Supplements JUNE 2002 VOLUME 29 / NUMBER 5 Sleep CENTER FOR SCIENCE IN THE PUBLIC INTEREST $2.50 —page 13— H EALTH LETTERTM ou can serve it to kids or adults. You can Yserve it to vegetarians or the meat-and- potatoes crowd. You can order it with just cheese or pepperoni. You can order it with anything from potatoes, pineapple, or pears to barbecue chicken, garlic shrimp, roasted duck, or fried wontons. And you can accent it with flavors like peanut and sesame sauce, curry and chutney, or chilies and salsa. You can order a thin crust, thick crust, stuffed crust, pan crust, or practically no crust. You BY JAYNE HURLEY can have it delivered to & BONNIE LIEBMAN your door, and it serves more people for less money than virtually any other restau- rant food. It should come as no surprise that Americans order three billion pizza pies a year, largely from the more than 60,000 pizzerias that oper- ate out of strip malls, food courts, and Main Streets. The question is: How many of our clogged arteries do we owe to this enor- mously popular dish? And, more to the point: Is there any way to make pizza healthy? (Continued on page 3) Photo: Renée Comet. f you don’t want to cook or eat out, pizza is often the default. One out of every six restaurants in the U.S. is a pizzeria. Annual sales reach some $30 billion, rival- ing only burger joints. And, in 1999, McDonald’s purchased a pizza chain called Donatos. What does that tell you? No one would dispute pizza’s popularity, but when it comes to health, you often hear different stories. For many people, pizza is a lousy food, period. On the other hand, some dietitians claim that pizza is nutritious because it has com- ponents of each of the four basic food groups. I“You get your grain in the crust; you get tomato sauce, which can count as your veg- etable; a cheese, which is your dairy; and protein in many toppings,” Connie Diekman, a spokeswoman for the American Dietetic Association, explained to HealthScout News, an on-line consumer health site, in December 2000. Never mind that almost all pizzas are loaded with salt, sometimes over a day’s worth. Never mind that pizza is a minefield of saturated fat, and not just from the sausage, ground beef, and pepperoni. Most pizzas have enough cheese to make a cardiologist order that second Jaguar. And, for many people, pizza isn’t pizza without cheese. Playing the Numbers crust and the mushrooms, especially considering that it’s often an 18-year-old who’s sprinkling on the shredded If you take the time to contact the companies or check the cheese and green peppers. The bad news is that they’re Web sites, the nation’s largest pizza sellers—Pizza Hut, sprinkling a lot more cheese than peppers. Domino’s, Little Caesars, and Papa Here’s a rundown of what to John’s—will tell you how much satu- expect from your next pizza. Our rated fat, sodium, and other nutrients charts (starting on p. 6) include their pizzas contain. But numbers for the 15 pizzas we are their numbers accurate? analyzed (they’re in bold) and And what about smaller, company information for sit-down chains like dozens of others. Just remem- California Pizza Kitchen ber that what you get from a and Pizzeria Uno, which pizza depends on how much offer no numbers at all? you eat. To find out, we bought samples from big and What’s a Serving? not-so-big chains across the country One slice is rarely enough, and sent them to an especially when chains independent labora- like Pizza Hut cut their tory for analysis (see large pies into slices 1 “How We Got Our that measure only 3 /2 Numbers,” p. 4). inches at their widest. The good news is But how many slices that the numbers pro- is a typical serving? vided by the chains are Since no one has good pretty accurate (though data, we used Pizza in some cases, companies Hut’s Personal Pan serve less pizza than they Cheese Pizza as a promise). The companies guide. It’s meant to seem to have a good han- Photos: Renée Comet (top); Nick Waring (bottom). dle on what’s between the ›››› NUTRITION ACTION HEALTHLETTER ■ JUNE 2002 3 COVER STORY order-taker understands that you want half the usual cheese on all of your pizza, not the usual amount of cheese on only half of your pizza. Don’t expect precisely half the cheese, though. When we ordered “half-the-cheese” pizzas from Domino’s, for exam- ple, we got anywhere from 25 percent to 75 percent less cheese