There are some nutritional advice givers who would have you believe that to eat healthily you need to have a ‘superfood’ salad every lunch time, washed down with some health supplements and a special exotic ingredient detox juice. In the real world what we hear from patients is a need for familiarity, consistent non-conflicting messaging and convenience – realistic, appealing and economically viable solutions within a busy working life.
The problem with the media visible evangelical diet crowd (often with a product incentive) is that they distract the average person from simple dietary principles and discourage and put some people off completely with extreme advice. The problem with the (Fast Moving Consumer Goods/FMCG) food industry is that ‘convenience’ normally equates to added-value poor quality processed foods and ‘health’ to fad or restrictive products.
It’s impossible to ignore the ubiquitous sandwich. In the Western world it is a working lunchtime favourite associated with supreme convenience on-the-go. Some UK surveys now suggest that half of us eat both breakfast and lunch at our desks! This pattern of eating is a clear contributor towards declining health trends. We see this recurrently in our morbidly obese patients who tell us that they don’t eat meals — this is driven by busy lives, the need for economical convenience and a public subconscious misconception that a healthy diet is about restriction (rather than a focus on ‘protective’ eating).
Personally we tend to split our breakfast-lunch meal options into quick weekday choices vs. weekend choices where we have more time. We can definitely relate to the mutually exclusive relationship between healthy eating and time — the working lives of doctors are busy, unpredictable (no defined lunch time) and unless you are organised we are at the mercy of what’s available in the hospital. The quality of hospital food is a completely different subject in itself but in reality the average UK working lunch sandwich is an unhealthy offering. Classic examples are two slices of sad and floppy low-quality white bread smothered with a thick layer of margarine or mayonnaise with a filling of processed meat or cheese. The focus is purely on volume and energy — a stomach filler or a hunger subduer rather than protective nutritional vehicle.
For these reasons the working sandwich has developed a bad reputation but a good sandwich can be an amazing culinary experience and healthy. It can be a vehicle package for wholegrain/ fibre/seeds (via good quality bread) with protective ingredients including oily fish and salads/vegetables. This requires imagination and a change in attitude to what the humble sandwich represents. Remember the quality of the ingredients is key — for example there is a huge difference between highly processed or preserved ham and quality charcuterie.
Tuna-sweetcorn mayonnaise is a popular choice and so with this sandwich filler we have ‘pimped-up’ the basic offering with cardiovascular health in mind. Tinned tuna is fine but sardines are better — you will generally have higher preserved Omega-3 fat content. The crunch texture adds to the eating enjoyment and is achieved by adding lots of chopped vegetables. Instead of smothering the mix in mayonnaise we use only a small amount and combine with hummus to create the feel of a luxurious, rich dressing. You can buy excellent pre-made extra-virgin olive oil hummus at most supermarkets which is essentially 45% fibre-rich chick peas with extra-virgin olive oil, tahini (sesame seed paste), garlic, lemon juice and seasoning. Finally we fill a high-quality wholemeal wrap or Pitta with as much mix as possible and finish with a handful of fresh baby spinach leaves for that extra all round boost. Just as good as an ‘open sandwich’ with a single slice of multi-seed wholemeal bread piled high with Rainbow Crunch and spinach leaves.
This sandwich filler perfectly illustrates the concept that the health of your meals is about what you put in (protective foods) rather than simply what you take out (damaging foods).