I love that the history of Italian-American dishes is often slightly sordid, and Fettuccine Alfredo is no exception. Technically this dish has roots in Italy, but the fettuccine burro e parmigiano, or pasta in bianco, created by Alfredo di Lelio in Rome in 1914 for his pregnant wife had little to do with the cream-based recipe that Americans call Alfredo sauce. That dish is basically just cheesy buttered noodles, except since Italians do food so well, even their cheesy buttered noodles for nauseated pregnant women are blanketed in a light, beautifully emulsified sauce made by whisking some pasta cooking water into the other ingredients. I've included that technique in this recipe, and it really levels things up.