Most of us automatically think of big pizza chains like Dominos, Papa Johns, Little Caesars or New York City’s infamous dollar slices when we hear the word pizza. It’s the usual late-night grub or party food staple — and as delicious as they can be, most traditional pizzas are not very healthy for you. The combination of high saturated fats, high carbs (devoid of most essential vitamins and nutrients), high sodium and use of processed meats make your traditional pizza a ticking time bomb for developing or exacerbating metabolic and cardiovascular conditions. However, there’s good news for all the pizza lovers out there. Healthy pizza options exist: you can make it yourself or find pizza chains that use healthier ingredients. 

Why traditional pizza isn’t healthy

Blame it largely on the cheese

One of the principal reasons your average pizza isn’t healthy is the cheese and its high saturated fats content. A medium-sized pizza typically includes 4-8 ounces of cheese, which means that one slice of pizza contains anywhere from half an ounce of cheese to one ounce of cheese. And, if you’re like most people, pizza isn’t a one-slice ordeal; it’s more like 2-3 slices.

Two slices of pizza with two ounces of cheddar cheese topping (a popular cheese choice for pizza) contain almost 11 grams of saturated fatty acids. This number nearly reaches most people’s daily budget for saturated fats: 13 grams per day. Two ounces of cheddar cheese also contain around 370 grams of sodium, not including the pizza sauce or the processed meats you choose for toppings. High sodium content has a close relationship with high blood pressure (hypertension), which could lead to heart disease or stroke. 

Other popular choices of cheese include Monterey Jack, Parmesan, Parmigiano Reggiano, Provolone and Mozzarella. Each of these cheeses has more or less the same high saturated fatty acids and sodium profiles, except for mozzarella, which is the healthiest amongst these options. You can search the nutritional data for each of these cheeses on the Department of Agriculture’s Food Data Central Search. 

… and the white flour

Traditional pizzas are also made with all-purpose flour, which, as we’ve explored in our Best Tortilla Alternatives guide, is highly refined and processed, carbohydrate-dense, yet missing most nutrients found in whole grains. Foods made with all-purpose flour can cause dramatic blood sugar level swings due to their large amount of empty and simple carbs and your body’s fast breakdown of them. Regular and excess consumption of unhealthy carbohydrates leads to the conversion of carbohydrates to triglycerides, which, if paired with low HDL (good cholesterol) and high LDL (bad cholesterol), can increase your risk of developing atherosclerosis — the buildup of plaque inside your arteries. This makes it hard for your body to transport oxygen-rich blood to your tissues and vital organs. 

See Confused About Carbohydrates? To learn more about the different types of carbs and which ones you should lean towards for better food nutrition. 

… and the added sugars and salt

As well, most traditional pizza sauces either contain large amounts of sodium, some added sugars, or both. One jar of Classico Signature Traditional Pizza Sauce contains 35 grams of sugar and over 2,200 mg of sodium! Granted, there are seven servings in one jar, but even one serving of this pizza sauce already contains 13% of your daily recommended intake for sodium. Keep in mind that the cheese you put on top also contains a lot of sodium.

… and the processed meat toppings

At this point, your traditional pizza is already not-so-healthy. Let’s say, you want to treat yourself to more than a regular cheese slice: you want a pepperoni slice, maybe even a sausage and pepperoni slice. 

These processed meat toppings contribute even more sodium to your overall pizza. One piece of pepperoni made from beef and pork contains around 32 mg of sodium. Let’s say that there are three pieces of pepperoni per slice: one pepperoni slice will have around 100 mg of sodium from the pepperoni pieces alone. When you add pieces of sausage to your pepperoni slice, your sodium content for the entire pizza goes through the roof. Processed meats also contain nitrite and N-nitroso compounds (NOC) for preserving meat and improving flavor, but they are believed to be human carcinogens and may cause digestive system cancers. 

How to build your own healthy pizza

Although we know that pizza can be unhealthy, we still like to have it every so often. So, to continue enjoying pizza without the associated health consequences of traditional pizza, let’s shift toward healthy pizza alternatives. 

What makes pizza unhealthy are the ingredients used to make it: all-purpose flour, the sauce, the cheese and the processed meat toppings, as well as the quantity of each ingredient. Healthy pizza options are those that use healthier and higher-quality ingredients along with ingredient portion control. So, is cauliflower pizza healthy? It is, as long as you also use healthy pizza ingredients. Below is a list of healthy pizza ingredients and alternative options for each layer of your healthy pizza. 

Healthy pizza crust

Traditional pizza crusts are made with all-purpose flour and are high in carbohydrates and lacking in nutrients. It doesn’t serve us much purpose other than to hold our pizza together. 

A healthier pizza crust uses unrefined flour such as whole wheat or whole grain (rye, spelt or buckwheat) and is made from grains that preserve the bran, germ and endosperm. The bran is the outer layer of the grain kernel that contains fiber, B vitamins, iron, magnesium, zinc and other important minerals. The endosperm is the middle layer that provides protein, carbohydrates and some vitamins and minerals. The germ is the core of the grain kernel and it is packed with vitamins and healthy fats. Whole wheat flour and whole grain flour preserve the nutrients of the grain and provide higher-quality carbohydrates for the body to use as fuel. You can DIY a healthy pizza base with either ingredients or purchase a ready-to-go pizza crust that contains whole wheat flour or whole grain flour. 

