Can Pizza Fit in to the Renal Diet? A Review of the Phosphorus, Potassium, and Sodium Content of Selected Frozen and Delivery Options

1

  • Barrett L.

Pizza Power 2013 State of the Industry Report .2

  • Rhodes D.G.
  • Adler M.E.
  • Clemens J.C.
  • LaComb R.P.
  • Moshfegh A.J.

pulmonary tuberculosis of pizza : What We Eat in America, NHANES 2007-2010. Food Surveys Research Group Dietary Data Brief No. 11. February 2014 .2

  • Rhodes D.G.
  • Adler M.E.
  • Clemens J.C.
  • LaComb R.P.
  • Moshfegh A.J.

consumption of pizza : What We Eat in America, NHANES 2007-2010. Food Surveys Research Group Dietary Data Brief No. 11. February 2014.

1

  • Barrett L.

Pizza Power 2013 State of the Industry Report . Pizza is one of the most wide consumed foods in the United States.According to “ What We Eat in America, ” the dietary consultation part of the NHANES 2007 to 2010, approximately 13 % of Americans are eating pizza on any given day.In summation, pizza can account for ampere much as 25 % of the day ‘s energy requirements and is a top contributor to sodium in the typical american english diet.Pizza sales at chain restaurants are growing, but according to industry reports, fixed pizza sales are besides up in the United States.With these foods trending among the general population, should we as nephritic dietitians expect that our patients will indulge ?3

  • Byham-Gray L.
  • Stover J.
  • Wiesen K.

A Clinical Guide to Nutrition Care in Kidney Disease .3

  • Byham-Gray L.
  • Stover J.
  • Wiesen K.

A Clinical Guide to Nutrition Care in Kidney Disease . Although most nephritic dietitians do not encourage their patients to eat pizza, it is credibly naturalistic to assume that at some point pizza will find its manner to the tables of our patients. The wide kind of ingredients found in pizza, including the crust and toppings, can be a significant reference of morning star, potassium, and sodium in the diets of nephritic patients. cheese, tomato-based sauces, and vegetable toppings may contribute to dangerous hyperkalemia. tall mallow and preservatives in kernel toppings and boodle additives may contribute to high serum phosphorus levels. Elevated serum morning star in nephritic patients may cause long-run nephritic bone disease and coronary artery calcification.In addition, the high sodium content of many pizza ingredients may contribute to increased thirst and interdialytic fluid gains in dialysis patients a well as dangerous increases in blood atmospheric pressure. The function of the nephritic dietician is to educate patients regarding the safest and healthiest food options for their checkup condition, in other words, recommending the “ best ” options for their patients. Often the dietician will recommend a “ fresh food ” approach or focus on homemade options which may or may not be naturalistic for many nephritic patients. sometimes, however, the dietician must recommend the “ not as badly ” option, particularly with pizza, to continue to provide realistic rede for patients navigating the real world of class reunions, date nights, grandkids ‘ birthday parties, and deep night pizza cravings. many more motivate patients will read food package labels before buy or eating an item, but often these food labels are incomplete and do not include morning star or potassium content. Some patients may tied determine if there is food information available on-line before heading out to a restaurant or may use a fresh phone app such as the KidneyDiet® application ( Pain Free Living, Inc., Whitby, Canada ) to look up nutrient information. Some nutrient databases are available that list all data per 100 g of food product, which is probably more helpful to the food and nutrition professional than to the patient or consumer. The US Department of Agriculture Food and Nutrition Database is an excellent source of information for both frigid and restaurant pizza products and was used chiefly for the purposes of this article. It lists a kind of food contents including the most presently available information on morning star, potassium, and sodium capacity of pizza. In accession, one can toggle bet on and forth between versatile serving size including a standard slit, a wholly pie, and a 100-g serve, whichever is the most useful. Serving sizes were shown to vary widely. The serve sizes for freeze pizza tended to be bigger than those for restaurant products and even among restaurant pizza ; the size of the slices varied from the traditional hacek serving to small squarely slices. Products like thin crust pizza with few or no toppings weighed less overall than a chummy crust pizza with “ the works ” on it. information on ingredients of versatile pizza brands was obtained from the ship’s company or manufacturer Web sites .4 Statista. Sales of the Leading 10 Frozen Pizza Brands of the United States in 2013. hypertext transfer protocol : //www.statista.com/statistics/189650/top-frozen-pizza-brands-in-the-united-states. access December 19, 2014 .

