WARNING: You all provided a lot of answers.

Your answers:
Jessie Powers Young You can swap full fat coconut milk for the
cream (much healthier fat), swap ghee or coconut oil for butter, nutritional
yeast will give a cheesy flavor you could probably use that instead of parm.
Use roasted spaghetti squash or zucchini noodles in place of the pasta.
Jessie Powers Young Oh and if it is not thick enough add some
arrowroot powder.
Tracy
Robert Lieberman How about keeping it real and delicious and cutting
the portion back to 2/3 cup?
Judy Rudzinski Eat a big salad and a small portion of
fettuccine goodness.
Jamie
Hawkins I would eliminate the Heavy cream and Butter and use olive
oil.
Tia
ReddBone Williams I would use low fat cream and low fat cheese.
Eliminate butter for olive oil add kale
Jamie
Hawkins add black olives
Linda P. Lark Hello Tisha. These are some of the ingredients I use to make mine. I've been making it this way for over 40 yrs and my family and friends along with myself love it. Try reducing butter amount to 2 Tablespoons or use 2 Tablespoons of olive oil or combine 2 Tablespoons of butter & 2 Tablespoons of olive oil together. Next substitute 1 cup of heavy cream with 1 cup diluted Carnation/Pet/ brand evaporated milk or any brand of your choice with 1 cup diluted evaporated whole/ undiļuted skim milk/lowfat milk or 1 cup half & half or combine 1/2 cup half & half and 1/2 cup of your choice of evaporated milk/your choice of lowfat/ 2%/skim/ while milk. In place of 1 1/2 cup parmesan cheese, substitute with an 8 oz bag and a half of Sargentos cheese/brand of your choice which equals 1 1/2 cups of 2% low fat low moisture grated italian cheeses or pizza cheeses which are all blended cheeses white in color and consist of grated parmesan, romano, smoked provolone/provolone, mozzarella and asiago cheeses. Or you can also combine1/2 cup fat free/lowfat cream cheese plus 2 Tablespoons nonfat/lowfat sour cream and 1 cup parmesan cheese or 1 cup of blended cheeses. Just tweak the amounts as desired. I also add a few teaspoons of white wine along with white pepper and just a hint of fresh or dried fennel to taste. Hope this helps you. Good luck and enjoy!
Rayelta
Nayar These were the ingredients to one variation:
1 Cup Soymilk
1/3 Cup Raw, Unsalted Cashews
1/4 Cup Nutritional Yeast
3 Tbs Low-Sodium Tamari or Soy Sauce
2 Tbs Earth Balance Margarine
1 Tbs Tahini
1 Tbs Fresh Lemon Juice
2 tsp Dijon Mustard
1/2 tsp Paprika (smoked is awesome)
1 Pinch Nutmeg
2-4 Cloves of Garlic, optional
Black pepper, to taste
1 Cup Soymilk
1/3 Cup Raw, Unsalted Cashews
1/4 Cup Nutritional Yeast
3 Tbs Low-Sodium Tamari or Soy Sauce
2 Tbs Earth Balance Margarine
1 Tbs Tahini
1 Tbs Fresh Lemon Juice
2 tsp Dijon Mustard
1/2 tsp Paprika (smoked is awesome)
1 Pinch Nutmeg
2-4 Cloves of Garlic, optional
Black pepper, to taste
Deborah Cook Adkins Oh boy that's a challenging
one!!! It's my favorite sauce too. Would love to see a healthy version
Leon
Trent Good luck with that.
Sue Gale Layman Cline Can you use skim milk, and
diet margarine? Maybe less cheese ...It might be thinner but should taste about
the same?? Other wise I have no idea
Pamela
Sue Olive oil for half the oil?
Cheryl
Sleeth I've done away with "white sauce"... I heat up
olive oil, add mince garlic, red pepper flakes, and when my noodles are done,
toss in the spaghetti...you could always sauté green peppers, add in cooked
chicken, cooked broccoli, ...any thing actually that you like....but, I will
never give up my red sauce...lol
Cherie Antin Fasbinder my sis in-law makes a
lightened alfredo that is pretty good... 1/2 C. reduced calorie margarine, 1 C.
freshly grated parmesan, & 2/3 C. light evaporated skim milk... add a
little garlic to taste.
