Can You Eat Pepperoni Pizza When Pregnant?

Yes, you can eat pepperoni pizza when pregnant, provided the pizza is cooked thoroughly and served piping hot. The heat from baking kills harmful bacteria like listeria that may be present in cold cured meats such as pepperoni. Cold or undercooked pepperoni should be avoided during pregnancy due to the risk of foodborne illness.

Pregnancy often brings intense cravings, and pepperoni pizza is a common one. The good news is that you don't have to give it up entirely. The key is ensuring the pepperoni reaches a safe internal temperature—typically 165°F (74°C)—which happens when the pizza is properly baked. This article explains why heat matters, how to enjoy pepperoni pizza safely, and what to consider regarding nutrition and other toppings.

Why Heat Matters for Pepperoni During Pregnancy

Pepperoni is a cured sausage made from beef and pork. Unlike cooked meats, it undergoes fermentation and drying rather than heat treatment. This process makes it shelf-stable but does not eliminate all bacteria. Listeria monocytogenes, a bacterium that can cause listeriosis, is particularly concerning during pregnancy because it can survive and even grow at refrigerator temperatures. Pregnant women are about 10 to 20 times more susceptible to listeriosis due to changes in the immune system, and infection can lead to miscarriage, stillbirth, or severe illness in the newborn.

When pepperoni is placed on a pizza and baked in a hot oven, the temperature exceeds 165°F (74°C), which kills listeria and other pathogens. This makes the pepperoni safe to eat. The NHS advises that cold cured meats like pepperoni should be cooked until steaming hot before eating during pregnancy. Similarly, BabyCentre UK confirms that cured meat toppings are safe if the pizza is cooked thoroughly and served piping hot.

For more on general food safety during pregnancy, see the NHS guidance on foods to avoid.

How to Safely Enjoy Pepperoni Pizza

Follow these steps to minimize risk:

• Order or bake it well-done: Ensure the pizza is cooked until the cheese is bubbling and the pepperoni is sizzling or slightly curled at the edges. This indicates the meat has reached a safe temperature.
• Eat it hot: Consume the pizza soon after it comes out of the oven. Do not let it sit at room temperature for more than two hours.
• Reheat leftovers properly: If you have leftover pizza, reheat it in an oven or air fryer until the pepperoni is steaming hot again. Avoid eating cold leftover pizza, as bacteria can grow if it has been stored improperly. The NHS recommends reheating until piping hot.
• Avoid cold pepperoni: Do not eat pepperoni straight from the deli counter or a charcuterie board unless you heat it until steaming. Deli slicers can harbor listeria, and cold cured meats are a known risk.

For a detailed explanation of the "steaming hot" rule and reheating tips, see PregnancyPlate's guide to pepperoni safety.

What About Cold or Leftover Pizza?

Cold pizza is not recommended during pregnancy. Even if the pizza was originally cooked safely, bacteria can multiply if it is not stored correctly. The NHS advises that leftover food should be refrigerated within two hours and reheated until steaming hot before eating. BabyCentre UK also suggests reheating leftover pizza thoroughly and consuming it within 48 hours. If you accidentally eat a slice of cold pepperoni pizza, do not panic—the risk of illness is low, but monitor for symptoms such as vomiting, diarrhea, or fever, and contact your healthcare provider if they occur.

Nutritional Considerations: Sodium, Fat, and Nitrates

While pepperoni pizza is safe when cooked, it is high in sodium, saturated fat, and often contains nitrates or nitrites used as preservatives. Excessive sodium intake during pregnancy can contribute to swelling (edema) and high blood pressure. The U.S. Dietary Guidelines recommend limiting sodium and saturated fat, especially for those with hypertension. Pepperoni is also calorie-dense, so moderation is key. Consider pairing your pizza with a side salad or choosing a thinner crust to balance the meal.

For more on the nutritional aspects of pepperoni during pregnancy, see Happiest Baby's article on pepperoni safety.

Other Pizza Toppings: What's Safe?

Most pizza toppings are safe during pregnancy if cooked properly. Mozzarella made from pasteurized milk is safe, whether melted or cold. Soft, mold-ripened cheeses like brie and blue cheese should be avoided unless thoroughly cooked. Seafood toppings such as prawns and tuna are safe if cooked, but tuna should be limited to no more than two steaks or four medium cans per week due to mercury content. Eggs on pizza are safe if they are British Lion stamped or cooked thoroughly. Vegetable toppings are always a healthy choice, but ensure they are washed before use.

For comprehensive guidance on pizza toppings during pregnancy, refer to BabyCentre UK's pizza safety article.

What If You Accidentally Ate Cold Pepperoni?

If you have eaten cold pepperoni or undercooked pizza, try not to worry. The risk of listeriosis is low, but it is important to be vigilant. Symptoms of listeriosis can appear up to several weeks after exposure and may include fever, muscle aches, nausea, or diarrhea. If you develop any of these symptoms, contact your midwife or GP promptly. Early treatment with antibiotics can reduce the risk to your baby.

Remember, this information is general and not a substitute for personalized medical advice. Always consult your healthcare provider if you have concerns about your diet during pregnancy.