Nearly half of all U.S. adults eat a sandwich a day. That means collectively we open our mouths and stomachs to at least 120 million sandwiches daily. And that's a problem, say researchers, because the beloved food is often loaded with sodium and fat—ingredients that can increase our risk of high blood pressure and cardiovascular disease.
"Many sandwiches, such as burgers and franks, and common sandwich components, such as yeast breads, cheese, and cured meats, are among the top contributors not only to sodium but also to energy in the diets of adult Americans," says nutritionist Cecilia Wilkinson Enns, co-author of a recent diet study published in the Journal of the Academy of Nutrition and Dietetics. Wilkinson Enns and her colleagues define a sandwich as anything made of bread and fillings, from watercress and cucumbers on a fat-free pita to a double cheeseburger with bacon.
Americans are getting nearly one-fifth of their recommended daily sodium intake from sandwiches alone, Wilkinson Enns and her colleagues found. And people who eat sandwiches tend to eat 300 more calories and 25 percent more sodium daily than those who don't.
That doesn't mean sandwiches are bad—you just have to build them right so they enhance your diet rather than bomb it. "The nice thing about sandwiches," says University of Illinois' Director of Sports Nutrition Chelsea Burkart, "is they're almost always a carb-driven combination of carbohydrates and protein. And athletes absolutely need more carbs."
Here's how to build a better sandwich:
Look for 100 percent whole grain or whole wheat bread with at least 20 percent daily value for fiber, says New York-based dietitian Mary Hartley. That way, you're knocking out a good chunk of your carb and fiber needs for the day. And while flatbread and pita appear smaller in volume, their calories tend to be more concentrated. Subway's six-inch flatbread, for example, has about the same amount of calories (220), as the company's other six-inch breads.
There's a saying among dietitians, says Burkart: the less legs, the better. In other words, animals with fewer legs, like turkey, chicken, and tuna, provide leaner meats. Also, take a look at the marbling of the meat. "That's fat," states Burkart. "So an Italian sub—every single meat in there is marbled. But it's not that fat is a problem so much as you're getting less protein."
And fresh meat has less sodium than preserved meat like prosciutto, cold cuts, or canned tuna, Hartley points out.
If you'd rather go meatless, opt for eggs, veggie patties with at least ten grams of protein per serving, like Sunshine's Quarter Pound Original burgers, and just about any natural nut butter. Just keep in mind you should aim for 20 to 30 grams of protein per meal, and most veggie patties alone won't hit that number. In that case, says Burkart, make up for it with a glass of whole milk.
Also, use your sandwich as an opportunity to load up on fresh vegetables. "Every sandwich," says Hartley, "is a vehicle for vegetables." Or even fruits like cranberries, apples, and oranges. "Really, any vegetable you can think of. The only vegetables that are high in sodium are pickles, pickled vegetables, sauerkraut, kimchi, and other fermented items. So go easy on them," Hartley says.
As for cheese, "cheese," gushes Burkart, "is awesome." Low-fat is fine, but be wary of shredded cheeses, as they tend to contain additives.
Holding off on high-fat spreads like Russian dressing and mayonnaise will cut calories—and taste. Boost the flavor with low-fat, low-added-sugar spreads like chutney, fig jam, bananas, sliced mangos, or cranberries. Hummus is good because it adds fiber.
If you're going for a fruit spread, particularly spreads touted for their antioxidants like cranberries (which are great for decreasing free radicals and improving recovery), the key is freshness. Their efficacy depends on how recently they were made. "Because antioxidants are not very stable, heat treating and shelf life play a role in their effectiveness," cautions Burkart. "So the antioxidants are usually lost in a processed food spread."