Tomatoes Irritating? Do You Miss Pizza? Try these low acid options!

Tomatoes Irritating? Do You Miss Pizza? Try these low acid options!

From pasta to pizza, salsa to chili, tomatoes are one of the favorite foods of summer. Unfortunately, for some people, tomatoes can cause discomfort due to their high acid and/or histamine content. The quantity and type of tomatoes used matters. A slice of tomato on a sandwich or salad may be quite tolerable though a serving of pasta sauce can irritate. Home grown tomatoes that are allowed to mature on the vine, especially yellow tomatoes, contain less irritating acid than typical store bought produce that is picked too soon.

If you miss tomatoes, you are certainly not alone. Here are some things to try:

  • Use a roasted red pepper sauce on pasta, pizza, or meat. The red sauce is visually familiar and the roasted red peppers offer a pleasant, smoky flavor while replacing most of the nutrients you would find in tomato-based recipes.
  • Swap a pesto or cream-based Alfredo sauce for tomato-based sauces on pasta or even pizza. Although the nutrient blast isn’t quite the same, you are adding a fair amount of protein to your dishes. If you are trying to watch your fat intake, substitute evaporated skim milk for the cream or whole milk and use olive oil instead of butter for the roux in the white sauce.
  • Grow your own tomatoes in a garden or using containers on your deck or porch. It is easy to research low-acid versions of tomatoes online, or you can simply ask your local nursery for suggestions. You can even cluster other plants with your tomatoes based on your favorite meals! For example, you can plan a pasta garden (tomatoes, oregano, and basil plants), a Mexican garden (tomatoes, green onions, and cilantro), or a salad garden (tomatoes, lettuce, spinach, green onions, and cucumbers). Have fun with it, knowing in the end you can have delicious meals using produce grown in your own back yard.
  • If you don’t have the time or space to grow tomatoes at home, don’t forget about your local farmers’ markets. These markets are often a treasure-trove of jewel toned heirloom tomatoes, the lighter colors often signaling a milder acid content. To locate a farmers’ market near you, visit Local Harvest and search using your zip code.
  • Finally, if you eat something that gives you discomfort due to high acid content in the food or beverage, don’t forget to keep Prelief handy to take the edge off.

Remember, your issues may come and go over time and you may eventually tolerate more foods than you do now. There is no reason to avoid something unless you need to, so if you are feeling pretty good, don’t be afraid to experiment occasionally with small portions of your trigger foods. You may be pleasantly surprised that you can indulge in some of your favorites once again!

My Way Pizza (Serves 4)


  • 1 cup chopped vegetables (broccoli florets, cauliflower florets, zucchini slices, shredded carrots, sliced mushrooms, sweet bell pepper slices)
  • Olive oil, salt, pepper (as tolerated)
  • Pizza dough (recipe below) or two medium pre-baked pizza crust (like Boboli)
  • ½ cup Alfredo sauce or pesto sauce (both recipes below)
  • 1 cup shredded mozzarella cheese
  • ½ cup Parmesan cheese


  1. Heat oven to 400°F.
  2. Spread chopped vegetables on cookie sheet lined with parchment.
  3. Drizzle olive oil, salt, and pepper (as tolerated) over vegetables
  4. Place vegetables in hot oven for 5 to 7 minutes until very slightly browned. Remove from oven and set aside.
  5. Divide pizza dough and placing on a pizza stone or large cookie sheet, spread into two, 10 inch circles. (Or place pre-baked pizza crusts on stone/pan.)
  6. Top each pizza with sauce, cheese, and vegetables.
  7. Bake for 10 minutes at 400°F or until cheese begins to turn golden. Remove from oven and let rest 5 minutes. Serve.

Basic Pizza Dough


  • 1 c. warm water
  • 1 package active dry yeast
  • 2-1/2 c. all-purpose flour
  • 2 T. olive oil
  • 1/2 t. salt

Combine water and yeast in a large bowl. Add 1-1/2 c. flour and mix well. Add oil, salt and remaining flour. With clean hands, work the ingredients together until stiff dough forms. (Add last cup gradually—you may not need all of it.)

Knead dough on floured pastry cloth or board for 5 minutes or until shiny and elastic. Place dough into large mixing bowl that has been coated with olive oil; turn dough to coat it and cover with kitchen towel. Let dough rest for one hour in warm place until doubled in size.

Remove dough to lightly floured surface and split into two balls. Cover and let rest again for another 15 minutes. Dough can now be shaped into pizza crust. Follow directions above to make pizza.

No Cheese Pesto Sauce for Pasta or Pizza


  • 3 c. fresh basil leaves
  • 1 c. fresh parsley sprig
  • 4 garlic cloves, crushed
  • 4 T. olive oil
  • 3 T. toasted pine nuts
  • Pepper, if tolerated, to taste

Use food processor to chop basil and parsley. Add garlic and olive oil; process another 20 seconds. Add pine nuts and finish processing. Use as topping for pasta or baked potatoes, or as a garnish for chicken.

No Cheese “Alfredo” Sauce for Pasta or Pizza


  • 1/4 c. olive oil
  • 2 T. flour
  • 2 cans evaporated skim milk
  • 1 t. minced garlic
  • 1 t. minced onion
  • 3 T. fresh basil, finally chopped
  • 1/2 t. salt
  • Pepper, if tolerated, to taste

Heat oil in saucepan over medium heat. Add flour, whisking until smooth. Add remaining ingredients, whisking until sauce has thickened. Use as a topping for pasta or baked potatoes, or as a garnish for chicken.

About The Author:

Julie Beyer, MA, RDN is a registered dietitian nutritionist who also happens to have interstitial cystitis and GERD. She is an author, speaker, IC patient advocate, and the owner of Confident Choices, a nutrition education company for bladder patients. Julie has written three books about this puzzling and painful bladder disorder, Customizing the Interstitial Cystitis Diet: A Confident Choices® Book, Confident Choices® A Cookbook for Interstitial Cystitis and Overactive Bladder, and a reference guide for nutritionists, Interstitial Cystitis: A Guide for Nutrition Educators.

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