Cook the pasta in a pot of salted boiling water. Drain and set aside.
While that’s cooking, heat the oil in a large pan and saute the leek and sage with the nutmeg for a few minutes, until the leek has softened. Add the cauliflower and pumpkin with a splash of water and stir through - pop the lid on and reduce the temperature, letting it steam for 10-15 minutes until fork tender. Stir intermittently and add extra water if it dries out.
Once tender, combine the cream cheese and pasta with the veggies - stirring well so the cream cheese melts and makes a sauce. Taste and season generously with salt and pepper.
Transfer into a grill-proof dish (if pan is not suitable) and top with almond meal and parmesan - place under the grill for 5 minutes or so until golden brown and going crunchy on top.
Serve as is or with some extra greens on the side.
Notes
Serve with a crunchy green salad or steamed low calorie non-starchy vegetables.
Store leftovers in an airtight container in the refrigerator for up to 3 days. Reheat and serve.
Batch cook and freeze in portions for up to 2 months. Defrost and reheat before serving.
Some brands of cheese (including parmesan/cream cheese) may contain rennet so are not strictly vegetarian. Check the product you buy uses vegetarian ingredients. Brands vary, it is always important to read labels first.
If following a gluten free diet, use a pulse-based pasta instead.