Pizza: Is it really good for you?

It's kind of thing you hope is true: eating pizza protects against heart attack. That, at least, is one possible explanation for the findings of Silvano Gallus's team at the Mario Negri Institute of Pharmacological Research in Milan.

They interviewed 507 people after their first heart attack, comparing their lifestyle with 478 other patients without heart problems. Not surprisingly, they found the heart-attack patients tended to smoke more, exercise less, be overweight and eat fewer fruits and vegetables.

Frequent consumers of Italian pizza had less than half the risk of an acute myocardial infarction compared with those eating pizza only occasionally. Even those who ate fewer than four portions a month seemed to gain some protection.

Pizza eaters were classed as occasional (1-3 200-gram portions a month), regular (more than one a week), and frequent (two or more a week).

The results show that the greater the consumption of pizza, the lower the risk of heart attack.

Just how pizza could be protective is not clear. The authors took into account a wide range of potential confounders, but these did not explain the link.

The authors say the finding may be a marker for the Italian diet, which has been linked to cardiovascular benefits. Yet when they allowed for the Mediterranean diet in the calculations, the odds ratios did not materially change. Pizza may also be an indicator of a diverse diet, but after adjusting for variety, the odds ratio for regular eaters of pizza did not change.

The authors point out that in Italy most pizza is usually consumed in traditional pizzerias and that consumption of "fast food" pizza is unusual. The average energy of a standard pizza in Italy is relatively low (500-800 calories), and 100 grams of a traditional Italian pizza has about 50 grams of carbohydrates, 20 grams of tomato sauce, 20 grams of mozzarella cheese, 4 grams of olive oil, and 2 grams of yeast.

"Some of the ingredients of pizza have been shown to have a favourable influence on the risk of cardiovascular disease. However, there is no single explanation for the present findings," say the authors.

And no, the work was not funded by a pizza company.

But don't rush out to the nearest pizzeria, Gallus and others caution. For one thing, a small study based on people's recollections is not definitive proof.

What's more, even if the results are accurate, they do not prove that pizza itself is good for you. It might just be that Italians with a lust for pizza tend to eat a more healthy diet overall. "Our message is not simply 'Eat pizza and you'll be protected'," says Gallus. "Our suggestion is 'Do not abandon the Mediterranean diet and diversity of food.'"

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Reference
Gallus S, Tavani A, Vecchia CL. (2004). Pizza and risk of acute myocardial infarction. Eur J Clin Nutr, 58, 1543-1546