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Keto Sausage and Peppers

Cheryl McColgan
NASM-CPT, E-RYT 500, BS Psychology and Graduate Training in Clinical Psychology

There are so many dishes that I've been making for years that have never made it to Heal Nourish Grow yet and this keto sausage and peppers recipe is one of them. It's on repeat in our house about every two to three weeks. When we were moving and staying with friends for a few days, I bought some sausage on sale. Her first suggestion to use it was sausage and peppers! It reminded me that I should finally get this recipe posted. It's delicious and easy, which is why it's in our rotation so often.

I created this as a standalone recipe since you may not want to make a big batch of keto marinara first. However, if you always have some on hand frozen like I do you can make this keto sausage and peppers even quicker.

This is an Italian inspired dish. Most internet sources say that it was created by Italian American immigrants. It's often served as street and festival food in the United States. It may have originated at the Feast of San Gennaro where it was first served back in 1927, but if you search “salsiccia e peperoni” on Italian Google, there are plenty of recipes. Regardless of the origin of this dish, it's simple and delicious!

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Keto Sausage and Peppers

Keto Sausage and Peppers

This keto version of sausage and peppers doesn't require a lot of variation from the original to make it keto friendly. The carbs in this dish all come from whole foods sources rather than pasta or bread. To make this dish fully keto, we skip the typical addition of sugar in the sauce. Simply use your favorite pasta substitute in place of wheat noodles. My favorites are zoodles or Natural Heaven noodles.

If you have my keto marinara on hand, you can skip some steps. Just cook your peppers in some olive oil until softened then add a two cups of marinara sauce. After that you'll move forward with the recipe by adding your browned sausage.

This dish is slightly higher carb due to the peppers and onions. The best way to make sure your keto sausage and peppers has as few carbs as possible is to use Dry Farm Wines (less than one carb in the whole bottle) and make sure your sausage doesn't contain any sugar. You can also halve the amount of peppers and onions. This reduces the carb count by four and a half per serving.

Keto Sausage and Peppers

Prep Time: 10 minutes
Cook Time: 40 minutes
Total Time: 50 minutes
Servings: 8 servings

Ingredients  

  • 2 tablespoons extra virgin olive oil
  • 1 ½ pounds Italian sausage, hot or mild
  • 2 large red bell peppers, sliced
  • 2 large yellow bell peppers
  • 2 large yellow onions, sliced
  • 4 garlic cloves, minced
  • 1 teaspoon salt
  • 1 teaspoon freshly ground black pepper
  • ½ teaspoon dried oregano
  • ½ cup chopped fresh basil leaves
  • 1 cup dry red wine
  • 28 ounces diced tomatoes
  • ¼ teaspoon red pepper flakes, optional
  • ½ cup parmesan cheeese, optional

Instructions

  • Heat the oil in a large skillet over medium heat.
  • Place the sausages in the oil and cook until brown on both sides, remove from pan.
  • Keeping the pan over medium heat, add the garlic, peppers, onions, salt, and pepper and cook until onions start to soften, about 5 minutes.
  • Add the oregano and basil and cook 2 more minutes.
  • Add the wine, tomatoes and chili flakes, if using. Stir to combine and bring to a simmer.
  • Cut the sausages into 1 inch pieces. Add the sausage back to the pan and stir to combine.
  • Cook until the sauce has thickened, about 20 minutes.
  • Serve in bowls, over zucchini or on a keto sandwich roll topped with some parmesan cheese, if using.

Video

Nutrition

Serving: 1servingCalories: 408kcalCarbohydrates: 14gProtein: 14gFat: 31gSaturated Fat: 10gPolyunsaturated Fat: 4gMonounsaturated Fat: 15gCholesterol: 65mgSodium: 1060mgPotassium: 652mgFiber: 3gSugar: 6gCalcium: 67mgIron: 3mgNet Carbohydrates: 11g

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Author

  • Cheryl McColgan

    Cheryl McColgan is the Founder and Editor in Chief of Heal Nourish Grow, where she has published evidence-based health and nutrition content since 2018.

    With over 30 years of experience in fitness, nutrition, and healthy living, and nearly 20 years of professional editorial and journalism experience, she brings both subject-matter depth and trained editorial judgment to everything on the site.

    Cheryl holds a degree in Psychology with a minor in Addictions Studies, completed graduate training in Clinical Psychology, and is a NASM Certified Personal Trainer and E-RYT Certified Yoga Instructor and trained in Yoga Therapy.

    She is the author of 21 Day Fat Loss Kickstart, Make Keto Easy, Take Diet Breaks and Still Lose Weight, The Grain Free Cookbook for Beginners, and Easy Weeknight Keto.

    Read more about Cheryl and the journey that created Heal Nourish Grow on the about page.

    Cheryl McColgan is the founder of Heal Nourish Grow, where she writes about protein, body composition, healthy aging, and evidence-based nutrition and wellness along with the everyday habits that actually make those things work in real life.

    With a background in psychology and graduate training in clinical psychology, plus nearly 20 years of experience in editorial and publishing, Cheryl approaches health from both a research and real-world perspective. She’s also been immersed in fitness and nutrition for more than 25 years, which gives her a practical lens most purely academic content tends to miss.

    Her work today focuses heavily on protein intake (especially for women), muscle retention, metabolic health, and sustainable fat loss, along with topics like sleep, wellness, recovery, and wearable health tech. You’ll also find a mix of high-protein, low-carb recipes designed to make hitting those goals easier without overcomplicating things.

    Cheryl’s interest in health and nutrition became more personal after navigating her own health challenges, which pushed her to dig deeper into how lifestyle, diet and daily habits impact long-term health. That experience continues to shape how she approaches everything on this site: practical, realistic, and focused on what actually works over time.
    What Cheryl Covers
    Most of the content here falls into a few core areas:

    Protein & Muscle Health: how much you actually need, especially for women and how to use protein to support strength, body composition, and aging
    Fat Loss & Metabolic Health: sustainable approaches that prioritize muscle retention and long-term results
    Healthy Habits & Lifestyle: sleep, movement, strength training, consistency, and the small things that compound over time
    Wearables & Recovery: real-world testing and comparisons of tools like Oura, Whoop and others
    High-Protein & Low-Carb Recipes: simple, realistic meals that support your goals without feeling restrictive
    Travel & Lifestyle: wellness-focused travel, outdoor experiences, and a slightly more elevated take on healthy living

    If you're new, here are a few good places to begin:

    30 Day Healthy Habits Challenge

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