“Spaghetti” in Creamy Tomato Sauce

We had such an awesome time this weekend spending time with my sister and her family, hanging out in San Francisco, and playing, relaxing and just being.  It was such a needed weekend of rest and we all came home rejuvenated and revived.  John and I headed straight for the gym when we got home for a much needed workout and when we got home the entire family pitched in and made our Memorial Day dinner.  It’s kind of chilly and cloudy so we did not do the typical barbecue, but instead cooked up what was in the fridge and together created an amazingly tasty and easy dish.  Here’s what the family had to say about dinner.

Coby (age 15): Um, it was… I don’t know; a satisfying meal to come home to after a long time away from home.

Jaden (age 7): AWESOME!!!

Rowan (age 3): Good.

John (getting old): I thought it was a great meal to come home to after traveling all weekend and having to eat out.  I liked how the zucchini was sliced thin and noodle like!

Me (not as old as John): Super freaking tasty and I love that we all pitched in.


Sausage “Spaghetti in Creamy Tomato Sauce

1.25 lbs mild Italian pork sausage, diced (we used the precooked sausage from US Wellness Meats – I’ll be there June featured chef so be sure to check their site and mine for my recipes using their amazing products!) YOU can use whatever meat you like – ground beef, sausage, chicken, beef – whatever you have on hand.

3 small leeks, diced

½ red onion, diced

1 red bell pepper, sliced thin

1 – 14oz can of artichoke hearts packed in water, cut into quarters

1 tablespoon coconut oil

5 zucchini squash, sliced thin like noodles (We sliced our zucchini thin with a mandolin slicer and then used a knife to slice the thin noodle strips into “spaghetti” like noodles.  You can also make it easier on yourself and use a julienne slicer.


1 – 14.5 oz can of organic diced tomatoes

2 tablespoons coconut cream concentrate from Tropical Traditions (or sub with coconut milk, or grass fed heavy whipping cream)

1 teaspoon crushed garlic

2 tablespoons fresh rosemary, minced

Black pepper and sea salt to taste

In a large skillet or wok heat the coconut oil.  If you are using raw meat, brown the meat in the coconut oil and add the onion, leeks, and bell peppers.  If you are using pre-cooked sausages like we did, cook the onions, leeks and bell peppers first in the coconut oil until tender and then add the meat and cook for another 3-4 minutes or until the sausage is warmed through.  In a small sauce pan mix together the can of diced tomatoes with the juice with the coconut cream concentrate.  Bring to a simmer and add the remaining sauce ingredients and mix well.  To the meat and veggies add the zucchini and artichokes and pour the sauce over.  Mix well and cook for another 5-6 minutes, just until the zucchini al dente – do not over cook or they will turn to mush! Serves 5.


[nggallery id=159]


  1. says

    That does look tasty! Your coconut cream concentrate looks an awful lot like something in my pantry labeled “coconut butter”, which although is tasty all by it’s lonesome, I’ve been wanting to find another use for it. I’m definitely going to have to try this one with it. Thanks!

    • Sarah says

      Hi Kendra! Coconut cream concentrate is a bit different than the coconut butter, I haven’t tried the butter yet to make a sauce with, it’s more of just the coconut meat mashed up and the cream concentrate has more of the actual oil in it.

  2. Michael says

    Planning it for our next meal. Looks fantastico……I don’t have coconut cream concentrate…should I use the whole can of coconut milk?

    • Sarah says

      I wouldn’t use the whole can, I would start with just a couple of tablespoons as suggested with the coconut cream concentrate and then add more to taste if needed. : )

          • Michael says

            Just had my second bowl full. My stomach is very satisfied….So good…. Made with lot’s of basil and coconut milk.

  3. says

    You know, I passed up zuchinni this year because I was afraid it would overtake the garden. Turns out that a dish like this would make short work of it though. You could also freeze it… Thanks for the idea!

  4. says

    I’m really loving your recipes! I do notice, though, that you use the term “one can” of this or that, and I never know the actual size of the can. At the store, foods come in different sizes. I wonder if you would consider also mentioning what size can you use. Thanks!

  5. says

    I was just looking at your recipe for ginger mayo on another post. You mentioned (for the salmon cakes) using 3 cans of salmon. What size cans?

    Also, is this the only mayo recipe you have? I heard on a podcast that you have a recipe for mayo that uses olive oil, but this one uses grapeseed oil. Is there another one that uses olive oil? Thanks!

