Pizza slices

You have probably heard that the best nutritional meal plan people living with diabetes should follow, is one that consists of nutrient-rich whole foods that contain plenty of protein, healthy fat, and fiber. You have probably also heard that people living with diabetes should avoid or reduce the consumption of certain foods and drinks, including sugary sodas, refined grains, candy, and pizza.

Did you know, between the years 2007 through 2010, the U.S. Department of Agriculture reported that one in eight people consumed pizza on any particular day? That’s a staggering statistic!  

Is pizza a safe choice for people living with diabetes? The short answer to this question is yes, people with diabetes can enjoy all types of pizza. In moderation, people living with diabetes can safely enjoy all types of foods that are often viewed as “unhealthy”, including yummy pizza.  As long as these foods are part of a nutrient-dense, balanced meal plan, you are welcome to it!

Your favorite takeout or pre-made frozen pizza may make for a deliciously convenient meal during a hectic day.  It’s a good idea, however, for people living with diabetes to consider the carbohydrate, sodium, and saturated fat content along with portion size before consumption. 

This article provides tips and strategies on how people living with diabetes can incorporate pizza safely into their nutritional meal plan, as well as considerations and precautions to take for maintaining healthy blood sugar management along the way.

Nutrition Facts of Pizza

The nutrition facts of pizza vary widely, depending on the ingredients used in making the crust, and the toppings offered.  It is a good practice to look at the nutrition information on the frozen pizza package, or when ordering at your favorite restaurant whenever possible.

One slice of cheese pizza contains the following:

  • Calories: 285 
  • Saturated Fat: 5 grams (g)  
  • Carbohydrates: 36 g
  • Sodium: 640 mg

One slice of pepperoni and cheese pizza contains the following

  • Calories: 339
  • Saturated Fat: 6 g
  • Carbohydrates: 37 g
  • Sodium: 807 mg

The American Diabetes Association recommends that people living with diabetes be mindful of carbohydrate intake to maintain healthy blood sugar control.  This is because carbohydrates are the macronutrient that has the greatest effect on your blood sugar levels. Diabetes also puts extra strain on the cardiovascular system, raising heart disease risk. For this reason, saturated fat and sodium levels should try to stay within moderate limits. 

Because of these factors, consider the following before your next pizza meal:

Pizza is high in refined and total carbs:

If you are living with diabetes, you are well aware that healthcare professionals generally recommend limiting your intake of refined and total carbs, including the white flour used to make pizza crust.  Refined grains, or white flour, is usually used to make pizza crust.  Refined grains are highly processed and are stripped of certain nutrients like protein and fiber. They have a greater effect on blood sugar levels than unrefined, or “whole” grains. These nutrient-dense carbohydrate sources, such as fiber-rich fruits and starchy vegetables, tend to not raise your blood sugar levels.

Also, research has linked diets high in refined carbs and ultra-processed foods like frozen pizzas with the following:

  • An increased risk of type 2 diabetes
  • Higher fasting blood sugar levels
  • Higher hemoglobin A1c 

Keep in mind that the carb content of a pizza slice can be much higher depending on the thickness of the crust, the size of the slice, and the toppings.

Pizza with veggies

Pizza is high in saturated fat:

A meal plan that contains high amounts of saturated fat may also worsen diabetes by contributing to insulin resistance, which negatively affects blood sugar management This doesn’t mean, however, that people living with diabetes have to avoid pizza altogether. It simply means you should consider moderating your intake of pizza, as well as other foods rich in refined carbs, and that the majority of your diet should comprise whole, nutrient-dense foods.

Glycemic Impact of Pizza

A slice of plain cheese pizza with processed tomato sauce on a regular, refined flour crust has a glycemic index rating of 80, making it a high-glycemic food. High-glycemic foods raise blood sugar quickly, so people living with diabetes should try to limit these foods in their meal plan. Pizza dough usually contains all-purpose flour, a processed, low-fiber grain. Fiber reduces the glycemic index of foods, so, whenever possible, it is best to choose a high-fiber, whole-grain crust for your pizza. If a whole-grain option is not available, order a thin crust instead of a thick crust. Fresh vegetable toppings also provide fiber and contain virtually no fat and sodium, and is the preferred choice than processed tomato sauce.

