Main Dishes

Paleo Pizza Casserole

OMG this recipe is SO DELICIOUS and it has everything in one. Veggies, protein, a little fats from the meat – it’s definitely going to fill you up without weighing you down!

PALEO PIZZA CASSEROLE is paleo because no cheese, grains, or artificial ingredients. Spaghetti squash is going to add tons of bulk and fiber so you will not be hungry for hours! This is perfect to meal prep for dinner or for lunches! Perfect by itself or you could pair a little side salad if you are reducing carbs or do like I did and roast some red and sweet potatoes with olive oil, rosemary, salt, pepper, garlic powder and smoked paprika and eat some carbs on the side! I love a good roasted potato combo! We are eating on this for lunches this week because sometimes I GET TIRED OF CHICKEN ALL THE TIME Y’ALL…so I love to mix it up! And the flavor of the sausage is so good, but it’s fatty so I like to cut the fat some by adding in ground turkey! You could totally do two lbs of ground turkey though, or a mixture of turkey/chicken or turkey/beef. I have to say I have not tried this recipe without the sausage so if you do make sure to add extra Italian seasoning. Like do 1 tsp basil and 2 tsp Italian seasoning to make sure you get good flavor!



1 medium to large spaghetti squash, cut in half, seeds removed

1 cup (or one medium-sized container) chopped or sliced mushrooms

1 medium-large zucchini, diced

1/2 bell pepper of choice, diced

1 medium onion, diced (or 1/2 of a large onion)

3 cloves garlic, minced

1 lb ground turkey

1 lb mild Italian sausage

3 whole eggs, whisked

2 small jars of pizza sauce (I just got the Whole Foods brand which doesn’t have added sugar, I think each jar was about 14 oz)

6 or so slices uncured pepperoni (or other uncured similar meat without nitrites or nitrates)

Seasonings: salt and pepper, about 2 tsp dried basil or Italian seasoning, dash or two of cayenne or red pepper flakes for a touch of heat!


Preheat oven to 400. Take a baking sheet and cover with foil and cut the spaghetti squash in half, long-ways, remove the seeds, coat a little with olive oil and salt and pepper. Bake face down for about 40 minutes until soft to touch. Turn off oven and set the squash aside to cool (face up after it’s cooked will allow it to cool faster).

Now take a dutch oven or other large pot and heat a touch of oil over medium heat (I like avocado oil usually or coconut or ghee). Add your sausage and turkey, onion, bell pepper and some salt and pepper (not too much salt as the pizza sauce and sausage are both salty). Break the meat up and saute occasionally, for about 5-6 minutes. Let the onions and peppers become a little translucent. Next add the mushrooms, the basil, minced garlic, red pepper flakes if you are adding, and continue to cook everything until the meat is browned. Be sure to keep the garlic moving and stirred periodically or it will burn easily! Once the meat is browned you can add the zucchini along with the pizza sauce and give it all a good stir. Bring to slight boil, and then turn all the way off.

Preheat oven back to 350 (it should preheat quickly since we just had it on for the squash!)

Take a 13×9 baking dish and using a fork shred the spaghetti squash threads into the dish, getting all of them in there. Next get your eggs together in a small bowl and whisk them up. Take all the contents from the pot you’ve just used on the stove and pour into the baking dish, smoothing everything out evenly, stirring a bit in the threads to get it evenly dispersed and pour in the eggs and gently stir and wiggle the eggs all into the casserole so they’re evenly dispersed. Place the uncured pepperoni slices (if using) on top of the casserole however you’d like. Feel free to cut them in half too and spread them out.

Bake for 1 hour at 350, uncovered. Let sit for five minutes before cutting and serving! Makes 8 servings.


What I love about this dish is the creativity you can apply! You can mix up the veggies, you can add cheese if you want (I would probably sprinkle it on top), you can switch up the meats you use, the options are quite varied!

MACROS…I am not quite sure but it’s at least 25 grams protein, very few carbs because it’s all vegetables, and probably about 15 grams of fat if I had to *guess*. But don’t worry. These are all great ingredients!!!!! JUST TRACK PROTEIN PEOPLE!


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