Marlene Helvey Use Evaporated milk in place of cream, non-fat
yet creamy, Use half the butter, or use coconut oil or olive oil.
Leon
Trent The noodles will still be there. Packed with carbs.
Deborah Cook Adkins Exactly ^^, only substitute I
can think for the pasta is maybe spaghetti squash or zucchini peeled like
noodles
Leon
Trent Exactly Deborah, u would just be putting a good sauce on top
of something very fattening.
Marlene Helvey You can get low carb pasta. My cousin uses it
for her diabetes.
Leon
Trent Yes, there are substitutes that have a smaller amount but for
some people it's still too much.
Peggy
Garrett Cook check out Davita site, they have an alfredo sauce that
is diabetic and renal friendly, tastes great.
Leon
Trent Sauce does not take the carbs away.
Leon
Trent Pasta still there.
Leslie DeLynn Hodges Ok Tisha, I've been trying to come up with a
substitute for the cream and hitting a road block. Instead of butter you can
use olive oil and nutritional yeast seasoning in place of the parmesan cheese.
What is the answer?
Ella
Lane Super easy! But I won't ruin it!
Stella Karakatsanis-Melone Put it on chicken
breast sans pasta is on way to take out carbs
James Gilligan Or on a veg
Colleen
Shine It is meant to be unhealthy:)
Robert Roy Johnson Butter from grass fed cows. Coconut
milk instead of cream. Raw, unpasteurized cheese from grass fed cows. Then
spoon it over cauliflower rice (looks like rice, but made from organic
cauliflower). I've done it and it's delicious.
Abe
Lentner Easy. Keep it exactly the way it is, but serve it in small
3/4 cup portions with a large side of lightly seasoned, steamed summer veggies.
Kerri Kasper Jonikas Replace heavy cream with coconut milk in a can and replace Parmesan with nutritional yeast.
Jill Kearns cup ghee, cup coconut cream or milk, garlic, nutritional yeast, soaked macadamia nuts - puréed in a food processor, parsley, sea salt to taste.
Not sure if you can dump 1 1/2 cups of nutritional yeast in and get the right flavor/texture like Parmesan cheese. I would guess 1/2 cup of nutritional yeast and 1 cup of nuts.
Not sure if you can dump 1 1/2 cups of nutritional yeast in and get the right flavor/texture like Parmesan cheese. I would guess 1/2 cup of nutritional yeast and 1 cup of nuts.
Kerri Kasper Jonikas Yeah nutritional yeast is a better sub for cheddar cheese. But could work in this case
Here's my Version: Keep it simple the way the original recipe states it; however, adding tapioca flour or arrowroot will help with the thickening.
Healthy Alfredo Sauce -

1 clove garlic, crushed
1 cup soy, almond or any other nutmilks - if you want, feel free to use the healthy fat of coconut milk
2 TT tapioca flour or arrowroot
1 cup Nutritional yeast - or just enough for the taste that you want
1/4 cup chopped fresh parsley - optional
TT Salt
TT White Pepper
Directions:
Melt healthy butter or oil in a medium saucepan over medium-low heat. Saute garlic for about a minute. Add milk and when slighty warm add the tapioca or arrowroot. Simmer for 5 minute - while whisking. Then add nutritional yeast while continually whisking. Heat thoroughly. Season and stir in parsley. Serve.
Second Option - Tofu
1 block of tofu
1 cup soy, almond or any nut or coconut milk
1/4 cup extra virgin olive oil OR Non-GMO Canola oil OR Smart Balance OR Earth Balance (lotta options
1 clove of garlic, crushed
1 1/2 cups nutritional yeast
1/4 cup chopped fresh parsley
TT Salt
TT White Pepper
Directions:
Mix tofu and milk in a blender until smooth. Melt healthy butter or oil in a medium saucepan over medium-low heat. Saute garlic for about a minute. Add tofu mixture. Simmer for 5-10 minutes. Keep whisking to keep sides and bottom from burning. Add nutritional yeast and continue whisking. Heat thoroughly. Season and stir in parsley. Serve.
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