Is Ensure Plus Good for You? Pros, Cons & Side Effects

Ensure Plus is a calorie-dense liquid nutritional supplement that can be genuinely helpful for people who are malnourished, recovering from illness, or struggling to eat enough, but it is not a health drink for the general population. Its 350 calories per 8-ounce bottle, packed with added sugars and a long ingredient list, make it a targeted medical nutrition product rather than something most healthy adults need in their daily routine. Whether it is “good for you” depends almost entirely on why you are drinking it.

What Is Actually in a Bottle

Ensure Plus is made by Abbott and marketed as a complete, balanced nutritional supplement. A single 8-ounce serving delivers roughly 350 calories, 13 grams of protein, about 50 grams of carbohydrates, and 11 grams of fat. It contains 25 vitamins and minerals, which is one reason it gets positioned as a meal replacement or a between-meal calorie boost for people who cannot meet their nutritional needs through food alone.

The calorie density is the defining feature. Compared to standard Ensure (which runs about 220 calories per serving), Ensure Plus packs significantly more energy into the same volume. That matters for someone who can only tolerate small amounts of liquid at a time, like a post-surgical patient or an elderly person with a poor appetite. For someone eating normally and not trying to gain weight, those extra calories are just extra calories.

The carbohydrate content is worth a closer look. A large portion comes from corn maltodextrin and sugar, with around 20 grams of added sugar per bottle depending on the flavor. That is comparable to a small candy bar. The protein comes from milk protein concentrate and sodium caseinate, both dairy-derived. The fat blend includes canola oil, corn oil, and medium-chain triglycerides. It is also fortified with synthetic forms of most essential vitamins and minerals, giving it a nutritional profile that looks complete on paper even if the ingredients read more like a chemistry set than a grocery list.

Where the Evidence Actually Supports It

The strongest case for products like Ensure Plus comes from research on malnourished older adults. Multiple trials have tested what happens when you give calorie-dense oral nutritional supplements to elderly people who are losing weight or eating too little, and the results are consistently positive for that specific population.

In one study of malnourished elderly residents in nursing homes, participants given a high-protein oral supplement gained an average of about 2.9 kilograms over the study period, with 80% achieving a weight gain greater than 1 kilogram.¹ A separate trial of free-living, frail, undernourished elderly people found that supplemented individuals consumed substantially more total calories per day (about 1,770 versus 1,440) and gained significantly more weight compared to the control group.² That same trial noted, however, that weight gain alone was not enough to improve functional status and that increased physical activity was also needed.

A community-based trial of malnourished elderly people found that nutritional supplementation improved overall nutritional status and increased handgrip strength during the supplementation period, though grip strength declined again after the supplement was stopped.³ This is a useful reality check: these supplements work while you are using them, and the benefits do not necessarily stick around once you stop.

Research in cancer patients tells a similar story. People with cancer cachexia, the severe wasting that accompanies many cancers, were able to stop losing weight when given calorie-dense oral supplements. In one trial, patients who actually consumed their supplements consistently showed a clear dose-response relationship: the more they drank, the more weight and lean body mass they gained. Weight gain in that group was also linked to improved quality of life.⁴

The pattern across these studies is clear: if you are losing weight involuntarily, eating too little, or wasting from illness, calorie-dense oral supplements can meaningfully help. The benefits are real, but they are benefits for people in nutritional trouble, not for people who are already well-nourished.

The Sugar Problem

The most common criticism of Ensure Plus is its sugar content, and the concern is legitimate. With roughly 20 grams of added sugar per bottle, drinking two or three servings a day (as some product labels suggest for weight gain) adds 40 to 60 grams of sugar to a daily diet. The American Heart Association recommends no more than 25 grams of added sugar per day for women and 36 for men, so even one bottle puts many people at or near the daily limit.

For people with diabetes or insulin resistance, this is a real concern. The combination of corn maltodextrin and sugar produces a carbohydrate load that can spike blood glucose quickly. Abbott makes a separate product line called Glucerna specifically for people with diabetes, which uses slower-digesting carbohydrates. If you have blood sugar issues and have been told to use a nutritional supplement, Ensure Plus is probably the wrong one to reach for without checking with your doctor first.

