Researchers tested a new program called MUTTON-HF that delivers traditional Navajo meals to people with heart failure living in rural areas. Over 4 weeks, 20 patients received healthy, culturally meaningful meals made from locally sourced ingredients. The program worked well—patients loved the meals, felt healthier, had better access to food, and reported improved physical abilities. This pilot study shows that combining traditional Indigenous foods with modern heart health care may be a promising approach for Native communities.

The Quick Take

  • What they studied: Can a meal delivery program using traditional Navajo foods help people with heart failure feel better and stay healthier?
  • Who participated: 20 adults (average age 58) with heart failure living in rural Navajo Nation communities in Arizona and New Mexico. Most were male, and all received care at Indian Health Service clinics.
  • Key finding: 90% of patients successfully received their meals, and most loved the program (rating it 8.6 out of 10). More importantly, patients showed real health improvements: food security doubled (from 40% to 85%), physical abilities improved significantly, and patients felt more connected to their cultural traditions.
  • What it means for you: If you or a loved one has heart failure and lives in a rural Native community, this suggests that culturally tailored meal programs could help you feel better and manage your condition. However, this is an early-stage study, so more research is needed before widespread use.

The Research Details

This was a pilot study—a small test run to see if an idea works before doing a bigger study. Researchers recruited 20 patients with heart failure from two clinics in Navajo Nation. For 4 weeks, each patient received 14 meals per week (2 meals daily) that were specially designed to be heart-healthy while using traditional Navajo ingredients and recipes. The meals came from local farmers and ranchers, supporting the community.

Before and after the program, researchers measured several things: whether patients could get enough food, how their heart symptoms changed, how they felt physically and socially, and how connected they felt to their cultural traditions. They also asked patients and community partners (farmers and ranchers) what they thought about the program through surveys and interviews.

This type of study is useful for testing whether a new program is practical and acceptable before investing in a larger, more expensive study. It helps researchers understand what works and what needs improvement.

Native American communities face serious health challenges, including high rates of heart disease and food insecurity (not having reliable access to healthy food). These problems are connected to historical injustices and ongoing barriers to resources. This study tests whether honoring traditional foods and cultures while addressing health needs could be more effective than standard approaches. By involving local farmers and community members, the program also supports economic health in the community.

This is a small pilot study with 20 patients, so results should be viewed as promising but not definitive. There was no comparison group (like patients who didn’t get the meals), which means we can’t be completely sure the meals caused the improvements—other factors could have helped. However, the high participation rate (90% of meals delivered), strong patient satisfaction, and measurable health improvements suggest the program is worth testing more thoroughly. The study was conducted over a short time (4 weeks), so we don’t know if benefits last longer.

What the Results Show

The program was highly feasible and acceptable. Of the 80 meal boxes delivered over 4 weeks, 72 (90%) successfully reached patients—a very high success rate for a rural program covering areas over 136 kilometers away. Patients rated the program 8.6 out of 10, and most said they would recommend it to others (Net Promoter Score of 45%, which is considered good).

Patients reported significant improvements in their ability to do physical activities. Their scores on a heart failure questionnaire measuring physical limitations improved from 59.6 to 82.7 (out of 100), and social limitation scores improved from 74.6 to 83.8. This means patients felt less limited by their heart condition in daily life and social situations.

Food security improved dramatically. Before the program, only 8 patients (40%) had reliable access to enough food. After 4 weeks, 17 patients (85%) reported food security. This is a major finding because food insecurity is linked to worse heart health. Patients also felt more connected to their cultural traditions, with cultural connectedness scores increasing slightly but meaningfully.

Among patients who were overweight or obese, average weight decreased by 2.3 kilograms (about 5 pounds), which is a healthy amount of weight loss over 4 weeks.

Community partners—local farmers and ranchers who provided the traditional foods—rated the program as highly feasible (nearly perfect scores of 19.8 and 20 out of 20). This suggests the program can work within existing community food systems. Importantly, 85% of patients said they planned to continue eating healthier after the program ended, suggesting lasting behavior change.

This study builds on growing recognition that culturally tailored health programs work better in Native communities than one-size-fits-all approaches. Previous research shows that food insecurity worsens heart disease outcomes, and that cultural connection improves health. This program combines both elements. The results align with other studies showing that medically tailored meal programs can improve health, but this is the first to specifically test this approach with traditional Indigenous foods in the Navajo Nation.

The main limitation is the small size (20 patients) and lack of a comparison group. We can’t be certain the meals caused all the improvements—patients might have felt better because someone was paying attention to them, or because they were motivated to join a program. The program only lasted 4 weeks, so we don’t know if benefits continue after meals stop. The study included mostly men (65%), so results might not apply equally to women. Finally, this was conducted in one specific community, so results may not apply to other Native nations or urban Native populations.

The Bottom Line

For patients with heart failure in rural Navajo Nation: This program appears promising and worth trying if available. It combines proven heart-healthy eating with cultural foods you may already enjoy. Moderate confidence level—this is early evidence, but results are encouraging. For healthcare providers: Consider supporting similar programs in your communities. The high feasibility scores and patient satisfaction suggest it’s practical to implement. For policymakers: This model deserves funding for a larger study to confirm effectiveness and for potential expansion to other communities.

This research is most relevant to American Indian and Alaska Native people with heart failure, especially those in rural areas with limited food access. It’s also important for healthcare providers, community leaders, and policymakers working in Native communities. People with heart failure in other settings might benefit from similar culturally tailored approaches, though results may differ. This is less relevant to people without heart failure or those with reliable access to traditional foods.

In this 4-week study, improvements appeared quickly—patients reported better physical abilities and food security within weeks. However, maintaining these benefits likely requires ongoing access to healthy meals and cultural connection. Long-term benefits (months to years) are unknown and need further study.

Want to Apply This Research?

  • Track weekly meal deliveries received (yes/no), daily heart-related physical limitations (1-10 scale), and weekly food security status (do you have enough healthy food?). This mirrors the study’s key measurements and helps users see their own progress.
  • If enrolled in a similar program, use the app to log which traditional meals you enjoyed most, rate how you felt after eating them, and set reminders to continue heart-healthy eating patterns. Share feedback about meals with program coordinators through the app to improve future deliveries.
  • Create a 4-week baseline period to establish your starting point for physical limitations and food security. Then track weekly during the meal program. After the program ends, continue monthly check-ins on these same measures to see if improvements last. Set goals to maintain the healthy eating habits you learned.

This research is preliminary and based on a small pilot study without a comparison group. Results suggest the MUTTON-HF program is feasible and acceptable, but larger studies are needed to confirm it actually improves heart health outcomes. If you have heart failure, consult your doctor before making major dietary changes. This program should complement, not replace, standard medical care including medications and regular doctor visits. Results may not apply to all communities or populations. Always work with your healthcare provider to develop a treatment plan suited to your individual needs.