The Honolulu Heart Program (HHP) is a prospective study of heart disease and stroke in Japanese-American men in Hawaii. Body weight, height, and subscapular and triceps skinfold thicknesses were measured by using standard methods at the baseline exam held in 1965-1968. The relationship of measures of body fatness to the 20-y follow-up for coronary heart disease (CHD) and stroke of these men was explored. Body mass index (BMI), subscapular skinfold thicknesses, and centrality index (subscapular skinfold thickness/triceps skinfold thickness) were predictors of CHD in this population, even after other risk factors were added to a multivariate model, indicating an independent contribution of body fat to CHD risk. Neither BMI nor centrality index was related to stroke. However, subscapular skinfold thickness was an independent predictor of stroke. The implications of these findings are that lifestyle changes that lead to an increase in obesity of Japanese men in Hawaii may increase risk for cardiovascular disease.