Keto Swedish Meatball Casserole

Yield

6 servings

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Ingredients

Meatballs

• 1 lb ground beef (or ½ beef + ½ pork for more authentic flavor)

• ½ cup almond flour

• ¼ cup grated Parmesan cheese

• 1 large egg

• 2 tbsp heavy cream

• 1 tsp salt

• ½ tsp black pepper

• ½ tsp allspice

• ¼ tsp nutmeg

• 1 tsp garlic powder

• 1 tsp onion powder

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Creamy Swedish Sauce

• 3 tbsp butter

• 1 cup beef broth

• 1 cup heavy cream

• 1 tsp Dijon mustard

• 1 tsp Worcestershire sauce (small amount keeps carbs low)

• ½ tsp salt (adjust to taste)

• ½ tsp black pepper

• ¼ tsp nutmeg

• Optional: ¼ tsp xanthan gum (for extra thickness)

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Casserole Add-Ins

• 1½ cups cauliflower florets, steamed and well-drained
  (acts as the “noodle” replacement)

• ½ cup shredded mozzarella or Swiss cheese

• 2 tbsp fresh parsley, chopped (optional garnish)

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Instructions

1. Prep

• Preheat oven to 375°F (190°C)

• Grease a 9×13-inch casserole dish

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2. Make the Meatballs

In a large bowl, combine all meatball ingredients.

Mix gently until just combined. Do not overmix or the meatballs will be dense.

Roll into 1½-inch meatballs (about 18–20 total).

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3. Brown the Meatballs

Heat a large skillet over medium heat.

Add meatballs and brown on all sides, about 5–7 minutes. They do not need to be fully cooked through.

Transfer to a plate and set aside.

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4. Make the Sauce

In the same skillet:

1. Melt butter over medium heat

2. Add beef broth and simmer 2–3 minutes

3. Stir in heavy cream, mustard, Worcestershire, salt, pepper, and nutmeg

4. Simmer until slightly thickened, about 5 minutes

For a thicker sauce, whisk in xanthan gum a pinch at a time and simmer 1 minute more.

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5. Assemble the Casserole

• Spread cauliflower evenly in the casserole dish

• Arrange meatballs over cauliflower

• Pour sauce evenly over everything

• Sprinkle shredded cheese on top

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6. Bake

• Bake uncovered for 25–30 minutes

• Sauce should be bubbly and cheese lightly golden

Optional: Broil 2–3 minutes at the end for extra browning.

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7. Rest and Serve

Let casserole rest 10 minutes before serving. This helps the sauce thicken and settle.

Garnish with parsley if desired.

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Texture & Flavor Notes

• Tender, juicy meatballs

• Rich, savory cream sauce with classic nutmeg/allspice warmth

• Cauliflower absorbs the sauce like noodles

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Macros (Approximate per serving)

• Calories: ~520

• Fat: 42g

• Protein: 30g

• Net Carbs: ~4g

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Variations & Tips

Extra Authentic Flavor

• Use half pork, half beef

• Add 1 tbsp finely grated onion to meatballs

Ultra Creamy

• Add ¼ cup cream cheese to the sauce

Dairy-Free

• Use coconut cream and dairy-free cheese (slight coconut note)

Freezer Friendly

• Assemble but do not bake

• Freeze up to 2 months

• Thaw overnight and bake as directed