Creamy Meatballs and Gravy

Jun 18, 2022 | Sides and Sauces

My Grandma Inez shows her love through her cooking, and she’s always excited for our family to try new things she makes. One slow cooker dish she makes quite often—and that we all love—are her meatballs and gravy. Because the recipe calls for so much mayonnaise and packets of gravy mix, I decided to use the paleo-friendly kind (use good oil!) and a blend of seasonings and tapioca flour to thicken the gravy. It worked like a charm. The meatballs have a lot of flavor from the Italian sausage, and they’re coated in a smooth, richly flavored gravy. You’ll love these. And I think my grandma would, too.

Prep time 30 minutes
Serves 6

11/2 pounds (680 g) ground beef
1/2 pound (225 g) bulk hot Italian sausage
1 cup (160 g) finely chopped onion
1 egg
3/4 cup (188 g) blanched almond flour
2 teaspoons sea salt, divided
3/4 teaspoon black pepper
Coconut oil or avocado oil, for cooking
3 cups (710 ml) beef broth
3/4 cup (175 g) Paleo-Friendly Mayonnaise
11/2 teaspoon onion powder
3 tablespoons (45 ml) coconut aminos
3 tablespoons (24 g) tapioca flour
2 teaspoons (22 g) Dijon mustard
1 tablespoon (30 g) tomato paste
Cauliflower Rice, Squash Noodles, or “Baked” Sweet Potatoes, for serving

1 Combine the ground beef, sausage, onion, egg, almond flour, 1 teaspoon salt, and 1/2 teaspoon black pepper in a large mixing bowl. Gently mix everything with your hands (without squeezing it in your fists), form it into tight, 11/2-inch (3.5 cm) balls, and transfer them to a large plate.
2 Heat 2 tablespoons (30 ml) of oil in a large skillet over medium-high heat. Place 1/2 cup (120 ml) of beef broth next to the stove. Sear the meatballs on a couple of sides, working in two batches. Add more oil between batches, if necessary. Transfer the meatballs to a 4-quart (3.8 liter) slow cooker. While the pan is still hot, pour the 1/2 cup (120 ml) of broth into the pan and scrape the browned bits from the bottom. Pour the contents of the pan into the slow cooker with the meatballs.
3 Combine the remaining 21/2 cups (570 ml) beef broth, mayonnaise, onion powder, coconut aminos, 1 teaspoon salt, 1/4 teaspoon pepper, tapioca flour, mustard, and tomato paste into a blender or food processor. Blend until smooth. Pour the sauce over the meatballs.
4 Cover and cook on low for 6 to 7 hours.
5 Serve with desired side dish.

More Paleo Recipes

A person in a knit sweater holds a bowl of homemade Apple and Pear Sauce topped with cinnamon, with fresh apples and pears in the background.

Apple and Pear Sauce

There is something so comforting about a simple, fruit-forward snack that isn’t loaded with refined sugars. I recently found myself craving a healthy treat that would satisfy my sweet tooth without the guilt, which led me to whip up this incredibly smooth Apple…

Bowl of homemade Paleo Hoisin Sauce with a whisk, surrounded by ingredients like almond butter and garlic on a wooden table.

Hoisin Sauce

If you’ve been missing that signature sweet and savory kick in your stir-fries, this homemade Paleo Hoisin Sauce is going to be a total game-changer for your kitchen. We all know the store-bought versions are usually packed with refined sugars and additives that just…

Close-up of a woman's hands holding a glass jar filled with dark, sugar-free Paleo Worcestershire sauce substitute.

Worcestershire Sauce

Let’s be real—giving up your favorite condiments is one of the hardest parts of cleaning up your diet. I used to miss that distinct, savory tang in my marinades, but this Paleo Worcestershire Sauce changed the game for me. It delivers all that deep, complex umami…

A person in a knit sweater holds a bowl of homemade Apple and Pear Sauce topped with cinnamon, with fresh apples and pears in the background.

Apple and Pear Sauce

There is something so comforting about a simple, fruit-forward snack that isn’t loaded with refined sugars. I recently found myself craving a healthy treat that would satisfy my sweet tooth without the guilt, which led me to whip up this incredibly smooth Apple…

Bowl of homemade Paleo Hoisin Sauce with a whisk, surrounded by ingredients like almond butter and garlic on a wooden table.

Hoisin Sauce

If you’ve been missing that signature sweet and savory kick in your stir-fries, this homemade Paleo Hoisin Sauce is going to be a total game-changer for your kitchen. We all know the store-bought versions are usually packed with refined sugars and additives that just…

Close-up of a woman's hands holding a glass jar filled with dark, sugar-free Paleo Worcestershire sauce substitute.

Worcestershire Sauce

Let’s be real—giving up your favorite condiments is one of the hardest parts of cleaning up your diet. I used to miss that distinct, savory tang in my marinades, but this Paleo Worcestershire Sauce changed the game for me. It delivers all that deep, complex umami…

Glass jar of homemade Paleo lacto-fermented horseradish paste sitting on a wooden table next to fresh horseradish roots and a grater.

Lacto-Fermented Horseradish

If you know me, you know I love adding a serious flavor kick to my meals, and this Paleo Lacto-Fermented Horseradish is my absolute favorite way to do it. Honestly, it tastes so much fresher than the store-bought stuff, and because it’s fermented, it’s packed…