Navajo meal program reduces hospitalization rate by 52%

Key elements of the study

This study, “Medically Tailored Traditional Food to Optimize Nutrition in Heart Failure (MUTTON-HF),” took place in 2025 at 2 Indian Health Service sites in Navajo Nation.

The study participants had been hospitalized or visited the emergency department in the last year. They were split between 2 groups:

• One group received typical dietary advice
• The other group received a culturally and medically tailored meal program consisting of Navajo food and recipes for 8 weeks

The meals were medically tailored by a local Diné (Navajo) dietician using traditional food and recipes. Produce and meat for the meals were sourced from local Diné farmers and ranchers and the research team ensured that study participants had the household appliances they needed to store and prep the meals. Meals could be picked up at mini-hubs established on the reservation or  were delivered to their homes as needed.

This was the first randomized clinical trial of an Indigenous Food is Medicine intervention to improve cardiovascular health outcomes, to the researchers’ knowledge.

Food examples

The meals included ingredients such as blue corn meal, butternut squash, pumpkin, wheat berries, mutton, tepary beans, sumac berry, oatmeal, wild rice, and more.

The dietician made sure that the meals met the American Heart Association’s sodium-restricted Dietary Approaches to Stop Hypertension guidelines and the American Heart Association Heart-Check Food Certification Program nutrition requirements.

Key numbers

• 206 adults in rural Navajo Nation were included in the study
• There was a 29% reduction in hospitalizations or emergency department visits among patients in the intervention arm compared to usual care within 90 days
• The hospitalization rate was reduced by 52.7% relative to the control group
• Heart failure hospitalizations were about 71% lower with the intervention group

Key quote

“The patients’ stories have been so impactful—we have been so moved by hearing the ways in which these meals have  transformed their health and wellbeing, and have nourished patients not only physically, but emotionally and spiritually as well,” CHIBE affiliate Dr. Lauren Eberly said.

What else they learned

• The researchers found decreases in financial strain, weight, and blood pressure in the intervention arm
• Patients reported significant increases in their fruit and vegetable consumption
• Food insecurity significantly decreased in the intervention arm
• Patients also had less physical limitation from their heart failure and self-reported more exercise in the intervention arm

Bottom line

“These results provide valuable insights into the implementation and effectiveness of this Food is Medicine program in a rural tribal setting and support its expansion to other similar settings,” the researchers noted.

Read the paper in JAMA Internal Medicine.

Photos courtesy of research team