Your liver reduction diet 2WW
Date issued: August 2025
For review: August 2027
Ref: C-623/JMJ/Oncology/Your liver reduction diet 2WW
PDF: Your liver reduction diet 2WW.pdf[pdf] 248KB
Why do I need to follow a pre-operative diet?
Before surgery, it is essential you follow a strict calorie-controlled diet. It is vitally important that for 2 weeks before your surgery (or 3, you will be told how long by your surgeon) you follow a very restricted diet that is low in fat, sugar and carbohydrates. This will reduce the size of your liver and minimise the risk of complications associated with surgery. It will also ensure the operation can be done by keyhole/laparoscopic surgery. If your liver is too big your operation will be abandoned as it will not be safe to proceed with the liver in the way.
By following a strict diet, your body reduces its glycogen stores (glycogen is a form of sugar stored in the liver and muscles). When you follow a very strict diet especially one that is low in carbohydrates, your body loses its glycogen stores and some water, which in turn shrinks the liver. Surprisingly the liver can replace its stores very quickly, so it is important that you follow the diet strictly. A single carbohydrate-rich meal shortly before your operation can undo all your good efforts and lead to difficulties during surgery.
This diet is not optional and only recommended prior to your operation. Much of the weight lost on this diet is water. As a result, you may become dehydrated so you need to drink more often than usual.
In addition to the diet remember to, avoid alcohol, stop smoking, and keep active e.g. walking 1-3 miles a day or swimming. Even gardening is an excellent exercise.
What if I am a Diabetic?
If you have diabetes and are treated with insulin or tablets (e.g. gliclazide, glibenclamide, tolbutamide) you may need to adjust your medication. Check your blood sugar levels more regularly to make sure that you do not experience hypos.
If your diabetes is controlled by diet alone, you will not need to worry about your blood sugars becoming too low.
Please contact the hospital Diabetes Centre on Plymouth 01752 792963, who will be able to advise you about your medication.
What does the pre-operative diet involve?
Each day you must choose 1 and ONLY 1 of the following options for that day.
Option 1. A liquid diet
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4 cans of Weight Watchers® or other low-calorie soups and
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4 Sainsbury Be Good to Yourself yoghurts (200g) or other low fat, low sugar varieties
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200mls semi-skimmed milk for hot drinks.
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Take a multivitamin and mineral tablet every day.
Option 2. A Slimfast® diet
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4 Slimfast® drinks (4 x 36.5g each made with 250mls skimmed milk) not readymade shakes, snacks or meal bars and
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1/3 pint skimmed or semi-skimmed milk for additional drinks.
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Take a multivitamin and mineral tablet every day.
Option 3. A low-fat carbohydrate diet
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This diet plan consists of set quantities of foods from 5 different food groups. This will provide you with a varied and balanced low-calorie diet of between 800-1000 kcal per day.
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Take a multivitamin and mineral tablet every day.
| 1 Portion | 1 Portion |
|---|---|
| 1 medium slice of bread or toast with a scraping of margarine | 2 egg-sized old potatoes (boiled or mashed) or 3 new potatoes with skin |
| 5 tablespoons of All-bran | 2 tablespoons boiled rice |
| 1 ½ Weetabix® | 3 tablespoons boiled pasta |
| 1 Shredded wheat® | 2 Rich tea biscuits |
| 3 tablespoons Bran flakes or Fruit and Fibre or Cornflakes | 1 Digestive biscuit |
| 3 tablespoons dry Porridge oats | ½ bagel |
| 4 tablespoons Rice Krispies® | 2 small oat cakes |
| 1 crumpet | ½ pitta bread or 1 small pitta |
| 2 crisp breads |
| 1 Portion | 1 Portion |
|---|---|
| 1 medium size piece of fresh fruit e.g. apple | 3 tablespoons of stewed or tinned fruit (no added sugar) |
| 2 small pieces of fruit (e.g. plum, Satsuma) | 1 small glass fruit juice (150mls) |
| 150g (5oz) strawberries | 1 heaped tablespoon of dried fruit |
| 1 handful of grapes |
| 1 Portion | 1 Portion |
|---|---|
| 3 heaped tablespoons cooked vegetables | Use a wide variety of raw and cooked vegetables and salads, e.g. aubergine, beetroot, broccoli, cabbage, celery, spinach, courgette, cucumber, fennel, leeks, lettuce, mushrooms, watercress, cress, peppers, radish, spring onions, swede, tomatoes (tinned or fresh) |
| 1 side salad (size of cereal bowl) | |
| 1 tomato or 7 cherry tomatoes | |
| 1 glass (200ml) tomato or vegetable juice |
| 1 Portion | 1 Portion |
|---|---|
| 200mls (1/3 pint) semi or skimmed milk for cereal and drinks | See also cottage cheese and soft cheese in Protein Food Allowance |
| 1 small pot of diet or light yoghurt |
Spices or condiments
Any of the spices or condiments listed below can be used to add flavour:
Salt, pepper, fresh or dried herbs, spices, mustard, curry powder, lemon/lime juice, yeast extract, fish sauce, soy sauce, Worcester sauce, OXO®, or other stock cubes, vanilla and other essences.
Sample menu
The following sample menu demonstrates what a typical day may include and how many portions of different food groups you can eat.
| Time | Amount and type | Food |
|---|---|---|
| Breakfast | 1 Carbohydrate | 3 tablespoons of cereal with milk from daily allowance or 1 slice of toast with a scraping of low fat spread and marmite® or jam. |
| Mid morning | 1x fruit | 1 apple |
| Lunch | 1x protein | 100g (4oz) lean ham with large mixed salad |
| 1x Carbohydrate | 2 ‘egg size’ potatoes | |
| Mid afternoon | 1x milk | 1 diet yogurt |
| Evening meal | 1x protein | 100g (4oz) roast chicken (no skin) |
| 2 x veg | Selection of vegetables | |
| 1x Carbohydrate | 2 heaped tablespoons boiled rice | |
| Evening | 1x fruit | 150g (5oz) strawberries or 2 small plums |
How much fluid can I have in total for all options?
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The remainder of the milk allowance. Plus, calorie free drinks to make up at least 2 litres of fluid.
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Spread drinks and food evenly throughout the day. Do not save everything for later in the day.
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Drink at least 2 litres of fluid every day and drink more in hot weather. This includes all fluids, beverages, milk, juice, squash. Remember to count these as part of your total daily calorie intake.
Who do I contact if I have any questions?
If you have any questions or concerns, or need any further information please contact your Dietitian or Specialist Nurse.
Dietitian:
Amy Wright, 01752 432243
Oncology specialist nurse:
Marilyn Bolter, 01752 431528
Jen O’Reilly, 01752 431528
