The liver reducing diet
The liver is the largest organ in the body and sits across the upper part of your digestive system (see the diagram below). Following this diet will reduce the size of your liver making the surgery easier and less likely to have complications.
It is recommended that a very restricted diet; one that is low in fat, sugars and starch, be followed for TWO WEEKS prior to surgery. By following this eating plan the energy supply in your liver is used up, causing it to shrink. You may need to follow this for longer if requested by the surgeon or dietitian, when you meet them in clinic. This eating plan is only recommended prior to surgery and it is NOT TO BE FOLLOWED AFTER THE OPERATION.
It is possible that you will lose a lot of weight on this diet, but it will mainly be water loss.Please ensure that you have plenty to drink throughout the day; it will not prevent you from losing weight. If you suffer with kidney disease please speak with your dietitian before commencing this diet.
You can have any 3 servings from this list per day.
| Starchy Foods | 1 Serving is Equal to: |
| Porridge oats or sugar free muesli | 1 heaped tablespoon (uncooked) |
| Breakfast cereal | 3 level tablespoons OR 1 wheat / oat biscuit |
| Bread | 1 medium slice OR ½ roll |
| Pitta, Chapatti, Wrap | ½ large OR 1 medium |
| Baked or boiled Potato (with skin) | 1 small potato ½ large potato 2 egg size potato |
| Pasta or Noodles | 2 tablespoons cooked 1 tablespoon uncooked |
| Rice | 2 tablespoons cooked 1 tablespoon uncooked |
| Cous Cous, pearl barley, quinoa | 2 tablespoons cooked 1 tablespoon uncooked |
| Crispbread | 2 |
| Cracker | 2 |
| Oatcake | 1 |
You can have any 2 servings from this list per day.
| Fruit | 1 Serving is Equal to: |
| Banana | 1 small |
| Large fruit e.g. melon, pineapple | 1 slice |
| Medium fruit e.g. apple, pear, orange | 1 fruit |
| Small fruit e.g. plums, Satsuma | 2 fruits |
| Grapes / Cherries | Approximately 14 |
| Berries e.g. strawberries | 1 large handful |
| Tinned/stewed fruit (unsweetened) | 3 tablespoons |
*Please avoid dried fruit and fruit juice as they contain a lot of sugar.
You can have any 2 servings from this list per day.
| Dairy Products | 1 Serving is Equal to: |
| Milk (semi-skimmed or skimmed) | 200ml OR 1/3 pint |
| Soya Milk | 200ml OR 1/3 pint |
| Diet Yoghurt | 1 small pot (125-150g) |
| Cottage Cheese (low fat) | 2 tablespoons |
| Cream Cheese (low fat) | 1 tablespoon |
| Low Fat Cheese | Matchbox sized piece |
You can have any 2 servings from this list per day.
| Protein Foods | 1 Serving is Equal to: |
| Chicken / Turkey | 50g (2oz) cooked OR 100g (4oz) raw |
| Beef / pork / lamb | 50g (2oz) cooked OR 100g (4oz) raw |
| White fish | 125g (5oz) cooked |
| Oily fish | 50g (2oz) cooked OR 100g (4oz) raw |
| Lean bacon | 2 grilled rashers (remove visible fat |
| Eggs | 2 medium eggs |
| Cooked meat slices | 2 medium slices OR 4 wafer thin slices |
| Beans, Pulses, Lentils | 4 heaped tablespoons cooked |
| Tofu, quorn, soya | 100g (4oz) |
You can have any 2 servings from this list per day.
| Foods High in Fat | 1 Serving is Equal to: |
| Butter or Margarine | 1 teaspoon |
| Low fat spread | 2 teaspoons |
| Cooking Oil | 1 teaspoon |
| Mayonnaise, salad cream, oil based dressing | 1 teaspoon |
| Reduced fat / Light Mayonnaise, salad cream, oil based dressing | 2 teaspoon |
| Thickened Gravy | 1 tablespoon |
| Unthicken Gravy | 4 tablespoons |
Alongside this, you can have an unlimited amount of most vegetables and salad to fill yourself up with these.
They should cover over half of your plate.
Avoid adding fat when cooking/at the table.
You should avoid the following vegetables for now as they contain too much starch:
- Beetroot
- Parsnip
- Peas
- Sweetcorn
- Squash
A typical day might look like this:
Sample meal plan:
Breakfast;
- 3 tablespoons of low sugar cereal e.g. porridge OR
- slice of toast with a scraping of low-fat spread
Mid-morning:
1 Portion of fruit
Lunch:
- Unlimited non starchy vegetables or salad
- 1 slice of toast with a scraping of low-fat spread
- A small portion (2oz or 56g) of lean meat, fish or cheese.
Mid-afternoon:
1 Portion of fruit
Evening meal:
- Unlimited non starchy vegetables or salad
- 2 egg sized potatoes or 1/2 a jacket potato
- A small portion (2oz or 56g) of lean meat, fish, cheese, tofu or quorn based dish.
Supper:
1 low fat, low sugar yoghurt.
Through the day:
200ml milk(for cereal and in cups of tea/coffee)
Suitable drinks include:
- Tea
- Fruit teas
- Coffee
- Oxo/Marmite/ Bovril
- Horlick/ Ovaltine (light options) x 1 per day
- Low fat hot chocolate x1 per day
- Water
- Sugar free flavoured water
- Low sugar cordial
- Diet drinks
Tips for success with the liver reducing diet
- Use smaller plates, bowls, knives and forks than you usually do. This will help you to control your portion size.
- Aim for half a plate of vegetables or salad at mealtimes; this will fill you without giving you too many calories
- Eat slowly and aim to make your meal last 20 minutes. Chew your food well and put your knife and fork down between mouthfuls.
- Include plenty of drinks. This can help to fill you up and reduce your appetite.You should now be eating less than you did before, so you will want to make the most of it. Eat without distractions and enjoy each bite.Choose wholemeal cereal, bread, pasta and rice. It will fill you up for longer.
Frequently asked questions
When will I know when to start the diet?
You will be given a date for surgery about 4-6 weeks before the operation. Start the eating plan 2 WEEKS before the date of your surgery.
Are there any side effects to following the diet?
Most people follow the eating plan very well without any problems. Some people experience headaches or feeling lightheaded initially, but these symptoms tend to resolve in under a week. You may feel hungrier or possibly lacking in energy. However, these feelings mean you are not giving the body with the energy it needs, which ends up with you losing weight. If you are still concerned you can contact the dietitians for more help.
What if my liver does not reduce in size?
In the few cases where the liver has not reduced in size it is usually due to the person not following the eating plan fully. Unfortunately, if this happens the surgery may have to be cancelled. Remember that this does not happen very often if you follow the dietary advice.
I am on medication to control my diabetes; will it need to be adjusted?
It is likely that you will need change the amount of medication you have whilst following the eating plan. Make sure that you seek advice from your Diabetes Care Team before you start so that you are ready to make the right changes. If you have a blood glucose testing device, check your blood sugars regularly. If you have diabetes but are not on medication, make sure you continue to have starchy foods at every meal as outlined in this plan.
A checklist of useful items to help with your recovery diet after surgery:
- Hand Blender/ Food Blender
- Food weighting scales
- Ice cubes trays/ Freeze-able pots
- Sieve
- Small plates and cutlery
- Drinking bottle with measurements, to monitor fluid