Type of Sandwich Consumption Within a US Dietary Pattern Can Be Associated with Better Nutrient Intakes and Overall Diet Quality: A Modeling Study Using Data from NHANES 2013–2014

Background Previous research in adults has reported an association between sandwich consumers and increased daily energy, total fat, and sodium intakes and decreased dietary fiber intake. Additionally, sandwich consumers had a lower diet quality, as compared to non-sandwich consumers. However, the research failed to differentiate between the types of sandwiches consumed. Objectives The purpose of this study was to model different sandwiches, using both whole-grain bread (WGB), enriched-grain bread (EGB), and soft taco tortillas, to examine associations with energy (kcal), nutrient intakes, and diet quality, in comparison to the typically consumed sandwich (control). Methods Data from the NHANES 2013–2014 was used to complete the analyses in adults ≥19 years old, and USDA food composites were used to create 5 sandwich types, using WGB, EGB, or soft corn tortillas. Results In the modeling analysis, adults consuming the soft corn tortilla taco had lower energy, as compared to those eating the typical sandwich. Total fat intakes were lower in the WGB and EGB grilled chicken/cheese/vegetable sandwiches and in the soft taco tortilla, in comparison to the control sandwich. Sodium intakes were lower in the WGB and EGB grilled chicken/cheese/vegetable sandwiches and in the soft taco tortilla, in comparison to the typical sandwich consumed. All WGB sandwich models and the soft taco tortilla had greater daily dietary fiber intakes, in comparison to the control sandwich. WGB, EGB, and tortilla sandwiches were also associated with greater intakes of shortfall nutrients. All sandwich models, except EGB with meat/cheese/vegetables, had higher diet qualities, in comparison to the control. Conclusions The current data support the inclusion of certain WGB and EGB sandwiches/tortillas, within recommended dietary patterns, in American adults, and suggest that ingredients within a sandwich, rather than the just the bread component, can be an important contributor to overall nutrient intakes and nutrients to limit in the diet.