I don’t know anybody who doesn’t like pizza — myself included. It’s my dietary Achilles heel. That’s why we have a monthly pizza night at the Kummer house, despite the fact that all four members of the family follow either a Paleolithic diet or an even-stricter Paleolithic ketogenic diet.
The fact that we limit ourselves to eating pizza only once per month should already give you a clue as to whether pizza is healthy or unhealthy. In fact, before I started writing the article, I thought it was common knowledge that pizza is junk food.
My assumption was that people just choose to eat it anyway, much like smokers know that nicotine causes cancer yet continue smoking cigarettes.
However, if you Google the phrase “is pizza healthy,” you get a bunch of search results on the first page with articles from reputable sources that claim that pizza is actually good for you.
I couldn’t believe what I was reading, so I decided to write this article to bust some of the myths surrounding this delicious junk food, and introduce you to a few healthy alternatives to traditional pizza that you can enjoy guilt-free — even if you’re on a paleo or ketogenic diet.
Before we get to that, let’s quickly discuss the three macronutrients that make up pizza (and the importance of each to the human body).
What You Need to Know About Macronutrients
There are three macronutrients: fat, protein and carbohydrates. Only two of the three are essential. That means we have to obtain them via food, because the body can’t make them.
Do you know which two are essential? No? Then keep reading because it’s important!
1. Fat and Essential Fatty Acids
The human body needs fat to function. And because the body can’t make its own fat, you have to obtain it through food. Fat is made up of fatty acids, and many of them are essential.
Fat plays an important role in your body — one that goes way beyond being an excellent source of energy. Every cell in your body uses cholesterol (a type of fat) for its membrane, and a quarter of your brain is made from it.
That’s why it’s so important to have enough healthy fats in your diet.
2. Protein and Amino Acids
The second essential macronutrient is protein, and the building blocks of protein are amino acids. Many of the amino acids you can find in dietary protein are essential amino acids — named such because the body can’t make them.
Nutrition isn’t the only factor that influences our health and wellbeing. Learn more about all five factors you need to pay attention to.
In case you’re wondering, there are also non-essential amino acids that the body can metabolize (make) from essential amino acids.
Protein is important for growing and repairing muscle tissue (and an array of other functions). That’s why it’s so important that you supply sufficient protein from high-quality sources, such as pastured or wild-caught animals.
3. Carbohydrates and Glucose
What you probably didn’t know is that the only macronutrient you don’t have to eat is carbs. There’s no essential building block in carbohydrates that the body can’t make.
That’s right — while some cells in your body require glucose to function properly, you don’t need to supply that by eating carbs. Instead, the body can make it on-demand using a process called gluconeogenesis, which is the creation of glucose from non-carb sources such as fat or amino acids.
So now that you understand why fat and protein are important, but carbs aren’t, let’s take a look at the components of pizza and their ingredients to see how they map to what we’ve just learned.
Components in Traditional Cheese Pizza
Most pizzas consist of a crust, sauce, cheese and optional toppings. For the remainder of this article, I’ll rely on nutritional information from Papa John’s. I realize that every pizza is a bit different, but since Papa John’s is popular and claims to offer “better ingredients” than some of the other chains, I figured I’d use them as an example.
Feel free to look up and plug in the numbers from your own favorite pizza chain. But chances are, they won’t be much different.
The “original” crust of a large Papa John’s pizza has:
- 34 grams of carbs (including 3 grams of sugar)
- 5 grams of protein
- 2.5 grams of fat
The ingredients of the crust include unbleached enriched wheat flour, water, sugar, soybean oil, salt and yeast.
I’ve bolded the problematic and/or unhealthy ingredients, and we’ll talk about them in more detail in a bit.
The cheese Papa John’s uses for its pizza adds the following macronutrients:
- 1 gram of carbs
- 4 grams of protein
- 5 grams of fat
Ingredients include part-skim mozzarella cheese (pasteurized milk, cultures, salt, enzymes), modified food starch, sugarcane fiber, whey protein concentrate and sodium citrate.
