Ensure is an American brand of nutritional supplements and meal replacement drinks manufactured by Abbott Laboratories, providing complete and balanced nutrition for adults, particularly those experiencing malnutrition, recovery from illness, or specific health conditions such as diabetes.[1] Introduced in 1973 as Abbott's first adultmedical nutritional product, Ensure was developed to address gaps in dietary intake by offering essential proteins, vitamins, and minerals in convenient, ready-to-drink or powder forms.[2] The brand has since expanded to support a range of nutritional needs, including muscle building, weight management, and glycemic control, with formulations backed by clinical research for efficacy in improving nutritional status.[3]Key products under the Ensure lineup include Ensure Original, which delivers 9 grams of protein and 27 vitamins and minerals per 8-ounce serving to supplement daily meals; Ensure Plus, offering 16 grams of protein and higher calorie content for those needing increased energy intake; and specialized variants like Ensure Max Protein with 30 grams of protein per serving to aid muscle maintenance, and Ensure Diabetes Care formulated with a low glycemic index for blood sugar management.[4][5] These products are available in various flavors such as vanilla, chocolate, and strawberry, and in formats including shakes, powders, and bars, making them versatile for oral consumption or tube feeding in clinical settings.[6]Ensure's nutritional profile emphasizes high-quality ingredients, including milk-based proteins for complete amino acid profiles, and is often recommended by healthcare professionals as an oral nutritional supplement to help prevent or treat undernutrition in vulnerable populations like the elderly or post-surgical patients. With ongoing innovations, such as enhanced protein levels and sustainable packaging, the brand continues to evolve to meet diverse adult health requirements while adhering to rigorous quality standards set by Abbott's global nutrition division.[7]
Overview
Description
Ensure is an American brand of ready-to-drink nutritional shakes and meal replacements designed for supplemental nutrition.[8] Produced by Abbott Laboratories, it offers variants such as Original and Plus to address diverse nutritional requirements.[3]The primary purpose of Ensure is to deliver balanced calories, protein, vitamins, and minerals to support individuals requiring dietary assistance, including those experiencing malnutrition or recovering from illness.[9] These products serve as convenient options for boosting daily nutrient intake without replacing full meals.[10]Ensure is categorized as an oral nutritional supplement (ONS), intended for consumption by mouth to complement regular diet, and is distinct from complete enteral nutrition formulas formulated primarily for tube feeding.[8] It is positioned as an accessible over-the-counter product available in grocery stores, pharmacies, and online retailers.[4] Global annual sales of the Ensure brand exceeded $3 billion as of 2024, reflecting its strong consumer demand.[11]
Manufacturer
Abbott Laboratories is a multinational healthcare company founded in 1888 by physician Wallace C. Abbott in Chicago, Illinois, where it remains headquartered in the suburb of Abbott Park. As of 2025, the company employs approximately 114,000 people worldwide and conducts operations across more than 160 countries, focusing on medical devices, diagnostics, nutrition, and established pharmaceuticals.[12][13]In 1964, Abbott acquired Ross Laboratories, the Columbus, Ohio-based firm that originally developed Ensure in 1973, thereby incorporating the brand into its growing nutrition portfolio and establishing the foundation for its Nutrition Products Group.[14][15] This acquisition integrated Ross's expertise in nutritional formulations, with Abbott subsequently managing all aspects of Ensure's production under its Nutrition division, now known as Abbott Nutrition.[16]Abbott Nutrition oversees the formulation, manufacturing, and global distribution of Ensure, utilizing key facilities such as its major plant in Columbus, Ohio, and additional sites in Tipp City, Ohio, to produce the product at scale.[14][17]Ensure forms a core part of Abbott's adult nutrition lineup, which also includes specialized products like Glucerna for diabetes management and Pedialyte for hydration, contributing to the division's annual revenue exceeding $8 billion through strong demand in supplemental nutrition markets.[11]
History
Development and Launch
Ensure was developed in the early 1970s by Ross Laboratories, a subsidiary of Abbott Laboratories since its acquisition in 1964, as an "adult medical nutritional" product designed for sole-source feeding and meal supplementation in clinical settings.[18] The initiative stemmed from the need to address malnutrition among patients unable to consume solid foods, with the research team at Ross, led by nutritionists, focusing on formulating a complete meal replacement that provided balanced macronutrients and emphasized digestibility.[18][19]Launched in 1973 as a ready-to-drink shake, Ensure was initially targeted at hospitals for use with elderly and post-surgical patients at risk of nutritional deficits.[19][20] This timing aligned with growing awareness in the U.S. healthcare system during the 1970s of hospital malnutrition rates, estimated at around 35% among inpatients, prompting innovations in enteral nutrition support.[21]Early market reception was positive within medical circles, as Ensure's calorie-dense, convenient format filled a gap for vulnerable patients requiring sole-source nutrition, quickly establishing it as a staple in hospital settings for weight maintenance and recovery.[20][18] By addressing the rising concerns over malnutrition in aging and surgical populations, the product gained traction among healthcare providers, laying the foundation for its role in clinical nutrition.[21]
