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Bring 1 large pot and 1 large saucepan of heavily salted water to a boil. Meanwhile, peel, seed, and dice 1 butternut squash. Coarsely chop 6 fresh sage leaves and some fresh parsley leaves if desired; set aside.
When the water is boiling, add the squash to the pot and 8 ounces dried macaroni to the saucepan. Cook until the squash is tender and pasta is al dente. Drain the pasta and return to the pot. Drain the squash and transfer to a blender.
Add 1 cup unsweetened almond milk, 1/4 cup nutritional yeast, juice of 1/2 lime, 2 chipotles in adobo, 1 tablespoon tapioca flour or cornstarch, and 1 teaspoon kosher salt to the squash. Blend until smooth.
Heat a drizzle of olive oil in the empty squash pot over medium heat until shimmering. Add the chopped sage and cook until fragrant. Pour in the butternut squash mixture and cook, stirring constantly, until it starts thickening. Thin out with more almond milk if desired, and taste and season with more salt as needed.
Add the macaroni and stir to combine. Transfer to a serving bowl and top with crispy fried onions and parsley if desired.