Papa John’s original sauce has the following macro profile:
- 2 grams of carbs (including 1 gram of sugar)
- 0 grams of protein
- 0.5 grams of fat
Ingredients include fresh vine-ripened tomatoes, sunflower oil, sugar, salt, garlic, spices, extra virgin olive oil, and citric acid (maintains freshness).
Macronutrients of Cheese Pizza
If you add everything up and omit the toppings, your plain cheese pizza from Papa John’s on an original crust has the following macronutrient profile:
- 37 grams of carbs
- 9 grams of protein
- 8 grams of fat
As you can see, the pizza consists of almost 70% of the one macronutrient (carbohydrates) that the body doesn’t need.
Excess carb intake is one of the two major contributing factors (besides chronic inflammation) to most metabolic diseases, including Type 2 diabetes, cancer, stroke, Alzheimer’s and heart disease.
Unsurprisingly, the majority of those carbs stem from the crust. So if you’re trying to make pizza healthier (or are trying to find lower-carb alternatives), focus on the crust first.
In other words, don’t waste time looking for keto-friendly pizza sauce if you’re planning on putting it on a regular wheat-flour crust.
But reducing pizza’s carb footprint is only half the challenge of making pizza healthier. What’s equally important is the type and quality of ingredients that make up your pizza.
So let’s look at some of the problematic ingredients typically found in pizza and discuss healthier alternatives.
Wheat Flour (Crust)
Humans didn’t consume significant amounts of wheat until about 10,000 years ago, when we started farming and domesticating animals. That’s a very short timeframe in the context of 2.6 million years of evolution.
Before 10,000 years ago, we only had sporadic access to wild-growing grains, and the amounts we consumed were nowhere near what they are today.
As a result, our bodies aren’t set up to properly metabolize the specific carbohydrate molecules and proteins in grains. Wheat in particular contains highly inflammatory proteins (such as gluten) and carbohydrates (such as amylopectin, which is a form of starch).
The latter makes your blood sugar spike faster than regular table sugar. Plus, it attaches to some of the same receptors as opioids, making you crave even more carbs.
When I start eating pizza, I can’t stop until the last piece is gone — thanks to a combination of my lack of self-control and the amylopectin in the crust.
However, despite all of the scientific evidence against grains, the U.S. government’s “Dietary Guidelines for Americans,” as well as most dietitians and the press, recommend eating grains because they’re a source of vitamins and minerals.
But that’s like smoking cigarettes to suppress your appetite in an attempt to lose weight. Sure, nicotine can help you feel less hungry. But the damage cigarettes do to your lungs, your blood vessels, and other parts of your body make smoking a terrible strategy for dropping a few pounds.
You can read more about why you should never eat grains again in this article. For now, remember that they’re loaded with blood-sugar-spiking carbs and inflammatory proteins.
As far as vitamins and minerals are concerned, you don’t need to eat grains to supply those micronutrients. Instead, you can get them from pastured meats and, in particular, organ meat (such as the liver). They’re also found in many vegetables.
Vegetable/Seed Oils (Crust, Sauce)
Most vegetable and seed oils, including soybean oil, are manufactured using high heat or harsh chemicals. That’s because it’s difficult to extract oil from seeds.
The problem is that high heat and chemicals destroy the delicate molecular structures of the fatty acids in those oils, making them inflammatory.
Additionally, most vegetable and seed oils contain a lot of omega-6 and not enough omega-3 to counter the effects of the inflammatory omega-6 fatty acids.
In comparison, oil from olives and avocados can be gently extracted without damaging the fatty acid molecules.
The bottom line is that vegetable and seed oils are incredibly unhealthy and you should stay away from them. Unfortunately, the pizza dough from most major brands (including Papa John’s), is made from those cheap and unhealthy oils (for what I assume are cost-saving reasons).
Interestingly enough, Papa John’s also uses seed oil in its tomato sauce, alongside extra-virgin olive oil. I guess the latter is too expensive for them to use it exclusively.
