In a large skillet over medium-high heat, cook 1 lb ground beef and ½ cup diced onion for 5-6 minutes until browned and soft.
Add 3 minced garlic cloves and cook for 1 minute. Then stir in 2 tablespoons tomato paste, 1 tablespoon Worcestershire sauce, and seasonings.
Pour in 2 cups beef broth, 1 cup milk, and 1 can diced tomatoes. Stir in 2 cups elbow macaroni.
Bring to a boil, then reduce heat to medium-low and cover, simmer for 10-12 minutes until pasta is al dente.
Remove from heat and stir in 1½ cups shredded cheddar cheese until melted. Adjust seasoning and serve.