Traditional Navajo Medically Tailored Meals Improved Heart Failure Outcomes

Study funded by the American Heart Association's Health Care by Food initiative, which received funding from The Rockefeller Foundation, finds that medically tailored meals reduced hospitalizations, proving that Food is Medicine interventions deliver real results for patients

Research Highlights:

• Among 206 adults living with heart failure in the Navajo Nation, those who received eight weeks of medically tailored meals, incorporating traditional Navajo foods, were less likely to visit the emergency room or require hospitalization, than those on standard care with no meals provided.
• Researchers found that within 90 days, 40.6% of participants in the intervention group experienced a hospitalization or emergency room visit, compared with 57.0% of those receiving usual care - a 28% relative reduction in risk. Hospitalizations were cut by more than half and heart failure - specific hospitalizations were significantly lower.
• General 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 as compared to usual care.

DALLAS | July 27, 2026 - 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, a relentless force changing the future of health for everyone everywhere, that received anchor funding from The Rockefeller Foundation, which has worked to expand access to FIM programs through vital research and improved implementation, communications and policy analysis.

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, spanning northern New Mexico and Arizona. Participants were randomized to receive either usual care or eight weeks of medically tailored meals, incorporating traditional Navajo ingredients and recipes. Those who received the tailored meals were less likely to visit the emergency room or require hospitalization.

Within 90 days post randomization, all-cause emergency room visits or hospitalizations were relatively reduced by nearly 29% (40.6% v. 57.0%), which was driven mainly by reductions in hospitalizations which were reduced in the meal intervention group by more than half (12.3% v. 26.0%), and heart failure-specific hospitalizations were nearly 70% lower among patients who received the medically tailored meals (13.0% to 3.8%).

Compared to those in the control group, the intervention resulted in several important physical health benefits. Participants receiving the tailored meals lost an average of 6.3 pounds more and experienced significant reductions in both systolic and diastolic blood pressure. Researchers also observed healthier eating patterns, including increased daily consumption of fruits and vegetables.

The study was funded by the Heart Association's Health Care by Food^TM (HCXF) initiative, which has received anchor funding from The Rockefeller Foundation. This initiative is conducting scientific research, public policy analysis and stakeholder education to advance Food is Medicine interventions that incorporate healthy food into health care to treat, manage and prevent diet-related diseases.

"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, MD, PhD, 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 and Director of the Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania. "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."

Addressing nutrition through culture and community

The MUTTON-HF program was developed through extensive community engagement, including listening sessions, focus groups and surveys conducted with Navajo Nation community members. The program brought together Navajo dietitians, local farmers and ranchers, and Tocabe, a Native-owned kitchen, to create meals that honored traditional foods, sourced through Native producers, when possible, while meeting the American Heart Association's heart-healthy nutrition guidance.

To ensure participation across the geographically large reservation, the program established food distribution hubs, mini-hubs and home delivery options. Participants also received appliances when needed, including 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, MD, MPH, an assistant professor of Cardiovascular Medicine in the Perelman School of Medicine at the University of Pennsylvania, a staff cardiologist for the Indian Health Service, and the 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 study published today in The Journal of The American Medical Association Internal Medicine.

Beyond reducing hospitalizations and emergency room visits, participants who received culturally and medically tailored meals experienced meaningful improvements in quality of life. Researchers found that participants in the intervention group reported significantly better overall health status compared with those receiving usual care. Improvements were seen not only in overall quality of life, but also in physical functioning and social participation, suggesting that participants felt better physically and were better able to engage in everyday activities and relationships.

Study details, background and design:

• Researchers enrolled 206 adults with heart failure receiving care through two Indian Health Service sites in rural Navajo Nation. 53.4% of participants were food insecure at baseline.
• Participants were randomized to receive either: 8 weeks of culturally and medically tailored traditional Navajo meals (14 meals/week 100% of meals included Native-sourced ingredients), or usual care and dietary advice (no meals)
• Overall quality of life was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ), a widely used measure of heart failure symptoms and well-being.

The Health Care by Food initiative, which was launched in 2023 with foundational support from The Rockefeller Foundation, was created to address startling statistics like these. The initiative has funded 23 early-stage clinical research studies focused on identifying effective Food is Medicine interventions that improve health by incorporating healthy food into the care of people with or at risk for chronic disease. The initiative also supports public policies that help advance scientific research and educate health care professionals about the potential of Food is Medicine to improve public health.

Co-authors and disclosures are listed in the manuscript.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• American Heart Association Scientific Statement news release: 'Food is Medicine' shows potential for improving diet quality and food security (June 2025)

• Reclaiming Indigenous Foods to Improve Health, Lauren Eberly (July 2026)
• American Heart Association Scientific Statement: 2026 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association | Circulation (March 2026)
• American Heart Association Presidential Advisory: Food is Medicine (Sept. 2023)
• American Heart Association health information: Living with Heart Failure and Managing Advance HF

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public's health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

About The Rockefeller Foundation

Investing $30 billion over the last 113 years to promote the well-being of humanity, The Rockefeller Foundation is a pioneering philanthropy built on unlikely partnerships and innovative solutions that deliver measurable results for people in the United States and around the world. We leverage scientific breakthroughs, artificial intelligence, and new technologies to make big bets across energy, food, health, and finance. For more information, follow us on LinkedIn @the-rockefeller-foundation, X @RockefellerFdn, Instagram @rockefellerfdn, and YouTube @rockefellerfound, and sign up for our newsletter at www.rockefellerfoundation.org/subscribe.

