Heart-Healthy Diet in Sri Lanka: Foods to Eat, Foods to Limit and a Sample Day

Heart disease and stroke are leading causes of death in Sri Lanka, and diet plays a major role. The traditional Sri Lankan plate, with rice, vegetables, mallum, pulses and fish, can be very healthy, but it can also be high in salt, coconut fat, refined starch and sugar. The aim of a heart-healthy diet is not to give up your cuisine but to adjust the proportions and cooking methods.

The big principles

1. Less salt: to lower blood pressure.
2. Less saturated and trans fat: to lower LDL ("bad") cholesterol.
3. More fibre: from vegetables, fruit, pulses and whole grains.
4. More fish and plant protein instead of fatty red meat and processed meat.
5. Less sugar and refined starch, to protect against diabetes and fatty liver.
6. Healthy weight and portions.

Foods to enjoy

• Vegetables and mallum: gotukola, kankun, murunga leaves, beans, ladies' fingers, pumpkin, brinjal, snake gourd, bitter gourd. Aim for at least half your plate.
• Fruit: guava, papaya, orange, apple, pomegranate, wood apple, in small portions and whole rather than as juice.
• Pulses: dhal, green gram, chickpeas, cowpea, soya. They lower LDL cholesterol and are rich in protein.
• Fish: especially oily fish such as mackerel (kumbalawa), sardines (salaya), tuna (balaya), and fresh seer fish. Two portions or more a week.
• Whole and less refined grains: red rice, parboiled rice, kurakkan, oats, whole-wheat bread and roti.
• Nuts and seeds: a small handful of unsalted cashews, almonds or groundnuts, and sesame.
• Low-fat dairy: curd, low-fat milk, in moderate amounts.
• Herbs and spices: garlic, turmeric, pepper, cinnamon, curry leaves, lime and tamarind add flavour with no salt.

Foods and habits to limit

• Salt: dried fish, salted fish, pickles (achcharu), soy sauce, stock cubes, instant noodles, chips and crackers. Aim for less than 5 g (one teaspoon) of salt a day.
• Coconut milk and oil: use thin coconut milk, less often, and cook many curries with little or no coconut.
• Ghee, butter, vanaspati and palm oil: use sparingly.
• Deep-fried foods: short-eats such as cutlets, patties, rolls and vadai, fried fish and chips. Choose baked, grilled, steamed or pan-fried foods.
• Processed meats: sausages, bacon, ham, canned meat.
• Sweets and sugary drinks: sweetened tea, soft drinks, packaged juices, kavum, kokis, cakes and biscuits.
• Large rice portions: keep rice to about a quarter of the plate.
• Excess alcohol and tobacco, including betel with tobacco.

Simple swaps

• Fried fish → fish curry with little coconut, or grilled fish
• Karawala sambol → fresh fish or egg
• Coconut milk gravy → tempered curry with tomato, onion and spices
• White bread and butter → whole-grain bread with a thin spread
• Cutlets → boiled egg, chickpea or dhal
• Sweetened tea → tea with less sugar, then none
• Packet crisps → roasted chickpeas or unsalted nuts

Healthy cooking methods

Steam, boil, grill, bake, pressure-cook or stir-fry with a teaspoon of oil. Use non-stick pans. Remove skin from chicken. Add lime, herbs and spices rather than extra salt. Reduce the amount of oil you use by measuring it, about 3-4 teaspoons per person per day.

Sample day of meals

Breakfast: one or two string hoppers or a small kurakkan roti with dhal curry and pol sambol in a small amount, or oats porridge with fruit. Unsweetened tea.

Mid-morning: a guava or small handful of nuts.

Lunch: red rice (a quarter of the plate), fish curry, dhal, a cooked vegetable and a mallum or salad.

Evening: boiled chickpeas or green gram, or fruit, with plain tea.

Dinner: a smaller portion of rice or roti with vegetables, egg or chicken without skin, and curd.

Heart health beyond diet

Be active for at least 150 minutes a week, aim for a healthy weight, do not smoke, and limit alcohol. Check your blood pressure, cholesterol and sugar regularly. Use our calculators to check your BMI, LDL cholesterol and waist-to-height ratio, and read how to lower cholesterol and how to lower blood pressure.

If you already have heart disease or diabetes

Follow the specific advice from your doctor or dietitian. People with kidney disease may need to limit potassium, and those with diabetes need to watch carbohydrate portions. See our diabetic diet guide for Sri Lanka.

When to see a doctor or dietitian

Ask for a personalised plan if you have high cholesterol, high blood pressure, diabetes, heart disease or kidney disease, or if your weight keeps rising despite effort.

References

• World Health Organization: healthy diet fact sheet
• American Heart Association: dietary guidance to improve cardiovascular health
• Sri Lanka Ministry of Health, Nutrition Division: food-based dietary guidelines for Sri Lankans
• DASH trial, New England Journal of Medicine