Sandwich Trouble

Sandwiches are a staple of the American diet, just as they are in the diet of pretty much every Western country. On any given day, 49% of adults in the United States will eat at least one sandwich. This may sound like a good thing — after all, sandwich chains like Subway have promoted themselves as healthy alternatives to other types of fast food. But even though they have a fairly innocent reputation, it turns out that sandwiches may be contributing to some of the problems in the typical American diet.

A study released last week looked at what nutrients sandwiches contribute to the typical diet. Published in the Journal of the Academy of Nutrition and Dietetics, the study used data from a 2009–2010 survey called “What We Eat in America,” part of the National Health and Nutrition Examination Survey by the Centers for Disease Control and Prevention (CDC). It asked 5,762 adults over the age of 20 what they had eaten and drunk on the previous day. Using codes for individual foods and data on the typical nutrient content of these foods, the researchers then calculated the estimated nutritional intake of each study participant.

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As noted in an article on the study at Medical News Today, the researchers found that sandwiches contribute, on average, 30% of the recommended daily intake of sodium, which is 2,300 milligrams for the general population. According to the CDC, however, many Americans should limit their sodium intake to 1,500 milligrams each day. This group includes people ages 51 and above, African-Americans, and anyone with diabetes, high blood pressure, or chronic kidney disease. About half of the US population, and most adults, fall under the lower-sodium-intake recommendation. So most adults are actually consuming 46% of their recommended daily sodium intake whenever they eat a sandwich. Since most Americans consume far more sodium than is recommended — the average daily intake is over 3,400 milligrams — the impact of sandwiches on sodium intake should not be taken lightly.

To make matters worse, it turns out that sandwiches also tend to be associated with increased calorie consumption, an outcome that the researchers didn’t expect. The average sandwich-eater, according to the study, consumed about 300 calories more than the average non-sandwich-eater on the day of the survey. Less surprisingly, the average sodium intake of sandwich-eaters was about 600 milligrams more than that of non-sandwich-eaters.

So what accounts for the typically high amount of sodium in sandwiches? A quick survey of the sandwich recipes here at DiabetesSelfManagement.com shows a wide range of sodium content among different sandwiches, from 253 milligrams in salmon sandwiches with spicy apricot sauce to 1,296 milligrams in ham and cheese on a stick. (Most of the recipes have low to moderate sodium content.) A pattern is clear: Sandwiches that contain processed and/or packaged items like ham, deli meats, and cheese tend to have higher sodium than those that contain home-cooked meat, poultry, or fish. And here may be the crux of the problem. Sandwiches are popular because they are easy to prepare, yet the most convenient sandwich ingredients typically have the worst nutritional profile. If everyone had to roast a chicken or grill salmon to make a sandwich, sandwiches would probably be far healthier but much less common.

What’s your position on sandwiches — do you eat them regularly? Do you rely on store-bought fixings for them, or do you make your own? Have you found any convenient methods of making sandwiches that aren’t high in sodium? Are people who want to limit their sodium (and calorie) intake better off just avoiding sandwiches altogether? Leave a comment below!

  • Lloyd Gillette

    One method I use to reduce sodium, carbs and calories in my sandwiches is to eliminate 100% all wheat bread altogether and use 100% whole wheat tortillas instead. I’ve really become a fan of wraps since being diagnosed with type 2 diabetes and control my diabetes with just exercise and smart diet choices.

  • BK

    My favorite sandwich, only available in the summer unfortunately, is Healthy Life Lite Italian bread (35 cal /slice) toasted with Kraft fat free mayo (10 cal /Tbsp), sliced fresh tomato from the garden and a generous portion of Romaine leaves. Who needs bacon! Not me for sure. Sorry about the brand names, but anything else is just not as good. Downside is not much protein.

  • JohnC

    The problem with sandwiches they contain bread or buns… with a lot of carbs that raise my blood sugar way too much and too fast (yes even whole grains). A lot of years ago it was glaring that so much of what you eat is in between two slices of bread. Really hard to cut back on carbohydrates. On the rare occasion I eat a sandwich, I’ve become pretty good at getting rid of the bread as I eat — I always have fun explaining to others why there’s a pile of bread on my plate. I get that look — the old guy is crazy :)
    And I do go easy on the sodium, even though it doesn’t really effect my blood pressure.

  • Kathah

    I have been using Healthy Life Wheat and/or flax seed breads. Unfortunately I also use ham most of the time, though sometimes turkey, tuna. or egg salad. Occasionally I make wraps but they have more carbs and calories than the Healthy Life bread. The rest of the day I am typically more careful about my salt. My blood sodium level is always below normal so my doctor doesn’t complain.

  • KC

    Never really thought about this before so thanks for the heads-up. Just looked at sodium content of cold cut brand we prefer (Dietz and Watson) and am glad to see a couple of lower sodium options. Bread is often a problem, especially in restaurants just because it’s hard to estimate carbs. Glad to have a locally available bran bread–tastes good and only 10 grams of carbs per slice.