Traditional Foods as Medicine: Research Revolutionizes Heart Failure Care in the Navajo Nation

In the vast, high-desert landscape of the Navajo Nation, a groundbreaking clinical trial is proving that the path to better cardiovascular health might not just be found in a pharmacy bottle, but also in the traditional kitchens of the Diné people. The results of the MUTTON-HF (Medically Utilized Tailored Traditional food to Optimize Nutrition in Heart Failure) trial, presented at the American College of Cardiology 2026 Scientific Sessions, offer a compelling look at how Food is Medicine interventions can drastically reduce hospitalizations for high-risk patients.¹

A Radical Approach to a Structural Problem

For decades, Indigenous populations have faced significant cardiovascular health disparities, often driven by nutrition insecurity—a legacy of settler colonialism that disrupted traditional food systems. The MUTTON-HF study, funded by the American Heart Association’s Health Care by Food initiative, sought to address this by reintroducing medically tailored, culturally relevant meals to patients struggling with heart failure (HF).^1-3

The trial was a pragmatic, randomized controlled study conducted at 2 Indian Health Service sites in rural Navajo Nation. It enrolled 206 patients, nearly all of whom were American Indian, with a mean age of 66. Participants were high-risk individuals who had been hospitalized or visited the emergency department for heart failure within the previous year.¹

The Intervention: Blue Corn Mush and Mutton Stew

The heart of the study was the culturally and medically tailored meal. Unlike standard healthy meal programs that might feel foreign to Indigenous patients, MUTTON-HF partnered with local Diné farmers and ranchers to source traditional ingredients. The meals were designed with Diné dietitians and produced by Tocabe, a Native-run meal company.¹

The sample menu reflects a deep respect for heritage: blue corn mush with blueberries, mutton rainbow stew, Three Sisters Chowder, and shredded bison wheatberry bowls. While culturally grounded, these meals were strictly engineered to meet the American Heart Association’s sodium-restricted Dietary Approaches to Stop Hypertension (DASH) guidelines. To overcome the logistical hurdles of the rural reservation, meals were delivered to central hubs or directly to homes by community health representatives, with the study even providing propane-powered appliances to those without electricity.¹

Clinical Success: Reducing the Burden on Hospitals

The data reveal a striking success. Patients receiving the tailored meals saw a significant reduction in the primary end point of all-cause hospitalization or emergency department visits within 90 days. Specifically, only 40.6% of the intervention group required such care, compared to 57.0% in the usual care group.¹

The secondary outcomes were equally impressive. Heart failure-specific hospitalizations plummeted from 13.0% in the control group to just 3.8% in the intervention group. Patients also reported better quality of life, with significant improvements in physical and social limitation scores on the Kansas City Cardiomyopathy Questionnaire. Furthermore, the intervention group lost an average of 3.5 lbs, whereas the control group actually gained weight, and systolic blood pressure dropped by an average of 6.7 mmHg more than the control group.¹

Why This Matters for Pharmacists

For pharmacists, particularly those practicing in rural or Indigenous communities, the MUTTON-HF data provide a new blueprint for holistic patient management. At the start of the study, over 55% of participants were food insecure and 64.2% had diabetes.¹ Pharmacists are often the most accessible health care providers; recognizing that nutrition insecurity is a clinical driver allows them to better counsel patients on why "eating right" is as critical as their pharmacotherapy.

The study found that creatinine levels decreased significantly in the intervention group (-0.15, p=0.03).¹ Improved renal function through better nutrition can directly impact how pharmacists manage drug dosing for medications cleared by the kidneys, such as sodium-glucose cotransporter 2 inhibitors or certain diuretics.

The study also noted a reduction in financial strain for those receiving meals.¹ When a patient’s food needs are met, they may have more resources to afford their medication copays, leading to better overall adherence. Finally, by seeing the success of a sodium-restricted DASH diet in action, pharmacists can more confidently advocate for food is medicine programs as a formal part of the therapeutic regimen, rather than mere lifestyle advice.

A Path Forward

The authors of the study conclude that leveraging the "protective assets" of Native communities—their food, their land, and their recipes—is central to advancing Indigenous health. While the study was short in duration and focused on a single health system, it proves that when medicine meets culture, the results are lifesaving. As the health care system moves toward value-based care, the MUTTON-HF trial stands as a powerful reminder that sometimes the best prescription is a traditional home-cooked meal.

REFERENCES

1. Eberly L. MUTTON-HF (Medically Utilized Tailored Traditional Foods To Optimize Nutrition In Heart Failure): a randomized controlled trial of an indigenous food is medicine intervention. Presented at: American College of Cardiology 2026 Scientific Sessions; New Orleans, LA.

2. Eberly LA, Sandman S, George C, et al. MUTTON-HF (Medically Utilized Tailored Traditional Foods To Optimize Nutrition In Heart Failure): a randomized controlled trial of an indigenous food is medicine intervention. Presented at: American College of Cardiology 2026 Scientific Sessions; New Orleans, LA.

3. Eberly LA, George C, Sandman S, et al. Feasibility of an indigenous food is medicine program for patients with heart failure in rural Navajo Nation: the MUTTON-HF nonrandomized clinical trial. JAMA Netw Open. 2026;9(2):e2556117. doi:10.1001/jamanetworkopen.2025.56117