Footnotes:

ONS - Oral nutritional supplements.

^*Retrospective database review of 283 patients (63% with cancer) who received 2 daily servings of Ensure Plus Advance or other oral nutritional supplements (The supplements that were used by the other ONS group contained 206–320 kcal, 10.7–20 g protein, 7.8–13 g fat, and 25.5–37.7 g carbohydrates) in combination with dietary counselling and exercise for 3-6 months.

^†Retrospective database review of 179 patients with cancer who received 2 daily servings of Ensure Plus Advance or other oral nutritional supplements (the supplements that were used by the other ONS group contained 206–320 kcal, 10.7–20 g protein, 7.8–13 g fat, and 25.5–37.7 g carbohydrates) in combination with dietary counselling and exercise for 3-6 months.

^§Retrospective database review of more than 16,000 patients who received 2 daily servings of Ensure Plus Advance (n=720) or standard oral nutritional supplements (n=720) during hospitalisation.
#Compared to other ONS.

^{^}Yearly cost of malnutrition and muscle loss. Cost worked out on the basis of annual malnutrition cost to the NHS of £23.5bn6 and annual excess cost of muscle loss in the UK of £2.5bn9

^‡As shown in a randomised control trial to investigate the effects of a specialised ONS on older women (≥65 years) who underwent surgery for hip fracture vs. standard postoperative nutrition. Muscle function was measured by handgrip strength.

^¶Ensure Plus Advance was shown to preserve muscle mass in elderly patients after hip fracture surgery with rehabilitation, when consumed twice a day for 30 days, as compared to standard care.

^{^^}Strength was measured by handgrip strength in a post hoc analysis of over 600 malnourished people with heart or lung diseases, age 65 or older. Ensure Plus Advance was consumed twice daily for 90 days. 

^§§Comparative figures showed the % difference for those receiving Ensure Plus Advance vs. those receiving other ONS in the 12 months after the intervention.

^◊Estimated NHS cost savings have been calculated by applying average percentage reductions in healthcare use from Cornejo 2025 to published UK NHS utilisation and cost figures. Retrospective analysis from the study reported 28.1% fewer GP visits, 38.7% fewer ED visits, and 50.8% fewer hospital admissions.2,17 Reductions were multiplied by UK averages (0.24 ED visits/year,18,19 3.3 GP visits/year,20 0.7 admissions/year21 with 8.3 bed days per admission22) and converted using typical NHS unit costs (£37 per GP visit,18 up to £563 per ED visit,18 £1,369 per hospital bed day23). This equates to a potential saving of approximately £4,123 per patient per year. Actual costs may vary depending on investigations, appointment duration, and local tariffs.

^**Hospital bed-day savings were estimated by applying Cornejo 2025 admission reduction (50.8%)2,17 to UK averages (0.7 admissions/year;21 8.3 days per stay22) = 2.95

^||Estimated NHS cost savings have been calculated by applying average percentage reductions in healthcare use from Cornejo 2025 to published UK NHS utilisation and cost figures. Retrospective analysis from the study reported 36.2% fewer GP visits, 52.7% fewer ED visits, and 66.1% fewer hospital admissions.2,217 Reductions were multiplied by UK averages (0.24 ED visits/year,18.19 3.3 GP visits/year,20 0.7 admissions/year21 with 8.3 bed days per admission22) and converted using typical NHS unit costs (£37 per GP visit,18 up to £563 per ED visit,18 £1,369 per hospital bed day23). This equates to a potential saving of approximately £5,371 per patient per year. Actual costs may vary depending on investigations, appointment duration, and local tariffs.

^##Hospital bed-day savings were estimated by applying Cornejo 2025 admission reduction (66.1%)2,17 to UK averages (0.7 admissions/year;21 8.3 days per stay22) = 3.8.

^¶¶Figures from Frishman 2025 are based on 30% reduction in hospital admissions at one month,3 which have been applied to UK healthcare costs to estimate average potential UK savings. Costs may vary depending on  investigation level, hospital duration, types of admission, and  treatment received. Hospital admission costs are calculated using the  average length of stay (8.3 days, 2022 data)18 multiplied by the average bed-day cost (£1,369), derived from elective, non-elective, critical  care, and standard bed-day costs.23 Estimated savings: Hospital bed days (2.5) hospital admissions costs (£3423).

^~As shown in a randomised control trial to investigate the effects of a specialised ONS on older women (≥65 years) who underwent surgery for hip fracture vs. standard postoperative nutrition. Muscle function was measured by handgrip strength. 

^‡‡Ensure Plus Advance was shown to preserve muscle mass in elderly patients after hip fracture surgery with rehabilitation, when consumed twice a day for 30 days, as compared to standard care. 

^††Strength was measured by handgrip strength in a post hoc analysis of over 600 malnourished people with heart or lung diseases, age 65 or older. Ensure Plus Advance was consumed twice daily for 90 days.

^Σ Ensure Plus Advance is the most loved high-protein ONS vs Fortisip Compact Protein and Fresubin PRO COMPACT. Research in healthy adults who were asked to drink comparative flavours of Ensure Plus Advance and Fortisip Compact Protein (243 people; 49% vs 41% respectively “loved the taste”), and of Ensure Plus Advance and Fresubin PRO COMPACT (234 people; 55% vs 45% respectively “loved the taste”). In both studies, participants who gave then overall taste of the drink a 6, 7, 8 or 9 out of 9 (where 1 = I extremely dislike it and 9 = I like it extremely) were directly asked if they “loved the taste”; those who responded lower were assumed as responding no, with that response included in overall reported statistics.

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4. NHS, 2025. Fit for the Future: 10 Year Health Plan for England, Available online: https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future Last accessed December 2025
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ANIEMEA-P-GB-202502858  |  December 2025