1. In a large skillet, brown the ground beef and Italian sausage over medium heat. Break into small pieces while cooking. Drain excess fat and set aside.

2. Bring a large pot of salted water to a boil. Cook the linguine according to package directions until al dente. Reserve 1/2 cup of pasta water before draining.

3. In the same skillet, melt butter and sauté minced garlic for 1-2 minutes until fragrant.

4. Reduce heat to low. Stir in cream cheese and milk or cream. Mix until smooth, then add Parmesan and continue stirring until the sauce thickens. Season with salt, pepper, and red pepper flakes if desired.

5. Return cooked beef and sausage to the skillet. Add the drained linguine and reserved pasta water. Toss to coat evenly.

6. Fold in fresh spinach and stir until just wilted. Serve hot with extra Parmesan if desired.