The Pizza Test By Dr. Tom Ingegno, DACM, MSOM, L.Ac.


Inflammation is one of the underlying causes and complications of most illnesses from which a person can be suffering.  Possibly the most common cause of chronic inflammation is your diet. Coincidentally, it's also the most difficult to change. I often joke it would be easier to get someone to convert their religion than to change their diets.

Fortunately, I have two “aces in the hole” for you! First - there is a ton of dietary information available today.  Most restaurants have at least a couple of menus options that will fit almost any diet restriction. There are also some amazing sources on the internet as well as books that can help you fill your belly with quality foods.  Whatever diet you follow (Whole30, Bulletproof, Paleo, The Plan or AIP), they all aim to improve your health by removing inflammatory foods from your diet.

Charm City Integrative Health - The Pizza Test

My second ace is our nutritionist, Caitlin Self, who is available for consultations, and regardless of your preferred eating style can help you make better choices.  She is currently available for consultation in our Baltimore office and has a special deal for members as well.

Honestly, I am a huge fan of Food Sensitivity Tests and Elimination Diets that are available to help people pin down their individual inflammatory foods.  There are some drawbacks to both. Food Sensitivity Tests can be costly out of pocket, and many insurance companies won’t cover them, because sensitivity is not an allergy, even though both can negatively impact your life and overall health.  Elimination Diets are in essence free but it often takes a long time to slowly eliminate foods and then reintroduce them to see how they affect you. In addition, dining out and some prepared foods may not totally list their ingredients which may mess up all your hard work.  

Now to the meat and potatoes of the article, or more appropriately, the Pizza.  One quick way to help figure out if you are sensitive to three common inflammatory compounds will only take a week of commitment and at the end, you get to dig into a slice of your favorite pizza.  (Please be warned, after this, pizza may no longer be your favorite!)

I like to start this test over the weekend so have time to meal plan.  I also suggest doing it on a week that doesn’t include any birthdays, holidays or special events where you will be tempted to slip up.  Spend time deciding on your menus for breakfast, lunch, and dinners for a total of 7 days. Make sure every meal you pick does NOT contain dairy, gluten or any nightshades.

Nightshades: Tomatoes (all varieties), Potatoes (white and red potatoes but not sweet potatoes), Eggplant, Peppers (Bell peppers, chili peppers, and any red spices), Paprika, and Goji berries

Nightshades: Tomatoes (all varieties), Potatoes (white and red potatoes but not sweet potatoes), Eggplant, Peppers (Bell peppers, chili peppers, and any red spices), Paprika, and Goji berries

Everyone knows someone who is Lactose Intolerant, but did you know that a second protein called casein is even more inflammatory and is the compound that makes Elmer’s glue so sticky.  When ingested in most people, it creates mucus in the sinuses and can make joints stiff and painful.  Check out what WebMD has to say here.

Charm City Integrative Health - Lactose Intolerance

Gluten is a protein that is present in anything containing wheat, rye or barley and is the reason bread, cereals, and other baked goods are so chewy.  This may be the most inflammatory compound in American diets. Here’s a great article from Chris Kresser that talks about some of the symptoms of gluten intolerance you may not have known.

Charm City Integrative Health - Gluten_Wheat Rye Barley

A third, but a lesser-known inflammatory family of foods, called nightshades. As an Italian-American, this one pains me the most, as it contains fruits and veggies including tomatoes, peppers, eggplants, and other foods generally considered healthy for most. talks about removing these from your diet for 3 months to see changes, for right now try one week.

*Bonus points if you can remove soy and corn from your diet for a week as well.  We can address issues with those more in the future.

Make a shopping list.  Choose simple recipes that do not contain the previously mentioned ingredients.  Even better - choose fresh organic foods. There’s no limit to the amount of food you consume during this week but eat sensibly.  Shop and meal prep ahead of time because this will help you be more successful and get thrown off track if the week throws you an unexpected curveball. However, don’t forget to leave the 7th day’s dinner menu open for your favorite pizza.  

Charm City Integrative Health - Planned Grocery List

This week you are going to track several variables to help you gauge your sensitivity.  You may notice changes in these factors at different times so writing them down and comparing day to day will help you reflect.

  • Weight: Weigh yourself every morning and evening.  This isn’t to lose weight, but you may notice a significant drop in weight when you are not consuming foods that cause inflammation.

  • Pain: If you have body aches, old injuries, or have experienced massive trauma, give yourself a 1-10 Pain Rating every morning and evening.  

  • Congestion:  Maybe you never have a stuffy nose or sinus issues, but more often than not you may be walking around with congestion you thought was normal. Give yourself a 1-10 rating.

  • Energy: Give yourself a 1-10 rating on this as well.  Be advised that 2-3 days into this process you may notice a drop in energy, or generally feel a bit crappy (that’s the medical term) because of the bacteria die off in your gut.  Don’t worry. The ones that are dying are hijacking your system and telling your brain to eat more foods that cause inflammation. The good ones will enjoy more room to reproduce. I’ll save that for another post.  Your energy should pick back up towards the end of the week

  • Sleep:  This goes hand and hand with the energy.  Many people are already tracking sleep thanks to devices like the Fitbit, but don’t feel like you need to buy a tracker for this self-experiment.  In this case, see how you feel when you wake up. Give yourself a 1-10 for your overall quality of sleep.

Now that you’ve made it to the seventh evening, go ahead and indulge in your favorite slice or two. Track how you feel immediately after eating as well as over the next few days.  

Use the variables above to compare how you felt to how you feel, after eating pizza.  Did you suddenly add weight? Do you have an increase in pain? How’s your energy?

Charm City Integrative Health - Energy

None of this is set out to demonize pizza, just to give you an insight into how to help your body function better.  If you noticed no difference, congratulations, you have an iron stomach and were blessed with great intestinal flora and good genes.  But, I am willing to guess, you saw some improvement in at least one of the above criteria. Now you can go back and eliminate, dairy, gluten, and nightshades one at a time to see where your sensitivities exist.  

Every service at Charm City Integrative Health addresses inflammation. This post, as well as a few others, will soon be compiled into a short guide titled, “5 Steps to Knock Down Inflammation”. Seriously, you don’t want to miss this super helpful, free guide! Sign up for our newsletter here and you’ll be one of the first people to get your hands on it.