Ask Dr. K: Make your deli sandwich a healthy meal

Sandwich shops can be a convenient lunchtime choice. The downside? Many deli sandwiches are made with cured and processed meats that have been linked to higher rates of heart disease, Type 2 diabetes and colon cancer. Deli meats and cheeses often are loaded with unhealthy fats (saturated fats and trans fats), calories and sodium.

If you can, try to make and bring your sandwiches from home. When you make your own sandwich, you have full control over what’s in it. If that’s not possible, you may need to do some research. Many national chains offer online nutrition information that can help you make better choices.

A balanced sandwich contains lean protein, healthful carbohydrates and a hefty serving of vegetables. To build (or order) a balanced sandwich, follow these basic steps:

Step 1: Start with a healthful foundation. You can make a sandwich on bread, tortillas, crackers, pita or any number of grain-based products. Just be sure to choose a whole-grain variety. That means choosing breads that list “whole” before the grain’s name as the first ingredient. Whole-grain breads have fewer “bad carbs” — carbohydrates that are broken down into rapidly absorbed sugars that increase your risk of getting Type 2 diabetes.

Step 2: Spread on a flavorful accent. Try a small amount of guacamole, mustard, light mayonnaise, roasted red peppers, tomato sauce or salsa.

Step 3: Add lean protein. Most of the meats I see friends eating in sandwiches are full of saturated fat. They are definitely not “lean” protein. Instead, try flaked tuna, chopped chicken, turkey breast, low-fat cheese, lean beef or hummus. If you really love cold cuts, look for whole-deli meats — minimally processed versions with less sodium.

Whole-deli meats are just seasoned and cooked meat, which is then sliced to make sandwiches. Processed deli meats, on the other hand, contain finely ground meat mixed with meat byproducts, preservatives and flavoring agents. I would generally avoid them. (Yes, I take my own advice.)

Step 4: Add crunchy companions to any meat. Consider romaine lettuce, shredded carrots or celery, sliced apples, sliced red and green peppers, sliced cucumbers, tomato, roasted red peppers, mushrooms, snap peas or cherry tomatoes.

Step 5: Think big. Layer your sandwich to make a large and appetizing creation with spinach and watercress, tomato, cucumber and onion.

If you’re a regular reader of this column, you’ve heard it before and you’ll hear it again: eating an unhealthy sandwich (or any type of food) won’t kill you. Unhealthy foods are not like poison — a single sandwich of processed meats won’t do to you what a single dose of arsenic will. Occasional unhealthy foods are not the problem. The problem is a diet that regularly includes them.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.