Obesity, cardiovascular diseases, and diabetes are becoming leading causes of morbidity and mortality in the Eastern Caribbean countries of St. Vincent and the Grenadines, Saint Lucia, Grenada, and Dominica. To promote healthful diets and lifestyles and encourage behavioral changes, Food-Based Dietary Guidelines (FBDG) were developed for the general population in each of these countries. This paper reports on the comprehensive process of developing the guidelines through consensus building among stakeholders, technical assessments and priority setting, and use of qualitative methods to field test messages to ensure public understanding and motivation. Nutritionists in each country received training and support from the Food and Agriculture Organization and the Pan American Health Organization's nutritionists.