While Alfredo Sauce Recipes can be fairly different, the directions are usually almost the same. To make alfredo sauce, you first melt butter in a pan and then add in cheese (usually parmesan) and cream. Once the cheese is melted, you can add salt, pepper, or whatever other seasonings you want.

Sometimes flour is added to Alfredo Sauce as a thickener, but it reduces the sauce's quality. You can also add Romano, asiago, or other cheeses to alter the sauce's flavor. After mixing with noodles, you can add chicken, shrimp, vegetables, or mushrooms on top of the dish, especially if it's a main course.

Fettucine al burro (the dish's Italian name) was popularized by Alfredo di Lelio, who ran Alfredo's restaurant in Rome. Normally the bowl had butter in it before adding the pasta as well as having sauce poured over the top. Alfredo added twice as much butter before putting pasta in the bowl thus making it "triplo burro" instead of "doppio burro".

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