In a large pot or Dutch oven, brown the ground beef over medium heat, stirring frequently until fully cooked (about 5-7 minutes). Drain any excess fat.
Add the diced onion, garlic, and bell pepper to the pot. Sauté for 3-4 minutes until the vegetables are softened.
Stir in the diced tomatoes (with their juices), tomato paste, beef broth, Worcestershire sauce, and Italian seasoning. Mix well.
Bring the mixture to a boil, then add the uncooked elbow macaroni.
Reduce the heat to low, cover, and let it simmer for about 15-20 minutes, stirring occasionally, until the pasta is cooked and has absorbed some of the sauce.
Season with salt and pepper to taste. If desired, serve hot with grated cheese on top.
You can customize this recipe by adding your favorite vegetables or adjusting the seasonings.
If you prefer a spicier dish, consider adding red pepper flakes or diced jalapeños.