This issue of Family & Community Health (29:1) centers on a topic that is of vital importance on the individual, national, and global scale, that being nutrition and health. Despite the fact that healthcare professionals have consistently acknowledged the importance of nutrition and proper diet as one of the most fundamental building blocks of a healthy lifestyle, the level of obesity within the United States has continued to grow. The Centers for Disease Control and Prevention estimates that approximately 65% of all Americans are either overweight or obese, and that the number of overweight children and adolescents has doubled within the past 20 years. The rise of obesity has corresponded to a dramatic increase in healthcare costs for the nation's obese population; these costs center on the treatment of 3 primary diseases: diabetes, hyperlipidemia, and heart disease.1 The alarming increase in childhood and adolescent obesity has resulted in some unique healthcare responses. For example, at the institution where I work, the University of Virginia, our Children's Medical Center has established a new Children's Fitness Clinic. This clinic is a comprehensive, team-based approach to provide assessment and individualized treatment plans for overweight children. Healthcare professionals are seeking to influence childhood obesity rates by appealing to their audience through one of the most effective means of reaching children, that being through the use of television. The Agency for Health Care Research and Quality has recently developed 2 DVDs designed to educate children about proper nutrition as well as exercise and to assist clinicians treat childhood obesity.2 In addition, the popular children's show, "Sesame Street," focused their 2005 season on health, nutrition, and exercise.3 It is important to recognize that proper nutrition is not an issue that is isolated to our nation's youth. The National Council on the Aging reports that the proportion of Americans over the age of 65 who are not able to receive proper nutrition and food is growing at an alarming rate. While there are government programs such as the Title III-C Elderly Nutrition Program of the Older Americans Act, which provides nutrition services through congregate and home-delivered meals (Meals on Wheels) and plays a vital role in meeting the nutritional needs of millions of seniors, the National Council on the Aging asserts that government funding is currently falling short of meeting needs and that funding for nutrition programs has failed to keep pace with the inflation of the nation's growing elderly population.4 For some the problem with health and nutrition is eating too much, while for others the issue is not having enough to eat; this dichotomy demonstrates the national scope of the problems associated with health and nutrition.

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The articles in this issue make it clear that the nutritional needs and challenges facing America's population also face populations in many other countries of the world. Indeed nutrition is a global health problem. Gro Harlem Brundtland, Director General of the World Health Organization, presents 3 points that explain why "proper nutrition and health are fundamental human rights." First, she states that nutrition affects and defines the health of all people without consideration of their socioeconomic status. She asserts, "It paves the way for us to grow, develop, work, play, resist infection and aspire to realization of our fullest potential as individuals and societies. Conversely, malnutrition makes us all more vulnerable to disease and premature death." Dr Brundtland's second point is that poverty is a major cause and consequence of poor health on the global scale. She points out that nearly 30% of the world's population is affected by hunger and malnutrition. Her third point is that "a strong human rights approach is needed to bring on board the millions of people left behind in the twentieth century's health revolution. We must ensure that our values and our vision are anchored in human rights law-only then can they become reality for all people." Dr Brundtland reminds us that health and sustainable human development are equity issues, and that "we must also realize that resources allocated to preventing and eliminating disease will be effective only if the underlying causes of malnutrition-and their consequences-are successfully addressed."5 These assertions support the value of a social-ecological model for designing nutrition interventions. As discussed in the foreword, a complex web of factors comprise the interventions.

Issues of poverty, homelessness, and malnutrition are severe problems in America as well as the world, and have a direct link to health and nutrition. It is my hope that the articles contained in this issue of Family & Community Health contribute to the field of research and reinvigorate initiatives aimed at improving health and nutrition at the individual, national, as well as global level.

Jeanette Lancaster

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