Recipe: Low-Carb Spaghetti Sauce

paleobetic diet, low-carb  spaghetti sauce

A spaghetti squash in the background

My wife is Italian so we eat a lot of spaghetti at the Parker Compound. When spaghetti squash is in season, we use it instead of wheat-based pasta with this sauce, to make it less fattening. The substitution also makes the combo compliant with paleo and diabetic diets.

A definitely non-paleo ingredient below is Truvia, a sweetener that’s a combination of stevia and erythritol. Stevia is supposedly “natural.” I don’t know where erythritol, a sugar alcohol, comes from. The purpose of a sweetener is to counteract the tartness or bitterness of the tomatoes. Honey would probably serve this purpose—for those of you on a pure paleo kick—but I’ve never tried it in this recipe. If you use the honey or the table sugar option below, it will increase the digestible carb count in each cup by three grams. Whatever your favorite non-caloric sweetener, use the equivalent of two tablespoons of table sugar (sucrose).


1 lb (454 g) sweet Italian sausage, removed from casing

3/4 lb (340 g kg) lean ground beef (lean = up to 10% fat by weight)

1/2 cup (118 ml) onion, minced

2 cloves garlic, crushed

1 can crushed tomatoes (28 oz or 793 g)

2 cans tomato paste (total of 12 oz or 340 g)

2 cans tomato sauce (total of 16 oz or 454 g)

1/2 cup water (118 ml)

2 tsp (10 ml) Truvia (combo of stevia and erythritol; optional substitutes are table sugar  (2 tbsp or 30 ml) or honey (1.5 tbsp or 22 ml), or leave out sweetener

1.5 tsp (7.4 ml) dried basil leaves

1/2 tsp (2.5 ml) fennel seeds

1 tsp (5 ml) Italian seasoning

1/4 tbsp (3.7 ml) salt

1/4 tsp (1.2 ml) ground black pepper

4 tbsp (60 ml) fresh parsley, chopped


Put the sausage, ground beef, onion, and garlic in a pan and cook over medium heat until well browned. Drain off the excess liquid fat if that’s your preference (not mine). You’ll probably have to transfer that mix to a pot, then add all remaining ingredients and simmer on low heat for two or three hours. You may find the flavor even better tomorrow. If it gets too thick, just add water.

If you’re predisposed to carbohydrate toxicity—high blood sugar—eat this over spaghetti squash rather than pasta. Here’s a post on cooking spaghetti squash. Small or inactive folks may find a half cup of sauce over one cup of cooked squash is a reasonable serving (about 250 calories). I prefer to double those portions, making it a whole meal.

Sometimes I just eat this sauce straight. But I’m weird. A cup of sauce with some veggies or fruit is a meal for me. If you have other uses for spaghetti sauce other than over spaghetti squash or grain products, please share in the Comments. One of my readers puts it on zucchini (presumably cooked).

Number of Servings: 9 (1-cup each)

Nutritional Analysis: (assumes you retained all fat)

55% fat

23% carbohydrate

22% protein

345 calories

21 g carbohydrate

4 g fiber

17 g digestible carbohydrate

985 mg sodium

1,117 mg potassium

Prominent features: Rich in vitamin B12, iron, copper, niacin, sodium, and selenium

Advanced Mediterranean Diet boxes: 1 veggie, 1 & 1/2 fats, 1/2 protein (Advanced Mediterranean Diet information here)

Steve Parker, M.D.

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