Begin by bringing a large pot of salted water to a rolling boil. Add elbow macaroni and cook for about 4 minutes, then drain.

In a large skillet or Dutch oven, heat a splash of oil over medium heat. Add ground beef and chopped onion. Cook for 5–7 minutes until browned.

Stir in minced garlic and Worcestershire sauce. Cook for 30 seconds until garlic is fragrant.

Mix in tomato sauce and diced tomatoes, add Italian seasoning and paprika, then reduce heat and simmer for 10 minutes.

Incorporate reserved macaroni and stir well. Simmer for an additional 3–4 minutes.

If desired, add shredded cheddar cheese and stir until melted.