In 1983, a nutritional support team was formed at the University of Ife-Ife, Nigeria, that used high calorie enteral mixtures successfully for dietary management of protein energy malnutrition (PEM) in children. PEM has several causes. Poverty is often cited, but the incidence of mild to severe PEM in children under 5 is higher in the Ivory Coast, Nigeria, Egypt and Sudan with per capita gross national product (GNP) above $400 than in Sierra Leone, India, Uganda, and Kenya with GNP below this amount. The consumption of legumes and oil seeds ward off kwashiorkor and marasmus, but in countries with traditional food practices they are not consumed in adequate amounts. Beans, groundnuts, melon seeds, and soya beans are cheap and produced in African and Asian countries. In Nigeria the traditional weaning food is a thin gruel made from maize, sorghum, or millet. Milk, groundnut paste, or sugar is not added. Legumes and other oil seeds are forbidden for children because of deep-rooted cultural practices that favor tubers. Longer duration of breast feeding protects infants from kwashiorkor or marasmus, but the recent drastic change in the pattern with early introduction of artificial feeding has resulted in early appearance of kwashiorkor or gastroenteritis. Low literacy of mothers is another factor, and it inversely correlated with infant mortality. The increase in the level of female literacy and maternal education in less developed countries is a major requirement from governments if they are to combat harmful food taboos. Since Williams associated maize diets with kwashiorkor in 1933, research has show energy deficiency more perilous than protein insufficiency in the treatment and prevention of PEM in these countries.