Last Saturday as I was poring through the Business Section of New York Times, I came across an interview with Nigel Travis, the CEO of Papa John’s Pizza. The reason that my eye even rested on this article for a second was the headline: “Atkins Who? Let Them Eat Pizza.” As I read through the piece looking for the Atkins reference (it was insignificant. When asked about concerns over health affecting is business, Mr. Travis replied: The Atkins diet affected the whole industry. That seems to have passed.) and read that there were almost 3000 Papa John’s Pizza places in existence, it got me to thinking.
There are pizza places of all kinds everywhere. There are, along with the aforementioned Papa John’s, Domino’s, Pizza Hut, California Pizza Kitchen, Godfather’s Pizza, Pizza Express, Old Chicago, Little Caesar’s, Chuck E. Cheese, and a host of others. And that’s not to mention the zillion independent, non-chain pizza places nor all the Italian restaurants that serve pizza. And it doesn’t take into account the enormous variety of pizzas that can be purchased at the grocery store and heated up at home. Most of these pizza places deliver, which can’t be said for McDonald’s, Burger King, Wendy’s and all the rest of the big-name burger chains. You’ve got to go there to get your burger–if you want a pizza (or two or three) all you have to do is pick up the phone.
In doing my research on the post a few days ago on the worthless saturated fat study, I noticed that most of the news outlets all used the results of this study to warn people off of hamburgers. Medical News Today wrote “Before you bite into that burger…” Healthday had a picture of a cheeseburger and fries in its article. And WebMD warns about “eating a meal high in saturated fats, like a cheeseburger…” None of these sources nor any other I found even mentioned pizza. Pizza, it seems, always gets a free pass when it comes time to disparage fast foods.
Having consumed more than a few pieces of pizza over my lifetime, I decided to take a look at pizza compared to cheeseburgers in terms of nutritional value.
I first (for about three seconds) considered making up some kind of chart showing how all the most common pizzas compared to all the burgers, but decided that I didn’t want to make a life’s work out of this. I decided instead to compare the most famous (and common) hamburger outlet’s fare with that of the most famous pizza chain. So it’s McDonald’s verses Domino’s head to head.
Both places have nutritional values posted (click here for McDonald’s; click here for Domino’s), but the McDonald’s is the easier to read. McDonald’s has their listing of nutritional contents set up by entree. Look up a Big Mac and here’s what it has in it. Domino’s takes a little more work. Just as you have to specify how you want to have your pizza made–what kind of crust? what topping? what sauce?–so have you to go through and build your pizza nutritional contents-wise.
I decided to compare a Double Quarter Pounder with Cheese to the Domino’s Feast Pizza with the Classic Hand-Tossed crust. Why? Because two pieces of this particular pizza equals the Double Quarter Pounder with Cheese calorically. The burger has 730 kcal; two pieces of the pizza contain 660 kcal. In order to make the calories come out equal, you would have to eat 2.2 pieces of the pizza, which is how I figured it. The problem with all this is (the extra 0.2 slices of pizza aside) how many times have you stopped at 2 pieces, or 2.2, to be exact? When I’m in hog mode, I can easily polish off three or four or… Even MD doesn’t stop at 2 pieces unless she’s mustering up some kind of superhuman restraint. I suspect that not many people double up on the Double Quarter Pounders with Cheese, but I imagine a whole lot of people eat more than 2.2 slices of pizza.
I compared the pizza and burgers in a couple of ways. I first looked at saturated fat because that’s what all the mainstream nutritional folks get their panties in a wad about. The hamburger contains19 grams of saturated fat; 2.2 slices of pizza contains 13.2 grams of saturated fat. Not a major difference, but if saturated fat is what you’re worried about, you would be better off with the 2.2 slices of pizza.
The other way I compared the two is by their ratios of carbohydrate to protein. I like to use this parameter when evaluating foods because it tells me how much stuff I don’t need (carbs) I have to take in to get the stuff I do need (protein). We all know that carbs, especially refined carbs, are absolutely non-essential for life. There are no diseases of carbohydrate inadequacy. Go ahead, look in any medical textbook–you won’t find a single listing. All carbohydrates do–especially of the refined variety–is run your insulin and blood sugar up and convert in the liver to fat, saturated fat at that. Protein, on the other hand, is essential to life. So is fat, but in much smaller quantities. And we all have a storage reservoir of fat, some of us more than others. But we all–even the skinniest of us–have plenty stored. Protein is a different story. There are protein insufficiency diseases in the medical textbooks, with the biggest one being protein malnutrition, i.e., starvation. If you don’t get any carbs, nothing happens, except maybe that you become healthier. If you don’t get protein, you ultimately die.
So, since protein is essential and isn’t really stored anywhere in the body (except in the muscle tissue, and we don’t really want to lose any of that) it makes sense to see how much harmful carb (or looking at it in the most sympathetic light–how much worthless carb) do we have to take in to get our protein.
In the case of the Double Quarter Pounder with Cheese we get 46 grams of carb along with our 47 grams of protein, or a ratio of 0.98, just under 1. With the 2.2 slices of Deluxe Feast pizza we get 99 grams of carbohydrate and 28.6 grams of protein giving us a ratio of 3.46, meaning that we have to eat 3.46 grams of carb for every gram of protein we get. Compared to the burger, the pizza doesn’t seem like such a deal. Especially when you consider that your GI tract will convert those 99 grams of carb in the pizza to almost a half cup of sugar. The 46 grams we get in the burger converts to a little less than a quarter cup, which is bad enough, but the half cup in the pizza is a little much. If–God forbid–you were to eat 3 or 4 slices of this pizza, as Emeril says, “I’m not gonna go there.”
Just in case you think I was stacking the deck in favor of the burger, go on the sites and compare for yourself.
The purpose of this exercise (other than to keep me busy for a couple of hours) was twofold. I wanted to see if pizza deserved the lack of attention it got from the anti-fat, anti-fast-food crowd, and, as far as I’m concerned, it really doesn’t. Yet somehow it manages to stay off the radar screens of all these dietary do-gooders. Second, I wanted to see for myself the difference in case I want to indulge in a little fast food. I wanted to see where my best bang for the protein buck came from. It’s pretty obvious to me.


