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The effect of a low total carbohydrate low sucrose diet on various parameters of lipid and carbohydrate metabolism was studied among residents of a North Slope Alaskan Eskimo village. For comparative purposes a group of Eskimo youths consuming a higher carbohydrate institutional diet was also stidied. Those Eskimos consuming their native diet had unusually low serum triglycerides and very low density lipoproteins and normal glucose and tolbutamide tolerance tests. Eskimos on a higher carbohydrate diet exhibited significant elevations of triglycerides and minor alterations in glucose tolerance testing. Differences in cholesterol intake between these groups were accompanied by changes in serum cholesterol and low density lipoprotein levels. Unusually high levels of free fatty acids without ketonemia in the North Slope sample were noted as well.