Are Ensure and Boost Really Good for You? Here's What You Need to Know!

The high calorie and high protein supplement aisle at the grocery store.

Introduction: The Question We All Ask

“Is this stuff really healthy for my dad?” Rachel* asked, her voice tinged with concern. As the adult daughter of a patient I was seeing in the hospital, she was inquiring about an oral nutrition supplement - Ensure. It’s a question I hear regularly from family members. Family members are usually on high alert while their loved on is in the hospital. There is a lot of information on the internet and social media about restricting certain foods or ingredients. But when it comes to high-calorie or high-protein drinks like Ensure and Boost, the answers as to what is healthy aren’t always clear.

Rachel dedication to helping her father, who had lost a significant amount of weight after eating very little over a few weeks was admirable. She wanted to stick with whole foods like oatmeal, miso soup, and vegetables—often enjoyable and nutrient rich foods, but low in calories. But, he now met the criteria to be described as malnourished. She hesitated to allow him to try high-calorie supplements, viewing them as “toxic.” Her intentions were noble, but discouraging the use of these supplements may have been slowing her father’s recovery by preventing him from getting the nutrition he needed.

Food First, Supplements When Necessary: A Balanced Approach

Food First

Whenever possible, whole foods should be the first option to meet nutritional needs. You can enhance regular meals by adding fats, proteins, or high-calorie additives to increase the calorie load. This is much more feasible to do at home. However, in a hospital setting, it can be difficult to customize your loved one meal, depending on the hospital. Preparing homemade meals or ordering food in is a good idea to get more of the food your loved one likes and is accustomed to, but may not always be feasible - especially when family members have busy schedules or making ends meet during a hospital stay is already a stretch.

When Supplements Are Needed

If your loved one isn’t eating enough, high-calorie supplements like Ensure or Boost can play a critical role in the recovery process. Research shows that using nutritional supplements during hospitalization can reduce the time spent in the hospital, speed up recovery, and help maintain muscle mass better than relying on food alone. (1) Certain formulations of supplements provide HMB (Beta-Hydroxy Beta-Methylbutyrate) – a branched chain amino acid. This has been shown to suggest it helps muscle function and improve hospitalization outcomes (2). Don’t dismiss the idea of supplements—they might be the tool your loved one needs to heal faster and return home.

When Is It the Right Time for a Supplement?

The Challenges of Illness and Nutrition

Everyone has a different vision of what "healthy eating" looks like. Factors such as family dynamics, culture, medical conditions, and food accessibility can all shape how we perceive healthy eating. While it’s clear that ultra-processed foods aren’t ideal, the nutritional challenges of illness should not be overlooked.

Patients recovering from illness often struggle to consume enough food, especially if they’ve been sick for a long period. Many patients lose significant amounts of weight, making it harder for them to recover. For some, the act of eating can become difficult, even when they try to “just eat more” as encouraged by family and caregivers. In these cases, supplements can make a significant difference in providing the nutrition necessary for recovery.

Reasons to Incorporate High Calorie Supplements Into Hospital Recovery

A hospital stay is temporary, but good nutrition is vital for faster recovery and fewer complications. Supplementing with high-calorie drinks can shorten hospital stays and reduce the likelihood of needing readmission (1). Once home, it’s easier to prepare meals and snacks that your loved one will enjoy and (likely) be willing to eat more. Your loved one may not need a supplement at home, depending on how well they are eating other food.

Some patients may need these high-calorie supplements for a longer time. While it’s ideal to use whole foods at home, supplement use can still be beneficial in certain situations:

1. Maintaining Muscle Strength

   
   

   Loss of muscle mass during illness can significantly impact daily activities like walking, cleaning, and cooking. Ensuring adequate calories and protein through supplements can help prevent this.

2. Avoiding Feeding Tubes

   
   

   If your loved one is not consuming enough nutrition, there is a chance they can die of malnutrition or their quality of life if negatively affected by their lack of nutrition. You may need to consider with the doctor if a feeding tube is right for your loved one’s situation. But, before needing to resort to that, trying high-calorie supplements could help maintain their health enough to avoid even needing to discuss a feeding tube.

3. Promoting Wound Healing

   
   

   Those with surgical wounds or bedsores require extra calories and protein for proper healing. Insufficient nutrition can delay healing, increase the risk of infection, and prolong recovery time. Supplements can assist in the healing process. (3)

4. Convenience

   
   

   When your loved one is home alone, they may struggle to prepare meals or snacks due to limited mobility or energy. A ready-to-drink supplement can provide a convenient way for them to easily meet their nutritional needs without the hassle of cooking.

