1. Choose 100 percent whole-wheat or whole-grain bread.
2. The fiber will help keep you full longer. I am not a fan of "diet" breads because I think they are generally too small and will not fill you up enough. A slice of bread should contain at least 3 grams of fiber, but no more than 100 calories.
3. If ordering a sandwich out, try to get it on sliced bread for portion control, rather than on a roll, bagel, or hero. If you do get the latter, make sure you "scoop" out the doughy inside and still opt for whole wheat if available. Wraps and pitas can also make for a great sandwich, but read the label, if possible, since they are sometimes sized for two not one.
4. 2. Add lean protein.
5. Ideal protein choices include 3 to 4 ounces of skinless chicken, fresh-roasted turkey, tuna canned in water, tofu, lean ham, or smoked salmon. If having sliced meat, figure that a single slice is approximately 1 ounce unless it's sliced extremely thin. Try and limit the very high-fat options like pastrami, corned beef, and salami.
6. If going meatless, I do like cheese, especially with hummus. If you want cheese and meat on your sandwich, then I suggest you subtract one slice of meat to make room for one slice of cheese. Eggs can also be great sandwich companions, but I recommend tossing all but one yolk and having no more than four whites to reduce calories.
7. 3. Include healthy fat.
8. Here is where a lot of people get into trouble. Fat belongs on a sandwich, it helps keep you satiated. I generally recommend that my patients skip anything made with regular mayonnaise, especially when eating out. It is surprising how many calories a simple tuna salad can have. If you are making your sandwich at home, I recommend using low-fat mayo. Or better yet, substituting mayo for hummus, low- fat plain yogurt, avocado, or oil and vinegar. Making egg salad with hummus is one of my favorites. If getting a sandwich from the deli, ask for mayo on the side or try switching to mustard.
9. 4. Pile on the vegetables.
10. As per No. 2 above, you need to watch how much protein you pile on your sandwich; too much equals too many calories. But with veggies, the more the merrier. Lettuce, cucumber, onion, tomato, roasted peppers, spinach—all help to create a larger, more filling sandwich without enlarging your waistline. Also, the more raw veggies on the sandwich, the longer it takes to chew, thus the slower you eat, and the more satisfied you feel.
11. 5. Don't be fooled.
12. Grilled veggies on a sandwich don't always make it a healthy option, though; sometimes they are loaded with calories from the oil. Pre-made sandwiches of simple sliced chicken or turkey can be deceptively high in fat if they contain dressings like ranch, blue cheese, or Caesar. And whole-wheat pitas and wraps don't automatically make for a healthy sandwich: They can be extra-large and overstuffed. Better off ordering ½ a sandwich in those cases.
13. Options for great-tasting, healthy sandwiches are endless. Some of my favorite combinations include:
14. • 2 tablespoons hummus, ¼ avocado, 2 slices smoked salmon, tomato, red onion, and cucumber.
• 3 egg whites chopped with 2 tablespoons hummus, topped with ¼ avocado, tomato, cucumber, red onion, and lettuce.
15. • 1 sliced grilled chicken breast or 4 slices turkey, ¼ avocado, tomato, cucumber, and lettuce.
16. • 3 scrambled egg whites on black-bean hummus, avocado, and tomato.
17. • 1 small can tuna mixed with chopped red onion, celery, and low-fat plain yogurt topped with tomato and lettuce. I tend to eat my sandwich open faced on either 100 percent whole-grain bread or a scooped whole-wheat bagel. This way it takes longer to eat and psychologically I feel I am eating more. Give me a piece of fruit for dessert and I am golden. If you like sandwiches, then forget about forgetting them. Instead, see them as an opportunity for a very healthy meal.