Addressing lifestyle patterns among South Asians in the U.S. is vital due to their elevated risk of cardiovascular disease (CVD). Despite global evidence supporting diet and physical activity in reducing CVD, achieving lasting clinical change remains challenging. In JAMA Cardiology, Anand Rohatgi, M.D., and his colleagues shared their expert opinion on the South Asian Healthy Lifestyle Intervention (SAHELI) trial – the largest study of its kind in the U.S. – showing both the difficulties and potential benefits of culturally tailored strategies to improve long-term health in this high-risk population.