Diabetes and sandwiches

Posted: April 10, 2011 by amygilman in Nutrition Q & Amy
Tags: , , ,

I am a Nutrition Editor at Foodpicker.org, a website designed to help people with diabetes.  Here is a question I recently received:

Question

On my lunch breaks I go to a sandwich shop.  I usually get a large deluxe sandwich with a side of potato salad or coleslaw.  Now that I have diabetes, I’m trying to modify my lunch order.  Can you make some suggestions of what to order?”

Answer

Kudos to you for taking an interest in modifying your lunch to help manage diabetes.  Eating out at a sandwich shop can be inexpensive and convenient however it may not always be healthy.  There may be many options that pack on the sodium and fat, which as you know is not an optimal situation for people with diabetes.  As an informed consumer, you can make healthier choices and still enjoy the price and the convenience of the sandwich shop.

Here are some tips for making healthy choices at a sandwich shop:

  • Convert from less healthy choices to healthier options:
    • Instead of high-fat meat such as ham, tuna (with a lot of mayo), bacon, meatballs or steak, try ordering lean meat such as chicken breast, turkey breast, tuna (without may), or a veggie sandwich.
    • Substitute low-fat cheese for regular cheese.
    • Choose whole grain bread instead of white or take one slice off and eat it as open-faced (depending on how many carbohydrates you need at each meal).
    • Substitute fresh fruit or a garden salad for the side of potato salad or coleslaw.
  • Prepare ahead: Many restaurants may have nutritional content on their website or in a pamphlet that you can pick up at the location.  Take a look at the nutrition facts to find optimal choices such as low fat, low calorie, and/or low sodium.  Sometimes a seemingly innocent little sandwich may appear healthy from a picture or a description, but may be a landmine of fat with some mayo-based dressing.  Let’s look at the some of the breads offered at Subway Restaurants (as an example) and figure out how to analyze the nutrient information.
    • 6” Italian white bread (calories-200, total fat-2g, sodium-390 mg, carbohydrate-38g, fiber-1g)
    • 6” 9-Grain wheat bread (calories-210, total fat-2g, sodium-410mg, carbohydrate-41g, fiber-4g)
    • 6” Roasted Garlic (calories-230, total fat-2.5g, sodium-1360mg, carbohydrate-45g, fiber-2g)
    • 6” Hearty Italian bread (calories-220, total fat-2g, sodium-390 mg, carbohydrate-41g, fiber-2g)
    • 6” Honey Oat (calories-260, total fat-3g, sodium-430mg, carbohydrate-49g, fiber-5g)

Source:  www.subway.com

The first thing that jumps out at me here is that the 6” Roasted Garlic has 1360mg of sodium.  Raise the red flag here as the current recommendations from the American Heart Association are to limit your daily                              sodium intake to 1500mg (Source:  www.heart.org) so this would be almost a day’s worth of sodium at one meal (and that is  just from the bread).  Next let’s look at fiber.  The two options for the highest fiber are the 6”         Honey Oat (5g ) and the 6” 9-Grain wheat (4g).  Since the Honey Oat has more calories, carbohydrates and fat, the optimal solution here may be to go with 9-Grain wheat bread.

  • Portion control: Portion control is important with sandwiches and subs as many places will serve enough food to feed all of your coworkers.  A suggestion would be to eat half of the sandwich and save the other half for the afternoon (about 3 hours later).  By cutting your portion in half PLUS eating three hours later, you may find you have better control over your blood sugars.  Sometimes if we eat a huge meal at noon and then nothing until 7pm, the blood sugars may spike and drop to extremes.
  • Drink water at your meal: This will help keep you full and is a much better option than soda.  Soda is a huge source of hidden calories and sugar.  (Note:  some populations may be required to drink in between meals and not during meals, such as those who have undergone bariatric surgery).
  • Special order: If nothing on the menu seems healthy, ask for something special.  Many restaurants will be accommodating for these types of requests.  Order a sandwich with whole grain bread, a small amount of turkey, load up the vegetables and top it off with a tiny bit of olive oil.
  • Eat mindfully: The last tip I will leave you with is to always be present while you are eating.  Try not to watch TV or work on your computer when eating.  Eat slowly and aim to chew your food about 20 times per bite.  This will help you learn the body’s cues for telling you when you are full.  Mindful eating also relaxes you, which may be better for digestion and may make you feel more satisfied.

Thank you for the question and I’m so happy to hear that you are making changes for a healthier you!

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