Cheese is an interesting food because it’s incredibly popular on the ketogenic diet due to its high-fat content. But it’s not paleo-friendly, considering that humans didn’t consume dairy until after we started domesticating animals about 10,000 years ago.
Without going into too much detail, you should know that certain cheeses are better than others, based on their lactose (milk sugar) content and the type of protein they contain. My recommendation is to stick with high-quality cheeses that are aged and made from the milk of goats or sheep, instead of those made with cow’s milk.
As far as Papa John’s cheese is concerned, it has a bunch of junk ingredients — such as modified food starch and sugarcane fiber — that shouldn’t be in cheese in the first place. So if you want extra cheese on your pizza, I’d add it yourself. That way, you at least know what you’re getting.
So How Healthy Is Pizza?
Based on everything we’ve learned about the ingredients of a standard pizza from one of America’s major pizza chains, it’s safe to conclude that pizza isn’t particularly healthy.
In fact, eating pizza results in a massive insulin spike that shifts your pancreas and insulin production into overdrive.
Additionally, by eating pizza you feed your body all these inflammatory foods that increase your risk of developing a chronic disease in the long run.
The bottom line is that you should consume regular pizza, like the kind we’ve been talking about, only in moderation.
What exactly does “in moderation” mean?
Well, it certainly doesn’t mean every day, or even once a week. I’d recommend not having regular pizza more than once per month.
The good news is there are numerous steps you can take to make pizza a little bit (or even a lot) healthier.
How to Make Pizza Healthier
For most people, healthy eating is a journey. I didn’t transition from breastfeeding as an infant to a Paleolithic ketogenic diet — though doing so would have been ideal. It took me decades to end up where I am right now, and I’m still learning and improving.
However, 20 years ago I didn’t know what I know now. So don’t take my example as an excuse to keep eating trash food; take your first steps today and have a clear goal of where you want to end up.
As far as pizza is concerned, here’s a roadmap for how your journey could look:
- Choose pizza from authentic Italian restaurants.
- Make your pizza at home using fresh ingredients.
- Choose pizza made with grain alternatives.
Let’s dive into these three options to understand how they’re better than buying pizza from Pizza Hut, Domino’s or Papa John’s.
1. Pizza From Authentic Italian Restaurants
We live in the Alpharetta/Milton area of Georgia (north of Atlanta), and we have two authentic Italian (Neapolitanian) restaurants nearby that make their pizza dough from scratch every day, using a few ingredients they import directly from Italy.
For example, Campania (one of our favorite pizzerias) makes their dough from “00” flour, natural yeast, and sea salt. They don’t add any crappy vegetable or seed oils, nor do they add any other “flavor enhancements.”
The same goes for their homemade tomato sauce and the cheese (Mozzarella di Bufala). In other words, you won’t find any inflammatory ingredients in those pizzas. So the only thing to worry about is the wheat flour and the carbs.
That’s why the pizzas you’ll get in such places are arguably healthier than the ones you’ll get from your favorite pizza chain (though still not healthy).
So if you have to have regular pizza on occasion, I recommend spending a few extra dollars and buying it from a pizzeria as opposed to a pizza chain.
2. Make Healthy Pizza at Home
Handmade pizza, crafted with imported ingredients, isn’t cheap. You might even end up paying in excess of $20 for a single pie. That adds up quickly if you want to feed a large family, or a group of kids at a birthday party.
So it might be cheaper and more fun to make your own pizza using fresh and organic ingredients.
And even if you use regular wheat flour for the crust, you can still make your pizza healthier by using extra-virgin olive oil, organic tomatoes, aged goat cheese, and uncured meats like pepperoni, calabrese and soppressata.
As an added benefit, it’s fun preparing your own food and you can even turn it into a family affair involving the kids. Our kids love decorating their own pizzas, and they’re typically less picky with toppings they put on themselves.
The other advantage to making your own pizza is that you can choose not to use wheat flour for the crust, which leads us to the third and healthiest option.
