Non-communicable diseases such as type 2 diabetes (T2D) mellitus, coronary artery disease, stroke and cancers, are major contributors to ill health across the world including Asia. These conditions are multi-factorial in origin, often involving complex gene-environment interactions. Singapore is a multi-ethnic island state and provides a useful model to evaluate determinants of the development of chronic diseases in Asian ethnic groups. Three major Asian ethnic groups are represented in Singapore: Chinese, Malays and Indians. The Singapore Multi-Ethnic Cohort (MEC) allows us to better understand how genes and lifestyle may influence health and diseases differently in persons of Chinese, Malay and Indian ethnicity. As these ethnic groups reside in the same Singapore setting, confounding of ethnic differences by differences between countries is avoided. Through the MEC, we hope to improve preventive and therapeutic measures, as well as provide information to advance public health and health education policies for Asian populations.