Prep your base. If using zucchini noodles, pat them dry with paper towels to limit wateriness. For shirataki, rinse well, boil for 2 minutes, then dry-sauté for 2–3 minutes to remove moisture. Roast cauliflower florets at 425°F (220°C) with olive oil, salt, and pepper for 20–25 minutes. For spaghetti squash, roast until tender and shred with a fork.

Cook any protein. In a large skillet over medium heat, add a bit of olive oil. Sauté shrimp 2–3 minutes per side, or cook chicken until browned and just cooked through. Remove and set aside. If using mushrooms, cook until browned and their moisture evaporates.

Sauté garlic. Reduce heat to medium-low. Add butter to the same skillet. Once melted, add garlic and cook 30–60 seconds until fragrant. Do not brown the garlic.

Make the sauce. Pour in the heavy cream and bring to a gentle simmer. Cook 3–4 minutes, stirring, until slightly thickened.

Melt in the cheese. Lower the heat and gradually whisk in Parmesan until smooth and velvety. Add nutmeg, salt, and pepper. If the sauce seems too thick, thin with a splash of cream or a tablespoon of water. If too thin, let it simmer a minute longer.

Brighten and finish. Stir in lemon juice to taste. Add parsley if using. Adjust salt and pepper.

Combine. Toss your prepared low-carb base and any cooked protein with the sauce over gentle heat for 1–2 minutes, just to warm through. Avoid overcooking, especially with zucchini, which softens quickly.

Serve. Top with extra Parmesan and a crack of black pepper. A pinch of red pepper flakes adds heat if you like.