Study funded by the American Heart Association's Health Care by Food initiative, which received funding from The Rockefeller Foundation, finds that medically tailored meals reduced hospitalizations, proving that Food is Medicine interventions deliver real results for patients

Research Highlights:

• Among 206 adults living with heart failure in the Navajo Nation, those who received eight weeks of medically tailored meals, incorporating traditional Navajo foods, were less likely to visit the emergency room or require hospitalization, than those on standard care with no meals provided.
• Researchers found that within 90 days, 40.6% of participants in the intervention group experienced a hospitalization or emergency room visit, compared with 57.0% of those receiving usual care - a 28% relative reduction in risk. Hospitalizations were cut by more than half and heart failure - specific hospitalizations were significantly lower.
• General 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 as compared to usual care.

DALLAS | July 27, 2026 - 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, a relentless force changing the future of health for everyone everywhere, that received anchor funding from The Rockefeller Foundation, which has worked to expand access to FIM programs through vital research and improved implementation, communications and policy analysis.

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, spanning northern New Mexico and Arizona. Participants were randomized to receive either usual care or eight weeks of medically tailored meals, incorporating traditional Navajo ingredients and recipes. Those who received the tailored meals were less likely to visit the emergency room or require hospitalization.

Within 90 days post randomization, all-cause emergency room visits or hospitalizations were relatively reduced by nearly 29% (40.6% v. 57.0%), which was driven mainly by reductions in hospitalizations which were reduced in the meal intervention group by more than half (12.3% v. 26.0%), and heart failure-specific hospitalizations were nearly 70% lower among patients who received the medically tailored meals (13.0% to 3.8%).

Compared to those in the control group, the intervention resulted in several important physical health benefits. Participants receiving the tailored meals lost an average of 6.3 pounds more and experienced significant reductions in both systolic and diastolic blood pressure. Researchers also observed healthier eating patterns, including increased daily consumption of fruits and vegetables.

The study was funded by the Heart Association's Health Care by Food^TM (HCXF) initiative, which has received anchor funding from The Rockefeller Foundation. This initiative is conducting scientific research, public policy analysis and stakeholder education to advance Food is Medicine interventions that incorporate healthy food into health care to treat, manage and prevent diet-related diseases.

"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, MD, PhD, 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 and Director of the Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania. "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."

Addressing nutrition through culture and community

The MUTTON-HF program was developed through extensive community engagement, including listening sessions, focus groups and surveys conducted with Navajo Nation community members. The program brought together Navajo dietitians, local farmers and ranchers, and Tocabe, a Native-owned kitchen, to create meals that honored traditional foods, sourced through Native producers, when possible, while meeting the American Heart Association's heart-healthy nutrition guidance.

To ensure participation across the geographically large reservation, the program established food distribution hubs, mini-hubs and home delivery options. Participants also received appliances when needed, including 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, MD, MPH, an assistant professor of Cardiovascular Medicine in the Perelman School of Medicine at the University of Pennsylvania, a staff cardiologist for the Indian Health Service, and the 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 study published today in The Journal of The American Medical Association Internal Medicine.

Beyond reducing hospitalizations and emergency room visits, participants who received culturally and medically tailored meals experienced meaningful improvements in quality of life. Researchers found that participants in the intervention group reported significantly better overall health status compared with those receiving usual care. Improvements were seen not only in overall quality of life, but also in physical functioning and social participation, suggesting that participants felt better physically and were better able to engage in everyday activities and relationships.

Study details, background and design:

• Researchers enrolled 206 adults with heart failure receiving care through two Indian Health Service sites in rural Navajo Nation. 53.4% of participants were food insecure at baseline.
• Participants were randomized to receive either: 8 weeks of culturally and medically tailored traditional Navajo meals (14 meals/week 100% of meals included Native-sourced ingredients), or usual care and dietary advice (no meals)
• Overall quality of life was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ), a widely used measure of heart failure symptoms and well-being.

The Health Care by Food initiative, which was launched in 2023 with foundational support from The Rockefeller Foundation, was created to address startling statistics like these. The initiative has funded 23 early-stage clinical research studies focused on identifying effective Food is Medicine interventions that improve health by incorporating healthy food into the care of people with or at risk for chronic disease. The initiative also supports public policies that help advance scientific research and educate health care professionals about the potential of Food is Medicine to improve public health.

Co-authors and disclosures are listed in the manuscript.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• American Heart Association Scientific Statement news release: 'Food is Medicine' shows potential for improving diet quality and food security (June 2025)

• Reclaiming Indigenous Foods to Improve Health, Lauren Eberly (July 2026)
• American Heart Association Scientific Statement: 2026 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association | Circulation (March 2026)
• American Heart Association Presidential Advisory: Food is Medicine (Sept. 2023)
• American Heart Association health information: Living with Heart Failure and Managing Advance HF

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public's health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

About The Rockefeller Foundation

Investing $30 billion over the last 113 years to promote the well-being of humanity, The Rockefeller Foundation is a pioneering philanthropy built on unlikely partnerships and innovative solutions that deliver measurable results for people in the United States and around the world. We leverage scientific breakthroughs, artificial intelligence, and new technologies to make big bets across energy, food, health, and finance. For more information, follow us on LinkedIn @the-rockefeller-foundation, X @RockefellerFdn, Instagram @rockefellerfdn, and YouTube @rockefellerfound, and sign up for our newsletter at www.rockefellerfoundation.org/subscribe.