Add 2 tablespoons of extra-virgin olive oil to a large high sided skillet or Dutch oven over medium-high heat.
When the pan is hot, turn to medium heat and add the diced onion, diced red pepper and garlic and cook until softened, about 4-5 minutes.
Add the ground beef to the skillet and season with the Worcestershire sauce, kosher salt, ground pepper, garlic powder, onion powder and smoked paprika. Cook, breaking up the ground beef as you cook (use a ground meat masher utensil if you have one), cooking until the beef is no longer pink, about 5-7 minutes.
Add the tomato paste and stir it into the ground beef.
Add the grated zucchini, stir and cook down for about 4-5 minutes until the grated zucchini is quite wilted and combined with the ground beef.
Add the shellbows, milk, bone broth (or chicken broth) and crushed tomatoes and stir to combine.
Bring everything in the pan to a boil over medium-high heat. Once boiling, reduce heat to keep at a simmer and cook uncovered, stirring very often, until most of the liquid is absorbed and you’re left with a creamy sauce, about 8-12 minutes.
Remove from the heat and stir in the cottage cheese and shredded cheddar cheese until combined.
Taste for seasoning and adjust with more salt and pepper if desired.
Notes
Want to add some spice? Top with red chili flakes when serving.
If you can't find shellbows, other noodles that could work are shells, large elbow noodles or even rotini.