The impact of smoking, alcohol consumption, obesity, and body fat distribution (measured either directly by dual photon absorptiometry as abdominal fat% (AF%) or as the waist-to-hip ratio (WTH] on serum lipids, lipoproteins, and apolipoproteins was investigated in 148 early postmenopausal women. All the women were healthy and none were taking medication known to influence the parameters studied. Smokers had significantly higher levels of triglycerides, low density lipoprotein cholesterol (LDL-C), and apolipoprotein B (P less than 0.05), and higher ratios of LDL-C/HDL-C and apolipoprotein B/A-I (P less than 0.01), but lower levels of high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (P less than 0.01). Moderate alcohol consumption was positively associated with HDL-C and apolipoprotein A-I (P less than 0.001). Body weight and body mass index (BMI) tended to be positively associated with an atherogenic lipoprotein and apolipoprotein profile. However, body fat distribution parameters (AF% and WTH) were stronger predictors of lipoproteins and apolipoproteins than were body weight and BMI, which did not seem to be independent predictors of lipoproteins and apolipoproteins. We conclude that cigarette smoking and a central fat distribution have a significant, independent, negative influence on lipids, lipoproteins, and apolipoproteins, whereas moderate alcohol consumption has a positive effect on these parameters in early postmenopausal women.