For the last decade, the focus of nutritional advice for prevention of chronic disease has been to limit or reduce total fat intake and to consume large amounts of carbohydrate. However, this advice is inconsistent with many lines of evidence indicating that unsaturated fats have beneficial metabolic effects and reduce risk of coronary heart disease. More recent evidence has also shown that the large majority of carbohydrates in Western diets, consisting of refined starches and sugars, have adverse metabolic effects and increase risks of coronary heart disease and type 2 diabetes. Unfortunately, a major opportunity for health improvement has been lost by failing to distinguish healthy from unhealthy forms of carbohydrates and fats. Recent analyses indicate that moderate changes in diet, together with regular physical activity and not smoking, can prevent the large majority of heart disease, type 2 diabetes, and some forms of cancer. These findings have substantial relevance for many populations in Asia, where incidence of type 2 diabetes is rising rapidly.