Precautions and Tips for Type 2 Diabetics

As was previously highlighted, it is safe to enjoy a slice of your favorite pizza on occasion, even if it contains ingredients like extra cheese or pepperoni. That being said, if you want to make your slice healthier, it’s best to limit certain ingredients.

Here are some ingredients to watch out for:

  • Processed meats like bacon, ham, and sausage
  • Fried chicken and fried vegetables like fried eggplant
  • Extra cheese topping and cheese-stuffed pizza crusts
  • Sweet toppings like barbecue sauce and sweetened pineapple chunks
  • Extra-thick crusts and deep-dish-style pizzas
  • Creamy, high calorie sauces like Alfredo sauce and ranch dressing

Many specialty pizzas contain one or more of these ingredients, which can significantly increase the carbohydrate content and overall calorie load of your slice.

Healthy Pizza Options for Type 2 Diabetics

In general, it is best for people living with diabetes to consume mostly whole, nutrient-dense foods, including vegetables, fruits, protein sources like fish and chicken, as well as beans, nuts, and seeds. When choosing carbohydrates, nutrient-dense carb sources-including fruits, non-starchy vegetables, and whole grains-are always the healthier options. These will less likely cause a spike in blood sugar levels.

If you order pizza, or make one at home, here are some ways to make your slice a bit more nutritious and blood-sugar-friendly.

Ingredients to choose:

When deciding on a slice, opt for toppings like these:

  • For fiber: grilled veggies, including zucchini, peppers, olives, artichokes, and sun-dried tomatoes
  • For protein: roasted chicken, fresh mozzarella
  • For healthy fats: olives, pine nuts
  • For carbohydrates: whole grain crust or a crust made with almond flour or cauliflowe
  • For Vitamin D: mushrooms
pizza salad

Choosing a whole grain crust or a crust made with almond flour or cauliflower can also boost your fiber intake! Plus, a crust made with almond flour or vegetables like cauliflower tends to be much lower in carbs than regular pizza, and it will affect your blood sugar less significantly than crusts made with white or whole wheat flour.

Moderation and Portion Control

If you’re a pizza lover and are living with diabetes, you don’t have to give up your favorite cheesy food!  Here are a few tips on how to incorporate pizza into an overall healthy diet.

  1. Let go of the guilt! Studies show that in the short term, restricting your favorite foods can actually cause you to crave them even more! 
  2. Pair pizza with healthy sides. Enjoying a slice of pizza alongside a large salad with a protein source like grilled chicken or salmon is a smart way to cover all of your nutrient needs and make the meal more filling. Plus, pairing a protein source to a carbohydrate helps to mitigate blood sugar spikes!
  3. Go for nutrient-dense toppings that are high in fiber and protein. When ordering your pizza, choose toppings like mushrooms, spinach, and artichokes for fiber, and add a protein source, such as grilled chicken.
  4. Make your own pizza at home using lower carbohydrate ingredients, such as almond flour and veggies, to make a diabetes-friendly pie that’s delicious and nutritious! Making your own pizza at home is not only a fun experience but also allows you to control the ingredients, so there’s nothing to fear!
  5. Be mindful of portion sizes. When having pizza, be aware of the slice sizes available. Even though frozen pizzas and chain restaurants have set slice sizes, independently owned pizzerias may cut very large slices, which contain more carbs and calories per slice.  Opt for thin crust pizzas wherever possible, which typically contain fewer calories and carbohydrates. 

If you are living with diabetes, following a nutrient-dense diet is essential for optimal health and blood sugar management. This doesn’t mean you have to give up pizza, though!  If you take a balanced approach to diet and nutrition, and focus on the overall quality of your balanced meal plan, you can enjoy your favorite foods, including pizza, from time to time and not think twice about it!

Remember, it is all about balance!

As always, if you ever have concerns about how to incorporate pizza, or any questionable food, into your nutritional meal plan, contact your healthcare team. 

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