Table 1

Pizza Comparison Chart: Frozen

Brand, Type of Pizza, Size of Slice Phosphorus (mg Per Slice) Potassium (mg Per Slice) Sodium (mg Per Slice) Added Phosphate
DiGiorno, cheese rising crust, 1/4 of pizza = 183 g∗ Pizza slices are shown as both a fraction and by system of weights in grams for comparison purposes . 441 359 1274 Yes
DiGiorno cheese thin crust, 1/4 of pizza = 161 g 380 375 815 No
DiGiorno pepperoni rising crust, 1/4 of pizza = 207 g 466 439 1538 Yes
DiGiorno pepperoni stuffed crust, 1/4 of pizza = 179 g 483 320 1348 Yes
DiGiorno pepperoni thin crust, 1/4 of pizza = 145 g 309 389 961 No
DiGiorno supreme rising crust, 1/4 of pizza = 227 g 479 477 1616 Yes
DiGiorno supreme thin crust, 1/4 of pizza = 155 g 290 431 860 Yes
Freschetta Brick Oven 3 meat medley, 1/5 of pizza = 131 g N/A 250 960 Yes
Freschetta Brick Oven 5 Italian cheese, 1/4 of pizza = 144 g N/A 200 930 Yes
Freschetta Brick Oven chicken club, 1/4 of pizza = 155 g N/A 230 830 Yes
Freschetta Brick Oven mushroom/spinach, 1/5 of pizza = 128 g N/A 260 610 Yes
Freschetta Brick Oven pepperoni/Italian cheese, 1/5 of pizza = 129 g N/A 220 930 Yes
Freschetta Brick Oven zesty Italian supreme, 1/5 of pizza = 132g N/A 210 780 Yes
Freschetta Naturally Rising 4 cheese medley, 1/5 of pizza = 148 g N/A 260 900 No
Freschetta Naturally Rising Canadian bacon/pineapple, 1/6 of pizza = 130 g N/A 220 760 Yes
Freschetta Naturally Rising classic supreme, 1/6 of pizza = 146 g N/A 270 910 No
Freschetta Naturally Rising Margherita, 1/6 of pizza = 129 g N/A 240 710 No
Freschetta Naturally Rising meat medley, 1/6 of pizza = 136 g N/A 270 930 Yes
Freschetta Naturally Rising sausage/pepperoni, 1/6 of pizza = 139 g N/A 290 920 No
Freschetta Naturally Rising signature pepperoni, 1/6 of pizza = 129g N/A 250 870 No
Kashi mushroom trio/spinach, 1/3 of pizza = 113 g 132 210 663 No
Kashi roasted vegetable, 1/3 of pizza = 116 g 132 210 633 No
Kashi, Margherita, 1/3 of pizza = 113 g 139 231 633 No
Kashi, Mediterranean, 1/3 of pizza = 120 g 193 202 637 No
Newman’s Own BBQ chicken, thin crust, 1/3 of pizza = 133 g N/A N/A 750 No
Newman’s Own 4 cheese medium crust, 1/4 of pizza = 135 g N/A N/A 700 No
Newman’s Own Buffalo chicken, thin crust, 1/3 of pizza = 132 g N/A N/A 580 No
Newman’s Own supreme medium crust, 1/4 of pizza = 145 g N/A N/A 790 No
Newman’s Own uncured pepperoni medium crust, 1/4 of pizza = 134g N/A N/A 860 No
Red Baron, 4 cheese, classic Crust, 1/4 of pizza = 149 g N/A 180 780 No
Red Baron, 4 meat, classic crust, 1/4 of pizza = 154 g N/A 240 890 Yes
Red Baron, 5 cheese, thin crust, 1/3 of pizza = 139 g N/A 230 840 No
Red Baron, pepperoni, classic crust, 1/4 of pizza = 146 g N/A 210 860 No
Red Baron, pepperoni, thin crust, 1/3 of pizza = 149 g N/A 270 1020 No
Red Baron, Singles, 4 cheese deep dish, 1 pizza = 159 g N/A 320 840 No
Red Baron, Singles, cheese, deep dish, 1 pizza = 159 g N/A 340 830 No
Red Baron, Singles, meat trio, deep dish, 1 pizza = 159 g N/A 330 920 No
Red Baron, Singles, pepperoni deep dish, 1 pizza = 159 g N/A 300 970 No
Red Baron, Singles, supreme deep dish, 1 pizza = 163 g N/A 320 900 No
Red Baron, special deluxe, classic crust, 1/5 of pizza = 130 g N/A 220 690 No
Red Baron, supreme, classic crust, 1/5 of pizza = 133 g N/A 190 720 No
Red Baron, supreme, thin crust, 1/4 of pizza = 124 g N/A 230 790 No
Tony’s cheese, 1/3 of pizza = 137 g N/A 210 600 Yes
Tony’s meat-trio, 1/3 of pizza = 146 g N/A 250 750 Yes
Tony’s pepperoni, 1/3 of pizza = 134 g N/A 220 650 Yes
Tony’s sausage, 1/3 of pizza = 142 g N/A 240 700 Yes
Tony’s sausage/pepperoni, 1/3 of pizza = 140g N/A 240 710 Yes
Tony’s supreme, 1/3 of pizza = 149 g N/A 250 710 Yes

