Entrees   |   Gluten-Free   |   Keto

Spaghetti Squash with Paleo Pesto & Turkey Meatballs

Spaghetti squash is the perfect pasta alternative! It’s also an easy way to get more veggies! It’s veggies on veggies with this recipe when we add the paleo pesto to the mix. The meatballs also include nutrient-dense ingredients such as ground flax seed and sun dried tomatoes. Dig into this paleo, pegan, gluten-free, dairy-free, added sugar-free dish!

Spaghetti Squash Benefits

Everyone in the paleo and nutrition world is buzzing about spaghetti squash and the squash hype is well-deserved. The benefits of replacing traditional spaghetti with spaghetti squash become very obvious when you do a nutrient comparison. One cup of cooked spaghetti made from white, enriched noodles contains approximately 220 calories, 42 grams of carbohydrates and very few nutrients. Comparably, one cup of cooked spaghetti squash provides about 42 calories, 10 grams of carbohydrates, and a variety of nutrients such as Vitamin A and potassium. It’s no secret that white pasta is nothing short of empty calories that are high glycemic (aka: spike blood sugar levels quickly). It leaves you feeling more hungry soon after and increases the risk of weight gain. If you are trying to switch to a more nutrient-dense diet, using spaghetti squash is the perfect choice.

How to Eat Spaghetti Squash

An even more perfect choice is pairing spaghetti squash with healthy sources of fats and lean sources of protein. This recipe provides all of those in one with the cashews and extra virgin olive oil in the pesto and organic turkey and ground flaxseeds in the turkeyballs. All of these ingredients fit within a Mediterranean/pegan lifestyle. The Mediterranean Diet is the most well researched type of diet that exists today and numerous studies can back up the benefits of this way of eating. A new study found that eating a Mediterranean diet that included either olive oil or nuts and did not restrict calories was associated with decreased body weight and less of an increase in waist circumference, compared to the control diet. The moral of the story is eat balanced meals that include nutrient-dense, whole foods for weight loss and healthy living!

Turkey MeatballsPaleo pasta with pesto and turkey meatballs Paleo pasta with pesto and turkey meatballs

Spaghetti Squash with Paleo Pesto & Turkeyballs

Servings: 4

Spaghetti Squash with Paleo Pesto & Turkeyballs


    For the Spaghetti Squash
  • 1 large spaghetti squash
    For the Pesto
  • 1 lemon, juiced
  • 1/4 cup cashews (unsalted), toasted
  • 1 cup spinach
  • 3 cloves of garlic, minced
  • 1 cup basil
  • 1/4 cup extra virgin olive oil
  • Dash of sea salt
  • Dash of black pepper
    For the Turkeyballs
  • 1 lb organic ground turkey
  • 2 Tbsp ground flax seeds
  • 2 Tbsp cilantro, chopped
  • 2 Tbsp sun dried tomatoes
  • 1 egg
  • 1 Tbsp extra virgin olive oil


  1. Preheat the oven to 400F. 
  2. Cut the spaghetti squash in half and place on a baking sheet, face down. 
  3. Bake the spaghetti squash in the oven for 40-45 minutes. 
  4. While the spaghetti squash is baking, begin to prepare the turkeyballs. In a medium sized bowl combine the ground turkey, ground flax seeds, cilantro, sun dried tomatoes, egg, EVOO and stir together.
  5. Form 12 medium-sized turkeyballs and place each on a greased baking sheet. 
  6. Put the turkeyballs in the oven next to the spaghetti squash for the last 20-25 minutes. If you cannot fit the two baking trays side by side then bake them separately. 
  7. Combine the remaining ingredients in a food processor to make the pesto—lemon juice, toasted cashews, spinach, garlic, basil, EVOO, salt and pepper. 
  8. Pulse the ingredients until they are well blended and smooth. 
  9. Remove the spaghetti squash from the oven and discard the seeds. Use a fork to create the ’spaghetti’ consistency and pour into four separate serving bowls. 
  10. Evenly distribute the pesto over the spaghetti squash and top with three meatballs per bowl!  

Nutrition Facts

Spaghetti Squash with Paleo Pesto & Turkeyballs


Amount Per Serving
Calories 375
% Daily Value*
Total Fat 15 g 23.1%
Saturated Fat 0
Trans Fat
Cholesterol 0
Sodium 0
Total Carbohydrate 19 g 6.3%
Dietary Fiber 5 g 20%
Sugars 7 g (Added Sugar: 0g)
Protein 28 g
Vitamin A Vitamin C
Calcium Iron

* Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.