Making Better Sandwiches, Fixing Nutrition Advice, and Eating Vegetables

Yesterday I scanning my twitter stream and almost cried.

A pretty well regarded nutritionist/RD who gets a lot of media, so his/her message is being heard by lots of people, was dolling out tid bits of nutrition advice which is usually good until I came across this.

“Remove half the pile of meat & replace w/ lots of veggies. The fiber will help fill u up & u won’t miss the calories ”

Not the best advice, but let’s turn this into a learning experience and see how we can acutally make sandwiches better (spoiler alert – it doesn’t have anything to do with eating less protein). Here are some points that I think are worth making.

Eating more vegetables doesn’t mean eating less protein/meat – I see all the times online and in food/nutrition magazines. Everyone is always trying to get people to replace meat with vegetables…but why? I think this advice stems from epidemiological research that generally corals people into two groups – high fat/meat eaters and vegetable eaters. The high fat/meat eaters always suffer from chronic disease and die early. This 50,000 foot view on nutrition and eating habits is naive at best. Even in the most perfect light, population based studies only show statistical associations and not cause and effect, so we should always take the conclusions from these studies with a grain of salt.

The classification of high fat/meat eaters also includes other less than optimal dietary and life habits such as eating lots refined sugars, doing less exercise, and smoking are the three that first come to mind. So the question then becomes does eating meat and a higher fat diet cause problems or do people with an array of bad habits enjoy not the healthiest cuts of meat? The latter seems to make more sense (wouldn’t you agree?)

Instead of replacing meat, can’t we just eat more vegetables?

This brings us to calories and the fact that calories aren’t equal.  The core of the ‘make your sandwich better’ strategy was a reduction of calories; unfortunately via an ‘all calories are created equal’ approach. All calories aren’t equal. If they were, replacing calories from carbohydrates with calories from protein wouldn’t improve your health (but it does, in a big way). This point was brought to the attention of millions of people last night on 60 Minutes when they did a story on the toxic effect of sugar and showed that by replacing a quarter of people’s calories with sugar sweetened beverages led to deleterious cardiovascular effects. Same number of calories, different outcome.

I don’t know why the all calories are not equal debate is even a debate as practicably we all know this to be true. If you sat down and ate a meal consisting of grilled salmon with wilted spinach and olive oil and then later in the day ate the equivalent amount of calories from a bag of chips – you’d feel different after each meal. Same calories, different effect.

Knowing that all calories aren’t created equal, is removing protein the best strategy for improving a sandwich? My vote is for no. Instead, let’s improve the carbohydrate:protein ratio of the sandwich by getting rid of some less than desirable carbohydrates while adding some more protein and vegetables.

Here’s a practical example.

On Friday I was flying back from Utah where I was the keynote speaker at the Utah State Dietetics Association State Meeting, the conference was great, the travel was not. My trip back consisted of the following connections:

Utah -> Arizona -> Philadelphia -> State College

My connection in Arizona was tight so while running through the airport, I was doomed to grab a sandwich at the California Pizza Kitchen ToGo stand. Sitting on the plane, getting ready to eat this sandwich I was given the task of making that sandwich a better lunch option than it currently was. First there was waaaaay to much bread so there was no way I was going to each both halves (it would have been more bread that I had eaten all month!). If I was to take the vegetables from one half, put it on the other half of the sandwich, while removing and disgarding some of the turkey (per the twitter advice) – how would that have made the sandwich better?

It wouldn’t.

Instead I took all the turkey and vegetables from one half of the sandwich and put in on the other half, tossing in the trash the remaining bread from the now empty sandwich half. I then removed the top slice half of the sub roll and got rid of it as well. This left me with one slice of bread, 2x vegetables, and 2x turkey. I added a couple packets of mustard and was ready to enjoy my carb reduced open face sandwich.

When looking to optimize your diet remember that eating more protein does not mean that you need to eat less vegetables and no matter what you hear, calories are not all created equal (deep down you know this is true anyway).