A heart-healthy Pakistani diet for cholesterol and blood pressure.

What is the best Pakistani diet for high cholesterol?

One that keeps the food you love but changes the fat in it. The WHO guideline on fats, updated in 2023, says the fat you eat should be mostly unsaturated, with no more than 10% of daily energy from saturated fat and no more than 1% from trans fat. Adults should keep total fat to 30% of energy or less.

In a Pakistani kitchen, saturated fat is found mainly in ghee, butter, malai, full-cream milk and the fat on mutton and beef. Unsaturated fat comes from liquid plant oils, nuts, seeds and fish.

To put the limit into food: on a day of 1,800 calories, 10% is 180 calories. A tablespoon of ghee is about 120 calories, and most of that is saturated fat. It doesn't take much ghee to reach the limit, before you've even counted the milk in your chai or the mutton in the salan.

WHO also says what to eat instead: unsaturated fats from plant sources, or carbohydrate foods with natural fibre. In plain words, that means a measured spoon of plant oil, and more daal, chana, chakki atta roti, sabzi and fruit.

Is ghee, oil or vanaspati better for your heart?

A liquid plant oil, used in measured amounts, is the best everyday choice. Ghee is fine in small amounts for flavour. Vanaspati is the one to replace first.

Vanaspati (banaspati ghee) is traditionally made by partially hydrogenating vegetable oil. That process is where industrially produced trans fat comes from. WHO's best-practice policy is either a limit of 2 g of industrial trans fat per 100 g of total fat, or a ban on partially hydrogenated oils. If the label on your tin says "partially hydrogenated", swap it for a liquid oil.

Plant oils such as canola, sunflower, corn and olive oil are mostly unsaturated. Not every plant fat is, though: palm oil and coconut oil are high in saturated fat, so read the label on blended cooking oils.

Whatever you use, the amount matters. Every gram of fat, healthy or not, gives 9 calories, so a heavy hand with oil adds up fast, especially if you're also trying to bring your waist down.

How much salt is too much with high blood pressure?

WHO advises adults to eat less than 5 g of salt a day (under 2,000 mg of sodium), which is just under a teaspoon. The global average for adults was about 11 g a day in 2021, more than double that. If you have high blood pressure, salt is the first thing to look at, and a lot of it never goes through your salt shaker.

Common sources in Pakistani food:

• Achar, chutney and papad. A spoon of achar with every meal adds up.
• Nimco, packet crisps and salted nuts with evening chai.
• Packet masala mixes, stock cubes and chaat masala. Many already contain salt, so check the label before you add more.
• Restaurant and takeaway food, from karahi and BBQ to burgers and Chinese-style dishes with soy sauce.
• Namkeen lassi and salty snacks at iftar.

To cut back, add salt at the end of cooking and taste first. Lemon, imli, fresh dhania and podina, roasted zeera, black pepper, garlic and ginger all bring flavour without salt. Cut down gradually rather than all at once. If you're thinking of switching to a low-sodium salt, ask your doctor first, especially if you take blood pressure tablets or have kidney problems.

Which Pakistani foods are good for your heart?

Many of the best ones are already in your kitchen. Daal, chana, lobia and rajma give you protein and fibre, and they're the kind of fibre-rich carbohydrate foods WHO suggests in place of saturated fat.

• Fish, grilled, baked or in a light salan, in place of fatty mutton or beef on some days of the week.
• Unsalted nuts such as badam, akhrot and pista: a small handful instead of nimco.
• Chakki atta roti instead of maida naan or paratha.
• Sabzi and fruit at most meals: a kachumber salad, or seasonal guava, kinnow or apple.
• Plain yoghurt and raita, made with low-fat milk if you can get it.

Our guide to a diabetic diet with Pakistani food uses the same building blocks, which helps if you're managing blood sugar as well.

How can you cook Pakistani food with less oil?

Measure it. In many kitchens the extra fat comes from oil poured straight from the bottle, a generous tarka on top, and frying. Small changes to how you cook let you keep the dishes you love.

• Use a spoon, not the bottle. A teaspoon of oil is about 45 calories and a tablespoon about 120. Measure what goes into the pan for a week and you'll see where the fat comes from.
• Make the tarka smaller. A teaspoon of ghee or oil with zeera, garlic and a dried red chilli still gives daal its flavour.
• Bhuno with water. When the masala starts to stick, add a splash of water instead of more oil. You won't see the oil separate on top the way recipes describe, and that's fine.
• Bake, grill or use the tawa. Chicken tikka, seekh kebabs and fish can go in the oven, on a grill or on a lightly oiled tawa instead of in the karahi.
• Spoon off the oil layer from the top of salan or nihari before serving.
• Trim the meat. Take the skin off chicken and cut the visible fat off mutton and beef.
• Keep fried food for occasions. Pakoray, samosas and paratha are fine now and then.

What are easy heart-healthy swaps for Pakistani food?

Pick two or three swaps that fit your week and start there.

What should you eat at restaurants and dawats?

Choose grilled over fried, and roti over naan. You can't control the oil or salt in restaurant food, so the choices you make at the table count for more.

• Order chicken tikka, seekh kebab or grilled fish, with salad, raita and roti.
• Ask for less oil in the karahi. It costs nothing to ask.
• With nihari or haleem, skip the extra tari (the oily top layer) and the butter naan.
• At a shaadi or dawat, fill half the plate with salad, daal or chicken first, then take a smaller serving of biryani or pulao.
• Keep halwa puri for the odd weekend breakfast.
• Enjoy mithai in small amounts. One gulab jamun or a small bowl of kheer is part of the occasion; three is a habit.

Our Pakistani diet plan for weight loss has more ideas for chai, dawats and weddings.

Can diet replace cholesterol or blood pressure tablets?

No. Don't stop statins or blood pressure tablets on your own, even if your numbers improve. Food changes work alongside medicine, not instead of it, and only your doctor should change the dose.

Tell your doctor before you make big changes, and keep your check-ups. A lipid profile (the cholesterol blood test) and regular blood pressure readings show whether things are moving. If you also have diabetes, take extra care: people on insulin or tablets such as gliclazide can get low blood sugar if they suddenly cut carbohydrates.

Our cardiometabolic health service covers weight, blood sugar and heart health using the food you already cook, and the Signature plan includes a Lab Insight Review of results such as cholesterol and HbA1c (see plans and pricing). If you'd like a plan built around your own kitchen, book a consultation.