Purpose of the Liver Reduction Diet

The primary goal of the liver reduction diet is to reduce glycogen stores in the liver, making it smaller and easier to move during surgery. Many individuals needing gastric sleeve surgery have fatty liver, resulting in a larger than normal liver. Reducing liver size is crucial to minimise risks and complications during surgery.

Our Experience with Conflicting Information

Preparing for this stage was challenging due to conflicting information online. It’s crucial to find reliable sources and stick to one plan. Generally, there are three types of liver reduction diets:

Milk-Only Diet

Outline:

• 4 pints of semi-skimmed milk
• 1 multivitamin and mineral tablet (e.g., Centrum Advance)
• 2 pints (1 litre) of other fluids

Allowed Drinks:

• No added sugar or diet soft drinks
• Tea or coffee with milk from the allowance (sweetener allowed, but no sugar)
• Water
• Flavoured water without sugar (check the label)

Food Plan Diet

This diet provides approximately 100g of carbohydrates per day, is low in fat, and moderate in protein, totalling 800-1000kcal per day. Accurate portion measurement is crucial to avoid overeating and ensure the diet’s effectiveness.

Meal Replacement Shake Diet

We chose this option primarily because of its lower sugar content compared to other plans. Selecting the right plan was quite challenging due to the numerous options available and the conflicting information about acceptable levels of carbs, sugar, and other nutrients. Ultimately, we aimed for a plan that provided around 1100 calories per day with low sugar and fat content. To achieve this, we mapped out our options in Excel, comparing various brands to find the best fit. You can see an example of our planning below.

Powder Only
Nurtition	Protein Works (60g)	Myprotein (51g)	USN (55g)
Calories (kcal)	213	200	197
Protein (g)	25	17	25
Carbs (g)	24	17	14
of which sugars (g)	2.2	14	3
Fat (g)	1.8	6.7	3.6

The table above shows the nutritional information for the powder only. To complete the plan, you need to choose a liquid to mix with the powder. Options include water or various types of milk. We initially tried water but didn’t like it, so we opted for skimmed milk due to its lower calorie content. When mixed with skimmed milk, the nutritional values are as shown in the table below.

With Skimmed Milk (400g)
Nurtition	Protein Works (60g)	Myprotein (51g)	USN (55g)
Calories (kcal)	353	340	337
Protein (g)	39.4	31.4	39.4
Carbs (g)	44	37	34
of which sugars (g)	22.2	34	23
Fat (g)	2.2	7.1	4

The table above displays the nutritional information for a single shake. Since our goal is to stay under 1100 calories daily, the next step is to calculate the total intake by multiplying the calories per shake until the total remains below the calorie limit. For us, this means having three shakes, as three servings fall under the calorie goal while four would exceed it. Based on this, we can create the final table below, which shows our total daily intake.

Total Daily Intake
Nurtition	Protein Works (60g)	Myprotein (51g)	USN (55g)
Calories (kcal)	1059	1020	1011
Protein (g)	118.2	94.2	118.2
Carbs (g)	132	111	102
of which sugars (g)	66.6	102	69
Fat (g)	6.6	21.3	12

Based on the above considerations, we decided to go with the Protein Works option. The primary factors influencing our decision were its lower fat and sugar content. We opted for the 48-meal replacement pack from Protein Works, purchasing two bundles to cover both of us for two weeks. This provided a total of 96 meals, which was sufficient for our requirement of 6 meals a day for 2 weeks, totalling 84 meals. This pack was also the most cost-effective option available to us.

Daily Routine:

• 1.5 scoops of powder mixed with 400ml of skimmed milk, three times a day (2pm, 7pm, and 11pm).

Our Experience with the Liver Reduction Diet

The liver reduction diet is challenging, particularly in the first few days. It’s essential not to cheat and to adhere strictly to your chosen plan, avoiding carbonated drinks and other prohibited items. James found it especially tough due to his caffeine addiction from consuming large amounts of Red Bull, Monster, and Coke.

Common Side Effects:

• Light-headedness
• Dizziness
• Bad breath (due to ketosis)
• Weakness in knees and arms
• Brain fog
• Hunger

Some side effects, like hunger, subsided after a few days, but others, such as brain fog and weakness, worsened, particularly in the second week. For James, working from home was beneficial, as commuting would have posed a safety risk due to these symptoms.

Staying Motivated

Maintaining motivation is crucial. Approach the diet with the mindset that it’s the last one you’ll ever need. Focus on the goal and remind yourself daily that each day brings you closer to not having to diet again. Avoid negative thinking, which can sabotage your progress and potentially lead your surgeon to cancel the surgery if you don’t stick to the LRD.

By sharing our experiences, we aim to provide clarity and support for those preparing for gastric sleeve surgery. Please remember, this is our personal experience and not medical advice. For medical guidance, always consult your GP.