The Latin American and Caribbean Region has different general characteristics as compared to other regions of the world. These peculiarities have determined certain food and nutritional problems which require specific programs and policies. Even though the universal coverage of basic needs is desirable, this is not the situation in the Region, and it is possible to identify integral vulnerable groups in every population. The study of problems related to food and nutrition requires a global and multidisciplinary approach considering ecological, economical, social and cultural factors affecting communities, especially marginal urban and rural populations. Nutritional diseases represent the last stages of the natural development of malnutrition, and although they are used as indicators of the nutritional situation, their magnitude always underestimate their real impact. It is in the large cities of Latin America that we can really understand the concept of malnutrition, which includes diseases related with both deficient and excessive food consumption. In fact, the development of sub-urban poor communities in large cities, short lactation period, low wages, low maternal schooling, soon lead to the development of under-nutrition in young urban populations. On the other hand, the interaction of urbanization, sedentary jobs, deficient food knowledge and excessive consumption of cheap foods, sometimes produces on the "survivors of under-nutrition" over-nutrition diseases, a problem which is acquiring more prevalence, especially in adults (obesity, diabetes and atherosclerosis). The real nutritional diseases in Latin America do not depend on the deficit or excess of a specific nutrient. The true causes are to be properly identified in order to state recommendations which benefit population groups, and not only reach academic purposes.