The American Indian population, including American Indians and Alaska Natives, totals nearly 1.5 million from over 500 tribes and nearly 300 reservations and Alaska Native villages. Earlier in this century, heart disease was rarely noted in American Indians, but in the past decade, cardiovascular disease has become the leading cause of death in American Indians. Several factors may be responsible for this increase: a decreasing incidence of infectious disease, an increasing incidence of diabetes mellitus, and an increasing incidence of obesity. Previous research on non-Indian populations indicates that obesity is an independent risk factor for cardiovascular disease and that it is associated with increases in other cardiovascular disease risk factors such as high blood pressure, diabetes, and low high density lipoprotein cholesterol levels. The high prevalence of obesity among American Indians, coupled with its role as a risk factor for hypertension, coronary heart disease, and diabetes, suggests that a reduction in the average weight of young American Indians would improve their health. Reduction of the prevalence of obesity in American Indians has been designated as a goal for improving the health of this minority population and reducing health disparities in our nation.