The Deal with Pizza


It always impresses me when I think about how pizza has become the universal comfort food. Anywhere you go, pizza seems to have a presence and answers so many different needs. There aren’t many foods that are as easy to pack and go, eating with one hand. It’s also hard to find the right mix of salty, rich, chewy, and crunchy in a single food—not to mention that there are few meals that a family of four can share for under $20.

This prevalence of pizza and the rising rates of obesity led to a research question. Last week, researchers released a study on the effect that pizza has had on the calorie intake of children and adolescents. The study, authored by Powell, Nguyen and Dietz, ran in Pediatrics. What we’ve discovered is that some findings aren’t what several media outlets have reported.


The study aimed to determine whether pizza contributes to excess energy intake and poor diet for children. Using 24-hour recalls for children age 2-19 years old from USDA’s NHANES data sets during the years 2003-2004 to 2009-2010, they measured the frequency of pizza consumption, calories from pizza, total calories, and intake of sugar, saturated fat, and sodium.

Despite the association with obesity that the authors seemed intent to show, total calories went down or stayed the same from 2003-2010 for both children and adolescents. Among those who ate pizza, children ate 408 calories and adolescents ate 624 calories per day from pizza. This is a 16% drop for children and 22% drop for adolescents from 2003-2004.

It’s also interesting to see how our pizza-eating patterns have changed. Calories from pizza at fast-food restaurants fell significantly over six years. There was no change in pizza purchased from retail stores, schools, and full-service restaurants. Pizza consumed at dinner decreased by 40% for children.

What impact do these changes have on our children’s health? Unfortunately, this research did not look at how changed eating patterns affected health outcomes. The authors claimed that families don’t sufficiently reduce non-pizza calorie sources, yet there’s no reference or evidence to support that assertion. There’s another big piece of missing information: What level of physical activity do children and adolescents eating pizza get?

Another big gap? The authors didn’t mention well-known healthful nutrients that come from pizza intake. Fiber, iron, calcium, vitamin A, vitamin C, vitamin B12, niacin, and lycopene all increase with pizza. The USDA Standard Reference of Nutrients database shows that a single slice of school lunch pizza supplies 4 grams of unsaturated fat (good fats) and 17 grams of protein.

Are there messages that we can take from this research? Pizza is better when eaten as part of a meal rather than as a snack to reduce your daily calories. Pizza contributes many healthful nutrients and isn’t associated with increasing the rate of childhood obesity. Mix it into your meal rotation to get the nutrient benefits without letting your daily calories get out of balance.