Acquisition and Expansion
In 1964, Abbott Laboratories acquired Ross Laboratories, the creator of Ensure, fully integrating its nutritional product line into Abbott's portfolio and enabling expanded production and distribution capabilities. This acquisition marked a pivotal shift for Ensure, transitioning it from a primarily hospital-based supplement introduced in 1973 to a product with potential for wider consumer access under Abbott's growing healthcare infrastructure.[22]During the 1990s, Abbott strategically expanded Ensure's availability to retail shelves, moving beyond institutional settings to target the aging baby boomer population amid increasing demand for convenient nutritional supplements. This period saw intensified marketing efforts, including campaigns emphasizing muscle health and daily nutrition, which helped position Ensure as a leading protein supplement with approximately $300 million in U.S. sales by 1996, representing about 80% of the market for such products. By the late 1990s, these initiatives contributed to robust growth, with Abbott's overall nutritional segment benefiting from heightened consumer awareness and retail penetration.[20][23]In the 2000s and 2010s, Abbott continued to innovate and broaden Ensure's reach, launching specialized variants such as Ensure Enlive in 2016, formulated with 20 grams of protein and HMB to support muscle rebuilding in active adults.[24] The brand underwent international expansion, becoming available in over 160 countries by the mid-2010s as part of Abbott's global operations, driven by rising demand in emerging markets for accessible nutrition solutions. A notable challenge occurred in 2018, when Abbott voluntarily recalled certain Ensure products, including Ensure Plus, due to potential bacterial contamination in specific lots; the issue was swiftly addressed through enhanced quality controls, with no reported illnesses linked to Ensure.[25][26]Recent developments through 2025 have focused on diversification and social impact, with the introduction of Ensure Plant-Based Protein shakes around 2020, featuring 20 grams of vegan protein from fava beans and peas to meet growing demand for non-dairy options. In March 2025, Abbott announced the discontinuation of select Ensure products, including certain High Protein flavors, to streamline the portfolio.[27][28] Abbott has also forged partnerships with health organizations, such as a 2011 collaboration with PATH and the Abbott Fund to fortify foods and prevent malnutrition in developing regions like sub-Saharan Africa and Southeast Asia, alongside the 2021 launch of the Abbott Center for Malnutrition Solutions, investing $45 million annually to address global undernutrition through targeted programs. These efforts have supported Ensure's evolution into a multifaceted brand, with global sales exceeding $3 billion in 2024.[29][30][31]
Product Line
Main Variants
Ensure Original is the foundational product in the Ensure lineup, offering complete and balanced nutrition in a standard shake format designed for general nutritional supplementation and everyday health support. Each 8 fl oz serving provides 220 calories and 9 grams of protein, making it suitable for individuals needing supplemental nutrition without specialized requirements.[32]Ensure Plus builds on the Original formula by delivering higher caloric density for targeted weight management, particularly in cases of malnutrition or involuntary weight loss. This variant contains 350 calories and 16 grams of protein per 8 fl oz serving, representing 50% more calories and 75% more protein compared to Ensure Original, to aid in gaining or maintaining healthy weight.[33]Ensure Complete provides complete, balanced nutrition with 30 grams of high-quality protein and 350 calories per 10 fl oz serving, featuring an all-in-one blend to support muscle, bone, immune, heart, and digestive health, particularly for recovery or maintaining lean body mass.[9]Ensure Max Protein targets muscle maintenance and strength, featuring a high-protein formulation with 30 grams of protein per 11 fl oz serving and only 150 calories, emphasizing low sugar content at 1 gram. Launched in 2018, it addresses the need for increased protein intake among adults, particularly those over 50, to support active lifestyles.[34][35]Ensure Enlive represents an advanced formulation incorporating HMB (beta-hydroxy-beta-methylbutyrate) alongside 20 grams of high-quality protein per 8 fl oz serving and 350 calories, aimed at muscle preservation and immune support during recovery from illness, injury, or surgery. This all-in-one blend is specifically engineered for rebuilding lean body mass and strength in rehabilitative contexts.