to increased consumption of highly processed foods, such as burgers, pizzas, french fries, chips, cakes, biscuits, and sweetened breakfast cereals (20,22). The concomitant reduction in whole grains has occurred even for those adhering to traditional staple foods, such as chapati, by exchanging the traditional atta with white flour.


Among the changes reported by immigrants to high-income countries is a reduction in the intake of


pulses and an increase in intake of meat and fish (21,23,24). Pakistani immigrants, however, are reported to have increased vegetable consumption postmigration (23,25). This seems like a positive modification, but it offsets the other changes such as decreased fiber, increased sugar consumption, and increased unhealthy fat intake.


Most immigrants increase their fat consumption significantly. Oil consumption increases, as


immigrant Pakistanis are more likely to deep fry; in their traditional premigration cooking practices, they tended to use butter, ghee, and full fat milk rather than oil (23). The most reported dietary features among Pakistani immigrants are the high consumption of sugary snacks and drinks, and fat-rich foods and snacks, especially among the younger generation (22,25). Changes in lifestyle following immigration often result in higher intakes of energy-dense foods, less pulses, and less physical activity. The Pakistani immigrant group constitutes a high-risk subgroup of the population that needs a selective prevention approach.


Pakistani cuisine varies from region to region. Cuisine from the eastern provinces of Punjab and Sindh is quite similar to the cuisine of Northern India and is generously seasoned and spicy. The cuisine in other parts of Pakistan, particularly Balochistan, Azad Kashmir, Gilgit Baltistan, Khyber Pakhtunkhwa, and the Federally Administered Tribal Areas is similar to neighboring countries Afghanistan, Iran, and Central Asia and is less spicy. Curries of meat and chicken rich in spices are preferred in the south. Barbecuing and beef is more common in the north, where land is more mountainous and less fertile and more suitable for animal husbandry and cattle-rearing.


Baloch cuisine refers to the food and cuisine of the Baloch people from the Balochistan region. Baloch


cuisine is quite similar to cuisine from neighboring Iran and Afghanistan and differs substantially from the cuisine found in other Pakistani regions. The sajji method of roasting whole lambs in a deep pit is a distinctive regional practice unique to Balochi cuisine. Lamb, beef, mutton, and dry fruits are favorite foods of the Balochi tribesmen.


PakhtunorPathan cuisine refers to the food of the people from Khyber Pakhtunkhwa (KPK). KPK


residents are heavy meat eaters and tea drinkers, mainly green tea but also black tea, which is referred to as sulemanior kahwa. The cooking techniques of Pathan are considered blander (spices are employed sparingly) than the other regions of Pakistan. The Pakhtuns are known for their love of lamb dishes. A specialty dish is oven-baked breads with cubes of meat.


Punjabicuisine (from the Punjab region of northwestern India and eastern Pakistan) is known for its


diversity of dishes. Vegetables, milk, and dairy products are avidly consumed. The cuisine includes large amounts of ghee (clarified butter), rice, and spices (masala). The Punjabi people are known for their roti and sophisticated cooking preparations. Sarsonkasaag (mustard leaves) and maakiki roti (cornbread) are local favorites. Punjabis also enjoy khatchapuri, a savory pastry filled with cheese. In Punjab, breakfast might include nihari (beef stew), paya (spicy hoof stew), and naan(leavened flatbread). Garbanzo beans are very popular and are used in many dishes, and yogurt is consumed with almost every main meal. Chicken with beans, called murghcholay, is a very popular dish.


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