Table 2

Pizza Comparison Chart: Delivery and Eating Out

Brand, Type of Pizza, Size of Slice Phosphorus (mg Per Slice) Potassium (mg Per Slice) Sodium (mg Per Slice) Added Phosphate
Domino’s 14″ cheese, hand tossed crust, 1/8 of pizza = 108 g∗ Pizza slices are shown as both a fraction and by slant in grams for comparison purposes . 220 174 565 No
Domino’s 14″ cheese, thin crust, 1/8 of pizza = 70 g 204 141 440 Yes
Domino’s 14″ extravaganza, hand-tossed, 1/8 of pizza = 151 g 278 263 689 N/A
Domino’s 14″ pepperoni, hand tossed crust, 1/8 of pizza = 113 g 216 207 690 N/A
Domino’s 14″ pepperoni, thin crust, 1/8 of pizza = 79 g 208 177 619 Yes
Domino’s 14″ sausage, hand tossed crust, 1/8 of pizza = 114 g 223 209 677 Yes
Domino’s 14″ sausage, Thin Crust, 1/8 of pizza = 78 g 211 180 566 Yes
Little Caesar’s 14″ cheese, round, regular crust, 1/8 of pizza = 89g 206 151 404 N/A
Little Caesar’s 14″ cheese, large deep dish, 1/9 of pizza = 102 g 225 163 441 N/A
Little Caesar’s 14″ cheese, thin crust, 1/12 of pizza = 48 g 143 85 218 N/A
Little Caesar’s 14″ meat/veggie, regular crust, 1/9 of pizza = 115 g 238 224 665 N/A
Little Caesar’s 14″ pepperoni, large, deep dish, 1/9 of pizza = 104 g 224 180 512 N/A
Little Caesar’s 14″ pepperoni, round regular crust, 1/9 of pizza = 90g 202 160 466 N/A
Papa John’s 14″ cheese, original crust, 1/8 of pizza = 117 g 238 161 676 N/A
Papa John’s 14″ cheese, thin crust, 1/8 of pizza = 87 g 213 139 459 N/A
Papa John’s 14″ pepperoni, original crust, 1/8 of pizza = 123 g 241 184 825 N/A
Papa John’s 14″ the works, original crust, 1/7 of pizza = 153 g 245 245 872 N/A
Pizza Hut 12″ cheese, hand tossed crust, 1/8 of pizza = 96 g 239 166 658 No
Pizza Hut 12″ cheese, pan crust, 1/8 of pizza = 100 g 241 168 624 No
Pizza Hut 12″ cheese, thin crust, 1/8 of pizza = 69 g 219 132 541 No
Pizza Hut 12″ pepperoni, hand tossed, 1/8 of pizza = 96 g 209 199 769 No
Pizza Hut 12″ pepperoni, pan crust, 1/8 of pizza = 96 g 197 191 664 No
Pizza Hut 12″ super supreme, hand tossed, 1/8 of pizza = 127 g 254 296 875 Yes
Pizza Hut 14″ cheese, hand tossed crust, 1/8 of pizza = 105 g 239 192 708 No
Pizza Hut 14″ cheese, pan crust, 1/8 of pizza = 112 g 242 190 650 No
Pizza Hut 14″ cheese, thin crust, 1/8 of pizza = 79 g 235 156 677 No
Pizza Hut 14″ pepperoni pan crust, 1/8 of pizza = 133 g 218 211 764 No
Pizza Hut 14″ pepperoni, hand tossed, 1/8 of pizza = 110 g 227 228 835 No
Pizza Hut 14″ pepperoni, thin/crispy, 1/8 of pizza = 80 g 195 178 774 No
Pizza Hut 14″ super supreme, hand tossed, 1/8 of pizza = 123 g 225 256 809 Yes