  1. I must say that Pizza in São Paulo, Brazil (where I live):
    -Tastes *much* better
    -Has *much* more topping with many more options
    -Can be ordered in any decent joint with a “fine” (less than 1/10 in) crust
    Oh, yes, I have been to the USA dozens of times and I don’t eat pizza there even when I am in “hog mode”. Only California Pizza Kitchen is barely passable.
    I guess pizza in São Paulo, although far from being low carb, is a much better deal, in all respects.
    Hi Mauro–
    Next time I’m in Sao Paulo I’ll give it a try.
    Thanks for the info.

  2. This is why I began to eat my pizza with a fork and only eat the toppings. It’s not that I had bothered to look up any pizza mfg’s information, it’s that I felt so bad, so bloated, half an hour after eating the 3 to 4 slices that I always eat — I don’t know anybody who stops at two. Now that I only eat the toppings I feel just like I do when I have a regular low carb meal, even if, according to your stats, I’m not getting enough protein.
    Just a note: the same family, my family, that watched my sister lose 90 lbs on low carb, complains when I eat the pizza sans crust! They make noises about wasting food! I can explain until I’m blue in the face, but they still don’t get the connection. Sometimes this is very frustrating.
    Hi LCForevah–
    Your way is the way I eat pizza when I eat it, which isn’t all that often. Considering just the topping the carb to protein ratio is much better.
    Consider yourself lucky that it’s only your family you have to deal with. I get this same kind of response when I talk about diet and nutrition to reporters, radio people, and the talking heads on TV, all of whom have graduated cum laude from stupid question school.
    Keep leaving those crusts–

  3. In Victoria, British Columbia, the owner of Villages Pizza derived a low carb crust, because he was doing Atkins.
    Now, it’s been two years since I was there, but at the time, they even sold the pizza dough mix in the local grocery store, so you could make it at home (and possibly even make bread, as well).
    I still was hesitant to eat much pizza, regardless of the low carb crust. I’d rather have a steak, pork chop, or some other “meaty” entree.
    I’m with you there. Give me a big steak any day.

  4. New Haven (Connecticut) has some of the best pizza in the world from people who are third- and fourth-generation Neapolitian and Sicilian. These pies are baked in brick ovens and the crust is rather thin.
    We also have a few Dominos and Papa Johns in neighborhoods that lack local pizzerias. Indeed I think there is no comparison to the authentic pies above, certainly not in the freshness and quality of the ingredients. The only excuse for eating these has to be distance and price.
    Either way, I think the real problem is when you rely on pizza as a regular staple and you normally eat more than three slices, when two would have sufficed.
    Hi Gary–
    As far as pizza goes, the thinner the crust, the better. I don’t really have a problem with pizza occasionally as a junk food treat; I only wrote the post because it seemed to me that pizza has been getting a free ride as far as the anti-fat folks were concerned.

