Pakistani cuisine is often spicy and also known for its richness. It is a distinct blend of foods from Afghanistan and Iran with strong culinary influences from the Middle East. Central and West Asian cuisines were brought more than 500 hundred years ago, fused with the already indigenous South Asian cuisine found in the Indus Valley and the Punjab.The food can also varies greatly from region to region within Pakistan, reflecting the country's ethnic, cultural and culinary diversity. The cuisine in Sindh and the Punjab can be very hot and spicy, and is generally identical to foods consumed in northern India. Food in the North-West Frontier Province, Baluchistan and Northern Areas is more similar to dishes found in Afghanistan, Central Asia, Iran and the Middle East, where mild aromatic spices are used. The main course is served with wheat bread (naan) or rice. Salad generally is taken with the main course rather than before. Assorted fresh fruit or desserts are consumed at the end.Meat (including Beef) plays a more dominant role in Pakistani food, compared to other South Asian cuisines. According to a 2003 report, an average Pakistani consumed three times more meat than an average Indian. International cuisine and fast foods are popular in cities. Blending local and foreign recipes (fusion food) is common in large urban centers. Furthermore, as a result of lifestyle changes, ready made masalas (mixed and ready to use spices) are becoming increasingly popular.