NEW ORLEANS — Making sure that people with heart failure (HF) eat healthy by delivering the right kinds of food to their doorsteps can improve quality of life, according to a study of a food-delivery pilot program in Dallas.

“There’s a high burden of food insecurity among patients with heart failure,” Ambarish Pandey, MD, associate professor of internal medicine in the Division of Cardiology and Geriatrics at UT Southwestern Medical Center in Dallas, told Medscape Medical News.

Pandey reported results of the FOOD-HF food-delivery pilot study at the American Heart Association (AHA) Scientific Sessions 2025.

“A food supplementation intervention is very feasible and well-liked by patients,” said Pandey, who is also medical director of the HF with preserved ejection fraction program at UT Southwestern Medical Center. “We were able to identify what kind of food supplementation is more preferable: Fresh food supplementation is a lot more liked. Patients like the flexibility of being able to cook the way they want to eat the food rather than being told what to eat.”

Food as Medicine

Pandey and colleagues randomly assigned participants to one of three dietary interventions: delivery of medically tailored meals plus counseling with a dietitian, delivery of boxes of fresh produce and other foods along with dietary counseling, or usual care consisting of dietary counseling without any food delivery. The trial enrolled 150 adults within 2 weeks after their discharge from the hospital for acute HF. The food-delivery program lasted for 90 days. 

Medically tailored meals consisted of 14 fully prepared, refrigerated meals each week. Fresh produce boxes included fresh fruits, vegetables, whole grains, dairy, eggs, olive oil, pantry stables, and recipes for nutritious meals.

A conditional delivery subgroup only received food if they picked up their medications from the pharmacy and went to their follow-up clinic appointments. Another subgroup received their food even if they did not go to the pharmacy or keep their doctors’ appointments. 

Compliance and food-delivery completion rates were high, Pandey said. Ninety-six percent of participants completed the 90-day follow-up, and 93.6% received food deliveries. 

The study, he said, had “relatively few” reports of the primary endpoint of HF-related hospitalizations or emergency department visits. A total of 32 events occurred overall over the 3-month follow-up period: 23 in the food-delivery groups and nine in the usual care group. There were no differences in rates across all groups or subgroups, Pandey said.

However, participants who received food deliveries were twice as likely as those who received usual care to achieve a meaningful improvement in quality of life, as measured with the Kansas City Cardiomyopathy Questionnaire (odds ratio, 2.09; P = .046), he added.

The primary objective of the study was to help in the design of future food interventions for patients with HF, Pandey noted.

“Food is medicine; it’s better than medicine,” he said. “One of the key causes of the high burden of cardiometabolic diseases is poor food choice and poor access to food.”

A Starting Point

The FOOD-HF findings show quality of life could be a more modifiable outcome than clinical ones, Pandey said, but future research could evaluate clinical outcomes of HF-related hospitalization and death and all-cause hospitalizations.

“We need to do a larger study with a longer intervention period,” Pandey said. FOOD-HF will aid in designing that future research, perhaps with a focus on delivery of fresh food vs medically tailored meals.

Keith C. Ferdinand, MD, director of preventive cardiology at Tulane School of Medicine in New Orleans, called the high rate of patients who completed the study a “tremendous success” and “encouraging.” He added, “It’s important to recognize that a large percentage of heart failure patients have malnutrition, which increases mortality and other adverse clinical events.”

The lack of a signal for readmission among the study population “is not necessarily a failure,” Ferdinand said. “The majority of readmissions and deaths in heart failure occur early and a lot of them are noncardiac, so it could be that studying all-cause readmissions or even randomizing patients even earlier might have a benefit.”

The FOOD-HF findings support larger clinical trials of food interventions powered for clinical events, Ferdinand said. “We have to look at different methods of food delivery and dietitian counseling needs to be adapted for different patient populations.”

The trial was supported by a grant from the American Heart Association. Pandey reported having financial relationships with Anumana, AstraZeneca, Roche Diagnostics, SC Pharmaceuticals, SQ Innovation, Ultromics, Tricoq Health, Lilly USA, Rivus, Cytokinetics, Sarfez Therapeutics, Edwards Lifesciences, Merck, Bayer, Novo Nordisk, Alleviant, Pfizer, Abbott, iRhythm, Axon Therapies, Kilele Health, Acorai, Kardigan, Novartis, Idorsia Pharma, Science 37, and Palomarin. Ferdinand reported having no relevant disclosures. 

Richard Mark Kirkner is a medical journalist based in Philadelphia.