South Asians are a growing migrant population, both globally and in Australia. This group are at higher risk for both cardiovascular disease and type 2 diabetes. The aim of this qualitative study was to compare dietary practices of South Asians, n = 41 (Indian, n = 25; Sri Lankan, n = 16) and Anglo-Australians, n = 16, with these conditions, using semi-structured in-depth interviews. Findings suggest that both groups had a high level of awareness of dietary practices necessary for optimum disease management, both prior to and post diagnosis. Bi-directional effects of migration were noted in the dietary practices of both groups suggesting hybrid diets are evident in Australia. A key barrier to implementing dietary changes highlighted by both groups of participants was a lack of specific, timely and detailed dietary advice from clinicians. Both groups expressed that advice should be repeated and reinforced throughout the course of their disease. In addition, South Asian participants wanted more culturally relevant advice. Clinicians providing dietary advice need to recognise that preferences for staple food items are resistant to change and may affect adherence. Acculturation was evident in the dietary practices of the South Asian participants. Nevertheless, many maintained traditional food practices which were tied to their cultural identity. It is recommended that clinicians consider these factors when offering advice.