Did you know that you could make a healthy pizza crust from a variety of vegetables? Cauliflower, broccoli, zucchini, spaghetti squash and spinach make for healthy keto pizza crusts. You can also use quinoa or portobello mushrooms for your pizza base. To make a pizza crust from any of the above vegetables:

1. Cut or grate the vegetable and soften it by steaming it or baking it in the oven.
2. Once your vegetable has softened and cooled, wrap the contents in a kitchen towel or a cheesecloth and wring most of the liquid out. 
3. Mix the vegetable content with 1 or 2 eggs, your preferred herbs and spices and other foods such as flax or cheese.
4. Pour your vegetable mixture onto a pre-lined baking sheet and form your pizza crust (about half an inch thick).
5. Bake at 400ºF for 10-12 minutes or until the crust has lightly browned. 
6. Flip the crust over and bake for another 8-10 minutes or until the crust has lightly browned. 
7. Let crust cool before adding pizza ingredients to it.

Alternatively, you can buy vegetable-based pizza crusts at the store, which simplifies the process of making a healthy pizza at home. Just be sure to read the nutritional label on the back of the product to make sure you’re using a healthy pizza crust for your foundation. 

Healthy pizza sauce

Your average jar of pizza sauce contains loads of sodium and even additives to help preserve the sauce when on the shelf. Healthier pizza sauce options will contain only natural ingredients and way less sodium. You can also make your own homemade pizza sauce so that your sauce is fresh and you know exactly what ingredients the pizza sauce contains.

Making your own healthy pizza sauce is easy. Blend your tomatoes with olive oil and water, then mix in sugar, salt, garlic powder and white vinegar. Transfer the sauce to a pot and cook until the sauce has reached a boil. Then, lower the heat so that the sauce simmers for another hour or two, making sure to stir throughout so that sauce doesn’t burn. Let the sauce cool a little bit before throwing it back into the blender and pulse until your desired sauce consistency. Voila, you’ve made your own healthy pizza sauce from scratch. 

Another great thing about building your own pizza at home is that you can customize it to your preference or dietary needs. Some of us are sensitive to tomatoes or cannot eat tomatoes as a part of our diet, but most pizza sauces are made using tomatoes. Don’t worry, you can still enjoy your pizza with these tomato-free healthy pizza base sauces:

1. Carrots, beets and apples
2. Garlic oil
3. Hummus
4. Pureed vegetables of your choice
   

You can find tons of healthy pizza sauce recipes online or experiment with what vegetables or healthy spreads you have at home. Who knows? You might just create a pizza sauce flavor that becomes a big hit at your family reunions. 

Healthy pizza cheese

Choosing the right cheese is half the battle of making a good pizza. Each type of cheese has its own flavor profile and, depending on your toppings, it can either contrast poorly or complement your toppings. Luckily, one of the most universal cheeses for pizzas, mozzarella, also happens to be one of the healthier cheese options. It has lower sodium and calorie contents than other cheeses, and it is a good source of protein and probiotics. Mozzarella also melts easily and delivers a more neutral cheese flavor, allowing your pizza toppings to be the star of the show.

Choose a high-quality, organic and low- or full-fat mozzarella cheese with less sodium to top your healthy pizza. Yes, full-fat cheese can still be considered healthy when supplemented with complex whole foods, a recent study finds. “Dairy fat may not negatively impact cardiovascular disease (CVD) risk when consumed in foods with a complex matrix.”

Another good cheese option for a healthy pizza is goat cheese. It has a tangy taste and can come in the form of a crumble or a spreadable cheese. Like mozzarella, goat cheese contains less sodium, fewer calories and fewer carbs than the other cheeses. It is also a better option for lactose-intolerant individuals as goat cheese is made from goat milk, rather than cow milk. 

Alternatively, you can opt for a no-cheese pizza by using a flavorful pizza sauce or spread such as pesto, tahini or hummus. 

Healthy pizza toppings

Traditional pizza slices usually feature some sort of highly-processed meat, which contains high sodium and possible human carcinogens (nitrites and NOC). Avoid these toppings at all costs. Healthier pizza topping options include most vegetables such as broccoli, onions, red pepper, arugula and black olives. You can also mash some protein-packed chickpeas to top your healthy pizza.

For meat lovers, you might enjoy shredded white chicken meat for a healthy pizza topping. White meat chicken is leaner than dark meat (chicken thighs/legs) and provides an ample amount of protein per serving. Be cautious, however, if you are grilling your chicken. Highly-charred meat contains harmful compounds called heterocyclic amines (HCA), which is a carcinogen associated with an increased risk of common cancers. 

Key takeaways

Is pizza healthy? Most traditional pizzas aren’t. They contain too much sodium, a lot of saturated fats, empty carbs and highly-processed meats. They are also calorie-dense without providing much nutrition. However, not all pizzas are the same. Healthier pizza options exist. Building your own pizza using healthy pizza ingredients such as unrefined flour, homemade pizza sauce, high-quality and organic mozzarella or goat cheese and vegetable toppings is the safest bet. You can also order pizza from stores that use similar healthy ingredients. So “they were wrong”; you can still enjoy pizza and be healthy at the same time!