than the chain’s regular cheese pizza. Still, on aver- age, that meant that a half-cheese serving had a third less sat be eaten by one person, and it weighs roughly nine ounces. fat. You probably won’t even notice the difference in taste. So, for each crust at each chain, we calculated the number of You can even try a pizza without any of the usual melted whole slices of cheese pizza that come closest to nine ounces. mozzarella. If the pizzeria offers Parmesan, order a cheese- That gave us a serving size of two to five slices, depending less veggie or chicken pizza and ask to have some Parmesan on the chain and the type of crust. In each case, it worked sprinkled over the pie before it goes into the oven. At some out to a quarter to a third of a large (14-inch) pizza per per- restaurants, creativity replaces cheese. California Pizza son. (A typical serving of pizza with topping weighs more Kitchen’s Tricoloré Salad Pizza is smothered with arugula, than nine ounces, but we assumed that if you’re a three- radicchio, red-leaf lettuce, diced tomatoes, shaved slice-eater, for example, you generally stick with three slices Parmesan, and a vinaigrette dressing. Bravissimo! whether the pizza has toppings or not.) Extra Cheese Exceptions: For California Pizza Kitchen, we used an entire 14-ounce pizza as a single serving, because that’s how Who would ever guess that two slices of Domino’s Hand it’s usually served. And for Pizzeria Uno, we used half a Tossed Extra Cheese Pizza pose the same threat to your pizza (19 ounces), because the company’s Web site says that blood vessels as two slices of Hand Tossed Sausage or each regular pie serves two. Pepperoni Pizza? The same is probably true at most other Obviously, no one serving size applies to everyone. So as chains, though Domino’s was the only company that gave you look through the chart, first check the serving (in paren- us numbers for its extra-cheese pizza. theses following each pizza’s name). That way, you can As if extra cheese on your pizza weren’t enough, the adjust the number of slices—and the fat, sat fat, etc.—to experts at Pizza Hut have come up with a brilliant way to match what you eat. work more cheese into your pizza—Stuffed Crust. You need cheese stuffed into a pizza crust like you need reverse lipo- Cheese suction to force more fat under your skin. A plain cheese pizza is the basic, stripped-down model. But Veggie don’t assume that it has the least amount of saturated fat. At Pizza Hut, for example, three slices of the Pan Cheese When you order a veggie pizza at chains like Pizza Hut or Pizza (Pan is the most popular crust) have 12 grams of sat Papa John’s, it typically comes with less cheese than a plain fat—more than half a day’s worth. That’s in the same ball- cheese pizza. It’s a win-win: You get more flavor, more park as three slices of Pan Pepperoni (13 grams) or Pan Ham fiber, more phytochemicals, and less fat. (11 grams). But beware: At other chains, like Domino’s, you may get The same generally holds true at Domino’s, Little Caesars, as much or more cheese on a veggie than on a regular cheese Papa John’s, and most other chains. Just keep in mind that pizza. According to Domino’s brochures, its Vegi Pizza has not all cheese pizzas are alike, even at the same chain. extra cheese. Our analyses turned up equal amounts in a Take Pizza Hut. You’ll get 12 grams of sat fat in a serving Vegi and a Cheese, but you may not be so lucky. of Pan or Personal Pan, 14 grams in Thin n’ Crispy or Hand Tossed, 18 grams in The Big Chicken New Yorker, and 20 grams (a Chicken on a pizza may not be tradi- day’s worth) in the Stuffed tional, but it can be delicious...and Crust. The last two will also How We Got Our Numbers less fatty than most red-meat top- give you 750+ calories and close We bought 15 popular kinds of pizza at 36 pings. Only pizzas topped with ham to a day’s worth of sodium. or veggies fall into the same sat-fat pizzerias in Chicago, Los Angeles, and range as chicken-topped pizzas. And Washington, D.C. We made a composite out Half-the-Cheese if you order your chicken pizza with & No-Cheese of six samples of each kind of pizza (for exam- less cheese than usual, the chicken ple, equal portions of two Pizza Hut Pan The simple solution to fatty piz- should help distract even die-hard Pepperoni Pizzas from each of the three cities zas: Order half the cheese.