Sandwiches Are Major Contributors of Sodium in the Diets of American Adults: Results from What We Eat in America, National Health and Nutrition Examination Survey 2009-2010

Efforts to sharpen the focus of sodium reduction strategies include identification of major food group contributors of sodium intake. Although sandwiches are a staple of the American diet, previous examinations of their contribution to sodium intake captured only a small subset of sandwiches. One day of dietary intake data from 5,762 adults aged 20 years and older in What We Eat in America, National Health and Nutrition Examination Survey 2009-2010 was analyzed. Sandwiches were defined in a manner that more accurately reflected their frequency of consumption. Two-sided t tests were used to compare percentages of men and women reporting sandwiches; contributions of sandwiches to energy and sodium intakes (amounts in kilocalories and milligrams, respectively, and percent of daily totals) by sex; and total energy, total sodium, and sodium density (mg/1,000 kcal) by sandwich reporting status (reporter/nonreporter). On any given day, 49% of American adults ate sandwiches. A significantly higher percentage of men than women reported sandwiches (54% vs 44%, respectively; P<0.001), and sandwiches accounted for higher percentages of men’s total energy and sodium intakes. Compared with individuals who did not report a sandwich on the intake day, sandwich reporters had significantly higher energy and sodium intakes; however, sodium density of the diet did not vary by sandwich reporting status. Although much national attention is appropriately focused on reducing sodium in the food supply, consumer choices still play a vital role. Due to sandwiches’ frequent consumption and considerable contributions to sodium intake, substituting lower-sodium for higher-sodium ingredients in sandwiches could significantly influence sodium intakes.