Key Points:
- The FOOD‑HF Trial was a single center randomized trial that enrolled 150 patients within two weeks of discharge for acute HF. Participants were randomized to one of three groups: (1) medically tailored meals (MTM) + dietician counseling, (2) fresh produce grocery boxes + dietician counseling, or (3) usual care: dietician counseling alone.
- Those patients who received either medically tailored meals or fresh-produce boxes plus dietary counselling experienced a significant improvement in quality of life compared with dietary counselling alone.
- There was no statistically significant reduction in heart-failure hospitalizations or ED visits in the intervention groups compared with usual care (RR 1.09; 95% CI 0.49-2.43; p=0.83).
- Among the food-delivery arms, those in the “conditional delivery” subgroup (food provided only when patients picked up medications and attended follow-up) reported higher quality-of-life gains than the unconditional delivery subgroup, and the fresh produce box group reported greater patient satisfaction than the prepared meal group.
Heart failure (HF) patients often face nutritional challenges, food insecurity and suboptimal diet quality: factors linked to worse outcomes. The concept of “food-is-medicine” interventions (e.g. medically tailored meals, produce prescription models) is gaining traction as a complementary strategy to improve health outcomes in chronic cardiovascular conditions.
The FOOD‑HF Trial was a single-center (Dallas, TX: UT Southwestern Medical Center and Parkland Health) randomized trial supported by the American Heart Association, enrolling about 150 adults within two weeks of discharge for acute HF. Participants were randomized to one of three groups: (1) medically tailored meals (MTM) + dietician counseling, (2) fresh produce grocery boxes + dietician counseling, or (3) usual care: dietician counseling alone. The intervention lasted 90 days. Within the two “food” arms, participants were further stratified into subgroups: conditional food delivery (only if medications picked up and follow-up attended) or unconditional delivery. Virtual nutritional consultations occurred at baseline, day 30 and day 60.
During the three-month follow-up there were 32 heart-failure-related hospitalizations or ED visits. The adjusted risk ratio comparing food intervention versus usual care was 1.09 (95% CI 0.49-2.43; p = 0.83), indicating no significant reduction in these events. Regarding quality of life (QoL), the food intervention arms achieved a win-ratio of 1.21 (95% CI: 1.14-1.29) on a hierarchical composite driven by QoL improvement, and the odds of achieving a meaningful QoL gain were 2.09 (95% CI 1.01-4.31; p = 0.046) versus usual care. The trial was relatively small (n = 150) and short-term (90 days), and the authors note that while the findings are promising for feasibility and quality of life, larger, longer-term trials are needed to assess hard clinical outcomes. Within subgroup analyses, the conditional-delivery food participants reported better QoL than unconditional delivery, and the fresh-produce box recipients that prepared their own meals reported higher satisfaction than the prepared meal recipients.
These findings suggest that implementing “food-is-medicine” interventions after HF hospitalization is feasible, acceptable, and can deliver meaningful gains in quality of life. However, the absence of a significant reduction in hospitalizations or ED visits signals that the intervention, as delivered over 90 days in a relatively small cohort, is not yet proven to impact hard clinical endpoints. The differential findings (conditional vs unconditional delivery, fresh produce vs prepared meals) hint that engagement, adherence and patient‐preparation may moderate effectiveness. As lead author Ambarish Pandey, MD, MS, FAHA put it: “If we can identify the best strategy for providing access to healthy food, this could be transformative for people with heart failure who are particularly vulnerable after hospitalization. I think healthy food can be as powerful as medications for people with chronic conditions like HF.” Given these findings, next steps should include multicenter trials with larger sample sizes, longer follow-up, and perhaps hybrid outcomes (diet quality, adherence, cost-effectiveness, clinical events) to define how and for whom such interventions should be integrated into standard heart-failure care.
