The Reason Fettuccine Alfredo Is Not Actually Popular In Italy - Tasting Table
Briefly

Many Americans dream of trying Italian dishes, especially pasta, yet fettuccine Alfredo, popular in the U.S., doesn't really exist in Italy. Instead, diners will find fettuccine al burro, a lighter dish made with just butter and Parmigiano Reggiano cheese. Created by Alfredo di Lelio in Rome in 1908 for his recovering wife, the dish gained fame later through American celebrities. The original restaurant, Alfredo alla Scrofa, remains a testament to its culinary heritage.
Fettuccine Alfredo, as known in America, does not exist in Italy; ordering fettuccine al burro gives a lighter, more authentic pasta dish with butter and cheese.
Alfredo di Lelio created fettuccine al burro to help his wife recover from childbirth, featuring just butter and Parmigiano Reggiano, avoiding heavy cream.
The dish gained fame when Mary Pickford and Douglas Fairbanks praised it after dining at di Lelio's restaurant, leading to its popularity among American celebrities.
Alfredo alla Scrofa is the historic restaurant in Rome where fettuccine al burro originated, serving iconic figures from Hollywood to literature since its opening.
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