Preheat oven to 350°F. Spray 2½ -quart casserole with nonstick cooking spray. Cook pasta to desired doneness as directed on package. Drain.
In large nonstick skillet, cook and break up ground beef over medium-high heat for 5 minutes. Stir in the fresh garlic. Continue to cook for about 2 minutes or until beef is browned. Pour into a colander and drain all the fat. Add back to pan.
In the meantime, add the zucchini and onions to a microwave safe plate. Cook in microwave for about 4 minutes, until soft. Add to pan of browned beef. Stir in cooked pasta, Alfredo sauce, cottage cheese, tomato and a little pepper. Mix well. Spoon mixture into sprayed casserole.
Sprinkle the cheese evenly over the top of casserole.
Bake uncovered for 20-25 minutes or until thoroughly heated and cheese is melted.