3. Buy (or Make) Grain-Free Pizza Crust
If you went with Option #1 or #2 above, you practically eliminated most inflammatory foods.
While that didn’t eliminate the carb-load of the crust, it definitely improved the overall health score of the pizza.
To significantly reduce the number of carbs in pizza — and thus make it keto or low-carb friendly — you have to get rid of the wheat in the crust. There’s no way around it.
As part of my Paleolithic/ketogenic journey, I’ve experimented with different ingredients and types of crust, and I’d like to share my findings involving the following flour alternatives:
- Nut flour (e.g., blanched almond flour* or coconut flour*).
- Paleo-friendly starches (e.g., tapioca starch).
- Veggies (e.g., riced cauliflower).
I’ve seen and tried different variations and combinations of the above-mentioned ingredients. These days, I usually buy frozen pizzas from the following brands:
- Cali’flour Foods* (Cauliflower Pizza).
- Liberated* (Paleo Pizza).
- Cappello’s* (Grain-free, Gluten-free Pizza).
The order above reflects my personal preference based on taste, texture and compatibility with my keto lifestyle.
1. Cali’Flour Foods
I love the ready-to-top crusts and pre-made pizzas from Cali’flour Foods, because both products are paleo and keto-friendly (with the exception of the cheese on the pizzas, which is technically not paleo).
Another thing I love about Cali’Flour is that one whole crust has only 3 grams of net carbs, as opposed to the almost 50 grams of carbs in a regular pizza crust.
Remember, net carbs are what’s left when you subtract the fiber and other non-caloric carbs from the total carbs. Those are the ones to pay attention to because they raise your blood sugar. Fiber, for example, doesn’t.
Almost as important is that the crust tastes really good. I won’t claim that it tastes 100% like a regular pizza pie but, to me, it’s nearly equally “addictive” and tasty — if perhaps in a slightly different way.
Until recently, we always ordered the frozen crust and then finished the pizza ourselves using organic tomato sauce, uncured calabrese and aged goat cheese. However, a few weeks ago we tried Cali’flour’s frozen pizzas and they were so delicious that we’re considering getting those in the future.
The bottom line is that if you’d like to try a truly healthy yet tasty alternative to traditional pizza, I’d recommend giving Cali’flour Foods a shot!
The second option I like is a paleo-friendly pizza crust from a company called Liberated. You can find their crusts at Whole Foods and Amazon*. Instead of using cauliflower, Liberated uses blanched almond flour and eggs as the main ingredients for its crust.
I truly like how the crust tastes, and appreciate that it has only 3 grams of net carbs per pie. That means the crust is also a great option if you follow a ketogenic lifestyle.
However, the texture and taste is more akin to unsweetened Christmas cookies than to a traditional pizza.
That’s not a bad thing, per se, but you shouldn’t expect a crust that’s made almost exclusively from almond flour to taste like one made from wheat flour. It’s delicious, but in a different way, so keep that in mind.
Cappello’s was the first grain-free pizza we ever bought, after stumbling across it at Whole Foods (you can also get it on Amazon*).
While Cappello’s crust is both grain-free and gluten-free, the company uses arrowroot flour and cassava flour to mimic the texture of traditional pizza crusts. If you’re not familiar with those ingredients, they’re paleo-friendly starches (carbs) that do raise your blood sugar — albeit slower than regular wheat flour.
As a result, their whole uncured salami pizza has a whopping 57 grams of net carbs. That’s a lot! But considering that the carbs from those ingredients raise your blood sugar levels slower than wheat does, and that they don’t have the inflammatory proteins of wheat, I’d choose Cappbello’s over regular pizza any day.
On the bright side, Cappello’s is likely the best pizza alternative because of its similar taste and texture. I’d even go as far as saying that if you want to get away from traditional pizza and start eating healthier alternatives, Cappello’s is an excellent gateway drug.
Frequently Asked Questions
If the restaurant uses carefully selected ingredients and avoids inflammatory vegetable oils, then hand-made pizza from an authentic pizzeria is healthier than what you’d get from your favorite pizza chain.
