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An Indigenous Food Is Medicine Intervention: The MUTTON-HF Randomized Clinical Trial
Lauren A Eberly1,2,3,4,5, Carmen George6, Sharon Sandman2
1Gallup Indian Medical Center, Indian Health Service, Gallup, New Mexico.
JAMA Internal Medicine
|July 27, 2026
Summary
Culturally tailored meals improved heart failure outcomes by reducing hospitalizations and emergency department visits in Indigenous patients. This Indigenous Food is Medicine program enhanced quality of life and food security.
Area of Science:
- Cardiovascular Health
- Nutrition Science
- Indigenous Health
Background:
- Nutrition insecurity significantly impacts cardiovascular health among Indigenous populations.
- Medically tailored meals incorporating traditional foods show promise for improving heart failure outcomes.
- The MUTTON-HF program was developed using community-based participatory methods to integrate traditional Navajo foods into a heart failure intervention.
Purpose of the Study:
- To evaluate the efficacy of a culturally and medically tailored meal program in reducing hospitalizations and emergency department visits for heart failure patients.
- To assess the impact of the intervention on quality of life, food security, and clinical measures.
Main Methods:
- A pragmatic, open-label randomized clinical trial involving 206 adult heart failure patients in the Navajo Nation.
- Participants were randomized to receive 8 weeks of a tailored meal program or usual dietary advice.
- Primary endpoint: proportion of patients with all-cause hospitalization or ED visit within 90 days; secondary outcomes included clinical and quality-of-life measures.
Main Results:
- The intervention group showed a significantly lower incidence of hospitalization or ED visits (40.6% vs. 57.0%, P=.02), primarily driven by reduced hospitalizations.
- Significant improvements were observed in Kansas City Cardiomyopathy Questionnaire scores and food security in the intervention arm.
- The intervention group also experienced significant decreases in financial strain, weight, and blood pressure.
Conclusions:
- An Indigenous Food is Medicine intervention effectively reduced hospitalizations and emergency department visits in heart failure patients.
- Community-based programs leveraging Indigenous assets are crucial for advancing Native health and well-being.
- The MUTTON-HF program demonstrates the potential of culturally tailored nutrition interventions for chronic disease management in Indigenous communities.
