Saute the finely chopped onions in about two tablespoons of coconut oil until soft (but not brown) this will take about 10-15 minutes. Add in the chopped sage for the last five minutes.
In your mixing bowl add pork, onions, sage, almond meal, salt and pepper and mix well.
Form the meatballs by hand, about two tablespoons of the mixture for each meatball.
You now have two choices for cooking the meatballs. You can brown them in a skillet then bake them, or you can skip the skillet part and simply place the meatballs on a parchment lined baking sheet then bake as directed below.
The main difference between the two methods is that if you skip the skillet part the gravy won't have any of the tasty bits from browning the meatballs.
To brown the meatballs place them in a hot well oiled cast iron or non stick skillet for about 3 mins each side to get them brown on the outside, then transfer them to a sheet pan lined with parchment paper.
At this point I usually try and scoop out any stray cooked onions from the skillet as they will start to burn if you brown a second batch meatballs and spoil the flavor of your gravy.
Bake meatballs into your preheated oven at 400F for 20 minutes.
In the same skillet you cooked the meatballs in, add the beef broth, coconut milk, and fish sauce.
Using a wooden spoon or a whisk stir well to get the bits of browned meat up from the bottom of the pan and into the gravy, simmer for five minutes.
If you want to thicken it you can use about 2-3 tablespoons of arrowroot mixed with about a tablespoon of cold water or beef broth.
Remove gravy from the heat and add the arrowroot mixture, stir really well then return to a low heat until the gravy thickens.
Sieve gravy to get any lumps out and season with salt and pepper to taste.