The randomized 12-week trial on the Navajo Nation enrolled 206 adults with heart failure and found that culturally tailored, locally sourced meals reduced hospital and emergency department visits. Participants received 14 meals per week plus appliances to store and heat food, and experienced weight loss and lower blood pressure. The intervention also improved reported food security and addresses access barriers on a reservation with very limited grocery availability. The study highlights how food-as-medicine approaches, rooted in cultural preferences and paired with logistical support, can improve health outcomes.
Food as Medicine: Culturally Tailored Navajo Meals Cut Hospital Visits for Heart Failure
Healthy, Culturally Tailored Meals Reduce Hospital Visits for Heart Disease on Navajo Nation
A first-of-its-kind randomized clinical trial on the Navajo Nation shows that culturally tailored, locally sourced meals can reduce hospitalizations and emergency visits for people living with heart failure. The 12-week intervention paired traditional foods with essential kitchen appliances, addressing both nutrition and access barriers.
Study Details
The trial enrolled 206 adults at two Indian Health Service sites across the Navajo Nation. All participants had a diagnosis of heart failure and had been hospitalized or visited an emergency department within the previous 12 months. Over 12 weeks, participants received 14 prepared meals per week made from healthy, locally sourced traditional ingredients.
Supportive Resources
To ensure participants could store and heat food, the study provided necessary appliances, including microwaves, freezers, propane-fueled refrigerators, stoves and propane supplies. This logistical support helped overcome persistent barriers to accessing and preparing nutritious meals on the reservation.
Results
The intervention group experienced fewer overall hospital and emergency room visits compared with baseline, along with clinically meaningful improvements in weight and blood pressure. Participants also reported increased food security, noting that the meal deliveries provided reliable access to nutritious food in areas where grocery access is limited.
"Food is medicine": the trial demonstrates that culturally relevant nutrition interventions can produce measurable health benefits.
Context and Significance
Heart disease is often described as a lifestyle-related condition where diet, activity and environment play major roles. Native communities face some of the highest rates of lifestyle disease, driven in part by historical policies that disrupted Indigenous food systems — including geographic isolation on reservations, erosion of traditional foodways, forced reliance on commodity foods and assimilation efforts. On the Navajo Nation, access challenges are stark: only 13 grocery stores serve the 27,000-square-mile reservation.
Implications
This trial underscores the potential of culturally tailored food programs to improve clinical outcomes and food security. Combining traditional foods with practical supports—like appliances and delivery—may be a scalable approach to reduce hospital utilization and improve chronic disease management in Indigenous and rural communities.
Next steps include larger trials, longer follow-up to assess sustained benefits, and exploration of cost-effectiveness and implementation pathways through tribal health programs and partners.
Help us improve.
