Present evidence suggests that modern humans were the first hominid species to successfully colonize high-latitude environments (> or =55 degrees N). Given evidence for a recent (<200,000 years) lower latitude naissance of modern humans, the global dispersal and successful settlement of arctic and subarctic regions represent an unprecedented adaptive shift. This adaptive shift, which included cultural, behavioral, and biological dimensions, allowed human populations to cope with the myriad environmental stressors encountered in circumpolar regions. Although unique morphological and physiological adaptations among contemporary northern residents have been recognized for decades, human biologists are only now beginning to consider whether biological adaptations to regional environmental conditions influence health changes associated with economic modernization and lifestyle change. Recent studies have documented basal metabolic rates (BMRs) among indigenous Siberian populations that are systematically elevated compared to lower latitude groups; this metabolic elevation apparently is a physiological adaptation to cold stress experienced in the circumpolar environment. Important health implications of metabolic adaptation are suggested by research with the Yakut (Sakha), Evenki, and Buriat of Siberia. BMR is significantly positively correlated with blood pressure, independently of body size, body composition, and various potentially confounding variables (e.g., age and smoking). Further, this research has documented a significant negative association between BMR and LDL cholesterol, which remains after controlling for potential confounders; this suggests that high metabolic turnover among indigenous Siberians has a protective effect with regard to plasma lipid levels. These results underscore the importance of incorporating an evolutionary approach into health research among northern populations.