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Food Supplementation in Patients Hospitalized for Heart Failure: A Randomized Clinical Trial
Ambarish Pandey1, Neil Keshvani1,2,3, Juan D Coellar1
1Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.
JAMA Cardiology
|April 8, 2026
Summary
Food supplementation with medically tailored meals or fresh produce was feasible and well-accepted in patients recently hospitalized for heart failure (HF). However, it did not improve the primary clinical outcome of HF readmissions or emergency department visits.
Area of Science:
- Cardiology
- Nutrition Science
- Public Health
Background:
- Low-quality diet is linked to adverse heart failure (HF) outcomes.
- Evidence on food-as-medicine interventions for HF patients is limited.
Purpose of the Study:
- To assess the feasibility and acceptability of providing medically tailored meals or fresh produce to patients recently hospitalized with HF.
- To explore the association of food supplementation versus usual care with clinical outcomes.
- To determine if conditioning food supplementation on healthcare engagement impacts outcomes.
Main Methods:
- An open-label, factorial randomized clinical trial involving 150 patients recently hospitalized with HF.
- Participants were randomized to receive medically tailored meals, fresh produce, or usual care for 90 days.
- A secondary randomization explored conditional versus unconditional food delivery based on healthcare engagement.
Main Results:
- Food supplementation delivery completion was high (93.6%) and adherence was good (4.7-5.5 days/week).
- Fresh produce was more acceptable than medically tailored meals (Net Promoter Score 8.6 vs 7.3).
- No significant difference was observed in the primary outcome (HF readmission or ED visit) between food supplementation and usual care (adjusted rate ratio 1.09; P=.83).
- The hierarchical composite outcome favored food supplementation (win ratio 1.21; P<.001).
- Conditional delivery did not impact HF event risk.
Conclusions:
- Ninety-day food supplementation is feasible and well-accepted in patients with recent HF.
- Food supplementation did not improve the primary clinical outcome of HF readmissions or ED visits.
- Conditioning food supplementation on healthcare engagement did not alter outcomes.
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