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Wellness

Is pizza healthy if you have diabetes?

You can still eat your favorite foods by opting for healthier ingredients and exercising portion control
Heidi Borst
By | Sep. 27, 2024 Medically reviewed by Luis Bendezu, MD
slice of pepperoni pizza - pizza for diabetics

Key takeaways

  • If you have diabetes, you can enjoy your favorite foods like pizza by opting for healthier ingredients and exercising portion control.

  • Choosing thin, whole-grain, or cauliflower crusts is an excellent way to reduce carbohydrates and increase pizza’s beneficial fiber content.

  • Load up your pizza with veggies and lean meats, and avoid excess cheese and high-fat meats like pepperoni and sausage.

  • Pairing pizza with a side salad or steamed vegetables helps balance out your meal with healthy fiber and nutrients.

  • Preparing pizza at home gives you more control over the ingredients, allowing you to customize the pie to meet your dietary needs.

In this article:

What’s one of the world’s most loved foods? Pizza! A favorite of kids and adults alike, the  Italian staple is a common comfort food. From gooey cheese to crunchy pepperoni, it’s no wonder the savory meal is so popular. If you have Type 1 diabetes or Type 2 diabetes, you might wonder if it’s possible to enjoy pizza as part of a diabetes management plan. With some thoughtful choices and careful planning, pizza can be diabetes-friendly. Here’s how to make the tasty treat a healthier choice.

Can diabetics eat pizza?

“Yes, people with diabetes can enjoy pizza, but they need to be careful with their choices,” says Raj Dasgupta, MD, an ABIM quadruple board-certified physician specializing in internal medicine. While most traditional pizzas aren’t high in sugar, they contain hefty amounts of refined carbs, meaning pizza can easily raise blood glucose levels. Still, by making smart choices about the crust and toppings and controlling portion sizes, Dr. Dasgupta says pizza can be part of a balanced diet.

Diabetics should stick to one or two slices of pizza, says Michael Lahey, MD, a physician at My Weight Loss Partner. However, the exact amount depends on their overall meal plan and how much carbohydrate they have left for the day.

Carbohydrate counting, or carb counting, is a common strategy for blood sugar control.  It involves tracking the carbohydrates in meals and snacks to stay within a specific daily range. The exact number of daily carbohydrates varies by individual and should be determined with the help of a registered dietitian nutritionist (RDN) or certified diabetes care and education specialist (CDCES.)

RELATED: What’s the best diabetes diet?

Is pizza bad for diabetics?

Pizza isn’t inherently bad for diabetics, but it’s best to enjoy it occasionally rather than as a regular meal, advises Dr. Dasgupta. Not only can pizza lead to spikes in blood sugar due to its high carbohydrate content, but many pizzas contain high amounts of saturated fats from pizza toppings like mozzarella cheese, pepperoni, and sausage. Saturated fats can increase your LDL cholesterol—the “bad” cholesterol contributing to high blood pressure, heart disease, and stroke. They also make it harder for the body to use insulin properly.

According to a recent systematic review and meta-analysis, individuals with diabetes may benefit from following a diet of less than 26% carbohydrates. For someone on a 2000-calorie diet, this would be 520 total calories in carbohydrates or approximately 130 grams of carbs per day. A 100-gram portion of cheese pizza (about one slice) from a fast food chain contains 33.4 grams of carbohydrates. That means consuming two pieces would eat up over half their total daily carb allowance.

Pizza can affect blood sugar within one to two hours after eating, depending on the individual’s metabolism and type of pizza consumed. Keeping portion sizes in check helps manage calorie intake and blood sugar levels, advises Dr. Dasgupta.

RELATED: What is the best diet for prediabetes?

What is the best type of pizza for people with diabetes?

Dr. Dasgupta suggests opting for whole-grain, thin, or cauliflower crusts. These options typically have more fiber and fewer carbs than traditional thick or deep-dish pizza crusts. Fiber helps stabilize blood sugar levels and lowers the risk of heart disease.

When selecting pizza, Dr. Lahey recommends focusing on healthier ingredients:

  • Crust options: Choosing whole wheat, low-carb, almond flour, cauliflower crust, or thin-crust pizza can reduce your total carbohydrates and increase your total fiber intake. Steer clear of pizzas with heavy crusts made with white flour, such as pan or Chicago-style pizzas.
  • Sauce: Most pizza sauces have sugar added, so people with diabetes should avoid them in large quantities or opt for white pizza with no sauce.
  • Cheese: While too little cheese isn’t a problem, adding too much of it means extra calories in the form of fat, which fuels insulin resistance. To reduce saturated fat content, opt for light cheese when ordering your pizza, or choose part-skim mozzarella if you’re following a pizza recipe at home.
  • Toppings: Stay away from high-fat, processed meats like pepperoni, sausage, and bacon. They contain high amounts of saturated fats and sodium. Instead, choose lean proteins like grilled chicken or turkey. Load up on vegetables like spinach, bell peppers, and mushrooms to increase your pizza’s fiber content and add nutrients.

A homemade pizza with a whole grain crust, plenty of vegetables, and a moderate amount of low-fat cheese is generally the healthiest choice for someone with diabetes, advises Dr. Dasgupta.

RELATED: Can you eat popcorn if you have diabetes?

Tips for diabetic pizza lovers

If you have diabetes and love pizza, you can enjoy pizza as part of a healthy diet with a little smart planning. Dr Lahey offers the following tips:

  • Pair it with veggies: Add a side salad or roasted vegetables to boost fiber and get the right combination for that particular meal.
  • Use healthier toppings: Nutrient-dense veggies like spinach, onion, and mushrooms and lean meats add beneficial fiber and protein to your meal.
  • Make it at home: You can control the nutrient content of your pizza by making it yourself with a whole grain or cauliflower base.
  • Watch portions: Limit your intake to one or two slices to reduce the amount of carbohydrates you consume.
  • Avoid high-calorie toppings: Limit high-fat cheeses, creamy sauces, and sugary tomato sauce.

The bottom line

With careful planning, you can enjoy pizza with diabetes. By choosing healthier crusts and toppings and being mindful of portion sizes, pizza can be incorporated into a balanced diet without significantly impacting blood sugar levels. With the right choices, it’s possible to indulge in tasty food without health consequences.