  6. Elisa says

    I had this for dinner tonight and it was fantastic. Thanks for the great recipes. BTW, I got your book Sunday and I can’t wait to start making those recipes as well.

  7. Tricia says

    Hi, Sarah! I just had to say that I’m really excited to stumble upon your wonderful blog! I have two little kids and I’m always looking for quick things to make that they won’t turn their noses up at. The lunch ideas are very helpful as well since I don’t want them eating the “healthy” carb-loaded offerings at school. I really like everything you have posted and I also ordered your book tonight. Thanks for the great recipes!

  8. says

    I wanted to tell you I think you did an awesome job on your book! I received it in the mail today and love it. My daughter is having some digestive issues and a paleo style diet was recommended. I am super excited to have found a book addressing this lifestyle including such great information related to children. I love that you included school lunch ideas. Thank you :) And… this recipe looks super yummy!

  9. Debra Ann says

    I have just started the Paleo lifestyle. I am so excited with my research and being on every diet in the world. I was really looking for something that was healing. Having a lot of stomach issues and defiantly a leaky gut… I was covered this past year head to toe with psoriasis not fun.. No medical doctor had answers, I did. It was stress and my diet. I derided my life and now it was time to detox my food. I research different detox methods and nothing felt right.. I am a Holistic Health Counselor a Massage and Energy Specialist I explain that they need to find the right diet for fueling their bodies. Educating them on Owning their life and Choices becoming Consciously Aware of Self, surroundings, and partaking in Healing within to heal what’s out… I work with rehabilitating clients who are in chronic pain, injures, illnesses of all ages.. I really think this is defiantly going to be something I recommend to my clients.. I just received my copy of your cookbook. awesome. Love the pictures I am very visual and looking at something let’s me create my own flavor.. I tried the tomato and egg today how delicious. Also made spaghetti squash for the first time.. My favorite… Thank you for such a great book. You are truly an inspiration.

    • Alisha says

      Very cool, Joanne!! Thanks for sharing!! If my food processor doesn’t do this, then I will be buying one. I make all my noodles with a veggie peeler and that can be very time consuming.

  10. Ashley says

    This looks AMAZING!! Thanks again for such a wonderful recipe Sarah, very much appreciated!! You really do help eating paleo so much easier, and fun! Can’t wait to try this next week!!!

  11. Croops says

    Hey Sarah,

    Love your book! Been using it for a few weeks now and the family love your recipes.

    Being Italian, I LOVE my pasta and have been missing it. I have yet to make the zucchini pasta coz I haven’t found a mandolin slicer yet!

    Firstly, I am in no way affiliated with this product but today I found a product called ‘Slim Pasta’ today – http://www.slimpasta.com.au – and wanted to know what you thought about it?

    Apparently it’s made from a vegetable called Konjac – also known as yam. Was thinking of getting some but not sure if it adheres to a Paleo diet.


  12. Cathy N says

    My husband and I made this tonight for dinner. It was soooooooo delicious. Thanks for posting all these yummy meal ideas. And we are just lovin’ your book. Lots of good stuff there. All these ideas and recipes make meal preparation a snap.

  13. Mishele says

    Hi Sarah, I saw your post this morning for this recipe, and decided to try it tonight. I didn’t have (I thought) the canned diced tomatoes, so I used a jar of Trader Joe’s traditional spaghetti sauce. Then, I found the can of diced tomatoes and added them. It turned out REALLY good! It was a bit watery from the diced tomatoes, but the flavor was great. My husband loved it, too. Before I went paleo (about 23 days ago, to be exact ; ) I never would have eaten red peppers or zucchini, or broccoli, or ANYTHING coconut, but your recipes are so good. I actually look forward to my veggies every night. Thanks for the great recipes and podcasts! Mishele in Paradise/Chico

  14. Cathy L from San Jose says

    My hubby LOVED this dish, even though I cheated a bit and didn’t make the sauce from scratch– I used a jarred sauce — still it met a deep seated need in my husband’s psyche. He misses pasta, and he also loves lots of veggies and this dish had it all.
    Thanks Sarah —

  15. Michelle says

    Didn’t have zucchini so I tried it with a broccoli, cauliflower, carrot, red cabbage slaw and it was wonderful!