[36][37][38]Among the specialty lines, Ensure Clear offers a fat-free, clear liquid alternative with a juice-like consistency and low viscosity, providing 240 calories and 8 grams of protein per 8 fl oz serving to accommodate patients with dysphagia or those on clear-liquid diets, such as pre- or post-surgical protocols.[39]Ensure Diabetes Care, available in select international markets, is formulated for individuals with diabetes, featuring a low glycemic index, high fiber, high-quality protein, and 36 essential nutrients to help manage blood sugar levels, weight, and overall health.[40]Ensure Plant-Based, introduced in 2020, caters to vegan and plant-exclusive diets with 20 grams of protein derived from fava bean and pea sources per 11 fl oz serving, at 180 calories, ensuring it is dairy-free, soy-free, gluten-free, and non-GMO while maintaining complete nutritional balance.[41][42][43]
Flavors and Formats
Ensure products are available in a variety of flavors designed to enhance consumer appeal and accommodate different taste preferences. Common flavors across the Original and Plus lines include Milk Chocolate, Vanilla, Strawberry, and Butter Pecan, which are formulated to provide a familiar, milkshake-like taste experience.[32][44] Specialty options expand accessibility, such as Café Mocha in the Max Protein variant, which incorporates caffeine equivalent to about one cup of coffee for an energizing twist, and plant-based offerings in Chocolate and Vanilla flavors using fava bean and pea proteins for vegan consumers.[45][42]The primary formats of Ensure include ready-to-drink liquid shakes, powder mixes for reconstitution, and pudding cups for those preferring a thicker texture. Ready-to-drink shakes are the most prevalent, available in standard 8 fl oz (237 mL) bottles for Original and Plus products, and 11 fl oz (325 mL) tetra packs for Max Protein and Plant-Based variants, offering convenience for on-the-go consumption. Powder formats, such as the Original Vanilla, come in cans that yield multiple servings when mixed with water or milk, while pudding is offered in 4 oz cups in flavors like Vanilla, Chocolate, and Butterscotch to support varied dietary textures.[32][46][6][47]Packaging emphasizes portability and bulk options to meet retail, home, and institutional needs. Single-serve tetra packs and bottles facilitate individual use, while multipacks range from 4-count to 24-count cases for household stocking. Institutional formats include larger bulk cases, such as 48 pudding cups or 24-bottle shake packs, tailored for healthcare facilities to ensure efficient distribution. As of 2025, low-sugar and zero-added-sugar options, like the Ensure Light line in Milk Chocolate and Vanilla with 0 grams of sugar, have been expanded in select flavors to align with health-conscious preferences.[3][48]
Nutritional Composition
Key Ingredients
Ensure formulations feature a blend of macronutrients derived from high-quality protein sources, including milk protein concentrate and soy protein isolate, which together provide 9 to 30 grams of complete protein per serving across variants to support muscle maintenance.[32] Carbohydrates primarily come from corn maltodextrin and sugar, serving as readily digestible energy sources.[49]The fat component consists of a blend of vegetable oils, such as canola, corn, and soy oils, which deliver essential fatty acids including omega-3 and omega-6 for overall cellular function.[50][51]Micronutrients include 27 vitamins and minerals essential for daily health; notable examples are vitamin D to aid calcium absorption and bone health, calcium at levels like 330 mg per serving in Ensure Plus variants, and antioxidants such as vitamins C and E to combat oxidative stress.[52][33]Additives enhance product stability and palatability, with carrageenan used as a thickener for smooth texture, artificial flavors and sweeteners like sucralose in non-plant-based options for taste without added calories, and HMB (β-hydroxy-β-methylbutyrate) incorporated in Complete variants to promote muscle protein synthesis.[53][54]Proteins are sourced from U.S. dairy and soy; vitamins derive from both synthetic and natural origins. Ensure products are gluten-free and suitable for those with lactose intolerance due to low lactose levels.[50]
Nutritional Profile
Ensure Original provides 220 calories per 8 fl oz (237 mL) serving, with 9 g of protein, 32 g of total carbohydrates (including 10 g of total sugars and 9 g of added sugars), 6 g of total fat, less than 1 g of dietary fiber, and 210 mg of sodium.[32] Ensure Plus delivers higher caloric density at 350 calories per 8 fl oz serving, featuring 16 g of protein, 47 g of total carbohydrates (20 g total sugars, 19 g added), 11 g of total fat, 0 g of dietary fiber, and 210 mg of sodium.[33] In contrast, Ensure Max Protein emphasizes elevated protein content with 150 calories, 30 g of protein, 7 g of total carbohydrates (1 g total sugars, 0 g added), 1.5 g of total fat, 4 g of dietary fiber, and 250 mg of sodium per 11 fl oz (330 mL) serving.[34] The plant-based option offers 180 calories, 20 g of protein derived from fava beans and peas, 13 g of total carbohydrates (7 g total sugars, 7 g added), 6 g of total fat, 5 g of dietary fiber, and 300 mg of sodium per 11 fl oz serving.[41]Across variants, Ensure products supply 25-50% of the Daily Value (DV) for most vitamins and minerals, supporting comprehensive micronutrient intake.[32] For instance, the Original shake provides 25% DV for vitamin A, 25% DV for vitamin B12, and 4.5 mg of iron (25% DV).[49] Similar profiles appear in other formulations, with adjustments for serving size and focus, such as 40% DV for iron in the plant-based version.[41]The following table summarizes key macronutrient differences across main variants for easy comparison (based on standard ready-to-drink servings; values may vary slightly by flavor):
