Pediatricians are passionate about the health and safety of every child, but sometimes that role can make us sound as if we are on a crusade against enjoyment. Turn off the TV! Get off the trampoline! No tiny pet turtles! No honey under 1, no popcorn under 4! No, we don’t have lollipops, but we do have stickers. And so on. It’s hard to be the heavy.
So imagine how my heart sank when I opened up Pediatrics and saw an article titled “Energy and Nutrient Intake from Pizza in the United States.” Et tu, Pizza? I sighed over graphs, footnotes and equations like this one: Y I = δ0 + δ1PIZZAi + δ 2WDi + δ3 Di+ vi + wi . The study reports that on any given day 20 percent of children and 23 percent of adolescents eat pizza, and on days when children eat pizza, their calorie intake is significantly higher than on days when they do not.
The report breaks down pizza consumption by sources and mealtimes. Kids eat pizza from fast food and full-service restaurants, school cafeterias and the freezer aisle. They eat it for breakfast, lunch, dinner and snacks. As you might guess, though, not all pizza is created equal. Fast-food pizza has more calories than store-bought, which in turn has more calories than school cafeteria pizza. (School pizza was nutritionally pretty similar to other school lunches.) The good news is that from 2003 to 2010, children and teens ate less of the high-calorie pizza. The bad news is that adolescents ate so much more pizza in general, the total pizza calories stayed about the same.
What’s a pediatrician to do? I don’t think pizza it the enemy. We just don’t need to eat it all the time. Here’s my advice for damage control:
- Let’s stop calling pizza a snack. Snack time consumption of pizza accounted for some of the biggest impact on daily calories. There are so many healthy after-school snack options out there – fruit, yogurt, vegetables, hummus, string cheese and nuts are good places to start.
- It can still be a birthday party without pizza, I promise. If you have planned a 2-3:30 p.m. birthday party, pass on the pepperoni. (I am fervently hoping I do not read an article about birthday cake …)
- Read the labels. Compare different frozen pizzas for calories, sodium and general nutritional content. Some have whole wheat crust or vegetables as toppings. If you choose restaurant pizza, check out the menu online to know what your kids are eating. Maybe one slice is plenty.
- Supplement with sides. Serving a salad, fruit or vegetables with pizza can round out the nutritional content of the meal and help kids fill up on healthier fare.
Everything in moderation is fine, but sometimes we have to redefine moderation to be happy and healthy. That’s my pie in the sky dream, anyway.
Dr. Suzanne Condron is a board-certified pediatrician at Kelsey-Seybold Clinic – Fort Bend Medical and Diagnostic Center whose clinical interests include obesity, nutrition, allergies, asthma, childhood development, literacy, infectious diseases and preventive medicine.
 Powell, LM, Nguyen, BT, and Dietz, WH. Energy and nutrient intake from pizza in the United States. Pediatrics 2015; 135; 324.