"Fathead" Pizza Crust - The Ketolicious Way: 4 Cheese White Pizza w Spinach, Ricotta, & Prosciutto

"Happiness is just a matter of digestion"

~Lin Yutang

What is a ketogenic diet?

The ketogenic diet is not a new fad trending on Instagram. The medical community has implemented it for nearly 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins cleverly adapted its strict adherence to very-low carbohydrates for the first two-week phase of his now iconic Atkins Diet for weight loss, after which dieters transitioned into a less restrictive protein and fat-rich regimen.

Essentially, the diet is designed to release ketones into the bloodstream. Shifting the consumption of energy from one kind of metabolic pathway to another. Most of our bodies' cells prefer to use glycogen (blood sugar) which comes from stored carbohydrates as the main source of energy to fuel our biological processes. When you restrict consumption of starches and sugar, the absence of circulating glucose in your body causes it to catabolize stored fats, breaking them down into molecules called ketone bodies. This process is called ketosis. Once you reach ketosis, your cells will exclusively use ketone bodies to generate energy until you start eating higher glycemic carbohydrates again.

It takes anywhere from two to seven days of eating fewer than 20-50 grams of carbohydrates a day to make this shift of primary energy source from sugar to ketones. Bear in mind, that there is no magic number of carbs that will guarantee this shift from sugar fuel to ketone fuel, the process is highly individualized and careful analysis of how many carbs you need to consume in order to remain in ketosis is part of the fun. Some people require an even more restricted diet to produce enough ketones as fuel. Generally speaking, you will be consuming 70 to 80% fat, 15 to 25% protein, and 5 to 10% of calories coming from carbohydrates.

There is much debate about the ideal ratio of macronutrients (protein, fats, and carbs) and there are many factors that can mitigate good results... for instance, some sources claim overconsumption of proteins can cause gluconeogenesis - i.e. the metabolic process responsible for turning proteins into glucose... a little gift from our forbearers. Glucose is the only energy source used by the brain (with the exception of ketone bodies), testes, erythrocytes, and kidney medulla. In mammals this process occurs in the liver and kidneys. If you consume too much protein on a ketogenic diet, your body may have an insulin response. This process inhibits the body’s ability to produce ketone bodies. The amount to which you need to limit your protein varies person to person and depends on many factors just like carbohydrates.

Good sources of fat on a ketogenic diet include coconut oil (because it’s high in medium chain triglycerides C8, C10, and C12), extra-virgin olive oil, avocado oil, grass-fed butter, clarified butter, ghee, tallow, olives, walnuts, coconut, bacon, and bacon fat. Most of these are saturated, and they are less likely to be oxidized when cooked. Extra-virgin olive oil should be used on salads or in areas where it will not be cooked, as it is oxidized more easily. Avocado oil has a higher smoking point so it can be used with cooking. Quality of fats is extremely important because when fats are oxidized (meaning when they are heated to a certain temperature and they produce oxygen-reactive species) they can form free radicals that can oxidize LDL cholesterol, which in turn can damage our arteries’ lining and cause hardening of the arteries.

Achieving ketosis is an exercise in trial and error, and I am not here to advocate the diet;  although, I do eat this way, as does my husband. For those of you interested in trying the diet, or those of you who are just looking for less starchy, less sugary alternatives to replace some of your favorite dishes, I have opted to start posting a series of recipes based on the ketogenic diet, but it might be more accurate to simply call them "low carb" recipes since (although I use no starches, glutens, or sugars), I cannot attest with any true degree of accuracy or veracity that all of these recipes will fall exactly within the 70 to 80% fat, 15 to 25% protein parameters that constitute a true ketogenic meal.

The Fathead Pizza concept I have adapted was originally posted by a couple of food bloggers in June of 2013. You can find their fathead recipe here. It is made like a Sicilian pie, rectangular in shape with a bit thicker crust.

My version is gluten-free, fragrant with the lovely scent of yeasty goodness and truly delicious. You'll find the full recipe below at the end of the post along with ingredients and instructions, but I thought first I'd walk you through some steps. 

Notes: The crust itself is a simple affair. The dough comes together easily, though it is a bit sticky. It's comprised mostly of mozzarella cheese melted with a little cream cheese,  almond flour, yeast (solely for its inimical flavor, but not for rising, this dough won't rise...), baking powder, psyllium husk (to give the dough a semolina-like depth and texture), one whole beaten egg, olive oil and/or ghee for flavor and also to coat your hands when kneading. You'll need parchment paper to roll it out and bake it on, but the dough itself is pretty fool-proof and bakes to thin crisp foldable perfection like an actual slice of Neopolitan pizza. I have even made incredible Chicago-style pan pizzas with it (just adding a few minutes to the blind-baking time).  The pizza reheats beautifully, btw. Reheat it in a slow oven (350 degrees). for 3-5 minutes. You can microwave it for a minute, but it will lose its lovely crispness if you do.

It is vital that you have all your ingredients assembled and ready (making sure, for instance, that you preheat your oven first with your pizza stone or pan in it,  and then add warm water to your yeast in a tiny bowl that you set aside for 10 minutes until its foamy, have your egg at room temperature and beaten,  have your toppings all chopped and cooked if they require cooking, your dry ingredients mixed,  etc.) before melting the mozzarella and cream cheese together in the microwave in a large microwaveable bowl - a bowl large enough to eventually add the other ingredients and work the dough in.

Bear in mind, the cheese dough will harden if too cool and will be impossible to incorporate with the other ingredients, though, of course, should you find the cheese has congealed into hard unworkable cement, you can always reheat it in the microwave for a few seconds to make it more pliant and malleable. No fear here...

