Build a Better Pizza

Keep your eye on a healthier pie

By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column

Reviewed By Kathleen Zelman, MPH, RD, LD

Ask any child for a list of his or her favorite foods and I'll bet a pile of pepperoni that, nine times out of 10, pizza makes the cut. This doesn't appear to be something we outgrow, either: In the 2002 Comfort Foods Poll, pizza was ranked the sixth most popular food among the more than 40,000 respondents.

But can you eat pizza and still eat healthily? The answer lies in the toppings, and the more Italian the pizza, the better.

As long as it's authentically Italian pizza, with a thin and bready (not greasy) crust made with a touch of olive oil, the crust isn't bad at all. Top it with lots of pizza sauce made with cooked tomatoes, olive oil and spices, and you're getting a nice dose of antioxidants.

Which brings us to the cheese: Cheese is a good source of protein and has vitamin B-12, calcium, vitamin D, and other vitamins and minerals. But it also contributes fat, saturated fat, and cholesterol, so don't go overboard. If you are making your pizza at home, use part-skim mozzarella and reduced-fat sharp cheddar to cut the fat and cholesterol almost in half.

A recent Italian study reported that pizza showed the most cancer-prevention promise of the many Italian foods tested. People who ate a slice or more per week had 59% less risk of esophageal cancer, 34% less risk of oral-cavity and pharyngeal cancer, and 25% less risk of colon cancer than others. Researcher Silvano Gallus, PhD, says he believes there is a protective compound in cooked tomatoes that may partly explain this effect.

Here are pizza ingredients with anticancer potential, according to recent research:

  • Tomato products. Tomatoes contain lycopene, an antioxidant also found in pink grapefruit and watermelon. Studies show it may help protect against breast, colon, lung, and prostate cancer. When looking for lycopene, there are two rules to follow: cooked or processed tomato foods actually contain more than raw tomatoes, and a little fat (like olive oil) makes it more available to body tissues.
  • Olives and olive oil. Olives contain the antioxidant hydroxytyrosol. They're also considered a flavonoid-rich food, and people who eat such foods are less likely to develop various types of cancer.
  • Onions and garlic. Both contain anti-carcinogenic compounds called organosulfer compounds. Men in China have the world's lowest rate of prostate cancer, and a diet rich in garlic, shallots, and onions may be one reason. Plants in the onion family contain other phytochemicals with antitumor activity.

12 Ways to Build a Better Pizza

If we make a few adjustments in our preferences and portion sizes, we can enjoy a slice or two of pizza as part of a healthy eating plan. Here are 12 ways to get the nutritional benefits of pizza without the extra calories, fat, and cholesterol:

  • Choose a restaurant whose pizza is closer to authentic Italian pizza, with a thinner, breadier crust, more sauce, and less cheese.
  • Order extra sauce to pump up the phytochemicals.
  • Order your pizza with half the cheese.
  • Go for veggie toppings: Onions, green peppers, olives, mushrooms, artichoke hearts, and zucchini add nutrients and fiber.
  • If you have to order a meat topping, ham and Canadian bacon are among the better options. If making pizza at home, use the 75% less-fat pepperoni (Hormel brand) available at supermarkets. If you have to have pepperoni on your takeout pizza, ask them to use half the usual amount.
  • Enjoy your pizza along with a fruit salad and a green salad (made with kidney beans, cherry tomatoes, cucumbers, grated carrots, and reduced-fat dressing, for example). This will encourage you to stop after a slice or two.
  • Don't make a pizza meal worse by ordering high-fat and high-calorie side dishes such as Buffalo wings or cheese bread.
  • If ordering at one of the chains, choose a slice of cheese or veggie lover's pizza.
  • Among Pizza Hut's Hand Tossed Pizzas, these are the best choices: Cheese (240 calories, 10 grams fat per slice), Ham (260 calories, 10 grams fat), Veggie Lover's (220 calories, 8 grams fat), and Chicken Supreme (230 calories, 7 grams fat).
  • Of Pizza Hut's Thin 'N Crispy Pizzas, these are the best choices: Cheese (200 calories, 9 grams fat per slice), Ham (170 calories, 7 grams fat), Veggie Lover's (190 calories, 7 grams fat), Chicken Supreme (200 calories, 7 grams fat).
  • At Domino's, the better options include Thin Crust cheese-only pizza, with 191 calories and 8.3 grams of fat in one slice of a large pie; Classic Hand Tossed cheese only, with 258 calories and 7.75 grams of fat for per slice of a large pie; and Hand-Tossed Vegi Feast pizza, 302 calories and 11 grams of fat.

Originally published August 28, 2003.
Medically updated Jan. 20, 2005.

SOURCES: International Journal of Cancer, July 2003. American Journal of Medicine, Dec 30, 2002. Food & Fitness Advisor, April 2003 and December 2002. American Institute for Cancer Research News, Winter 2002. National Cancer Institute Reports, November 2002. Young S. Kim, Ph.D., National Cancer Institute program director.

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