  5. Although I’m still young (21), I seem to recall that my teachers in primary and secondary school, when they briefly taught nutrition (maybe in health class?), represented pizza as an ideal food choice, being what they called a “combination food.” That is, a food that consists of multiple food groups. Pizza easily brings fruits and vegetables, dairy, grains, and meat all to the table.
    Keeping in mind that this concept was taught along with the grain-based food pyramid, it adds a bit of sense as to why so few people are critical of pizza as much as burgers and fries. Since, whereas burgers are nothing but saturated fat and grease on bread, pizza provides wholesome grains and a variety of vegetables and meats. That’s the image our kids are given, anyway.
    Pizza is one of the few things I miss dearly on my low carb diet. While I love steak, it’s hard to beat a good pizza.
    Should you be looking for a few more hours to kill, you should do one of these analyses on Chinese food. That’s probably my fast food of choice. But I suppose I don’t need your numbers to tell me how awful it is for my body. It’d be interesting, nevertheless.
    Hi Jason–
    In my opinion the old eat-from-the-four-basic-food-groups recommendation wasn’t all that much better than the food pyramid. It’s true that there was more emphasis on meat and less on the 8-11 servings of grain, and meat wasn’t demonized like it is in the new regulations, but it still was far from ideal. The old way would have found pizza the ideal food; the new way would have you avoid it due to its fat content. Both ways are wrong in my opinion.
    I imagine that it would take a whole lot longer than a couple of hours to do an analysis on Chinese food because I would have to create the nutritional profile instead of reading from a website. And which Chinese food would I use that is comparable to a Dble Q Pounder with Cheese? I’ll leave that analysis to someone more industrious than I. I can predict, however, that the carb to protein ratio would be abysmally high.

  6. Excellent post, practical too. If presented with a pizza, I’ll leave the crust.
    I recently bought “PPLifeplan” and am enjoying the truly scientific, and again practical approach. Thank you Dr(s) Eades.
    Hi Richard–
    Thanks for the kind words about the PPLP.

  7. Aww, Dr. Mike, you would have to post about pizza when I just had some last night! In my defense, I’ve been sick with the crud that’s been making it’s way around my office and maybe you can explain why all my favorite foods like steak, pork chops, etc. have absolutely no appeal to me when I am ill. Heck, you could place a heaping platter of Alaskan King Crab claws in front of me (my most absolutely favorite seafood) and I wouldn’t want it. Nope, the only thing that had any appeal was pizza. But I did make hubby order the smallest one that Blackjack makes and with the thin crust that resembles a cracker in thickness. The only other thing that I crave when sick is my version of comfort food: soft-boiled eggs over broken up buttered toast in a bowl and eaten with a spoon after stirring the whole thing together. Mom used to make that for Sunday night suppers when my dad had to work.
    But you are absolutely correct, pizza does seem to get a free pass in the junk food department. Just last week alone, I can’t tell you how many times I heard cheeseburgers refered to as the ultimate artery-clogging fatty food.
    Hi Esther–
    You’ve brought up a point that I’ve thought a lot about over the years. I’m the same way; when I’m healthy I exist on meat and eggs along with a little other stuff and do just fine. When I get sick, though, I want carbs. I’ve tried to figure out a rationale for the switch over in food preference, but all I have is speculation. It can be looked at in a couple of ways. Type I diabetics often get in trouble with blood sugars running out of control when they are ill. The amount of insulin they normally use to keep sugar under control is suddenly not enough. They become insulin resistant. It’s probably safe to assume that people without diabetes experience the same phenomenon, but they make enough of their own insulin to cover the rise in blood sugar. The question is, what’s going on here?
    It’s well known that glucose and vitamin C share the same means of getting into the cells. If glucose levels go up, then vitamin C entry into the cell is restricted. Since vitamin is an anti-oxidant and since a part of the immune response to viruses is the production of free radicals to destroy them, maybe the increase in blood sugar is nature’s way of giving the free radicals a chance to do their job unhampered by vitamin C. Or maybe the viruses take control of a part of the brain as they do with the temperature regulating system (that’s why you go from hot to cold to hot ad infinitum with a viral infection) causing a rise in sugar to prevent vitamin C from getting into the cells because vitamin C does have–a la Linus Pauling–an anti-viral effect. Or it could be none of the above. But I’ve at least thought about it.