  16. says

    This looks so awesome! I don’t have a Trader Joe’s around here but I went into one in Chicago and saw those same Artichoke Hearts. I would have bought a few cans had I not lost my wallet!

    Trader Joes is way too awesome!

  17. says

    Love it!!! Made some lame versions of this in the past on lazy nights (zucchini noodles & canned tomatoes & garlic powder). Thanks for reminding me that there are ways to upgrade easy to delicious!!!!

  18. Brad Thomas says

    This recipe was easy, didn’t take a lot of time, and tasted great (both nights)! I think it helped that we prepped everything with our shirts off.

  19. Catherine says

    This was great!
    One of my family’s staple on busy nights was to julienne zuchinni, add arrabiata sauce (made sure all ingredients were paleo) and the hot italian sausage. This dressed it up tremendously. I loved the artichoke addition. I used two tablespoons coconut milk, and it was great. I had my doubts, (coconut milk and italian) But I am glad i did.
    Great Job!

  20. Phoebe says

    Julienne zucchini as pasta is AMAZING, wow thanks! I made this tonight but with Trader Joe’s spaghetti sauce mixed with sauteed ground beef, garlic, mushrooms, onions and green peppers and oh my gosh, it was so good. My husband and I both agreed it was the best “pasta” dish we have ever had!

  21. Jeannine says

    I was SO excited to get my coconut cream concentrate in the mail just to try this recipe! Delicious! Multiple compliments from my husband gives this recipe a 5 star rating in my book.

    I used grass-fed ground beef w/ italian seasoning instead of sausage. I left out the peppers, doubled the recipe, added fresh torn basil to the sauce, & finely diced the artichoke hearts to “hide” them from my 3 1/2 year old who avoids big chunks.

    I’ve been using spaghetti squash for “noodles” but really enjoyed the thinly sliced zucchini. Also, I LOVE the lasagna recipe from your book, that was my first use of zucchini for noodle replacement.

  22. Heather says

    Just had this for dinner. So good! We are learning the paleo ropes and really enjoying it right now. My husband is all for it, and my two year old doesn’t seem to miss her pasta or bread much! This meal was my husband’s favorite paleo meal so far. Mine was the ginger beef, which Im making this weekend. We both loved the curry meatballs too! I need to get your cookbook asap. Thanks!

  23. Dawn says

    Just made this for dinner tonight. It was absolutely delicious! Thank you so much. I never would have thought to use zucchini this way. All the dish was missing was some nice, crusty french bread…jk. I’m new to Paleo and bread has always been my addiction and downfall. Doing without will be an adjustment. But this meal was so good and satisfying that I actually didn’t really miss the bread like I thought I would. I ordered your cookbook yesterday and can’t wait to get it! Next I’m making your cobbler for dessert-I expect it will be fantastic. Thank you!

  24. Sara Towne says

    We tried this before and it was so good! Tonight I needed a recipe to use some Italian sausage for and came across this but we didnt have any zucchini or leeks. Did everything else the same- still delicious!!

  25. says

    Made this tonight for dinner, it was amazing! Even the bf, who’s usually not too keen on zuchinni and pepper liked it :) I made meatballs instead of sausages and used real tomatos not canned – great stuff, thanks alot!! :)

  26. Shannon says

    This dish was super good. I didn’t have any coconut milk or paste on hand so I blended the artichoke hearts in the food processor first and added them to the sauce instead of leaving them whole. The result was a creamy delicious tomato sauce with a little kick from the artichokes. To me it tasted like I had added cheese to the dish without the negative effects of dairy, yummy :)

  27. Rebecca says

    Oh my gosh, this was AMAZING!!! My husband and I went Paleo only a few days ago and were both a little worried about missing pasta. After tonight, there is no going back. This is better than any pasta dish I have EVER had. Plus, my 7-month-old baby, who usually is not too big on anything except breastmilk, absolutely loved it. We’re doing baby-led-weaning, and at one point she had a strip of zucchini in each hand, alternating putting them in her mouth! Thank you for the best recipe ever!!!!!!!!

  28. Joanna says

    So delicious! Thanks so much for all your recipes. Not sure I would have survived the first 2 months of my paleo diet without your website :)

  29. Hannah S. says

    Thank you for showing pictures of the ingredients! Very helpful when putting my shopping list together. Going to have this tomorrow night!

Leave a Reply

Your email address will not be published. Required fields are marked *