The dish we know as Fettuccine Alfredo here in the US evolved from a creamless recipe in Rome. The eponymous Alfredo di Lelio modified the traditional “fettuccine al burro,” which featured a sauce of Parmigiano-Reggiano and butter, to include even more butter, dubbing it “fettuccine al triplo burro.” When he eventually had his own restaurant near Piazza Navona (Alfredo alla Scrofa, at Via della Scrofa 104, Roma), patrons began to refer to this dish as Fettuccine Alfredo. We have been to the famous restaurant and did not think their current Alfredo was very good at all, perhaps because it is the butter-only version of the recipe without nutmeg.
Somewhere someone in the USA introduced cream and nutmeg to the ingredient list, which we prefer that more. This particular recipe comes from Marcella Hazan, an authentic Italian cook who emigrated to the USA and wrote some great books in the 1970's and onwards.
As noted on the Ingredients page, I get my Parmigiano-Reggiano directly from a dairy in Italy, but the heavy cream I get from a local dairy with grass-fed cows. Real parmigiano-reggiano is more important than getting the freshest cream. Grating the nutmeg is also key.
My family prefers store-bought maccheroni over homemade for this particular recipe. I like both. If you would like to try it with homemade fettuccine, I recommend the semola version of the pasta all'uovo and that you be careful not to overcook it. It needs to be al dente for this recipe. Note that it will cook slightly more as you mix it on low heat, so err a little on the side of al dente. This is something I always struggle with getting right.
Note: When I get a chance, I will provide the butter-only version of the recipe without the nutmeg for comparison. Even though I'm pretty sure I won't like it as much, I'd like to try it again.
1 lb (453 g, but 500 g is fine) fettuccine (Giuseppe Cocco or De Cecco) or other pasta of your liking
1 cup (240 g) heavy cream (ideally from a local dairy)
3 Tbsp (43 g) unsalted butter
1/2 tsp (3 g) salt
3/4 cup (75 g) grated Parmigiano-Reggiano, aged no more than 3 years
Freshly ground black pepper, to taste
Half a nutmeg, grated finely (freshly grated nutmeg makes all the difference!)
1. Put roughly two-thirds of the heavy cream and all of the butter in a pot (e.g., an enamel-covered cast-iron one). Simmer until thickened. Turn off heat.
2. In the meantime, cook pasta according to directions on the package (macaroni) or in the recipe (homemade). Drain.
3. Transfer pasta to the pan with the sauce. Mix over low heat to coat the fettuccine well.
4. Mix in the salt, pepper, and nutmeg (I keep these all on the same plate).
5. Add the remaining third of the cream and all the cheese. Toss until sauce has thickened. If it seems a little dry, add a little more cream.
6. Serve immediately, with extra cheese on the side.