Start your pasta and cook according to package directions.

Saute the sage leaves in the butter or coconut oil.

Whisk in the pumpkin and cream (or coconut milk), and a pinch of nutmeg; simmer 5 minutes. Taste add salt and pepper as desired. (It usually needs a big pinch of salt.)

Toss with the cooked and drained pasta. Top with grated Parmesan (if not making this vegan).