Variant
Serving Size
Calories
Protein (g)
Total Sugars (g)
Original
8 fl oz
220
9
10
Plus
8 fl oz
350
16
20
Max Protein
11 fl oz
150
30
1
Plant-Based
11 fl oz
180
20
7
[32][33][34][41]Most Ensure products, including Original, Plus, Max Protein, and Plant-Based, carry kosher and halal certifications, ensuring suitability for diverse dietary observances.[32][55]
Uses and Health Benefits
Targeted Populations
Ensure is primarily targeted at elderly adults over the age of 65, who often experience sarcopenia and involuntary weight loss due to aging-related muscle decline.[56] These individuals benefit from its nutrient-dense formulation to help maintain muscle health and overall nutritional status amid reduced appetite or absorption challenges.[11]In medical recovery contexts, Ensure is recommended for patients post-surgery, undergoing cancer treatment, or recovering from illness, where supplemental calories and protein are essential to combat malnutrition risk.[57] Healthcare professionals, including dietitians, frequently suggest it to support energy needs and tissue repair during periods of increased nutritional demands.[58]For athletes and active individuals, high-protein variants like Ensure High Protein are designed to aid muscle repair and meet elevated protein requirements from physical activity.[59] These options provide a convenient way to replenish nutrients before or after exercise, supporting recovery in those with demanding lifestyles.[60]Special needs populations include those with dysphagia, for whom the Ensure Clear variant offers a clear liquid option that is easier to swallow while delivering essential nutrients.[39] Vegans can utilize the plant-based version, which provides 20 grams of protein from fava bean and pea sources without dairy or animal products.[42] Additionally, lower-carbohydrate options such as Ensure Light cater to individuals managing diabetes by helping control blood sugar levels alongside nutritional support.[61]Globally, in developing countries, Ensure is incorporated into programs addressing undernutrition among adults through Abbott's partnerships and donations, such as supplemental nutrition initiatives in high-malnutrition areas like Guatemala.[62] These efforts focus on vulnerable populations where access to balanced diets is limited, aiding in the prevention and treatment of malnutrition.
Supported Health Outcomes
Clinical studies on oral nutritional supplements like Ensure demonstrate benefits for weight management, particularly in malnourished older adults. A randomized controlled trial involving a hyperproteic nutritional supplement similar to Ensure reported an average weight gain of 2.86 kg after 12 weeks of consumption, with 80% of participants achieving at least 1 kg increase.[63] A systematic review and meta-analysis of nutritional support interventions, including oral supplements, found that such therapies promote weight gain of approximately 0.94 kg in medical inpatients, including elderly individuals at risk of malnutrition.[64] Consuming 1-2 servings daily has been associated with improved nutritional status and reduced risk of further weight loss in this population.[65]Certain Ensure variants fortified with β-hydroxy-β-methylbutyrate (HMB), such as Ensure Enlive, support muscle health by aiding lean mass retention and growth. In a 12-week randomized trial, older malnourished patients consuming a high-protein oral nutritional shake with 3 g of HMB daily experienced significant increases in muscle mass and nutritional markers compared to controls.[66] Another clinical study on HMB supplementation in elderly hip fracture patients using an Ensure Plus Advance variant showed preservation of muscle function and muscle mass.[65] These effects are attributed to HMB's role in reducing muscle protein breakdown, particularly beneficial during recovery from illness or inactivity.Components in Ensure, such as antioxidants and zinc, contribute to immune support by potentially lowering infection rates. A systematic review of oral nutritional supplements indicated a 30% reduction in overall complications, including infections, among users compared to standard care.[67] In clinical settings, supplementation with nutrient-dense formulas like Ensure has been linked to fewer respiratory infections in vulnerable adults, enhancing immune cell function through micronutrient provision.[50]Vitamin D and B-vitamins in Ensure aid bone health and energy levels by fulfilling recommended daily allowances (RDA) and addressing deficiencies. Supplementation with vitamin D, as provided in Ensure (meeting 25-50% RDA per serving), is positively associated with improved bone mineral density in older adults.[68] For energy, B-vitamins support metabolic pathways that reduce fatigue; a review highlights their role in enhancing energyproduction and alleviating tiredness in deficient individuals.[69] Clinical evaluations confirm that Ensure's formulation helps improve fatigue scores and bone density markers when integrated into diets lacking these nutrients.[70]These supported outcomes are most evident in populations with nutritional deficiencies, such as the elderly or those recovering from illness, where Ensure serves as an adjunct to dietary intake.[71] It is not intended as a replacement for a balanced diet but as a targeted supplement to bridge gaps in nutrient consumption.[50]
