To Lower Sodium Intake, Skip the Sandwich

Sandwiches are major contributors to daily sodium and calorie intake, a new study suggests.

On any given day, approximately 49% of all Americans aged 20 years and older eat at least 1 sandwich, which accounts for one-fifth of their total daily sodium intake, according to research from the US Department of Agriculture.

The 2010 Dietary Guidelines for Americans recommend a maximum daily sodium intake of 2300 mg, although certain medical conditions necessitate a daily intake of 1500 mg. The study results determined that the sodium levels in sandwiches comprise 30% of the less restrictive guideline and 46% of the more restrictive allowance.

Sandwich-eating participants also had higher sodium intakes than non-sandwich eaters, consuming an extra 600 mg of sodium per day, on average.

Participants who ate sandwiches had significantly higher calorie intakes on the days they consumed a sandwich, taking in an average of approximately 300 additional calories.

“The unanticipated finding that sandwich consumption is associated with higher overall intake of energy underscores the importance of making healthful choices of sandwich ingredients,” said study co-author Cecilia Wilkinson Enns, MS, RD, in a press release. “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.”

According to the study authors, higher levels of sodium intake among sandwich eaters were linked to higher levels of daily energy consumption, as well.

“Regardless of sandwich reporting status, sodium density was approximately 1700 to 1800 mg per 1000 kcal, suggesting that the higher sodium levels of sandwich reports are explained by their higher energy intake,” study co-author Rhonda Sebastian, MA, said in a press release.

The research, which appears in the Journal of the Academy of Nutrition and Dietetics, faced a unique challenge with the ingredient combinations that can comprise each sandwich. Prior analyses defined sandwiches using a single reference code for the item, rather than breaking each sandwich into its component ingredients and then assigning reference codes for them. In doing so, those studies found sandwiches comprised only 4% of daily sodium intake.

The new study, which relied on data from the federal nationwide “What We Eat In America NHANES 2009-2010” survey, allowed participants to report the ingredients in their sandwich and show how the items were linked together as a sandwich. The survey also allowed participants to report certain sandwiches—particularly fast-food ones—as a single item.

The study authors recommended substituting lower sodium ingredients for higher ones in order to reduce daily sodium intake.