You must use regular grated mozzarella for the crust itself - do not use fresh mozzarella for the crust, it is far too wet. In fact, if you choose to use fresh mozzarella as a topping, I strongly recommend using sheets of paper towels to absorb all the excess liquid, lest the milky whey run all over your pizza crust and dampen it.

Naturally, you can easily add any toppings you like. You can use a marinara sauce, sausage, mushrooms, pepperoni... anything and everything, so long as you cook whatever raw ingredients you choose beforehand. The baking time for the pizza is too short to add raw ingredients, unless, that is, you like raw food atop your crust, then by all means... indulge.

A  large classic silicon spatula, the kind you use to fold egg whites into mixtures with, is my tool of choice for combining the melted cheese with the other dough ingredients. It makes an enormous difference, because it really allows you to work the dough, pressing it out like the paddle of a mixer would without sticking to it, and, of course, you must use your well-oiled hands at the end to completely incorporate the dough's ingredients with a little kneading, before rolling - human hands are the greatest most sensitive tools of all. 

Roll the dough out between 2 pieces of parchment paper so it doesn’t stick to your rolling pin. Roll it out to about a 12-inch circle or a little larger if you like your pizza thinner and want to have rolled up crust ends like Neopolitan-style pizza. You must dock the crust... Poke the dough all over with the tines of a fork. Don’t forget this step or it will bubble up and make it very challenging for you to layer your toppings on it! 

Then you must blind bake the dough. Transfer the dough circle onto the preheated baking stone (WITH the parchment paper beneath) and bake until it’s starting to turn golden brown in spots, about 6 - 8 minutes. If using a cookie sheet instead of a baking stone, cook 8-10 minutes. Once again, this dough is sticky and if you bake it without parchment paper, it will turn your stone or pan into a gooey mess when you try to extract it. Do not use aluminum foil in lieu of parchment paper... the dough sticks to it... I learned this the hard way;)

Now add your toppings and cook the fully loaded pizza for another 8-10 minutes, or until your toppings are hot, the cheese sauce is set, and the fresh mozzarella is melted.

"Fathead" Pizza Crust 

Ingredients

Pizza Dough:

• 1 teaspoon instant yeast
• 2 tablespoons warm water
• 1 cup almond flour
• 1 tablespoon psyllium husk powder
• 1 teaspoon baking powder
• 1 and 1/2 cups shredded low-moisture part-skim mozzarella
• 1 ounce cream cheese, cubed
• 1 large egg beaten, be sure egg is at room temperature
• Avocado oil, olive oil, or ghee, for oiling your hands

Garlic Cream Sauce:

• 2 tablespoons unsalted butter
• 2 large cloves garlic crushed or minced
• 1 ounce cream cheese
• 1/2 cup heavy whipping cream
• 1/2 cup of ricotta cheese
• 1/8 teaspoon black pepper
  1 teaspoon fresh or dried parsley flakes

Other:

• 8 ounces fresh mozzarella, thinly sliced, drained on paper towels
• 6 ounces cooked spinach, sauteed in olive oil, drained on paper towels
• 6 cherry tomatoes, sliced in half
  Parmigiano-Reggiano, grated to taste, for garnish (optional)
  4 ounces of thinly sliced prosciutto, for garnish (optional)
  red pepper flakes, for garnish (optional)

Instructions

• For the pizza dough, preheat oven to 425F. If you have a baking stone, place it in the center of the oven to preheat.
• Add the yeast and warm water to a small bowl and stir to combine. Set aside until foamy, about 5 to 10 minutes.
• Whisk together the almond flour, psyllium husk powder, and baking powder in a medium bowl and set aside.
• Make the garlic cream sauce. To do so, heat the butter in a small sauce pan over medium heat. Once melted, add the garlic and cook 1 minute, stirring constantly. Add the cream cheese, heavy whipping cream, ricotta, dried parsley flakes, and black pepper - whisking until the sauce is smooth. Cook over low heat. Reduce the sauce until it has thickened. Turn off the heat. 
• Add the mozzarella and cream cheese to a large microwave-safe bowl. Microwave for 60 seconds and then give it a stir, and continue microwaving in 20-second increments until the cheese is fully melted and combined when stirred. Stir the yeast mixture into the melted cheese until combined with a silicon spatula being sure to really work it in well, and then stir in the beaten egg until combined. Stir in the almond flour mixture until it forms a dough, pressing with the sides of the spatula.
• Oil your hands and knead the dough a couple times until it comes together as a ball. Then flatten into a disc. 
• Roll the dough out between 2 pieces of parchment paper to a 12-inch circle. Poke the dough in several places with a fork.
• Transfer the dough circle with its parchment paper beneath it onto the preheated baking stone and bake until it’s starting to turn golden brown in spots, about 6 - 8 minutes. If using a cookie sheet instead of a baking stone, cook 8 - 10 minutes.
• To make the pizza, leave the oven on 425F and leave the pizza stone in the center of the oven.
• Once the crust is pre-baked, spread the garlic cream sauce on top. 
• Place your cooked spinach leaves, fresh mozzarella slice, and cherry tomatoes, arranging them decoratively on top
• Slide the pizza onto the pizza stone in the 425F oven and bake until the cheese is melted, and the cream sauce is set about 8 to 10 minutes.
• Sprinkle grated parmigiano on top. Arrange prosciutto slices evenly & decoratively. I like to roll them, but you can do it any way you like. Sprinkle red pepper flakes and/or additional parsley. Slice with a pizza cutter into wedges. Mangia.