A recent New York Times article chronicles the rounds of a physician checking on his patients, who suffer from malnutrition, (either due to a secondary disorder, or as the primary cause of hospitalization). As we age, there are many reasons that eating enough nutrition can become problematic, including:

  • Depression
  • Missing teeth, making eating and chewing difficult
  • Digestive problems
  • Side effects of medications or other illnesses
  • Many other issues

The physician, Dr. Dave Lieberman, M.D., noted that many of his patients were growing weaker and thinner because of lack of proper nutrition, a condition he calls “protein calorie malnutrition.”
Protein calorie malnutrition is common for patients in ICU who are unconscious or too weak or ill to eat, as well as those at home who, because of lack of adequate nutrition, have been diagnosed “failure to thrive.”

As the doctor walks from room to room, to examine his patients, he notes the various flavored liquid drinks each patient has on their breakfast tray—just as he had ordered. So, why does the physician identify a problem with the seemingly nutritional supplement drinks in various flavors? Primarily, the issue is sugar.

When the ingredients on the nutritional shake labels are examined, it’s noted that the number one ingredient (and most prevalent composition of the shakes) is water. Next on the list—corn syrup. What? Corn syrup is a substance that people are warned adamantly against because it causes high blood sugar, insulin resistance, diabetes, and increases the risk of heart disease and even Alzheimer’s disease. As Dr. Lieberman continues to read the nutritional shake labels, he discovers additional reason for concern. It becomes clear to him, that the presumably high protein energy shake contains only 10 grams of protein (a mere fraction of the amount (around 46 to 56 grams per day) needed by the average sedentary adult. This means an adult would need to ingest 5 to 6 shakes (or more) per day to get the amount of protein required daily for a sedentary adult.

So, why does corn syrup (and insufficient protein levels), account for the primary ingredients of a so called healthy nutritional shake for hospitalized patients? The responsibility undoubtedly lies with the food industry, namely, the big guns in hospital nutrition such as Nestle’ and Abbot. “Supplement shakes like these, with confidence-inspiring names like Boost and Ensure, are marketed aggressively to consumers and health care providers alike as a healthful panacea for all those struggling to take in enough daily calories. The theory behind these drinks is simple and makes sense: They provide a dense and palatable form of calories that can be tolerated even by those who have poor appetite, no teeth, difficulty swallowing or any of the other myriad symptoms that accompany illness,” says Dr. Lieberman.

“This is how I’ve been treating malnutrition?” Beverages that contain refined sugars like these have been linked in many rigorous studies to metabolic derangements like Type 2 diabetes, heart disease and fatty liver disease. When I see patients in the office, I remind them at every visit to avoid these kinds of heavily processed and sweetened foods and drinks.” says Lieberman.

A physician should be able offer a healthy, low sugar, high protein therapeutic option for patients who need wholesome nutrition the most; instead of providing sugary unhealthy shakes with marginal amounts of protein.

If companies such as Nestle’ and Abbott do NOT provide healthy options in a nutritional supplement, then it’s up to healthcare providers and consumers to work together (in conjunction with hospitals) to come up with a better solution.


Lieberman, D. (2018, January). Sugary Shakes in the Hospital Aren’t Good Medicine. New York Times. https://www.nytimes.com/2018/01/25/well/live/sugary-shakes-hospital-doctors-patients-nutrition-boost-ensure.html