But remember, healthier doesn’t mean healthy. It’s like smoking filtered as opposed to filterless cigarettes; the filtered ones are arguably healthier, but it’s still not a healthy habit.
Much like pizza from restaurants, homemade pizza can be healthier or healthy, depending on the ingredients you pick. If you choose to stick with healthy oils and organic vegetables, then your homemade pizza is definitely a step in the right direction.
If you choose grain-alternatives for the crust — such as riced cauliflower — you can turn a traditional fast food into a delicious and wholesome meal for the whole family.
Cow’s cheese contains an inflammatory protein called casein beta A1. Dairy products (including milk) from goats, camels or sheep have casein beta A2, which has been shown not to be inflammatory.
Check out my YouTube video titled “Is Cheese Healthy and What’s The Best Choice?” for more information.
Probably not. We used to buy almond cheese, thinking that it was a healthier and more paleo-friendly option to regular cheese. However, all the plant-based cheese we found used either casein (the protein you don’t want) or other inflammatory ingredients.
So from a health perspective, I don’t think it’s worth buying.
No! Most processed vegan foods contain soy or other inflammatory ingredients, and are thus less healthy than their animal-based counterparts. That’s especially true for plant-based cheese alternatives.
Most of the time, our kids bring their own lunch boxes with food that’s compatible with our Paleolithic ketogenic diet. Occasionally, they’re allowed to have a slice of the pizza served at the party, but that means they can’t have any more (regular) pizza for the rest of the month.
In other words, if we have a pizza night planned on Sunday and they have a slice of pizza at a birthday party on Friday, they’ll have to eat something else on Sunday.
Yes, thin-crust pizza usually has fewer carbs than pizza with a traditional (thick) crust. I’d stay away from deep-dish pizza if you’re trying to reduce your carb intake.
Not really. While whole wheat products have more fiber, which might slow down the conversion of carbs into glucose, a slice of whole wheat bread still raises your blood sugar faster than plain table sugar. So don’t bother. Wheat is poison for your body regardless of how it’s processed.
I recommend using a vented pizza pan instead of a regular baking sheet. When you order from Cali’flour foods, you get a vented pan with your first shipment!
Traditional pizza is the opposite of paleo because of the wheat flour crust, the vegetable oils in the crust and sauce, and the cheese. To make pizza paleo-friendly, you have to substitute for the wheat flour with a paleo-friendly alternative (such as almond flour) and (technically) omit the cheese.
If you can’t go without the cheese completely, try to stick with cheeses that are less inflammatory. To find out which cheese to pick, check out my YouTube video.
Regular pizza isn’t keto-friendly, mainly because of the carbs in the crust. But if you substitute wheat flour for riced cauliflower (recommended), or even blanched almond flour, you can enjoy pizza even if you follow a ketogenic or low-carb lifestyle.
Wrapup — How Healthy Is Pizza?
I hope this article has helped you understand why most traditional pizza isn’t healthy, despite claims from registered dietitians and nutritionists that (whole) wheat products are an excellent and necessary source of vitamins and minerals.
I’ve even heard some people claim that pizza is a vegetable because it’s covered in tomato sauce!
Both statements are ridiculous and lack any scientific basis.
However, that doesn’t mean you should never have pizza again. We have regular pizza once a month and we try to buy it from one of the local pizzerias here in the Alpharetta/Milton area.
Needless to say, we enjoy the heck out of that monthly feast! Additionally, we have a subscription for Cali’flour’s pizza crusts*.
That way, we can have family pizza nights more frequently — without compromising our health.
If you stumbled across this article, I assume you enjoy eating pizza but you might be looking for ways to make this dish more compatible with your dietary lifestyle.
If that’s the case, I encourage you to give the pizza alternatives I mentioned above a try. If you do, let me know how you liked them by leaving a comment below!
I’m a healthy living and technology enthusiast.
On this blog, I share in-depth product reviews, actionable information and solutions to complex problems in plain and easy-to-understand language.