  8. Sir..with all this talk of ‘big food’ surely its time for the fasting opus to evoke the evol.imperative of going without ?
    Living on water and air alone these past 2 months has becoming somewhat daunting.
    I beseech thee !
    Hi Simon–
    An opus, by its very nature, takes a while to create. I hope you don’t run out of water and air by the time I get finished.
    And who says the evolution imperative implies going without? Certainly not the mass of Paleolithic data.

  9. Has anyone come up with a good lowcarb crust so we can stop missing a food favorite? I’ve been planning to try a crust made of sunflower seeds, water and shredded cheese (based on a cracker recipe from a Dana Carpender). I REALLY miss the pizza.
    Hi David–
    We like to make pizzas (when we have them, which ain’t all that often) out of low-carb tortillas. I think they’re really tasty and, in fact, taste as good–if not better–than the thin crust ones you get at the pizza places. Ours have all fresh stuff on them and no trans fats.
    See MD’s blog on Aug 12, 2005 entitled: Low-pizzas on the grill.
    Give it a try and let me know how it goes.

  10. Sir..i won’t even attempt to counter that with data as i know full well this is your speciality subject and i have bugger all data and what i have i likely got in part from yee !
    But given that short term fasting does seem to have benefits then it stands to reason does it not that the genome evolved around food availability that was sufficiently erratic to have that factored in ?
    Am all ears
    Hi Simon–
    I think you’re absolutely on the mark. Researchers have been all over what the optimal diet it–very few have looked at meal timing (a subject in which I am intensely interested). Although food was plentiful in Paleolithic times, it still had to be hunted and/or gathered, with the former accounting for most of the calories. I seriously doubt that my Paleolithic ancestors ate three squares a day. How hungry do you have to be to get motivated to go out and hunt?

  11. Hi Dr. Eades,
    It should be obvious why pizza gets the free pass. What is the center of a hamburger? It’s the “evil” beef made from the “evil” cow! Pizza, on the other hand, can be vegetarian, etc. You don’t usually think of “beef” when you hear the word pizza. Since going zero carb, I really don’t miss pizza much to be honest. I just realized that the crust and sauce is just a facilitator to get to what I really love, the meat and cheese!
    Hi Rob–
    I’m sure you’re right. Burgers equate to beef, and, God forbid that we should eat that.

  12. Pizza, like cheeseburgers, is one of my favorite foods to eat when I fall off my diet occationally. The last time I had it was the day before a 12k race. A friend and I demolished a large one (with CinnaStix), with two slices carefully saved for breakfast the next day. I love LOVE *LOVE* pizza.
    I knew it was pretty high carb, which is why I chose it as my night-before carb up.
    I have low-carb pizza crust mix in my cupboard, and it doesn’t make a half bad pizza for those times when I want the taste without all the carbs. The brand is Carb Sense, which recently changed its name to Eat Well, Be Well. I buy from
    Off topic, two things:
    1) I just finished the Protein Power LifePlan – great book! I loved it.
    2) I started taking magnesium like the book recommends and my headaches have reduced in severity. I suspect that if I take a bit more they will go away all together. THANKS for that advice! I have had nearly daily headaches since last year and have no idea why.
    Hi Victoria–
    Thanks for the compliment on the book. I’m glad the magnesium is working for your headaches. We have certainly given a lot of it for that (even IV sometimes), and it works well.

  13. I graduated from nursing school (diploma!) back in 1976. I’m not sure if our hosp was “cutting edge” with diabetes (we were with heart disease…Framingham Union!), but we were taught that sugar/starch was what caused weight gain, contributed to (at least) and exacerbated diabetes, and a diet high in protein and low in carbs was the best diet for everyone. Meat/Fish/Poultry and veggies were encouraged, starchy fruits/veggies, bread, rice, etc kept to a minimum. (Funny that the Framingham heart study contributed to the fat fears, huh?)They did encourage margarine and liquid over solid oils, but meat was ok, red or white.
    Anyway, while I was still in school, I remember having a dispute with a boy friend. He insisted that pizza was better for you than a burger….and that milk made you fatter than beer! I tried over and over to explain the process I was taught….that excess sugar was much more likely to cause weight gain than fat was. I guess this was the beginning of the whole low fat craze, but it certainly wasn’t what I was taught in school!
    Years later I remember my mother in law raving about how pizza was much better for you than a red meat meal!!! I didn’t even bother that time.
    Thanks for your posts! Thanks for your book! And, my latest discovery, thanks for your cookbooks!
    I make a Mexican pizza with tortillas….little bit of salsa, good cheese, meat, veggies, a dollop of sour cream and a handful of black olives! Yummy!! Sometimes I put a top tortilla on it and call it a quesadilla!
    Hi Alcinda–
    Thanks for the kind words about the books and cookbooks. Glad you’re enjoying them.
    We also use the tortillas for pizzas. See MD’s blog from August 12, 2005.