Table 1 contains nutrient information for selected frozen brands, including some that are missing data on phosphorus content but which were still included as they are among the top 10 leading frozen pizza brands sold in the United States.The first column indicates the pizza brand and style and includes the serving size of the slice expressed as a fraction of the entire pizza as well as in grams. Column 2 indicates phosphorus content per slice in milligrams, column 3 indicates potassium content per slice in milligrams, column 4 indicates sodium content per slice in milligrams, and column 5 indicates whether the product has added phosphates. Where an “N/A” appears, it indicates that data were not available for that product. Table 2 gives the same information as Table 1 for restaurant pizza brands.3

  • Byham-Gray L.
  • Stover J.
  • Wiesen K.

A Clinical Guide to Nutrition Care in Kidney Disease .Table 3,

Table 3

The Most “Renal Friendly” Frozen Pizza—and the Top 7 Picks Are …

Brand, Type of Pizza, Size of Slice Phosphorus (mg Per Slice) Potassium (mg Per Slice) Sodium (mg Per Slice) Added Phosphate
Freschetta Naturally Rising Margherita, 1/6 of pizza = 129 g N/A∗ These values are not available ; however, all pizza contain some phosphorus . 240 710 No
Kashi mushroom trio/spinach, 1/3 of pizza = 113 g 132 210 663 No
Kashi roasted vegetable, 1/3 of pizza = 116 g 132 210 633 No
Kashi, Margherita, 1/3 of pizza = 113 g 139 231 633 No
Kashi, Mediterranean, 1/3 of pizza = 120 g 193 202 637 No
Newman’s Own Buffalo chicken, thin crust, 1/3 of pizza = 132 g N/A∗ These values are not available ; however, all pizza contain some morning star . N/A∗ These values are not available ; however, all pizza contain some morning star . 580 No
Red Baron, special deluxe, classic crust, 1/5 of pizza = 130 g N/A∗ These values are not available ; however, all pizza contain some phosphorus . 220 690 No

Table 4

The Most “Renal Friendly” Delivery or Carry-Out Pizza—and the Top 7 Picks Are …

Brand, Type of Pizza, Size of Slice Phosphorus (mg Per Slice) Potassium (mg Per Slice) Sodium (mg Per Slice) Added Phosphate
Little Caesar’s 14″ cheese, round, regular crust, 1/8 of pizza = 89g 206 151 404 N/A∗ This information is not available .
Little Caesar’s 14″ cheese, large deep dish, 1/9 of pizza = 102 g 225 163 441 N/A
Little Caesar’s 14″ cheese, thin crust, 1/12 of pizza = 48 g 143 85 218 N/A
Little Caesar’s 14″ pepperoni, large, deep dish, 1/9 of pizza = 104 g 224 180 512 N/A
Little Caesar’s 14″ pepperoni, round regular crust, 1/9 of pizza = 90g 202 160 466 N/A
Papa John’s 14″ cheese, thin crust, 1/8 of pizza = 87 g 213 139 459 N/A
Pizza Hut 12″ cheese, thin crust, 1/8 of pizza = 69 g 219 132 541 No

Figure thumbnail gr1

Figure 1

General guidelines for selecting pizza.

As a typical alimentary prescription for a hemodialysis affected role is 2000 milligram of sodium, 2000 magnesium of potassium and < 1000 milligram of phosphorus, it is slowly to see how a few slices of some brands of pizza could push a affected role over the restrict of some or all of these nutrients for the stallion day. table 4 show the top 7 picks for “ renal-friendlier ” pizza for both frozen and restaurant pizza brands based on all 4 nutriment criteria listed in table 1 Table 2 Although these circus tent picks are surely not ideal foods for the nephritic patient, they represent some options that are available. figure 1 includes suggestions for counseling patients when selecting pizza brands so that if they do choose to indulge in one of America 's darling foods, they can make an inform choice regarding brands and part sizes .

nutrient information Sources

US Department of Agriculture National Nutrition Database : hypertext transfer protocol : //ndb.nal.usda.gov/nbd www.dominos.com.www.freschetta.com.www.newmansown.com.www.pizzahut.com.www.redbaron.com.www.tonys.com.

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Publication History

Footnotes

fiscal disclosure : The writer declares that there are no relevant fiscal interests .

Identification

department of the interior : hypertext transfer protocol : //doi.org/10.1053/j.jrn.2015.02.002

Copyright

© 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved .

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