The global prevalence of type 2 diabetes (T2D) is increasing, with sub-Saharan Africa having the highest projected increase. Notably, the way T2D develops differs by ethnicity, but risk stratification and guidelines for the prevention of T2D rely on evidence from studies including predominately Europeans. The overarching goal of this primary precision prevention project is to develop ethnic-specific clinically feasible and cost-effective ways to predict risk for T2D and to find culturally acceptable preventative dietary modifications in European and sub-Saharan African populations.