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Introduction The population of Finnmark county, northern Norway, located above the artic circle, has the highest mortality from coronary heart disease (CHD) in Norway, and among the highest in the [...], Introduction: Students aged 13 and 14 y, in a region in northern Norway with high blood cholesterol levels and high mortality from coronary heart disease (CHID) in the adult population, were studied with respect to lifestyle, dietary habits, nutritional intake and blood lipids including fatty acids in serum. The students came from a coastal community with seawater fish as an important part of the traditional diet, and an inland community with meat from reindeer as a major constituent of the diet. Objective: To investigate whether the traditional diet was maintained among the adolescents and to evaluate the lifestyle and blood lipids. The study was followed up after 1 y. Results: The adolescents from the coastal region did not maintain the traditional diet. In the inland region the students had a high intake of meat, probably reflecting the traditional food culture. The inland boys had higher mean body mass index (BMI) than the coastal boys, and 12% had BMI>28, as compared to none of the coastal boys. Other findings showed that the students had higher levels of blood cholesterol than in the south of Norway and several other countries (about 25% had total cholesterol >5.2 mmol/l), higher intake of dietary sugar and fat than the national recommendations and little intake of seawater fish with corresponding low levels of n-3 fatty acids. This did not change after 1 y of follow up. Some 10-20% reported daily smoking and 8-13% reported that they rarely or never did physical exercise. About 30% of the students presented no factors negatively related to development of cardiovascular disease. Conclusion: The findings demonstrate, in the majority of students at the age of 13 and 14 y, the appearance of factors contributing to development of cardiovascular disease (CHID). Sponsorship: This study was supported by the program 'Medisinsk forskning i Finnmark, University of Tromso'. doi:10.1038/sj.ejcn.1601381 Keywords: adolescents; blood lipids; fatty acids; diet; lifestyle