I dislike categorizing anything as healthy or unhealthy because I believe you can eat pretty much anything in moderation as part of a balanced diet. That said, you can use lean meat or turkey pepperoni, whole wheat or protein pasta, and reduced-fat cheese to decrease the calorie count. Also, considering adding some vegetables that are common pizza toppings to the casserole, such as mushrooms, bell peppers, olives, or onions. It's like a supreme pizza pasta!