For someone who is malnourished and underweight, the sugar content matters less. When the immediate clinical problem is insufficient calorie intake, the priority is getting energy in, and sugar is an efficient way to pack calories into a small volume of liquid. The risk calculation is different for a 75-year-old who has lost 15 pounds and barely eats versus a 40-year-old who drinks it as a convenient breakfast replacement.

Common Side Effects

Most side effects of Ensure Plus are gastrointestinal and relatively mild. Bloating, gas, nausea, diarrhea, and constipation are the complaints that come up most frequently. These tend to be more pronounced in people who are not used to liquid nutritional supplements or who drink them too quickly.

Several factors contribute to digestive discomfort:

• Osmolality: Calorie-dense liquid supplements pull water into the gut, which can trigger cramping and loose stools, especially when consumed on an empty stomach.
• Lactose traces: While Ensure Plus is labeled as suitable for lactose intolerance, it contains milk-derived proteins. People with a true milk protein allergy rather than just lactose intolerance may react to the casein and whey in the formula. Extensively hydrolyzed or amino acid-based formulas are recommended for confirmed milk protein allergy.⁵
• Artificial sweeteners and flavors: Some flavors contain sucralose or acesulfame potassium, which cause GI symptoms in some people even at low doses.

Starting with small amounts and sipping slowly rather than gulping a full bottle usually reduces these issues. If GI symptoms persist after a week or two, the product may simply not agree with you, and alternatives with different protein sources or lower osmolality are worth trying.

How Liquid Calories Affect Your Appetite

One of the less obvious effects of liquid meal replacements is what they do to hunger signals. Research comparing liquid and solid meal replacement products in older adults found that the liquid form did not suppress appetite the way solid food does. Participants reported feeling hungrier after a liquid supplement and went on to eat about 13% more food at their next meal compared to when they consumed the same calories in solid form.⁶

This is actually a useful feature for people who need to gain weight. If someone is struggling to eat enough, a supplement that does not kill their appetite for the next meal is a better tool than one that makes them too full to eat dinner. The liquid form of Ensure Plus appears to work partly because it adds calories without replacing meals entirely.

But for someone who is using Ensure Plus as a convenient meal replacement while managing their weight, this same property works against them. Liquid calories that do not register as a full meal can easily lead to consuming more total calories in a day than intended. If you are not actively trying to gain weight, drinking a 350-calorie supplement that does not make you feel full is a recipe for unintended calorie surplus.

The Compliance Challenge

A practical issue that rarely makes it into product marketing is that many people find oral nutritional supplements hard to keep drinking over time. Research on adherence to these products has identified several reasons people stop. Sensory changes due to illness, aging, or medication can make the sweetness cloying or create unpleasant aftertastes. The timing of when supplements are offered matters too, as drinking a sweet, thick liquid right before a meal can suppress the appetite for real food, while drinking it between meals works better.⁷

The cancer cachexia trial mentioned earlier actually ran into this problem directly: compliance was poor in both study groups, and the researchers had to rely on dose-response correlations rather than group comparisons because so many participants did not drink their prescribed amounts.⁴ Flavor fatigue is real. If you have been prescribed Ensure Plus or something similar, rotating flavors, serving it cold, or mixing it into smoothies can help, but there is no getting around the fact that drinking the same sweet liquid two or three times a day for months gets old.

Undesirable flavors in these products are not a marketing failure. They often stem directly from the nutritional ingredients themselves, particularly the vitamins, minerals, and protein isolates that give supplements their distinctive metallic or chalky undertones.⁷ The more nutrient-dense the product, the harder it is to make it taste like a milkshake.

Who Should Probably Skip It

Ensure Plus is not appropriate for everyone, and some groups should actively avoid it or choose alternatives:

• People with milk protein allergy: The casein and whey protein in Ensure Plus can trigger allergic reactions ranging from hives to anaphylaxis. This is distinct from lactose intolerance. If you have a confirmed dairy allergy, plant-based or amino acid-based supplements exist for this reason.
• People with diabetes who are not underweight: The high glycemic carbohydrate load makes Ensure Plus a poor choice for blood sugar management. Diabetes-specific formulas with modified carbohydrate profiles are a better fit.
• Healthy adults looking for a convenient breakfast: If you are eating adequately and maintaining a healthy weight, adding 350 calories of sugar-heavy liquid supplement to your day is not doing you any favors. A piece of fruit and some yogurt would give you better nutrition with less processed input.
• Children: Ensure Plus is formulated for adults. Pediatric nutritional supplements like PediaSure are designed with different calorie, protein, and micronutrient ratios appropriate for growing bodies. Using an adult formula for a child without medical guidance can create nutritional imbalances.

