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Liver Reduction Diet

Medically reviewed by Prof Rishi Singhal MBBS, MRCS, FRCS, MD
By Heather Fry BSC (Hons)

Last Reviewed 17/04/2024

What is the liver reduction diet?

A liver reduction diet (LRD) is a low-energy, low-carb, low-fat diet that reduces liver size for keyhole surgeries such as bariatric surgery. We advise you to stick to a maximum of 850kcal per day.

You will be asked to follow a liver reduction diet (LRD) before your bariatric surgery, such as the gastric sleeve, to reduce the size of your liver to make it easier for your surgeon to perform the keyhole surgery. We advise you to have a maximum of 850kcal per day along with a maximum of 80g of carbohydrates. This will force your body to use up glycogen stores in the liver, along with a quantity of water. These stored resources leave your liver, causing it to become softer, more flexible and easier to move during surgery. We advise you to start taking the recommended vitamin and mineral supplements when you start the liver reduction diet to reduce the risk of early deficiencies.

How long is a liver reduction diet?

It can vary depending on your BMI and typically we expect you to follow the below:
• If your BMI is 30-32 follow the diet for 3 days (850kcal per day)
• If your BMI is 32-35 follow the diet for 5 days (850kcal per day)
• If your BMI is 35-40 follow the diet for 1 week (850kcal per day)
• If your BMI is 40-50 follow the diet for 2 weeks (850kcal per day)
• If your BMI is 50-60 follow the diet for 3 weeks (week 1 1000kcal per day; weeks 2 & 3 850kcal per day)
• If your BMI>60 follow the diet for 4 weeks (weeks 1 & 2 1000kcal per day; weeks 3 & 4 850kcal per day)

What is the diet?

You need to follow a strict calorie intake of a maximum of 850kcal and 80g carbohydrates per day. If you have been advised to do this diet for longer than 2 weeks, it is normally suggested to start with 1000kcal per day before reducing to 850kcal per day for the last 2 weeks. For example:

Pre-op BMI

Length of LRD

Week 1

Week 2

Week 3

Week 4

>60

4 Weeks

1000kcal

850kcal

50-60

3 Weeks

1000kcal

850kcal

40-50

2 Weeks

850kcal

35-40

1 Week

850kcal

You can see below a number of breakfast, lunch and dinner options that will keep you within the calorie limit and provide a healthy nutritional balance. You can of course have alternatives if they fit within the calorie and carbohydrate allowance. You can also follow a liquid liver reduction diet with having meal replacement shakes. The diet should be supplemented with water and/or low-calorie free drinks to ensure you are getting at least 2L of fluid per day. Tea and coffee can be taken with small amounts of milk only – no sugar.

Breakfast

200kcal

Egg and soldiers: 1 slice bread (small loaf) toasted with 10g Lurpak lighter and 1 boiled egg. Activia 0% yogurt pot (115g).

Bacon bagel: ½ thin bagel toasted with 10g Lurpak lighter and 1 grilled sausage or 2 grilled chipolatas.

Beans on crumpet: ½ crumpet toasted topped with 30g baked beans and 15g half-fat cheddar cheese. Danone Light & Free yogurt pot (115g).

Nutty cereal: 10g plain, non-sugary cereal mixed with 20g mixed nuts and ½ medium (50g)banana served with 200ml semi-skimmed milk.

Eggs “Florentine”: ½ English muffin with 10g light olive spread, 2 poached eggs and 25g spinach.

Lunch

300kcal

Tuna pasta salad: 60g boiled pasta mixed with 90g tinned tuna, 15g light mayonnaise, 2tbsp (60g) sweetcorn and 60g tomatoes. 1 small orange or 2 small clementines (110g).

Ham ‘n’ egg: 1 mini pitta bread (35g) with 10g light I Can’t Believe It’s Not Butter, 2 thick slices ham (50g), 1 boiled egg, 60g tomatoes, 20g lettuce leaves and 120g (2”) cucumber.

2 rye crispbreads (20g) with 10g Lurpak lighter, 50g half-fat cheese, 20g onion slices and 40g pickled beetroot.

Omelette: made with 2 eggs, 20g onion, 80g peppers, 45g spinach and 60g tomatoes, topped with 25g half fat cheese. 50g Galia/honeydew melon.

Pizza: 1 mini pitta bread (35g) topped with 25g pizza sauce, 40g mozzarella cheese and 40g cooked chicken – grilled until cheese is melted. 160g strawberries.

Dinner

300kcal

Roast dinner: 130g roast chicken with 100g boiled sweet potato, 60g boiled green beans and 90g boiled cauliflower.

