Jaden’s mom writes, “My son’s coach takes the kids to Subway after swim meets, and I worry because I’ve heard that processed meat used in sub sandwiches causes cancer.”

From Subway to Firehouse Subs to Jimmy John’s, subs are a popular choice for athletes. While there are many choices at sub shops, many do include processed meats. Let’s talk about what that means and if the health risk is as great as you might think.

Processed meats, including bacon, ham, hot dogs, corned beef, bologna, deli meats, and beef jerky, are preserved or “processed” to enhance flavor and preserve foods by smoking, curing, salting, or adding preservatives.  The American Institute for Cancer research says there is an increase risk of colon cancer from consuming processed meats, and they also suggest limiting red meat to 18 ounces per week, also to reduce colon cancer risk.

But, recently, I attended a conference and heard Dr. Dominik Alexander, an epidemiologist at EpidStat Institute in Ann Arbor, Michigan speaking about diet and cancer. Dr. Alexander started his presentation with a provocative question, “Name a single food that is clearly and convincingly established as causing or preventing cancer?” He went on to explain that studies of diet and cancer show correlations (and not always strong correlations), not causation. “Cancer formation is multi-factorial and it is complex; it may be impossible to fully disentangle the true association of a single food on cancer development.” He also reminds us that food is not eaten in isolation, and the interplay of various foods in the diet, along with other lifestyle choices greatly affects cancer risk.

So, back to your question: sub shops offer a variety of choices, and to make the sandwich nourishing for a young swimmer, I suggest the following strategies:

• Mix it up. It is OK to choose the cold cut combo now and then, but also consider rotisserie chicken, roast beef, or tuna subs. Most subs contain at least 20 grams of high quality protein, making it a good recovery meal.
• Load up on the good toppings. Lettuce and tomato are fine, but don’t overlook the banana peppers, cucumbers, green peppers, shredded carrots, or jalapenos. Some sub shops also include spinach, sauerkraut, or red cabbage as sub toppers; all nutrient-rich choices.
• Bread is good: The carbs in the sub roll help replace the glycogen lost during intense training and competition. There are so many choices so go with what you like. Whole grain rolls provide more fiber, but white or wheat rolls are enriched with B-vitamins and iron and are fortified with another B-vitamin, folic acid. Don’t be fooled by the spinach wrap; very little spinach is in the wrap, so you are better off adding spinach as a topping.
• Watch the sides: Sugary soft drinks and chips may round out the combo, but water is a better choice, and look for baked chips when available.

Dr. Alexander concluded by saying, “what science does continue to tell us is that the best way to prevent cancer is to follow an overall balanced diet, maintain a healthy weight, be physically active, and don’t smoke.”  So, keep on swimming, maintain a healthy weight, never, ever smoke, and enjoy all foods in moderation.

Dr. Alexander spoke at a conference that was sponsored and paid my travel expenses, but I was not asked to write this article and I was not compensated by any group to write this. I have no affiliation with any of the sub shop places mentioned in this post.