Galactosemia, a rare genetic condition that prevents the body from processing galactose (a component of lactose), is another absolute contraindication for any dairy-based formula. This is uncommon enough that most people will never encounter it, but it is screened for at birth in most countries.

Ensure Plus Versus Whole Food

A question that comes up frequently is whether you could just eat more food instead of drinking Ensure Plus. In many cases, yes. For someone who simply is not eating enough due to a busy schedule or skipped meals, adding calorie-dense whole foods like nut butters, avocados, full-fat dairy, and olive oil to existing meals is nutritionally superior to relying on a processed supplement. Whole foods bring fiber, phytochemicals, and a diversity of nutrients that a synthetic formula cannot fully replicate.

But the people who benefit most from Ensure Plus are often the people who genuinely cannot eat more. An elderly person with severe appetite loss, a cancer patient dealing with nausea and taste changes, someone recovering from jaw surgery, a person with swallowing difficulties: these are situations where the liquid format and engineered calorie density solve a problem that whole food cannot. Telling a frail 80-year-old who can barely finish half a sandwich to “just eat more avocado” misses the point entirely.

The honest assessment is that Ensure Plus occupies a legitimate medical niche. It is an effective tool for preventing or reversing malnutrition in people who cannot eat enough real food. It is not a health food, it is not a wellness product, and drinking it when you do not need it adds calories, sugar, and processed ingredients without a corresponding benefit. The “good for you” question really translates to “are you the person this product was designed for,” and for most people browsing the supplement aisle out of curiosity, the answer is probably no.

Long-Term Use and What the Research Does Not Cover Well

Most of the clinical trials on oral nutritional supplements run for a few weeks to a few months. The nursing home study lasted long enough to document significant weight gain, and the community trial tracked participants for 24 weeks, but long-term data beyond six months to a year is thin.³ That community trial also showed that improvements in grip strength faded after the supplementation period ended, which raises the question of whether extended use sustains benefits or whether the body simply returns to its previous trajectory once the extra calories stop.

There is also very little research on what happens when healthy adults use these products over months or years as habitual meal replacements. The sugar load, the reliance on synthetic micronutrients rather than food-sourced ones, and the displacement of whole foods from the diet are all plausible concerns, but they have not been studied rigorously in that context. Most research focuses on clinical populations where the benefit clearly outweighs the cost, and that makes sense from a research-funding perspective, but it leaves a gap for the casual consumer who just wants to know if their daily Ensure Plus habit is doing any harm.

If you find yourself relying on Ensure Plus for more than a few weeks without a medical reason, it is worth asking whether the underlying problem could be solved differently. Poor appetite, difficulty cooking, dental problems, depression, or simply not knowing how to prepare quick, nutrient-dense meals are all solvable issues that do not require an ongoing supplement subscription. For the people who truly need it, though, the product works as intended: it gets calories and nutrients into bodies that are not getting enough from food alone, and the evidence behind that use case is solid.

The Emerging Question of Gut Health

An area of growing research interest is how liquid nutritional formulas interact with the gut microbiome. Most of the work so far has been done in the context of enteral nutrition for inflammatory bowel disease rather than products like Ensure Plus specifically. Early animal research suggests that enriching enteral formulas with prebiotics can influence the gut bacterial community in ways that reduce inflammation, including increased production of butyrate (a short-chain fatty acid that feeds colon cells) and shifts toward more beneficial bacterial species.⁸

Standard Ensure Plus does not contain significant prebiotic fiber. It contains a small amount of fructooligosaccharides in some formulations, but nothing approaching the levels studied in research on gut-health-optimized formulas. Some newer competing products have started adding prebiotics, probiotics, or both, in response to growing consumer interest in microbiome health. Whether that translates to meaningful clinical differences for the average supplement user remains an open question. The gut microbiome research is genuinely exciting, but it is still largely in the animal-model and early-clinical-trial phase. For now, the practical takeaway is simple: if you are relying on a liquid supplement for most of your nutrition, the lack of dietary fiber is a real gap that whole foods would normally fill, and it is one more reason to use Ensure Plus as a bridge rather than a permanent dietary foundation.