A pragmatic, open-label RCT (MUTTON-HF) tested an 8-week culturally and medically tailored meal program using traditional Navajo foods vs. usual dietary advice in 206 adults with heart failure at 2 Indian Health Service sites in rural Navajo Nation (May–November 2025), with 12-week follow-up.
The intervention significantly reduced the primary outcome of all-cause hospitalization or ED visit within 90 days (40.6% vs. 57.0%; RR 0.72; 95% CI 0.54–0.96; P = .02), driven largely by fewer hospitalizations (12.3% vs. 26.0%) and fewer HF-specific hospitalizations (3.8% vs. 13.0%). Quality of life (KCCQ), food security, blood pressure, weight, and financial strain also improved significantly in the intervention arm.
Open-label design precludes blinding. The trial was conducted at only 2 IHS sites in a single Indigenous nation, limiting generalizability to other Native communities. Full text pages were not extractable, so additional design details (e.g., exact blinding procedures, dropout rates) could not be verified.
For Indigenous patients with heart failure and prior hospitalization, a community-designed traditional food program can meaningfully cut rehospitalization rates — consider partnering with tribal communities to implement culturally grounded food-as-medicine programs. Usual dietary advice alone appears substantially less effective in this population.
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