In a large pot of boiling salted water, cook the pasta al dente according to package instructions. Reserve 1 cup pasta water, drain and set aside.,
STEP 2
Heat the olive oil in a large skillet over medium heat. Add the garlic and sage, and cook until aromatic, 1 minute.,
STEP 3
Add the pumpkin puree, salt, pepper and nutmeg and continue to cook for 2-3 more minutes. Add the milk and stir until well combined and creamy.,
STEP 4
Toss the reserved cooked pasta with the sauce, add ½ cup of the reserved pasta water to combine until the sauce clings to the pasta and is glossy. Sprinkle the grated parmesan cheese on top, if using and serve immediately.