Is It Okay to Drink High-Calorie Supplements Every Day?

For the Healing Person:

For individuals who are ill and struggling to consume enough food, high-calorie supplements like Ensure or Boost can be a valuable tool to help prevent further weight loss. However, they should not replace meals but rather complement the diet. Ideally, these high-calorie, high-protein supplements should be consumed between or after meals to boost overall calorie and protein intake.

Generally, up to two servings of Boost or Ensure (or their equivalents) per day are considered safe. These supplements are packed with vitamins and minerals so there may be some concern about long term use of more than two servings per day due to the micronutrients. Be sure to consult with your loved one’s healthcare provider, as the type of supplement they need may vary depending on their specific health conditions and nutritional requirements.

For the Healthy Person:

For healthy individuals, it's best to meet nutritional needs through whole foods whenever possible. Supplements should only be used when necessary, as consuming them regularly in large quantities can lead to weight gain or an overconsumption of certain vitamins and minerals.

Additionally, they can be quite expensive, and supply shortages often occur, making it harder for those who truly need these supplements to access these products. It's best to reserve high-calorie, high-protein supplements for times when they’re truly needed. If possible, consider making homemade protein shakes in a blender as an affordable and customizable alternative!

Do You Gain Weight on Ensure?

High-calorie supplements like Ensure can help with gaining weight when used as part of a balanced diet. If someone consumes only 1-2 supplements per day without eating other food, they will not eat enough calories to gain weight. They would continue to lose weight. And remember, the goal during illness is to prevent weight loss and support healing—not to focus on weight loss.

Popular Oral Nutrition Supplements

Here’s a list of some of the popular high-calorie and/or high-protein supplements you may encounter in the hospital:

• Ensure

• Boost

• Mighty Shake

• Kate Farms

• Fair Life

• Glucerna

• Novasource Renal

• Nepro

• Premier Protein

• Juven

• Magic Cup

• Thrive

Creative Ways to Use High-Calorie Supplements

Incorporate high-calorie drinks like Ensure or Boost into your meals in these fun and creative ways:

• Blend into milkshakes with frozen fruit

• Mix with ice cream

• Use as a milk substitute in baked goods

• Pour over oatmeal or cream of wheat

• Stir into coffee as a creamy alternative

• Combine it with milk or your favorite milk alternative to make the supplement less sweet

Reasons to Hesitate: Concerns About Supplements

Some people may feel reluctant about using high-calorie supplements. Common concerns include the sugar content, unfamiliar ingredients, environmental impact of plastic packaging, and ethical issues related to the companies producing them. Sometimes people associate supplements with older adults or feel uncomfortable drinking calories.

In the hospital, however, it may be difficult to provide your loved one with enough nutrition to support their healing journey, especially if their appetite is poor. So, keep an open mind. It’s important to have ongoing discussions with your loved one’s healthcare provider to determine if supplements and/or the homemade options are the right choice based on the unique needs of your loved one.

Potential Negative Side Effects of High-Calorie Supplements

Some individuals may experience side effects like gas, bloating, or diarrhea. However, these symptoms can often be due to medical conditions or medications rather than the supplements themselves. Depending on your loved one’s health conditions, some supplements may throw their electrolytes or blood sugar out of balance. It’s important to weigh the potential benefits against any risks and discuss options with your loved one’s healthcare provider.

Consult a Healthcare Provider

High-calorie supplements meet specific medical needs, such as providing more calories for patients with diabetes, kidney failure, or post-surgery recovery. Always consult your loved one’s doctor or dietitian to find the best supplement for their situation.

Disclaimer:

Clinical dietitians working in hospitals are healthcare professionals offering expert guidance and do not financially benefit from recommending any supplements. I have never been paid by or sponsored by any of the supplement companies noted in this blog post.

If you want to help your loved one navigate the hospital nutrition, please subscribe for blog updates!

*I draw inspiration from real people and events for my stories, but I fictionalize them to protect privacy.

References:

1)    Mullin, Gerard E., et al. "The association between oral nutritional supplements and 30-day hospital readmissions of malnourished patients at a US academic medical center." Journal of the Academy of Nutrition and Dietetics 119.7 (2019): 1168-1175.

2)    Mullin, Gerard E., et al. "The association between oral nutritional supplements and 30-day hospital readmissions of malnourished patients at a US academic medical center." Journal of the Academy of Nutrition and Dietetics 119.7 (2019): 1168-1175.

3)    do Espírito Santo, Allan Carlos Soares, et al. "Impact of oral nutritional supplement composition on healing of different chronic wounds: A systematic review." Nutrition (2024): 112449.