To investigate whether body fatness influences the metabolic risk profile in a group of healthy, normal-weighted men and to determine which anthropometric measurements that are most closely associated with the risk profile in this group of men. A cross-sectional study where total fatness and abdominal fatness were determined by older (BMI, WHR, impedance) and more recent anthropometric indices (sagittal diameter (SD) and conicity index (Valdez et al., Int. J. Obes. 1993; 17: 955)). The metabolic risk profile was determined by lipoproteins, insulin, glucose and blood pressure. The study comprised a homogeneous group of 58 men who were all healthy and normal-weighted (BMI = 24.2 +/- 1.8) and were all 44 years old. In relation to total fatness, BMI was more closely correlated to the various risk parameters than the fat mass determined by bioelectrical impedance independent of using several different equations in estimating the fat mass. From simple comparison of correlation coefficients, SD and SDH (SD/height) seemed to be the best indices of abdominal fatness in predicting an enhanced metabolic risk profile. The conicity index was considerably inferior in comparison to the other indices of abdominal fatness. In multiple regression analysis abdominal fatness as determined by SD or SDH explained most of the variation in the metabolic risk profile and no significant influence of total fatness (BMI) was found when taking the influence of abdominal fatness into account. The most pronounced effect of abdominal fatness in these non-obese men was a reduction of HDL-cholesterol, an elevation of the triglycerid level and an elevation of the insulin level. Thus, even a minor accumulation of adipose tissue in the abdominal region in these otherwise non-obese men was associated with a considerably adverse metabolic risk profile. SD or SDH seemed to be slightly more correlated to the risk profile than other anthropometric indices of abdominal adipose tissue mass (e.g. WHR). The new conicity index was inappropriate for predicting the risk profile associated with abdominal fatness in these non-obese men.