  14. If you google “deep dish pizza quiche”, you can find a good grainless pizza crust. There is another version that uses ground up pork rinds to make a passable firm crust. It is VERY filling and works on those occasionally pizza cravings.
    Another place the burger beats the pizza is you can order the burger without a bun but you can’t order a pizza without a crust. I’m celiac, so I can’t just eat the toppings off of a pizza. It’s gluten infested at that point.
    Hi Ryan–
    Thanks for the info. I may give the pork rind version a try the next time I have a pizza urge.

  15. Well, I’m glad to know I’m not the only one who craves carbs when sick. The explanation does make a sort of sense to me. The first day when I felt the worst, hubby grilled me a lovely steak, the sort of thing that I would have polished off any other time. I could barely eat a few bites and it had no appeal at all.
    The crust being my least favorite part of a pizza, I can do without it. Occasionally we make what we call “that pizza dish” by putting pizza sauce on the bottom of a large pan and then layering our toppings on it (usually crumbled Italian sausage, red onion, red pepper, mushrooms and chopped black olive) and pop into a very hot oven sans cheese for about 10-15 minutes to cook the veggies and then throw the cheese on it and return it to the oven until the cheese is melted and nicely browned. You do have to use quite a bit of cheese as it’s what holds everything together; however, we get 8 servings out of it and it makes for yummy lunches the rest of the week. Unlike regular pizza, it reheats very well.

  16. As far as an analysis of Chinese fast food, Panda Express is a chain of Chinese restaurants found primarily inside malls. Their nutritional information is available on the web (Google Panda express nutrition). If you do not eat the rice that is included with every meal, some of their dishes are better than a DQP with cheese, at least in terms of carb to protein ratio. The sodium content is sky high, though.
    Hi Martha–
    Thanks for doing the analysis. Maybe I’ll hit a Chinese restaurant the next time the junk food demon pulls my chain.

  17. Pizza’s probably a killer, which would explain why it tastes so dang good. 🙂 I eat the toppings with a fork. Though the sauce is often very carby as well. I’ve seen a lot of lowcarbers say they crave and miss pizza.
    The kitchen forum has a ‘deep dish pizza quiche’ thread, amazing. Tastes nothing like quiche, is almost infinitely versatile as a recipe, and amazing –even highcarb eaters love it. When I used to make this (I’m just re-beginning LC) I would use some kind of meat like the large deli pepperoni, have it sliced super thin, and bake that first so it was overlapping crispy, then put the contents in the muffin/cake pan and bake again, so the crust was meat. I realize pepperoni’s probably the worst meat you can eat for health reasons, but maybe that idea can be toyed with for other variants.
    I modified that recipe to add in a little bit of grated cauli, protein powder, and finely chopped meats to the main ‘bulk’ part and even that comes out firm and yummy. The stuff freezes and reheats great too. Hope this helps at least one person get a pizza fix at home in a healthy way.
    Hi PJ–
    Thanks for the recipe. Sounds delicious.

  18. A few points:
    1. The stuff they sell at Domino’s is *not* pizza. I don’t even think it qualifies as “fast food” as I’m not sure it qualifies as food at all.
    2. I agree about using tortillas for pizza crust. A good low-carb pizza is a Mission low-carb tortilla placed in a cast-iron skillet, topped with a bit of a mild marinara, a big mound of mozzarella, a bunch of pepperoni and baked at 350 for about 15 minutes. I do this when I haven’t had time to cook and don’t have leftovers handy as it’s the fastest meal to make with stuff I always have on hand. The tortilla crisps up much like a thin-crust pizza (though admittedly, if you put enough real fullfat mozzarella and pepperoni on *anything* it’d taste pretty good).
    3. A very good comfort food when sick is egg-drop soup. You can make it with either a chicken or turkey soup, a clear vegetable soup, broth or even bouillon, depending on what you have on hand. It’s dead simple, you just crack and mix an egg or two and pour it through a colander into the simmering liquid and whisk it and the egg cooks almost instantly. It’s nice bland food, but you can add more eggs to make it more substantial as needed.
    Hi jpatti–
    Thanks for the recipes.

  19. This is exactly what I expected to find out after reading the title . Thanks for informative article

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