Energy and Nutrient Intake From Pizza in the United States

This study by Powell, NGuyen and Dietz shows the extraordinary adverse impact of pizza on the nutritional status of children and adolescents. Their concern about the energy, saturated fat and salt intake from pizza is in complete agreement with ours and other findings on current pizza compositions [1, 2]. Whether from fast-food outlets, schools or home-prepared, pizzas, as meals, are too high in fats and saturated fat, too high in sodium, and commonly lack a range of essential nutrients including iron, zinc, iodine, vitamin C, vitamin B12 [1].

Implementation of nutritional guidelines to reduce chronic diseases has been incomplete and slow, but the consistent evidence of adverse public health effects from our most popular and ubiquitous 'junk-food' represents a huge opportunity for health and regulatory agencies to work constructively with the food industry [3].

Reformulating 'junk food' ready meals, such as pizza, has the potential to improve public health without requiring drastic changes in eating habits, and without depending on education which tends to widen health inequalities. Powell et al suggest that the nutrient content of pizza needs improved. We have already shown that this is entirely achievable using standard product reformulation, while still using on traditional ingredients and methods [1]. The end-products, produced initially as a range of frozen pizzas in collaboration with industry, look, smell and taste as good as any similar pizzas, as judged by both adult and children consumers [1]. They are now available at a variety of outlets across the UK. Goto et al [4] also showed that a nutritionally improved regular pizza was acceptable in US young adults.

Perhaps surprisingly, the concept of a 'nutritionally balanced', or 'nutritionally complete' meal is new. Consumers have been bombarded with terms such as 'healthy', which have no nutritional criteria and have lost any meaning. We have shown how current ready meals are nutritionally incomplete and fail to match nutritional guidelines [5]. Indeed we were not able to identify any commercially produced meal which provided all essential nutrients and matched nutritional guidelines. While it is not necessary to eat three perfect nutritionally balanced meals a day, it is clearly undesirable to eat three unbalanced, incomplete meals. It is also difficult, and sometimes impossible, to rescue nutritional quality if one meal is badly designed, and most pizzas sadly fall into that category. We have proposed simple criteria to define a nutritionally balanced meal, and demonstrated with pizzas and many other meal-types how that can be achieved without impairing enjoyment of the meal. It must now be up to the food industry, perhaps with pressure from consumer groups and public health agencies, to review and modify recipes and redesign them with input from trained nutritionists. It would help if some training in the biological role of foods were to become obligatory in the training of chefs and food producers, and for consumers to see when meals are truly nutritionally balanced, beyond just those nutrients included in the US Nutrition Facts panels.

References:

[1] Combet, E., Jarlot, A., Aidoo, K. E., & Lean, M. E. (2014). Development of a nutritionally balanced pizza as a functional meal designed to meet published dietary guidelines. Public Health Nutrition, 17(11), 2577-2586.

[2] Food Standards Agency (2004) Programme of mini surveys: pizza survey. Food Survey Information Sheet. http://www.food.gov.uk/multimedia/pdfs/fsis5804.pdf

[3] van Raaij, J., Hendriksen, M., & Verhagen, H. (2009). Potential for improvement of population diet through reformulation of commonly eaten foods. Public health nutrition, 12(03), 325-330.

[4] Goto, K., & Bianco-Simeral, S. (2011). Acceptance of a healthier substitute for regular pepperoni pizza among campus consumers. Californian Journal of Health Promotion, 9(1), 9-17.

[5] Celnik, D., Gillespie, L., & Lean, M. E. J. (2012). Time- scarcity, ready-meals, ill-health and the obesity epidemic. Trends in Food Science & Technology, 27(1), 4-11.

Conflict of Interest:

M.E.J.L. has acted as scientific advisor for Eat Balanced Ltd, previously received a consultancy fee from the company, and has bought shares to the value of ?10 (c.$13) in order to declare his strong commitment to this nutritional principle.