Peel and cut the butternut squash cut into small chunks. Peel and finely slice the garlic, if using.
In a large saucepan or skillet, heat olive oil over medium-high heat. Add garlic and saute for about a minute, or until fragrant. Stir in the butternut squash and saute for 3-5 minutes. Season with salt and pepper.
Pour in the water and bring to a boil. Cook for 8-10 minutes. Stir in the pasta - the water should just cover the pasta, if not, add a little more water. Reduce the heat, cover the pan and cook according to pasta packet instructions, stirring occasionally.
Add in the spinach halfway through the cooking time. Remove the remove the lid, turn up the heat and continue to cook for a couple of minutes to reduce the water.
Turn off the heat. Squeeze in the juice from half a lemon and add grated Parmesan. Stir until silky and smooth. Season to taste and garnish with fresh cilantro or parsley. Serve.
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