making meaningful improvements in quality of life

Beyond reducing hospitalizations, the intervention group demonstrated meaningful improvements across several secondary outcomes. Participants reported a better quality of life, as measured by the Kansas City Cardiomyopathy Questionnaire, alongside decreased food insecurity and reduced financial strain. Clinically, they experienced significant reductions in both weight and blood pressure. Additionally, dietary habits improved, with participants increasing their intake of fruits and vegetables.

The findings underscore the potential of “Food is Medicine” interventions to address health inequities. “This is a powerful example of how health systems can partner with communities to co-create solutions that are both effective and sustainable,” Eberly said. “Programs like this can help reshape how we think about chronic disease management.”

The study was funded by the American Heart Association’s Health Care by Food Initiative and conducted in collaboration with Navajo Nation partners and Indian Health Service facilities.