English is also used among the educated and upper classes, where it is seen as a marker of higher socioeconomic status (4).


Pakistan is an agricultural country, and about 64% of its population lives in rural areas. Agriculture is


central to the country’s economic growth and development. As the dominant economic sector, agriculture represents 24% of Pakistan’s gross domestic product (GDP) and employs over half of the labor force (5).


Pakistan has been the melting pot of different cultural traditions since the prehistoric period. The


earliest settlers of the region mingled with Aryan invaders. Various immigrants of Persian, Afghan, Greek, Arab, Mongolian, and Turkish origin also settled in what is now modern-day Pakistan.


The majority of Pakistanis are Muslim (97%), with a minority population of Christian, Hindu, and


Sikh citizens. All are free to practice their religion, according to the constitution of Pakistan. Pakistani society is extremely patriarchal. Each family is headed by the senior male patriarch, who is


responsible for providing for the family and maintains the dominant socioeconomic role. Traditionally, women and men operate in separate spheres and, especially in rural areas, women may have restricted mobility outside of the home. Regionally, Pakistan has one of the lowest rates of females in the workforce (6).


Fifty-eight percent of households are food insecure, and more than 30% live below the poverty line


(5). According to the National Nutrition Survey 2011, stunting, wasting, and micronutrient malnutrition are widespread and attributed to deficiencies in food availability, quality of diet, and nutritional knowledge; inadequate health and nutrition of mothers and children; and micronutrient deficiencies of iron, zinc, and Vitamin A. Forty-three percent of children under age five were shown to be stunted, and 15.1% wasted (7,8,9). Almost one-third of children across the country are underweight, and the situation is worse for children in rural areas. The rate of acute malnutrition (15.1%) is at a critical level, while severe acute malnutrition (5.8%) is very high (7). Over half of all nonpregnant and pregnant women surveyed were found to be anemic (7).


Pakistan’s five ethnic provinces are Gilgit Baltistan, Balochistan, Khyber Pakhtunkhwa, Sindh, and Punjab. Depending on the area and ethnic background they are called Gilgiti, Baloch, Pakhtuns, Sindhis, and Punjabis, respectively. There can be further subethnic divisions based on language and communities. Every province has its own cultural and regional practices (see the Regional Food Practices section for more information).


On the whole, the more affluent prefer dishes containing meat, chicken, and beef. Pork is completely


forbidden (haram) as per Islamic teachings; because of cultural preferences, even non-Muslims in Pakistan find the thought of consuming pork to be distasteful. Most dishes are rich in spices, and the more desirable recipes contain meat; offering a vegetable dish to a guest is considered inhospitable.


Most main courses also include curries, a mixture of spices and vegetables such as potatoes, okra,


eggplant, spinach, cauliflower, bitter gourd, and rutabaga. Pakistani cuisine also favors lentils due to their affordability, long-shelf-life, and high protein content.


Although eating habits differ by region, the mainstay of the Pakistani diet is a flatbread made from


flour called chapati (alternative spelling: chapatti) or roti. Almost every neighborhood in the urban areas has a tandoor oven where roti/chapati are cost-effectively prepared in bulk; otherwise they are prepared at home before meals. In most places, bakeries produce a vast variety of rolls, both sweet and plain, and loaves of bread from wheat flour. Whereas chapati and roti are consumed every day, paratha (flatbread


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