China and the Former Soviet Union have both undergone substantial political and economic change in recent years as they began the transition from planned to more liberal market economies. The approaches to market liberalization in Russia (privatization in the minimum time) and China (gradual liberalization of prices and slow withdrawal of agricultural subsidies) were quite different. This paper examines some of the health implications associated with these changes, particularly in relation to the increasing burden of diet-related chronic diseases. The changing patterns of tobacco and alcohol use, increase in sedentary lifestyles and increased consumption of non-traditional, energy-dense processed foods, high in salt, fat and sugar are examined, as are the strategies used by foreign direct investors in these emerging markets to ensure market penetration, to gain a fuller understanding of how children and adults' choices of food are being influenced as a result of these socioeconomic changes. Some of the threats and opportunities facing Chinese and foreign food producers in these new conditions are assessed. It is suggested that to ensure successful prevention of future diet-related chronic diseases in such rapidly changing conditions, there needs to be a move beyond reliance solely on health education programmes and individual or local community-based interventions. A series of strategies involving multiple stakeholders should be considered as options for intervention.