Maintaining a healthy diet, being physically active, avoiding tobacco and alcohol abuse, getting adequate sleep and, where necessary, taking appropriate medications have long been first-line recommendations to prevent and treat cardiometabolic conditions — the leading causes of death and disability worldwide. But despite randomized controlled trials that demonstrate the efficacy of lifestyle modification interventions to reduce hypertension (for example, the ‘dietary approaches to stop hypertension’ diet), diabetes (for example, the diabetes prevention programme), high cholesterol (for example, the Mediterranean diet) and their associated burdens, we have had limited success in encouraging individuals to practice and sustain these healthy behaviours at the population level. The numbers of people who are affected by obesity, diabetes and hypertension have more than tripled worldwide in the past four decades. In addition, behavioural strategies (for example, structured counselling programmes) used to promote the uptake of lifestyle interventions have had small or short-term effects1. As a result, a question that arises is whether we should still look to behaviour change interventions and strategies to help us to prevent and manage cardiometabolic diseases.