Criticism
Nutritional Concerns
Ensure Original contains 9 grams of added sugars per 8-ounce serving, equivalent to 18% of the daily value, which has raised concerns about its suitability for individuals managing diabetes or blood sugar levels.[49]The protein sources in Ensure, primarily soy protein isolate and milk protein concentrate, pose risks for individuals with allergies to soy or dairy, as these are common allergens that can trigger adverse reactions such as hives, digestive distress, or anaphylaxis. Additionally, Ensure includes carrageenan as a stabilizer, a food additive approved by the FDA for general use but linked in animal and laboratory studies to intestinal inflammation, ulceration, and exacerbation of conditions like inflammatory bowel disease.[49][72]Ensure Plus provides 350 calories per 8-ounce serving, offering concentrated energy that may contribute to unintended weight gain or overconsumption if intake is not carefully monitored, particularly among sedentary or elderly users. Its low dietary fiber content, at 1 gram per serving in standard variants, further limits satiety and may not adequately support digestive health or prolonged fullness.[44][49]As an ultra-processed product, Ensure derives much of its composition from refined ingredients like corn maltodextrin and blended vegetable oils rather than whole foods, potentially diminishing its nutritional quality despite fortification. Long-term exclusive use could lead to excessive intake of certain vitamins and minerals, such as vitamin A or D, exceeding tolerable upper limits and risking toxicity symptoms like hypercalcemia or liver strain, according to general guidelines on supplement overages.[49][73]While Ensure meets FDA requirements for labeling and safety as a medical food or oral nutritional supplement, its fiber profile remains notably low at 1 gram per serving compared to updated competitors like Boost Plus, which offers 4 grams as of 2025, potentially falling short in promoting gut health or meeting broader dietary fiber recommendations.[74][75]
Marketing Practices
Abbott Laboratories has promoted Ensure through television advertisements since the 1990s, frequently depicting active and healthy seniors to emphasize themes of vitality and aging gracefully.[76] These campaigns positioned the product as a means to support energy and nutrition for older adults, with early ads drawing scrutiny from the Federal Trade Commission for implying unsubstantiated claims of doctor recommendations as a mealsupplement for healthy, active adults in their 30s and 40s.[76] In more recent efforts, Abbott has expanded into digital marketing, partnering with over 50 social media influencers to create authentic content integrating Ensure into daily routines for diverse audiences.[77]Marketing materials consistently highlight Ensure's status as the number one doctor-recommended complete and balanced nutrition brand, leveraging this endorsement to build consumer trust.[78] While direct partnerships with organizations like AARP were not identified, Abbott has collaborated with healthcare providers and institutions to promote Ensure in clinical settings, enhancing its perceived credibility among medical professionals.Ensure's promotional strategies have faced controversies, particularly regarding claims of providing "complete nutrition." In the 2010s and beyond, multiple class-action lawsuits accused Abbott of misleading consumers by marketing the product as a healthy, all-in-one nutritional solution suitable for non-medical use, despite its high sugar content and limitations as a supplement rather than a meal replacement. Recent lawsuits, including a 2023 case in the Northern District of California alleging false labeling on balanced nutrition due to sugar content (partially trimmed but ongoing) and a 2025 Second Circuit affirmation of dismissal in a related consumer challenge to misleading labeling, continue to highlight these issues.[79][78][80] Critics have also pointed to advertising tactics that may exploit fears of malnutrition among the elderly, portraying the product as essential to prevent health decline without sufficient evidence for broad populations.[80]Globally, Abbott ties Ensure marketing to public health themes, such as caregiver support in Asia through campaigns like Ensure Gold, which encourage nutritional supplementation during cultural events like Tet.[81] In regions like Asia and Africa, promotions often align with initiatives addressing aging and malnutrition. Despite ongoing scrutiny, these strategies have driven substantial growth, with Ensure achieving over $3 billion in annual global sales by 2025.[31]