1 package (8 ounces) manicotti shells, cooked and drained
1/4 cup butter
1/4 cup all-purpose flour
1/2 teaspoon salt
2 cups milk
In a saucepan, combine the water, tomato paste, sugar and Worcestershire sauce. Bring to a boil. Reduce heat; cover and simmer for 30 minutes. Meanwhile, in a large skillet, cook beef and garlic over medium heat until meat is no longer pink; drain and set aside.
Place spinach in a steamer basket; place in a saucepan over 1 in. of water. Bring to a boil; cover and steam for 2-3 minutes or until wilted. Drain on paper towels; finely chop. Add to beef. Stir in the Parmesan cheese, cream, egg, parsley, salt and pepper. Stuff into manicotti shells. Spread 1 cup of the tomato sauce in a greased 13-in. x 9-in. baking dish. Place manicotti over sauce.
For white sauce, melt butter in a small saucepan. Stir in flour until smooth; gradually add milk. Bring to a boil; cook and stir for 1-2 minutes or until thickened. Pour over manicotti. Top with remaining tomato sauce.
Cover and bake at 350° for 30 minutes. Uncover; bake 15 minutes longer or until heated through. Let stand for 5 minutes before serving.