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Official Protocol

The Liver-Shrinking Pre-Op Diet

The primary purpose of this diet is to shrink your liver prior to surgery by depleting stored glycogen. This ensures a safer, smoother procedure.

When to Start Your Diet?

Find your BMI below to know exactly when to begin your pre-op protocol.

BMI Range Diagnosis Starting Point
30.0 - 34.9 Obesity I 1 week before
35.0 - 39.9 Obesity II 2-3 weeks before
40.0 - 49.9 Morbid Obesity 1 month before
50.0 - 59.9 Super Obesity 2 months before
> 60.0 Super Super Obesity 3-4 months before

The 10 Golden Rules

Essential guidelines to follow during your Pre-Op phase.

1. Protein Shakes

Drink at least 2-3 protein shakes per day to maintain muscle mass.

2. Vegetables

Eat raw and cooked vegetables—as many as you want!

3. Avoid Carbs & Starches

Avoid peas, corn, potatoes, pasta, rice, bread, cereals, popcorn, and sugar sauces.

4. Lean Protein

Eat at least 2 servings (4oz each) of lean protein: chicken, turkey, fish, lean beef, eggs, or tofu.

5. Add Berries

Add 1/2 cup of frozen berries or strawberries to your protein shake.

6. Shake Liquids

Add unsweetened almond milk, coconut milk or 2% milk to your shake.

7. Keep Satisfied

Add chia seeds, almonds, nuts, or psyllium husk to help you stay full.

8. Hydration

Drink at least 50-60 ounces of water daily. Avoid sugar-added drinks.

9. & 10. Avoid Completely

Strictly avoid carbonated drinks (soda, sparkling water, beer) and caffeine (coffee, black tea).

Daily Guideline Structure

Breakfast

2 eggs + veggies + 1 tsp oil

Snack

1 Protein Shake

Lunch

4oz lean meat + veggies + 1 tsp oil / avocado slice

Snack

1 Protein Shake

Dinner

4oz lean meat + salad + 1 tbsp dressing

Meal Ideas (Mix & Match)

  • • Scramble eggs with mushrooms
  • • Scramble eggs with spinach
  • • Scramble eggs with tomato & onion
  • • Scramble eggs with broccoli
  • • Scramble eggs with kale
  • • Scramble eggs with portobello
  • • Scramble eggs with ham
  • • Scramble eggs with tomato sauce
  • • Boiled egg with green beans
  • • Scramble eggs with cauliflower
  • • Omelette
  • • Scramble eggs with cherry tomato
  • • Scramble eggs with zucchini
  • • Scramble eggs with bell pepper
  • • Scramble eggs with nopales
  • • Scramble eggs with asparagus
  • • Boiled egg with tomato slices
  • • Boiled egg with asparagus
  • • Spinach quiche
  • • Sunny side up egg with spinach

Chicken & Fish

  • • Chicken fajitas
  • • Spinach and cherry tomato stuffed chicken
  • • Grill chicken with cooked veggies
  • • Chicken soup with veggies
  • • Chicken with mushrooms or asparagus
  • • Chicken salad
  • • Steam fish with cooked veggies
  • • Mustard fish & sauté veggies
  • • Pesto fish with veggies
  • • Lemon and basil fish
  • • Garlic fish foil pack

Beef & Turkey

  • • Steak with mushrooms and onions
  • • Beef fajitas
  • • Beef roll up with veggies
  • • Beef stew or soup
  • • Meatballs / Meatloaf with veggies
  • • Turkey meatballs with zucchini noodles
  • • Herb roasted turkey with veggies
  • • Mushroom spinach filled turkey breast
  • • Turkey taco lettuce cups
  • • Zucchini stuffed with ground beef

Base (All you can eat)

Raw vegetables

  • Cabbage, Lettuce, Spinach, Broccoli, Kale, Cauliflower, Arugula, Mushrooms, Zucchini, Carrot, Tomato, Cucumber, Sprouts, Beets, Onion, Bell pepper, Celery.

Choose 1 (Protein)

  • • Chicken
  • • Fish
  • • Salmon
  • • Tuna
  • • Turkey
  • • Edamame
  • • Beef
  • • Egg

Choose 2 (Dressing)

  • • Avocado
  • • Olives
  • • Vinaigrette
  • • Italian dressing
  • • Olive oil
  • • Balsamic vinegar
  • • Lemon, Salt and pepper

The Protein Shake Guide

1

Quantity

20-30 grams of protein per shake.

2

Type

Isolated whey is highly recommended for best absorption.

3

Carbs & Sugar

Less than 5 grams per shake.

4

Products

Powder, drinks, or clear drinks are allowed.

5

Brands

ON Whey, Isopure, Premier Protein, Muscle Milk.

Pre-Surgery Supplementation

  • Multivitamin for adults: Alive, One A Day, Centrum Silver (Any presentation allowed).
  • Probiotics: 15-40 Billion CFU (Lactobacillus and Bifidobacterium).
  • 🛑 STOP vitamins, minerals, and probiotics 1 WEEK BEFORE SURGERY.

The Final Countdown

2 Days Prior to Surgery

Start CLEAR LIQUID DIET + Greek Yogurt

Add two greek yogurts per day (flavored ok, no fruit pieces). This helps with post-healing.

  • • Gatorade / Powerade zero carb
  • • Electrolytes
  • • Apple juice (diluted 50%)
  • • Chicken, beef or fish broth
  • • Light gelatina & Popsicles sugar free
  • • Chamomile tea

8 Hours Prior to Surgery

Strict NPO (Nothing by mouth)

Absolutely nothing to drink or eat after midnight preceding surgery or 8 hours prior to your surgery.

Post Surgery & Recovery

5 Hours Post Surgery:

Start chewing ice chips (do not swallow the ice) to decrease nausea. Walk to decrease gas pain.

Day 1 to 3 (Clear Liquid Diet):

After the leak test, start phase I. Drink 1-2 oz per hour till tolerance. Avoid straws and chewing gum.

Post-Op Supplementation (Phase 2):
  • • Multivitamin: 2 per day
  • • Calcium citrate + Vit D: 1200-2000 mg
  • • Iron: 40-65 mg
  • • B12: 350 mg | Biotin: 250-400 mg | Zinc: 5 mg
  • Rule: Chewable, liquid, or dissolve only. NO capsules/tablets. Do not take Iron & Calcium at the same time (wait 3 hours).

Experiencing Hairloss?

Common 3-6 months after surgery due to hypocaloric diet. Ensure you are getting:

Collagen Zinc Iron Biotin

Low Energy Levels?

Energy decreases because of the restriction (dropping from 2500 cal to 500-1000 cal). If you feel extremely low, ensure you are covering:

Vitamin B12

Need Nutritional Support?

Contact Ana Sanchez, our Head Dietitian

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