Add minced garlic to a medium pot. Mix with around the pot using a spoon. Let it heat for 30 seconds to 1 minute.
Add in milk, cream and pumpkin. Mix well. I use a whisk to mix right in the pot.
Add in spices (turmeric, sage, onion salt/powder, seal salt and pepper). Whisk well again.
Add in butter. Whisk as it melts and bring to a boil. Reduce heat and let simmer on low for 15 minutes. Whisk frequently as it simmers. It will reduce and thicken.
During this time, prepare your pasta according to instructions on the box.
After 15 minutes, add in flour and grated pecorino / parm. Whisk very well. Sauce will thicken even more.
Add in vegetable stock and continue to mix until it is creamy, smooth and well combined.
Add more seasoning to taste.
Serve hot with cooked pasta! Top with fresh pepper and chili flakes.