Abstract:
Background: Precision nutrition aims to optimize health outcomes through individualized dietary interventions tailored to clinical, metabolic, and lifestyle characteristics. Medically tailored meals (MTMs) represent an emerging application of precision nutrition by addressing malnutrition, food insecurity, and poor dietary adherence through personalized dietary support designed to meet disease-specific nutritional needs. While previous studies have reported clinical benefits of MTMs for glycemic control and bone health in older adults, evidence regarding their effectiveness in patients with heart failure (HF) remains limited.
Objective: To evaluate the effects of medically tailored meal interventions on mortality and rehospitalization outcomes among patients with heart failure and to examine the potential role of precision nutrition strategies in improving post-discharge care.
Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, Embase, Cochrane Central, and additional sources were searched from inception to April 2026. Eligible studies included adults with heart failure receiving medically tailored meal interventions or individualized dietary programs. Randomized controlled trials, cohort studies, and comparative studies were included. Primary outcomes were all-cause mortality and rehospitalization. Random-effects meta-analyses were performed using risk ratios (RRs) and 95% confidence intervals (CIs). Subgroup analyses were conducted according to intervention duration, comparing short-term inpatient dietary interventions (approximately 7 days) with longer post-discharge MTM programs (approximately 30 days).
Results: Nine studies involving 5,157 participants were included in the systematic review, of which seven comparative studies comprising 5,091 participants were eligible for meta-analysis. Long-term MTM interventions delivered after hospital discharge were associated with significant reductions in heart failure rehospitalization (RR 0.53; 95% CI 0.32–0.89) and mortality (RR 0.56; 95% CI 0.40–0.80). In contrast, short-term inpatient dietary interventions demonstrated no significant effects on rehospitalization (RR 0.92; 95% CI 0.54–1.59) or mortality (RR 0.91; 95% CI 0.24–3.37). All-cause rehospitalization at 30 days was not significantly reduced overall (RR 0.86; 95% CI 0.49–1.52), and mortality at 30 days also showed no significant benefit (RR 0.77; 95% CI 0.52–1.14). Narrative findings suggested improvements in food security, nutritional status, intervention adherence, and quality of life among patients receiving MTMs.
Conclusion: MTM programs, as a precision nutrition strategy, may improve clinically important outcomes among patients with heart failure, particularly when delivered during the vulnerable post-discharge period. While short-term inpatient dietary interventions demonstrated limited effectiveness, longer-duration personalized meal programs were associated with significant reductions in both heart failure rehospitalization and mortality. These findings support the integration of individualized nutrition interventions into heart failure management and highlight the potential of precision nutrition approaches to improve patient-centered outcomes and healthcare utilization.
