The product can be prepared in a microwave, baked in a traditional oven, or cooked on a kitchen stove. Extra ingredients, such as cooked ground beef, jalapeños, sliced hot dogs, Spam, tabasco sauce, fried bacon, canned tuna or salmon, peas, broccoli or other vegetables are sometimes incorporated into the dish. In preparing the dish, the macaroni is cooked and drained, then mixed with the cheese sauce. In the latter case, the consumer may add either milk or water, and margarine, butter or olive oil. Packaged versions of the dish are available as a convenience food, consisting of boxed pasta and either a liquid cheese sauce, or powdered ingredients to prepare it. In Scotland, the dish is often presented in a pastry shell as "macaroni cheese pie". A precooked version known as "Macaroni and cheese loaf" can be found in some stores. The dish may be served after mixing the sauce with cooked macaroni, or may be served after mixing the pasta and sauce and then baking the dish, sometimes covered with a breadcrumb topping.
Taste and opinion differs widely, but modern opinion seems to favor substantial amounts of cheese. Cheese is incorporated into the sauce either as flavoring or as a substantial portion of the final product. The thickness of the final sauce depends on the proportions of milk and flour. Another method, considered less traditional, is to whisk kneaded flour-butter ( beurre manié) into scalded milk. A white sauce, called Béchamel sauce in French cooking, is traditionally made by whisking scalded milk gradually into a white flour- butter roux (equal parts clarified butter and flour by weight). In the French style of cooking, such a sauce is called Mornay sauce. Macaroni and cheese is generally cooked macaroni with white sauce that has a cheese flavor.
The dish has been popular in the United Kingdom since the Victorian era. There are also records of his purchasing, or attempting to purchase, imported pasta after his term as president. Thomas Jefferson, who called all pasta "macaroni", is known to have had a pasta maker as early as 1793 and to have served a macaroni pie at the White House in 1802. It was considered an upperclass dish even in Italy until around the 18th century. It was made with fresh hand-cut pasta which was sandwiched between a mixture of melted butter and cheese. A cheese and pasta casserole known as Makerouns was recorded in an English cookbook in the 14th century. However, pasta and cheese casseroles have been recorded in cookbooks as early as the Liber de Coquina, one of the oldest medieval cookbooks. Macaroni is mentioned in various medieval Italian sources, though it is not always clear whether it is a pasta shape or a prepared dish.
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