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Updated: May 24, 2022

I am inspired by the current baby formula shortage to write about Fettuccine Alfredo, a dish created to help a sickly mother nurse her baby.

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Rome, 1908– A young mother is sickly and weak after giving birth to her first child. Her husband, chef Alfredo di Lelio (see photo above) fears that she is too unhealthy to nurse their newborn son. So he creates a dish that, he optimistically surmises, will fortify her constitution enough to restore her maternal prerogative. And thus was Fettuccine Alfredo born, from just three ingredients– egg noodles, butter, and cheese. His recipe was simplicity itself– cook the noodles, drain them but leave just a little water, toss with butter, then toss with freshly grated Parmesan cheese.

Fast-forward to today. I have heard more than one restaurant professional describe Fettuccine Alfredo as a “Heart Attack on a Plate,” so unapologetically loaded with saturated fats it has become. This current version of Fettuccine Alfredo enjoys worldwide fame, and yet would be almost unrecognizable to its creator– pasta (egg or not) drowning in cream-based quicksand copiously enhanced with garlic and often incorporating broccoli or artichokes and such proteins as chicken or shrimp. Furthermore, “Alfredo Sauce” is available at your local supermarket, shelf-stable in its jars, i.e., loaded with preservatives; “creamy,” and yet sometimes even devoid of actual cream. I feel compelled to observe here that “Alfredo Sauce” could rightly be called a “sauce after the fact,” much like the “Buffalo Sauce” derived from the original Anchor Bar Wings recipe and now available by the bottle, or the jus in “Prime Rib au jus” that is widely found in chemical-laden powdered form in conveniently packed envelopes for instant mixing. All three of these are sauces abstracted from the eponymous finished dish rather than a preceding, stand-alone component thereof… almost like a novel based on a movie instead of vice-versa. To me there is something not quite genuine about that, like it’s not supposed to work that way.

How did we manage to get from the original version of Fettuccine Alfredo to this? It reminds me of the evolution of all good things, like, for instance, the basic Toyota 2WD 4-cylinder pickup truck. I bought one in 1995, and it was as small and simple and inexpensive and perfect as a vehicle could be… no radio, no A/C, just four wheels and a heater. In 1999– 200,000 high MPG, low-cost miles later– I sold it and bought another. The new one was a little bigger and heavier and more expensive, and yet no more functional and not as elegant as its predecessor. After a couple of Hyundai Accents, I bought my third Toyota pickup in 2014. It was WAY bigger and heavier yet, loaded with superfluous features for which I had no use or desire. And then in 2020 I traded it in and finally graduated to a 4WD version of the Toyota pickup with half a back seat accessible by backward half-doors– a space too small for humans, yet big enough to stash stuff like laundry and tools. Its sticker price was over thrice that of my first, and it is only marginally more useful.

All in all, I liked that first pickup best… I thought that all the additional weight and gadgetry were not only a pointless waste but actually detracted from the original simple concept. And I suspect that if Alfredo di Lelio’s wife were here today, she would feel the same about the evolution of Fettuccine Alfredo. So I set out to re-create as closely as possible the original. And as I read up on the dish’s history, I encountered a few mysteries that aroused my Inner Hunter to investigate further.

According to multiple histories I found online, the original version called for “fresh Parmesan cheese.” Did that mean fresh vs. aged, or freshly grated, or both? No one seemed to know for sure. However– some of the earliest descriptions described the cheese as sufficiently creamy that it would smoothly melt into the butter and thereby coat the noodles with silky richness. This would preclude properly labeled Parmigiano-Reggiano, which is aged 24 months to such dry granularity that it certainly could not be described as the least bit creamy, and would not have behaved as such.

One current recipe, published by a major foodie magazine, smugly extolled the superiority of its version for eschewing cream and thereby hewing to the original, and yet it called for aged Parmigiano-Reggiano. Questionable reasoning like that only sharpens my hunger for the whole truth. Upon consulting the cheese manager at a quality grocer, I tried a different cheese– Grana Padano, which could perhaps be described as a “junior varsity” Parmesan… same region, same milk, same culture, etc., but with less rigid standards and, most importantly, less aging. Upon pinching a wedge of it I felt a little youthful springiness, and the cheese guy confirmed that it was, in fact, creamier than the decidedly non-creamy Parmigiano-Reggiano. Could that be what Chef Alfredo meant by “fresh Parmesan?” I wanted to find out, so I bought some.

Egg noodles were easy enough to find. I opted for the fresh rather than the dried, as this was what Chef Alfredo used. (The Pennsylvania Dutch Noodle Company offers a popular line of dried egg noodles.) For the butter I sought a rich, high-butterfat version, and I left the store with a two-stick package of VERMONT CREAMERY Unsalted Cultured Butter that boasts 82% butterfat content. (Regular American butter comes in at 80%, and the 2% makes a significant difference; meanwhile, the “Cultured” means that the milk underwent an overnight fermentation that gave it a slight and delightful buttermilk tang that endured as it was churned into butter.)

From these three ingredients I made old-school Fettuccine Alfredo… and it was utterly delicious. (No, I didn’t start lactating.) How could it possibly be any better? But then, like a judge who has privately already decided a case but nonetheless agrees to hear the other side, I made the Modern Version–

Fresh Egg Noodles, Individual Portion (4.5 oz) or Double Portion (9 oz.) There will be just enough sauce for a light coating of the double portion.


3 Cloves of Garlic, Finely Minced

Dab of Clarified Butter

1 Cup Heavy Cream

¼ Stick Vermont Creamery Unsalted Cultured Butter at Room Temperature

½ Cup Shredded Grana Padano Cheese

Pinch of Finely Chopped Italian Parsley

Freshly Ground Pepper

Pinch of Freshly Grated Parmesan (for topping)

Briefly cook garlic in just enough clarified butter until it is about to change color. Add cream and reduce by half. Remove from heat and swirl in butter. Stir in Grana Padano and then parsley. Stir occasionally while the well-salted pasta water comes to a boil. Cook pasta to al dente, then toss with sauce. Top with Parmesan and serve.

It was freaking fantastic. Which version did I like best? I can’t choose one over the other; I consider them two different dishes. I would lean toward the original when using high-quality fresh egg pasta, and use the modern version for dried pasta, eggy or not. Furthermore, I can easily imagine other uses for this sauce, which seems an awful lot like a gluten-free version of classic Sauce Mornay. Accordingly, I would readily use it with chicken, fish, and especially sea scallops. I would use it on broccoli or cauliflower. In fact, while writing this I whipped up a little of this sauce and cooked some cauliflower; I tossed the cauliflower in the sauce, put it in an oven-friendly ramekin, and fired up the broiler to see if this sauce could withstand being gratinéed without breaking. Not only did it survive the process, but it was so delicious that I couldn’t imagine it being any better with $28/lb. dry-pack sea scallops.

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In this case as in others, the search for the truth is never complete. I’m still waiting to hear from friends of friends in Italy’s Emilia-Romagna region for more inside information on what Chef Alfredo actually meant by “Fresh Parmesan.” But I like what I’ve found so far.

And speaking of truth-searching, the long-held truism that saturated fat automatically kills people is up for new discussion among the scientific/medical intelligentsia. In other words, the cream-laden version of Fettuccine Alfredo might not be a “Heart Attack on a Plate” after all. Whatever the verdict from the health professionals, always remember that Eating Well is Living Well.

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