About 47 years ago, the Ni-Hon-San Study showed that prevalence of coronary heart disease was highest in San Francisco Japanese Americans, lowest in native Japanese in Hiroshima, and intermediate in Honolulu Japanese Americans. Our current findings indicate that the prevalence rate of coronary heart disease and characteristics of Seattle Japanese Americans are almost identical to those of San Francisco Japanese Americans 30 years ago. Despite many contributions of the Ni-Hon-San Study results to the scientific community, we fear that the lessons learned were not disseminated widely enough to encourage the Japanese American population in the mainland United States to change their lifestyles for disease prevention. The same lessons should be equally applied to other populations in the US as well as people in Japan because many are adopting Western lifestyles. Public health efforts should reemphasize the importance of health promotion activities.