Differences in dietary intake of Korean Americans (KA) by the length of residence in the U.S. were studied in relation to health and disease patterns in Michigan. Of 1860 questionnaires mailed, 637 (34.3%) responded with demographics, anthropometrics, self-reported disease patterns, lifestyle, and dietary patterns (93-item FFQ developed for KA). Complete responses were available for 498 people (263 men,253 women, aged 30-87 yr), who were then divided into three groups based on the number of years lived in the U.S.: 15y, 16-25y, 26y. Age-adjusted weight, height, BMI, and waist to hip ratio were within the normal ranges and did not differ among the three groups. Chronic diseases frequently reported in men and women (age-adjusted) included hypertension (14.4%, 14.1%), digestive diseases (5.4%, 8.5%), diabetes (3.6%,4.9%), and arthritis(3.3%, 12.5%), respectively. The length of residence in the U.S. was inversely associated with the age-adjusted prevalence of digestive diseases (12.4%, 6.5%, 0.4% in men, 13.0%, 11.7%, 0% in women). The length of residence was positively associated with health consciousness, receiving regular health care, taking supplements regularly, and exercising, while inversely related to smoking. The majority favored American foods for breakfast and Korean foods for dinner. Foods frequently consumed included cooked rice (w/other grains). kimchi, coffee (w/cream and sugar),bread (white and dark), citrus juice, milk (low fat and skim), lettuce and cucumber, apple, seaweed, and soda. Intake frequency of the Korean starch food group was inversely associated with the length of residence for both men and women (p<0.001), but not with the American starch food group. Fat intake did not differ by the length of residence in the U.S. The dietary changes were associated with the length of residence and chronic disease patterns for the first generation of KA, which should be further examined 'for the subsequent generation of KA.