Jacket potato: 100g small baked potato topped with 50g half fat cheese and 2tbsp (80g) baked beans. Serve with 120g (2”) cucumber, 20g lettuce and 60g tomatoes.

Stir fry: 40g boiled egg noodles topped with stir-fried 120g prawns, 60g raw carrot, 60g raw broccoli, 60g edamame beans and 40g beansprouts. You can use 2tbsp soy sauce and chilli flakes to flavour.

Fajitas: 1 mini wrap (31g) filled with stir fried 80g steak slices, 80g raw peppers and 20g raw onion. Flavour with fajita spice.

Chilli con carne: 1 heaped tbsp (40g) cooked rice topped with 140g cooked extra lean (5% fat) beef mince, 1 heaped tbsp (35g) red kidney beans, ½ tin (200g) tinned tomatoes. Flavour with spices

Vegetarian pre-op liver reduction diet

Breakfast

200kcal

1 medium whole grain toast with 2 scrambled eggs

1 medium whole grain toast with 1 egg and 1 vegetarian sausage

Weetabix with 125ml skimmed milk and half a banana or some strawberries or sprinkled with a little dried fruit

40 grams porridge, bran flakes, All-bran or Fruit & Fibre with 125ml skimmed milk and half a banana

Homemade smoothie with berries, a small banana and some oatmeal

Lunch

300kcal

150g reduced-fat cottage cheese mixed with 80g grated carrots and 80g cubed pineapple.

120g Muller Light Greek Style yoghurt. 80g reduced Feta, 10g olives and 150g tomatoes. 130g peaches and 125g Activia 0% yoghurt.

120g baked aubergine topped with 160g tinned tomatoes, 50g half-fat cheddar and mixed herbs (grill to melt cheese). 180g blackberries and 90g Weight Watchers fromage frais.

20g bread/pitta bread toasted, 40g reduced sugar baked beans, 150g cherry tomatoes (grilled) and 50g half fat cheddar, 80g apple and 200g plain soya yogurt.

30g boiled rice and 110g Quorn mince lightly fried with 20g sweet corn and 150g chopped tomatoes. Use herbs and spices to flavour, 100g pear and 120g Muller Light Greek Style yogurt.

Dinner

300kcal

10g couscous (dry weight), 150g Quorn meat free Fajita Strips, 20g red kidney beans and 70g mixed frozen veg (boiled). Flavour with spices. 120g Tangerines.

60g potato (flesh only) boiled and mashed with milk from allowance at breakfast, 60g grilled Linda McCartney sausages and 40g reduced sugar baked beans. 20g ready to eat figs.

40g Rice noodles (cooked), 150g Quorn meat-free steak strips, 30g canned baby corn, 70g red pepper strips, 20g blackeye beans or chickpeas. Stir-fry in 5 sprays Fry-light and flavoured with spices as desired. 80g cherries.

120g tofu pieces marinated in 1 tbsp Light Soy Sauce, ½ tsp garlic powder, ½ tsp onion powder, ½ tsp ground ginger, ½ tbsp maple syrup, ½ tbsp rice vinegar, ½ tbsp sesame oil, ½ tbsp hoisin sauce, ½ tsp cornstarch. Stir fry with 45g raw carrot, 25g mangetout, 65g raw broccoli/ cauliflower and 15g raw onion. Serve with 30g boiled rice. 80g strawberries and 90g raspberries.

20g wrap (toasted) served with 120g plain Quark, 75g cucumber sticks, 125g celery sticks, 50g pepper sticks and 35g cherry tomatoes.

Liquid liver reduction diet (850kcal per day)

Please choose 1 option from the list below. If you choose meal replacement shakes, please make them up as advised by the manufacturer. The diet should be supplemented with water and/or calorie free drinks to ensure you are getting at least 2L of fluid per day. Tea and coffee can be taken but do not add sugar or milk (unless you’re taking it from the allowance stipulated in one of the options below).

Option 1
1800ml semi-skimmed cow’s milk

Option 2
4 Asda Great Shape meal replacement shakes

Option 3
4 Holland & Barrett SlimExpert meal replacement shakes

Option 4
4 LighterLife Fast ready-made meal replacement shakes

Option 5
4 SlimFast Original ready-made meal replacement shakes

Option 6
4 Tesco Slim meal replacement shakes

Option 7
2200ml lactose free semi-skimmed milk

Option 8
4 SlimFast Vitality meal replacement shakes (vegan)

Option 9
4 USN Diet Fuel Vegan meal replacement shakes

Option 10
2000ml original/sweetened soya milk